Regional campaign “Now More than Ever: Better Labels, Better Choices, Better Health” launched by The Healthy Caribbean Coalition (HCC) in collaboration with the Pan American Health Organization (PAHO), UNICEF and the OECS Commission to raise awareness about the impact of childhood overweight and obesity and the regional NCD epidemic, while promoting children’s right to nutritious foods and mobilising public and policymaker support for the adoption of the octagon shaped warning labels on the front of packaged foods as the best way to help Caribbean citizens identify products that are high in sugars, fats and salt.
What Is Front-of-Package Warning Labelling (FOPWL)?
Front of package warning labels (FOPWL) are labels or seals applied to the front of packaged products which allow consumers to correctly, quickly and easily identify when a product contains excessive amounts of critical nutrients. Critical nutrients of public health concern are: sugars, total fats, saturated fats, trans fats and sodium. These nutrients when consumed in excess are linked to obesity and NCDs, in particular high blood pressure, high fasting blood sugar levels and overweight/obesity.
The actual front-of-package text-based seals are placed in the main panel visible to the consumer to indicate if the product is “HIGH IN SUGAR”, “HIGH IN SODIUM”, “HIGH IN SATURATED FATS”, “HIGH IN TOTAL FATS”, and/or “HIGH IN TRANS FATS”.
Nutrient profile models are used to establish the thresholds that define when these critical nutrients are in excess.
Why Do We Need Front-of-Package Warning Labelling (FOPWL)?
High blood pressure, high fasting blood sugar levels and overweight/obesity are the top three risk factors for mortality in the Americas.
Noncommunicable diseases (NCDs) are the leading causes of mortality, morbidity and disability in the Caribbean. In all of the Americas, the Caribbean has the highest rates of NCD mortality.
Rates of overweight and obesity in the region are among the highest in the world and most worrying among children where 1 in 3 children and teens is overweight or obese.
Unhealthy diets pose a greater risk to morbidity and mortality than tobacco use, alcohol use and unsafe sex combined. Unhealthy diets are a major risk factor contributing to the high rates of obesity and NCDs; and are fueled by the widespread availability and consumption of processed and ultra-processed products which contain high levels of “critical nutrients”, namely sugars, total fats, saturated fats, trans fats and sodium.
COVID-19 has underscored the urgent need to invest in evidence-based policies and programmes aimed at preventing and treating obesity and NCDs.
The Scientific Evidence To Support Octagonal Front-of-Package Warning Labelling (FOPWL)
There are hundreds of different front of package labelling (FOPL) systems applied to products worldwide, with different purposes. However, there is robust scientific evidence showing that front-of-package warning labels (FOPWL) or nutritional warnings are the best performing labelling system for the objective of allowing consumers to correctly, quickly and easily identify products that contain excessive amounts of critical nutrients of public health concern (ie. sugars, fats and salt/sodium).
Scientific evidence, across different populations, supports that ‘high in’ front of package warning labels:
are the most effective labelling scheme in terms of helping consumers make informed food choices about foods high in fats, salts and sugars.
modify consumer behavior by decreasing the intent to purchase products high in critical nutrients of public health concern (ie. sugars, fats and salt/sodium) and shifting their purchases to healthier options.
generally raise consumer awareness about the high levels of critical nutrients of public health concern (ie. sugars, fats and salt/sodium) found in packaged processed and ultra-processed products.
There are different warning systems used for FOPWL, but scientific evidence consistently indicates that octagon-shaped warning symbol outperforms other systems (such as the traffic light and the magnifying glass) on key features, including their capacity to capture consumers’ attention; the ease with which consumers can process, understand, evaluate and use the information; and the influence on consumer’s purchasing decisions[1].
The octagonal warnings have been introduced in Chile, Peru, Uruguay and Mexico, and have been recently approved by the Argentinian Senate. In Chile, a comprehensive regulatory approach including octagon warnings, showed a decrease in household volume of high-sweetened beverages purchases by 23.7%[2]. In Mexico, it has been projected that the octagonal warnings will reduce obesity by 14.7% after five years of implementation and save the country an estimated US$1.8 billion in obesity costs[3].
A recent study in Jamaica conducted by the Ministry of Health and Wellness of Jamaica, the University of Technology of Jamaica, and PAHO found that octagonal warning labels performed best in improving the capacity of consumers to take healthier food decisions in Jamaica[4].
