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Nutrition labelling is any description intended to inform consumers about the nutritional properties of a food product and has focused primarily on nutrients. However, literature has shown that the nutritional quality of packaged foods is not limited to the amount of nutrients, considering that individuals do not consume only nutrients separately, but rather the entire food matrix. Therefore, to analyze the nutritional quality of a packaged food, it is necessary to read its ingredients. This scoping review aims to discuss (1) the list of ingredients as a source of health and nutrition information in food labelling; (2) opportunities to improve the nutrition labeling policies around the world. The study was carried out through a systematic search on Codex Alimentarius meeting reports. Results show that the list of ingredients is used as a source of nutritional and health information on food labelling; however, this label item is not considered in the regulatory field as a nutrition labelling requirement. It is suggested that nutrition labelling be discussed as a tool for food choices in the context of public health from a broader, consistent, convergent perspective, considering the list of ingredients as an item of nutrition labelling requirement to be included in public policies around the world.

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Introducción: El consumo de bebidas azucaradas y alimentos no saludables es un problema de Salud Pública y de las Políticas Públicas que buscan reducir el impacto de las Enfermedades No Trasmisibles (ENT) en América Latina. Objetivo: identificar las Políticas Públicas generadas en Colombia, Argentina y Chile para la regulación del consumo de azúcar y comida chatarra. Materiales y Métodos: Análisis exploratorio a través de una revisión de literatura y revisión de documentos normativos. Resultados: Colombia en el año 2021 sancionó la Ley 2120 denominada "Ley de Comida Chatarra", que promueve el acceso a información necesaria para fomentar entornos alimentarios saludables y prevenir las ENT, que incluye nuevas normas para el etiquetado de alimentos y describir sus características al consumidor y así limitar el consumo de alimentos procesados y ultraprocesados. Chile fue pionero en el desarrollo de los sellos de advertencia y desde el año 2014, aplica un impuesto adicional a las bebidas no alcohólicas. Argentina en 2021, sancionó la ley que obliga a la industria de alimentos a disponer de etiquetas en los envases que alerten al consumidor sobre los excesos de azúcares, grasas y sodio Conclusiones: Los tres países investigados cuentan con políticas de etiquetado de alimentos procesados, y en Chile existen impuestos a las bebidas azucaradas. Es importante estudiar el impacto de dichas políticas en la prevalencia y severidad de las ENT y de la caries.

Abstract: The consumption of sugar-sweetened beverages and unhealthy foods is a public health problem that has become a regulatory issue for the public policies aimed at reducing the impact of Non Communicable Diseases (NCDs) in Latin America. Objective: to identify the Public Policies in Colombia, Argentina and Chile for the regulation of the consumption of sugar and junk food. Materials and methods. Exploratory analysis through a literature and policy documents review. Results: In 2021, Colombia approved the Law 2120 called "Junk Food Law" promoting public access to information for a healthy food environment to prevent NCDs. It includes food labeling for overweight and obesity prevention and establishes a specific labeling regulation for processed and ultra-processed food and sweet drink products. Chile was pioneer in the development of warning stamps on food packages and since 2014 also taxes sweet non-alcoholic beverages. In 2021, Argentina approved a law to add labels on food packages to alert consumers about excess of sugars, fats and sodium. Conclusions: The three investigated countries have labeling policies for processed food, and Chile puts taxes on sugary drinks. It is important to study the impact of these policies on NCD prevalence, severity and on dental caries.

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Chile has enacted stringent legislation regulating food and beverage labeling and advertising. This study assesses the changes in the average relative allocations of food and beverage budgets for regulated versus not regulated products in households of different socioeconomic and demographic backgrounds. A household fixed effect before-after model is estimated and the marginal effects in the changes of levels and trends in budget shares and purchased volumes after the implementation of the regulations are examined. The results highlight how impactful food policies can shift consumption toward healthier products.

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Introduction: In 2020, Brazil approved the introduction of a new front-of-package nutrition labeling (FoPNL) in the format of a magnifying glass (MG) after years of discussion. There is currently a lack of understanding of the role of the food industry in that process. This study aimed to describe the corporate political activity (CPA) of the food industry and conflicts of interest situations, as they happened during the development and approval of a new FoPNL system in Brazil. Materials and methods: We undertook bibliographical and documentary searches using material from food companies, trade associations and front groups involved in the regulatory process. We (1) collected information about the case study context, (2) collected data from documentary sources, and (3) prepared a synthesis of the results and a timeline of key events. Results/Discussion: During the FoPNL regulatory process in Brazil, the food industry opposed the introduction of warning labels, a model supported by health authorities and implemented with success in other countries in Latin America. The food industry rather promoted a traffic-light labeling system, known to be less effective at guiding individuals to make healthier food choices. Later in the process, when it was evident that its preferred model would not be used, and a MG would rather be introduced, the food industry argued for the use of a different version of this FoPNL model. We found that the food industry, all along the process, was directly involved in and influenced the development of the FoPNL, by providing technical support, advising and lobbying policymakers. The food industry also established relationships with a consumer non-governmental organization and nutrition professional societies. The food industry also produced and disseminated information supporting its position in order to influence public opinion and high-level decision makers, and used the legal system to delay the process. Conclusion: The FoPNL in Brazil is neither aligned with the recommendations of international health organizations nor with existing independent scientific evidence. The new FoPNL, as adopted in Brazil, reflects some of the preferences of the industry; it is likely that the influence of that sector during the legislative process was pivotal, even if its initial proposal was not adopted.

