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Global Forum on Food Security and Nutrition • FSN Forum

Re: Call for examples and good practices on investments for healthy food systems

Food and Nutrition Department
Food and Nutrition DepartmentMinistry of HealthChile

Proponent

Food and Nutrition Department

Date/Timeframe and location

Chile

Main responsible entity

Ministry of Health

Nutrition context

In the last decades, the nutrition situation in Chile has shifted with the prevention and control of prevalence of undernutrition and increase of overweight and obesity. Modern diets have been incorporated to daily diets and traditional foods have been replaced gradually. Currently, cardiovascular diseases are the first cause of death and one of the main morbidities among adults while risk factors for chronic diseases, such as sedentarism, inadequate diet (high calories, sugar, fat and sodium and low nutrients), tobacco and alcohol consumption, have also increased.

The prevalence of overweight and obesity in Chile is:

  • Obesity in children under 6 years old 11,4%
  • Overweight in children under 6 years old 23,7%
  • Obesity in adults over 15 years old 25%
  • Overweight in adults over 15 years old 40%

Key characteristics of the food system(s) considered

Chile’s food system is undergoing structural changes (Transitional). As urbanisation increases, food commodities are increasingly sourced from complex supply and value chains driven by large retailers and processors. While productivity enhancement is still a priority, the government targets investments that shape the transformation of the food system. Chile has demonstrated the ability to invest in and implement strong supply side interventions as well as demand side interventions. Chile experienced a nutritional transition that contributed to currently 40% of adults and an increasing number of children and adolescents in the country present overweight or obesity.

Annual sales per capita in 2013 of ultraprocessed foods in Chile were 201,9 kg, becoming the second market of these foods after Mexico in Latin-America and Caribbean region.  59,8% growth of ultraprocessed foods in Chile from 2000 to 2013.   

Key characteristics of the investment made

The national strategy includes an approach based in social health determinants and health in all policies in order to change food environments.

Laws and regulations for food labeling:

In 2012, the Chilean government approved a Law of Nutritional Composition of Food and Advertising (Ley 20.606). In June 2015, the Chilean authority approved the regulatory norms required for the law’s implementation (Diario Oficial No 41.193) which came into effect on 27 June 2016. The regulatory norms define progressive limits for calories (275 calories/100g or 70 calories/100ml), saturated fat (4g/100g or 3g/100ml), sugar (10g/100g or 5g/100ml) and sodium (400mg/100g or 100mg/100ml) content considered “high” in food and beverages. All food that presents addition of sugars, sodium or sat fatty acids and exceeds these limits must have a front-of-package black and white warning message inside a stop sign that reads “HIGH IN” followed by CALORIES, SATURATED FAT, CALORIES or SUGAR OR SODIUM, as well as “Ministry of Health”. A warning message will be added to products that exceeds the limit (eg a product high in fat and sugar will have two stop signs). The regulatory norms provide specifications for the size, font and placement of the warning message on products. The limits for calories, saturated fat, sugar and sodium will be implemented using an incremental approach, reaching the defined limits by 1 July 2018 (see "O – Offer healthy food and set standards in public institutions and other specific settings" and “R – Restrict food advertising and other forms of commercial promotion” for details of the law's school food and advertising restrictions).

Taxation: Since October 2014, Chile applies 18% ad valorem tax to sugary drinks that contain more than 6,25g of sugar per 100ml. Sugary drinks with less than 6,25g of sugar per 100ml are taxed with 10%. Sugary drinks are defined as non-alcoholic drinks with added sweeteners and include energy drinks and waters.

Agreements: In 2011 the Chilean government agreed a voluntary target with bakers to reduce salt content of bread to 400mg/100g. Today the average reduction reaches 480mg/100g

Programmes:

  • Healthy Strategies, Municipalities, Communes and Communities: This strategy aims to install stable structural conditions over times that support the change of lifestyles through the development of healthy environments for the population. In this context, the challenge for governments is to bring about the behavioral change of society and individuals towards healthier lifestyles that will reduce the prevalence of these risk factors. In this area, policy-making at the territorial level considers the living conditions of people and communities, which must respond to the various realities, taking into account their culture, local history, resources, capacities and strengths of the people, as well as the Various forms of linkage characteristics of each community.
  • healthy Life: this program contributes to reducing the incidence of risk factors for developing diabetes mellitus and arterial hypertension through an intervention in eating habits and physical fitness for children, adolescents, adults and postpartum women.

Key actors and stakeholders involved (including through south-south/triangular exchanges, if any)

Chilean government: Ministry of Health, Ministry of Economy, Ministry of Finance, Ministry of Agriculture, National Consumer Service, National Television Council, Chile University, parliament, National Institute of Food technology (INTA).

Key changes (intended and unintended) as a result of the investment/s

Key changes Law 20.606:

  • Mandatory use of warning signs in food with addition that exceed the limits stablished by the Ministry of Health.
  • Prohibition of sale in schools of foods that exceed the limits established by the Ministry of Health
  • Prohibition of advertising of foods that exceed the limits established by the Ministry of Health

*Six months after the entry into force of Law 20.606:

  • Execution of more than 2,100 inspections, with a compliance of 64, 4%. In addition, the percentage of defaults tended to decrease over time
  • Broad compliance in television advertising, finding only 2 pieces with suspected breaches since the entry into force
  • The food industry, through SOFOFA, reported a 18% reformulation of its products.
  • The perception of Chileans is positive regarding the measures implemented by the regulation, declaring between 74.4% and 92.4% of cases as "good" or "very good" each of the regulations.

Challenges faced

  • Modern lifestyle, difficulties to organize time to cook at home.
  • Difficult to address adult population with health messages
  • Coordination with different sectors
  • The social value given to sugary drinks and “high in” snacks
  • The role and interests of the food industry
  • Technical difficulties associated to the inspection of advertisement in internet and cable tv.

Lessons/Key messages

  • The need to understand food patterns as a social habit, modeled by social determinants
  • Integrated work between ministries and other sectors to change laws and benefit health
  • The change of food environments as a key goal for  public health