PAHO, Ministry of Health and Wellness of Jamaica, the University of Technology, Jamaica Research: Superior Efficacy of Front-of-Package Warning Labels in Jamaica
This fact-sheet presents the results of the first study to take place in the Caribbean to examine the best performing front-of-package labeling (FOPL). It was conducted by the Ministry of Health and Wellness of Jamaica, the University of Technology, Jamaica, and the Pan American Health Organization, and contributes to the evidence that has been accumulated in the Region of the Americas on the topic. Consumers showed the octagonal warning labels had the highest chances of correctly identifying when products were excessive in sugars, sodium, or saturated fats, of correctly identifying the least harmful option, and of choosing the least harmful or none of the products more often. read more.
Front-of-Package Warning Labelling (FOPWL) – A Critical Part of Broader Strategy To Encourage Healthier Diets
Front-of-package warning labeling (FOPWL) is a key policy as part of a broader healthy food policy package aimed at combatting obesogenic environments which lead to overweight and obesity in children and diet-related NCDs more generally.
FOPWL is an enabling policy that allows governments to more easily introduce important complementary policies including those which protect children from the sale and marketing of unhealthy foods and which make healthy foods more affordable and accessible for families.
The Process To Develop a CARICOM Front-of-Package Warning Labelling (FOPWL) Standard
The CARICOM Regional Organisation for Standards and Quality (CROSQ) is undertaking the revision of the (2010) CARICOM Regional Standard for Specification for labelling of pre-packaged foods (CRS 5:2010) to incorporate FOPWL specifications.
This process was initiated in 2018 and is being led by a Regional Technical Sub-committee (RTSC) comprised of representatives of eleven (11) Member States (MS) (Antigua and Barbuda, Barbados, The Bahamas, Dominica, Guyana, Haiti, Jamaica, Saint Kitts and Nevis, Saint Lucia, Suriname and Trinidad and Tobago).
The RTSC has been responsible for disposing and consolidating comments received from the National Bureaus of Standards (NBSs) in all CARICOM MS (Antigua and Barbuda, Bahamas, Barbados, Belize, Dominica, Grenada, Guyana, Haiti, Jamaica, Montserrat, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, and Trinidad and Tobago), which have engaged in several rounds of extensive consultations with all relevant stakeholders.
In January 2021, the RTSC completed a Final Draft CARICOM Regional Standard (FDCRS)that has been submitted for voting to all CARICOM MS during the period 17 February- 14 April, 2021. At country level, the voting process will be facilitated by the National Bureaus of Standards through consensus building with all stakeholders.
If the Final Draft CARICOM Regional Standard (FDCRS) is supported by at least three quarters of all MS, the FDCRS will then be submitted to the CROSQ Council for approval, and then presented to CARICOM Council of Trade and Economic Development (COTED) for final endorsement.
The current FDCRS meets the highest level of scientific rigor, including octagon-shaped warning labels indicating if a product is “HIGH IN” one or more critical nutrients, and the PAHO nutrient profile model (PAHO NPM) to establish the thresholds that define when these critical nutrients are in excess.
If you are interested in learning more about the process and advocating in your country please reach out to the HCC via email at hcc@healthycaribbean.org.
Support for Front-of-package Warning Labelling (FOPWL)
More recently, Primer Minister and Chairman of CARICOM, Dr. the Hon Keith Rowley of Trinidad and Tobago, noted in this Statement at the CARICOM 32nd Intersessional Heads of Government Meeting that “We need to redouble our efforts in addressing NCDs and exploring their nexus with food and nutrition security”, and hoped for deliberations on Advancing the Regional Agenda on Food and Nutrition Security to assist in this regard. Read the full statement here.
Regional campaign “Now More than Ever: Better Labels, Better Choices, Better Health” launched by The Healthy Caribbean Coalition (HCC) in collaboration with the Pan American Health Organization (PAHO), UNICEF and the OECS Commission to raise awareness about the impact of childhood overweight and obesity and the regional NCD epidemic, while promoting children’s right to nutritious foods and mobilising public and policymaker support for the adoption of the octagon shaped warning labels on the front of packaged foods as the best way to help Caribbean citizens identify products that are high in sugars, fats and salt.
