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Chilean experience: a good practice of food policy
1. Chilean experience: a good
practice of food policy
Daniela Godoy,
J.D. , MPP and MPH candidate
Researcher at SEED Program
2. 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
4. ¿What is the healthy food
environment policy
index?
5. 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
6. 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
8. 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)
9. 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!
15. 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)
16. Under 5 child obesity and
overweight rate by income
level
Fuente: Casen 2011, Ministerio de Desarrollo Social
17. 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%
18. National plan and actions were
required
IMPROVE
OVERWEIGHT
AND OBESITY
PROBLEM
Source: Drewnowski 2012
19. 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 FamilyOutdoors Lifestyle
21. 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
22. 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
23. 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).
24. 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% .
25. v. Summarize
Policy 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
26. 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)
27. 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
30. 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.cl
Source: SIMCE 2010 on Physical Activity, taken to 13,585 8th Grade Students
Source: CHILE SALUDABLE study conducted by Fundación Chile, Collect GFK, Choose a Healthy Lifestyle and Family Foundation 2012
Chilean experience
Editor's Notes
The healthy food environment policy index consists in recommended policies for countries that incorporates the WHO´s Global action plan for the prevention and control of non-communicable diseases 2013-2020. For each policy the index has a set of good practice indicators which has been developed and pilot tested. The index comprises a policy component with seven domains on specific aspects of food environments and six domains on specific aspects of infrastructure.
This study includes an evaluation of the healthy food environment policy index in New Zeeland. A national expert panel assessed the extent of implementation of policies on food environments by the Government of New Zealand in comparison with international best practice. Also, this panel identified and prioritized concrete actions to increase the healthiness of food environments and reduce obesity and diet-related NCDs.
Expert panel
-public health and nutrition experts
-academics
-NGOs representatives
-Individuals who were worked for the government or the food industry were excluded
They divided the policies in two groups: Food Environments and Infrastructure. Each group includes actions or interventions. The expert panel evaluate the policies that were existed in New Zeeland and recommend which of them are the most effective policies.
Blues circle are the summarize of the recommendations to improve the healthiness of food environments and to reduce obesity and diet-related NCDs in New Zealand.
7 recommendations
1.Implementing a comprehensive national action plan for obesity and NCD prevention
2.Setting priorities in statements of intent and setting targets for reducing childhood and adolescent obesity, reducing salt, sugar and saturated fat intake and food composition
3.Increasing the funding for population nutrition promotion in a specific amount
4.Reducing the marketing of unhealthy foods to children and adolescents through broadcast and non-broadcast media and in settings such as schools
5. Ensuring that foods provided in or sold by schools and early childhood education services meet dietary guidelines
6. Implementing the Health Star Rating food labeling system to compare the nutritional profile of package food
7. Introducing a tax of at least 20% on SSB
Smart food policy for this paper is the policy that works on reducing obesity.
It is a map of the policy actions to improve nutrition that are implemented in Europe. Also, is an evaluation about their perceived effectiveness.
4Ps: price, product, place and promotion.
They conducted interviews with 71 national experts.
They classified policies in 4: price, product, place and promotion.
They concluded that Voluntary policies or reformulation have little impact. Mandatory more effective than voluntary.
It is a framework to promote healthy diets and reduce obesity. It has information about policy area, evidence of policy area and examples of potential policy actions. Areas are nutrition label standards, offer healthy food, use economics tools, restrict food marketing, improve food supply, set retail environment incentives, harness food supply chain, inform people, nutrition advice in health care and give nutrition education. Each area has the good practices of different countries around the world.
The United States data:
Extreme obesity, obesity and overweight rates are 75.4% on adults
Results from the 2009–2010 NHANES, using measured heights and weights, indicate that an estimated 16.9% of children and adolescents aged 2–19 years are obese.
Results from the 2011–2012 National Health and Nutrition Examination Survey (NHANES), using measured heights and weights, indicate that an estimated 33.9% of U.S. adults aged 20 and over are overweight, 35.1% are obese, and 6.4% are extremely obese.