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ABSTRACT The participation of the ultra-processed products industry in efforts to reduce obesity and diet-related non-communicable diseases has been questioned, especially because there is evidence of its interference in policy-making processes. This article builds on the Collective Action Theory and the literature of political science to discuss the role of this sector as a special interest group that uses its significant economic power to influence government decisions in its favor. In Brazil, its participation occurs mainly with industry associations. However, it has not yet been established whether their interests prevail in the decision-making process. It has been suggested that research should be carried out to determine the degree of success of their actions, identifying the conditions associated with the convergence of policy results with their interests and indicating to what extent civil society organizations are able to make public interests override private ones.

RESUMO A participação da indústria de produtos ultraprocessados nos esforços para reduzir a obesidade e doenças crônicas associadas à má alimentação tem sido questionada, sobretudo porque há evidências de sua interferência no processo de formulação de políticas públicas. Este artigo se alicerça na teoria da ação coletiva e na literatura de ciência política para discutir o papel desse setor como um grupo de interesse especial que utiliza seu significativo poder econômico para influenciar decisões governamentais em seu favor. No Brasil, sua atuação ocorre principalmente por meio de associações. Ainda não se pode assegurar, todavia, que seus interesses prevaleçam no processo decisório. Sugere-se a realização de pesquisas que determinem o grau de sucesso de suas ações, identifiquem as condições associadas à convergência dos resultados das políticas com seus interesses e apontem em que medida as organizações da sociedade civil são capazes de fazer os interesses públicos se sobreporem aos privados.

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BACKGROUND: In line with calls for action from international health organizations, Chile implemented in June 2016 a set of regulations to tackle the obesity epidemic. The new regulation includes the mandatory use of front-of-package warning labels on packaged foods/beverages high in energy, sugars, saturated fats and sodium. Additionally, such foods cannot be sold nor offered in daycares/schools and cannot be promoted to children under 14yo. The law is targeted to children; thus, this study examined mothers' understanding, perceptions, and behaviors associated with the regulation one year after its implementation, using a qualitative approach. METHODS: Nine focus groups of mothers (7-10 people each) of children (2-14yo) were conducted in July 2017 in Santiago-Chile. They were stratified by socioeconomic status (SES) and children's age. Macrocodes were developed by three researchers, combining an iterative process of deductive and inductive thematic analyses. Quotations representing each category were selected. RESULTS: Mothers understood the new regulation as a policy to fight child obesity and were aware that products with more labels were less healthy than products with fewer labels. Attention and use of labels in the buying decision-making process ranged from participants who did not pay attention to others who relied on them as a quick shortcut (mostly from middle and upper-SES); many mothers indicated changing their purchase habits only when buying new products. Mothers declared that young children accepted school environment changes while teens/preteens resisted them more. Many mothers agreed that schools have become key promoters of food behavioral change. Mothers were less aware about the food marketing regulations. Mothers declared that they perceived that the regulation was changing the perceptions, attitudes and behaviors toward healthier eating patterns. CONCLUSION: After the first year of implementation, the regulation was well known by mothers of diverse SES and different children ages. The degree of use of warning labels was heterogeneous among participants, but most of them agreed that their children, particularly the youngest have positive attitudes toward the regulation and have become promoters of change in their families. Many mothers also expressed that they perceived an important shift toward healthier eating, which may lead to a change in eating social norms. This information contributes to better understand how regulatory actions may influence people's consumer behaviors.

