Chilean experience: a good practice of food policy

Daniela Godoy, J.D. , MPP and MPH candidate

Researcher at SEED Program

Definitions for Policymakers

According to researches which means a food policy?

According to evidence which are the food policies that work?

How we can deal with stakeholders to implement the “best” policy?

Questions for researches

What are food policies?

Which are the “best” food policies to address obesity?

What are the stakeholders involved?

Obesity improvement 4x100 meters relay. Runners: Researches, Policymakers, Politics, Private Sector

Researchers´ findings

• What researchers have discovered about the “best” food policy to address obesity?

3

• Which are the definitions and indicators that researchers have used in their investigations, to define “best policy”?

¿What is the healthy food environment policy index?

Policy Action Example 1. Food Environments Food composition Food reformulation targets

(sodium/saturated fat)

Food labeling Ingredient lists / nutrient declaration

Food marketing Restrictions for unhealthy food advertising to children in media and schools

Food prices Reducing taxes on healthy foods and Increasing taxes on unhealthy food

Food provision Policies to promote healthy food choices

Food retailing laws about in-store availability of healthy vs unhealthy foods

Food trade and investment Health impacts of trade agreements /protection of regulatory capacity of the government

Policy Action Example 2. Infrastructure support systems

Leadership National plan, political support, dietary guidelines, priorities reducing health inequalities

Governance Use of evidence, transparency, restricting commercial influences on policy development

Monitoring Food environments, nutrition status

Funding For population nutrition promotion and obesity

Platforms for interaction Multispectral coordination

Health-in-all-policies Assessing pubic health impacts of food policies and of non-food policies

¿What means smart food policy?

Smart food-policies actions should work through 4 mechanisms:

•Providing and enabling environment for healthy preferences (e.g. intervention to control of the targeted marketing geared toward to parents)

•Overcoming barriers to healthy preferences (e.g. intervention to increase the quality and quantity of available fruits and vegetables in rural areas)

•Encouraging people to reassess unhealthy preferences and to don´t purchase unhealthy food (e.g. interventions to change prices of healthy and unhealthy food)

•Stimulating a food-systems response (e.g. mandatory labeling of trans fats to incentivize food industry)

Smart food-policies actions should implement in 3 areas:•School settings (e.g.: nutrition education)

•Economic instruments (e.g.: taxes, subsides)

•Nutrition labeling (e.g.: nutrient information)

The most effective are which have focus on:•Preferences

•Behaviors

•Socioeconomic and demographic characteristics

We are working

on!

Novel Framework and public nutrition database: 4Ps

public

Mapping of existing and planned policy actions within 30 European countries

Rudd Center Legislation Database

http://www.uconnruddcenter.org/legislation-database?

From Bill to Public Law

https://www.congress.gov/content/legprocess/legislative-process-poster.pdf

Nourishing Framework of Cancer Research Fund International

http://www.wcrf.org/int/policy/nourishing-framework

CHILE

•High obesity and overweight rate (67% adult, 40% adolescent and 23% children)

•High sedentary rate (over 90% women and over 80% men)

•High level of salt intake (9.8 grams per day per person)

•High blood pressure level among adults (27%)

•Health disparities in the most vulnerable population (low- income level and low-socioeconomic level, rural areas, women, old people, children)

Under 5 child obesity and overweight rate by income level

Fuente: Casen 2011, Ministerio de Desarrollo Social

Risk factors by years of education

Fuente: Encuesta Nacional de Salud 2009-2010

81,7%63,3%

82,2%

96,9%

26,4%47,8%

6,2%

51,1%

20,5%

16,7%

National plan and actions were required

IMPROVE OVERWEIGHT AND OBESITY

PROBLEM

Source: Drewnowski 2012

i. Elige Vivir Sano (EVS) or “Choose to Live Healthy”

National Plan designed in 2011 and became a law in 2013. It promotes the adoption of healthy habits and preferences to reduce risk factors that lead to obesity and non-communicable diseases, through social marketing, public interventions, and private practices.

Eat Healthy Get Active Enjoy Your Family Outdoors Lifestyle

i. EVS Capacity Work Areas

ii. EVS was included in National Health Strategy

To reduce 10% the prevalence of child obesity in 10 years

To increace 30% the prevalence of Physical Activity in young people in 10 years

iii. 20.606 Act

It establishes food composition limits and food marketing standards. In concrete:

1.Companies responsibilities to get true information about the nutritional components of the food that they produce and sell

1.School´s responsibility to have learning activities to promote healthy eating and physical activity, and to warn about the harm effects of a unhealthy diet

1.Front-of-pack label for food and beverages with high-calories, high-sugar, high-salt, high-fat

1.Ban to offer, sell and advertise these kind of foods and beverages in schools

•Ban to market and advertise these products to children under 14

iii. 20.606 Act

It was really controversial when it was passed in the Congress. Ministry of Health has written 3 draft regulations that specify this act (e.g.: which is the best label that the “high-products” should have when they are commercialized in the supermarket and other market places).

iv. 20.780 Act

It establishes an additional tax over the price for SSB (10%). Also, indicates that if the SSB are high-sugar level (more 15 grams of sugar per each 240 ml) the additional tax over the price for SSB should have 18% .

v. SummarizePolicy Action

1. National Health Strategy (Ministry of Health)

Policies on food provision, leadership, governance, monitoring, funding, platforms for interaction

2. Elige Vivir Sano Act (Ministry of Social Development)

Leadership, governance, monitoring, funding, platforms for interaction

3. 20.606 Act (National Congress, Ministry of Health, civil society, private sector)

Food composition, food labeling and food marketing

4. 20.780 Act (Ministry of Budgets) Food prices of SSB

Policy Recommendations:

Chile, Brazil, Peru and South Africa could be an example of targeted advertisement regulation for other countries, but they need to research the impact of its regulation

It is important to know the impact of the food and beverage taxes in the developed countries before considering as a “good policy” for developing countries. They are not reduced SSB consume necessarily (Joua and Techakehakij, 2012)

Policy recommendations:

The most common challenge of these acts and policies is the lobby and conflict of interest (Yanamadala et al.,2012). Researches can give guidelines for policymakers

Each policy should have a clear main goal before its design. Avoid fake society expectations. Lower support of the population is a barrier for policy success (Gollust et al., 2014). Researches can give information about the population support

Evaluate and research the impact of the mandatory regulation and policies vs voluntary regulation and policies

Research opportunities

Thanks!

@danigodoygablerwww.desarrollosaludable.cl

Adults

•Overweight and obesity: 66.7% •Sedentary (women): 92.9%•Sedentary (men): 84%•Diabetes: 9.4%•High blood pressure: 26.9%•Metabolic syndrome prevalence : 35.3%•Salt intake: 9.8 grams a day

Our children

• 40% of youth have overweight or obesity [15 to 29 years]• Only 9% of young people have a

satisfactory physical condition (SIMCE Phys. Ed.) [8th grader]• The main reasons young people

do not practice sports are: lack of time (60%) and lack of interest (21%) [15-29 years]• 22.4% of children under age 6 are

obese and overweight (2011)

Source : Encuesta Nacional de Salud Chile 2010; Encuesta Mundial de Salud Escolar en Chile OMS 2004 (jóvenes entre 13 a 15 años)Source : www.Alimentatesano.clSource: SIMCE 2010 on Physical Activity, taken to 13,585 8th Grade StudentsSource: CHILE SALUDABLE study conducted by Fundación Chile, Collect GFK, Choose a Healthy Lifestyle and Family Foundation 2012

Chilean experience