Statement From CANDi in Support of Octagonal Front-of-Package Warning Labels

by HCC

Statement from CANDi in support of octagonal front-of-package warning labels –19 March 2021

The Caribbean Association of Nutritionists and Dietitians (CANDi), a member of the International Confederation of Dietetic Associations, stands in support of the adoption of the octagonal “High in” front-of-package warning labels (FOPWL) as part of the regional labelling standard for pre-packaged foods, in order to help combat obesity and the burden of non-communicable diseases (NCDs) in the Caribbean.

Statement from CANDi in support of octagonal front-of-package warning labelsVoting is currently underway across CARICOM Member States – until 14 April 2021– to adopt the Final Draft CARICOM Regional Standard for Specification for labelling of pre-packaged foods (FDCRS 5:2010). CANDi fully approves this Final Draft CARICOM Regional Standard which includes the octagon-shaped front-of-package warning labels (FOPWL) indicating if a product is “HIGH IN” one or more critical nutrients (such as sugars, sodium, or fats), and the PAHO nutrient profile model (PAHO NPM) to establish the thresholds that define when these critical nutrients are in excess. This meets the highest level of scientific rigor which is what will be effective for meeting the needs of the Caribbean population.

NCDs are significant contributors to the burden of death and disease in the region, responsible for almost 80% of deaths in 2016, with just over one third of these occurring in persons under the age of 70[1] . The major risk factors were high blood pressure, high blood sugar and overweight and obesity, which together accounted for almost half of NCD deaths and an estimated 4.6 million disability-adjusted life years (the total of time in years lost due to dying prematurely or not enjoying full quality of life due to disease) in 2019[2]. The Caribbean notably has one of the highest burdens of obesity in the Americas region, where approximately 1 in 3 Caribbean children and adolescents (5-19) is overweight or obese, which is well above the global average for this age group[3],[4] .

Members of CANDi have seen first-hand the shift towards unhealthy diets, consisting primarily of widely available, affordable, processed and ultra-processed foods, high in sugars, fats and salt. This dietary transition has been even more marked in our small developing state settings where half of Caribbean countries import over 80% of what we consume and most of what we import are processed and ultra-processed products[5] . There is clear evidence that links the consumption of processed and ultra-processed foods high in fats, sugar and sodium to the development of obesity and NCDs[6],[7],[8],[9].

The COVID-19 pandemic has heightened awareness of obesity and NCDs as those living with these conditions are most vulnerable to severe illness and higher mortality rates. Now more than ever, Caribbean people need to know what is in their food so they can make informed decisions about the food they purchase for themselves and their families. Currently nutrition labelling of pre-packaged products across the region is weakly regulated. The Caribbean consumer is therefore left to decode complex package labelling which is often confusing, misleading, illegible, written in foreign languages or altogether absent. As dietitians and nutritionists, we have first-hand experience in the difficulties this creates when working with clients concerned preventing and managing obesity and other diet-related NCDs but achieving and maintaining optimal health and nutrition.

Octagonal front of package warning labels will make it easier for consumers to quickly and correctly identify foods high in sugars, fats and salt. These labels have been implemented in countries such as Chile, Uruguay and Peru and have been deemed effective in helping consumers quickly, easily and correctly identify unhealthy products. Further, a recent study conducted by the Ministry of Health and Wellness of Jamaica, the University of Technology, Jamaica, and the Pan American Health Organization found that the octagonal warning label, was most effective in identifying packaged products that were detrimental to consumer health, when compared to other front of package labelling schemes.

This is also an issue of consumer rights. Consumers have a right to clear information about the products they purchase and consume. The right to access healthy food was underscored by the former UN Special Rapporteur on the right to health, Dr. Dainius Püras, who issued a statement in July 2020 emphasising that “States’ obligations include ensuring equal access for all to nutritiously safe food as an underlying determinant of health”, and identified “front-of-package warning labelling [as] a key measure for States to tackle the burden of NCDs”.

Finally, octagonal FOPWL is a key policy element of a comprehensive strategy to tackle unhealthy food environments and combat obesity and diet-related NCDs. It is also a critical enabling policy that will allow governments to more easily introduce important complementary policies such as regulating the sale and marketing of unhealthy products in settings like schools and workplaces and making healthy foods more affordable and accessible, particularly for vulnerable populations.

The introduction of octagonal front of package warning labels will benefit all Caribbean people including the most vulnerable. It is the most effective and simplest labelling system that allows all consumers, regardless of literacy levels, to correctly, quickly and easily identify products that are harmful to their health. The Board and members of CANDi from across the region, encourage key stakeholders and Caribbean leaders to vote to adopt this standard and pave the way for the Caribbean to join a growing number of countries fighting back against obesity and NCDs with warning label regulations protecting the rights of their citizens to know what is in their food.

Now more than ever, our Caribbean people deserve more detailed and accurate food labels to help make more informed food choices.

Respectfully, CANDi Board or Directors, 2019 – 2021

The Caribbean Association of Nutritionists and Dietitians (CANDi) is the professional Association for all Nutritionists and Dietitians in the Caribbean. The association promotes excellence in the practice of Nutrition & Dietetics  thereby contributing to the improvement of the nutritional status and overall health of the peoples of the Caribbean Region.

The Caribbean Association of Nutritionists and Dietitians is a member of the International Confederation of Dietetic Associations (ICDA).

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[1] PAHO/WHO, Noncommunicable Diseases in the Region of the Americas. Facts and Figures. Washington, D.C., United States of America, 2019. Available from:

[2] The Institute of Health Metrics and Evaluation. Global Health Data Exchange, available from:

[3] Healthy Caribbean Coalition. Childhood Obesity Prevention. Available from:

[4] WHO. Obesity and Overweight, 2020). Available from:

[5] Healthy Caribbean Coalition. NCDs and Trade Policy in the Caribbean, 2017.

[6] Nardocci M, Leclerc BS, Louzada ML, Monteiro CA, Batal M, Moubarac JC. Consumption of ultra-processed foods and obesity in Canada. Can J Public Health. 2019;110(1):4-14.

[7] Fiolet T, Srour B, Sellem L, Kesse-Guyot E, Allès B, Méjean C, Deschasaux M, Fassier P, Latino-Martel P, Beslay M, Hercberg S, Lavalette C, Monteiro CA, Julia C, Touvier M. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ. 2018;360:k322.

[8] Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, Chung ST, Costa E, Courville A, Darcey V, Fletcher LA et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metabolism. 2019; 30, 1–11.

[9] Srour B, Fezeu LK, Kesse-Guyot E, Alles B et al. Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé). BMJ. 2019;365:| 1451.

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