Structural measures take time to become effective in the daily practices of the population. Law 20,606, which regulates the nutritional composition of food and its advertising, better known as “food labeling law” or “black stamp law”, sought to simplify the nutritional information of those components linked to malnutrition due to excess and non-communicable diseases. By setting thresholds for sodium, sugars, saturated fat and energy/calories per 100 grams of a food product of industrial origin, it is decided whether or not the product should carry a “HIGH IN” warning stamp, which contributes to discriminating food products whose consumption is potentially harmful to health. In the strict sense of the word, they are unhealthy foods, opposed to the healthy foods par excellence, such as fresh fruits and vegetables and minimally processed products.
Law 20,606 does not prohibit the consumption of such foods, but provides tools to the population to discern. It seems, however, that this has not been enough to limit the growth of malnutrition and associated diseases such as diabetes, for example. All recent measurements, as well as the latest National Health Survey (ENS, 2016-2017) indicate that – in recent decades – population obesity has not stopped increasing in Chile. The ENS itself sheds light on possible actions that can help us face the increase in malnutrition. Unlike these, tobacco consumption has had a sustained decline in the country. If in the 2003 ENS 43.5% of the population claimed to be a consumer, in the same Survey in 2017 only 33.3% did.
What happened in between? In 1995 a law was created (19.419) that labeled cigarettes as harmful to health, limiting their advertising completely and prohibiting their consumption in certain enclosures. In 2012, through Decree 49 of the Ministry of Health, this warning labeling was tightened to include very explicit images of the health consequences associated with cigarette smoking. The following year Law 20,660 was enacted, which also extended the smoking ban to any public space, educational facilities, and included the prohibition of the sale of cigarettes 100 meters around these establishments. Finally, in 2014, the tax burden on cigarettes was increased, currently paying a 52.6% tax on their sale price to the consumer. New restrictions linked to smoking are currently being discussed.
Advancing structural policies to combat smoking is supported by the WHO Framework Convention on Tobacco Control that entered into force on 27 February 2005. This convention represents an exemplary shift in the development of a policy strategy to address issues relating to the globalization of an epidemic related to noncommunicable diseases, stating that parties “are determined to give priority to their right to protect public health.”
Treating unhealthy ultra-processed products as tobacco is treated implies sincerely that, if we want to curb their consequences (overweight, obesity and other non-communicable diseases), a series of complementary measures must be implemented to Law 20,606, which limit their availability and hinder their physical and economic access.
Law 20,606, in addition to labeling unhealthy foods with a stop disc, restricts advertising aimed at children under 14 years of age of “HIGH IN” foods, and prohibits the sale and advertising of these unhealthy products in school establishments. However, unlike tobacco, this labelling does not highlight the deadly health consequences of these products, nor does it address excessive advertising targeting adolescents; It could also extend the sales restriction to other organizational food environments, such as higher education establishments, health centers and sports establishments; Nor does it restrict its sale around educational establishments, as tobacco regulation does. Finally, although there is a corrective tax on sugary drinks, this tax is insufficient and does not include solid foods with stamps.
The challenges, which we rather call opportunities for action, are manifold and we cannot expect the health problem to continue to increase with an impact not only health but alsoeconomic and social. A Framework Convention under the auspices of the WHO (like the one on tobacco), to combat malnutrition in all its forms, seems to be an urgent need.
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