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Resumo Este artigo aborda a dinâmica das práticas da vigilância sanitária de alimentos no Brasil, destacando as suas particularidades quanto aos riscos e modalidades de intervenção, assim como ressaltando os recentes instrumentos adotados para o controle dos riscos relativos à composição nutricional dos alimentos e suas repercussões no âmbito institucional. Instituída no Brasil desde a Primeira República, essa prática vem se remodelando ao longo dos anos, tanto pela complexidade crescente dos riscos, quanto pela introdução de novos instrumentos institucionais. Nos últimos anos, evidencia-se um esvaziamento da competência regulatória quando da adoção dos instrumentos, acordos e termos de compromisso, firmados entre o governo e as indústrias para lidar com os riscos de ordem nutricional dos produtos alimentícios. Instrumentos construídos sem a participação dos consumidores, com elasticidade de prazos para cumprimento pelas indústrias e ineptos para a fiscalização, denotando retrocessos na construção democrática e na prática da regulação sanitária de alimentos no Brasil.

Abstract This article addresses the dynamics of Brazilian food control practices, highlighting their special risk-related features and the types of intervention, as well as the recently adopted instruments to control risks related to the nutritional composition of food and their institutional repercussions. Food regulation in Brazil dates back to the First Republic. The practice has been remodeled over the years, due to both the increasing complexity of the risks and the introduction of new institutional operational mechanisms. In recent years, with the adoption of instruments such as agreements and terms of commitments established between government and industry and designed to control risks, it has become possible to identify widening gaps in regulatory competence. The adoption of mechanisms without the participation of consumers, with elastic deadlines for compliance by industries and insusceptible to inspection, represents a setback in the democratic process and the practice of health regulation of food currently under way in Brazil.

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Resumo Para o Brasil urbano, a Primeira Guerra Mundial foi o disparador de uma dramática crise alimentar que trouxe consigo um aumento massivo de falsificações, gerando enorme celeuma em meio ao grande público. No alvo das críticas estavam as autoridades sanitárias, evidentemente incapazes de reprimir a fraude. O texto abrange o período da Primeira República e demostra que desde a sua proclamação a questão da regulação do comércio alimentar fazia parte das políticas sanitárias, mas que sua institucionalização foi seguidas vezes postergada em razão da existência de outras prioridades. Isso mudou apenas com as reformas sanitárias dos anos 1920, o que permite identificar a crise alimentar da Primeira Guerra Mundial como ponto decisivo para a responsabilização do Estado brasileiro nesse âmbito.

Abstract For urban Brazil, the First World War triggered a dramatic food crisis that brought with it a massive increase in falsified goods and led to an uproar among the general public. Critics targeted the health authorities, who were evidently unable to suppress these frauds. This text spans the First Republic period and shows that since its proclamation the issue of regulating the food trade was part of health policies, but implementation was repeatedly delayed because of other priorities. This situation only changed with the health reforms of the early 1920s, which allows us to identify the First World War food crisis as a decisive point for the Brazilian state to take responsibility in this area.

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OBJECTIVE: To analyse patterns of knowledge, comprehension, attitudes and practices regarding the traffic light label placed on processed food packages to inform Ecuadorian consumers about levels of added fat, sugar and salt. DESIGN: Twenty-one focus group discussions organized by age group, sex and place of residence. Interviews with representatives of companies that manufacture or market processed foods. Analysis of regulations and structured observations of processed food labels. SETTING: Cities and towns in Ecuador's coastal, highland and eastern lowland regions. SUBJECTS: One hundred and seventy-eight participants in twenty-one focus group discussions and nine key informants. RESULTS: Focus group participants knew about the traffic light label and understood the information it conveys, but not all changed their attitudes and practices related to the purchase and consumption of processed foods. Children, adolescents and adult males reported using the information infrequently; adolescents interested in health and adult women used the label the most to select products. Representatives of companies that manufacture or market processed foods generally opposed the policy, stating that the information is misleading. Nevertheless, some companies have reduced levels of added fat, sugar or salt in their products. CONCLUSIONS: The traffic light label is an effective tool for conveying complex information. Its potential contribution to reduce consumption of products with high levels of fat, sugar and salt could be enhanced by promoting healthy diets among consumers who have not changed purchasing and consumption behaviour, by placing the label on front panels and by monitoring the production and marketing of processed foods.

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Lutein is a carotenoid with antioxidant activity that is present in various dosage forms. The bioavailability of carotenoid from oral dosage formulations depends on their release, dissolution and its permeability through the gastrointestinal tract. Here, a dissolution test was developed for evaluating formulations and the bioavailability was assessed. The test utilized a USP-apparatus II with rotations of 50, 75 and 100rpm in water with P80 at 1, 2 and 5% (w/v). A non-everted rat intestinal sac model was used in conjunction to assess the intestinal permeability. The most discriminative conditions were 100rpm in water with 2% polysorbate 80, which showed profile differences between two formulations. The intestinal permeation studies showed a lag-time and apparent permeability coefficient that were characteristic of highly permeable drugs. We suggest that a dissolution test can be an essential quality control tool for formulations containing compounds as lutein, although not mandatory by the regulation agencies.

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Childhood obesity in Chile is at its highest history level of food consumption away from home and it is becoming more frequent; in turn, infant food offer is being questioned in the world by its relationship to childhood obesity and its unhealthy characteristics. In this study 45 children's menus of family and fast food restaurants were evaluated, conducting a qualitative and quantitative analysis. The obtained results showed that most of the menus exceeded nutritional recommendations in fat and sodium, and 40% of them provided over 800 calories, considered half of energy recommendations for a child per day. In conclusion, the energy input supplied by the analyzed infant menus exceeds the requirements of children, there is no direct relationship between price and nutritional quality, and the children's menus have few healthy properties, 80% being classified as bad or very bad according to Chilean Dietary Guidelines 2013.

En Chile, la obesidad infantil está en su nivel más alto, el consumo de alimentos fuera del hogar es cada vez más frecuente, siendo la oferta alimentaria infantil cuestionada a nivel mundial por su relación con la obesidad infantil y por poseer características poco saludables. Se evaluaron 45 menús infantiles de restoranes familiares y de comida rápida realizando un análisis cualitativo-cuantitativo. Se observó que la mayoría de los menús estudiados exceden las recomendaciones de grasa y sodio (sobre 150% y 328%, respectivamente); y 40% de ellos superaban las 800 calorías, considerada la mitad de las recomendaciones de energía para un niño al día. Así, el aporte de energía entregado por los menús analizados superaba los requerimientos infantiles, no existiendo una relación directa entre el precio y calidad nutricional. Estos menús tienen pocas propiedades saludables, clasificándose 80% como malos o muy malos según las guías alimentarias para la población chilena publicadas por el MINSAL el año 2013.

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El reglamento de etiquetado nutricional para alimentos preenvasados de Costa Rica basado en la normativa del Codex Alimentarius entró en vigencia en el 2002. En este mismo año, se realizó una investigación con el propósito de describir la situación basal del etiquetado nutricional en estos alimentos. En un supermercado representativo del área metropolitana de Costa Rica se recolectó la información declarada en las etiquetas de todos los alimentos preenvasados, excepto de las bebidas alcohólicas. Se analizaron seis variables mediante el programa SPSS. Se revisaron 2.910 etiquetas de alimentos clasificados en 19 categorías. El 58,4% (n=1698) incluyó información nutricional, dato que varió según país de origen y categoría del alimento. De las etiquetas con información nutricional, 68,1% declararon el contenido nutricional, 1,2% descriptores nutricionales y 27,4% ambos. En el 95% del etiquetado nutricional se declaró el contenido de energía y macronutrientes. Se identificaron al menos 100 descriptores nutricionales y saludables diferentes, con mayor frecuencia se empleó el de contenido (74,7%), seguido por el de adición (16,9%). Los componentes referidos con mayor frecuencia fueron vitaminas y minerales, vitaminas, carbohidratos, grasa total, colesterol y energía; y los grupos de alimentos que los declararon fueron: cereales y derivados, alimentos infantiles, leches, bebidas, alimentos para regímenes especiales y sustitutos. En una misma etiqueta fueron declarados entre uno y cinco descriptores. En una década en Costa Rica se triplicó la proporción de alimentos preenvasados con etiquetado nutricional, por lo se concluye que la tendencia de su declaración es ascendente, sostenida y representa una herramienta accesible para la promoción de la salud en la población, siempre y cuando la información sea confiable y segura.

The nutritional labeling regulations for prepackaged foods based on the Codex Alimentarius legislation enacted in 2002 in Costa Rica. In the same year, a research was conducted in order to describe the baseline of nutritional labeling. The declared information on the labels of all prepackaged foods was collected, except for alcoholic beverages. Six variables were analyzed using SPSS. 2,910 labels of foods were reviewed and classified in 19 food categories. 58.4% (n= 1698) included nutritional information, proportion that varied by country of origin and food category. Of the labels that included nutritional information, 68.1% had nutritional panel, 1.2% nutrient claims and 27.4%, both. 95% of the nutritional components declared on the labels included energy and macronutrients data. At least 100 different nutritional and health claims were identified. Most frequently used claims were content (74.7%), followed by addition (16.9%). The components most frequently mentioned were vitamins and minerals, vitamins (alone), carbohydrates, total fat, cholesterol and energy. Food groups who reported these descriptors were: cereals and by products, baby foods, milks, beverages, foods for special dietary uses and substitutes. One to five descriptors were used in a label. In a decade the proportion of prepackaged foods with nutritional labeling tripled in the metropolitan area of Costa Rica. It is concluded that the tendency of nutrition information declaration is up, sustained and represents an accessible tool for health promotion, if the information provided is reliable and secure.

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