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Podcast Guest: Cash, Sean

E270: Do food labels influence kids shopping choices?

Interview Summary

Gabi and Sean, I’m excited to discuss our new paper, Front of Pack Labels and Young Consumers an Experimental Investigation of Nutrition and Sustainability Claims in Chile that was recently published in a Journal of Food Quality and Preference. Gabi, let’s begin with you. So why look at Chile? Can you explain the focus of the Chilean labeling and food environment policies there?

So, the setting of our study, as in the previous study, was Chile because recently the country implemented the law of food labeling and advertising, which includes three main components. The first one being mandatory front of package warning labels on packaged goods and beverages. The second one being restrictions on all forms of food marketing directed to children younger than 14 years. So, including printed media, broadcast, and also all digital media. And the third component being at school regulations at different levels including preschool, elementary, and high school levels.

Briefly, food manufacturers in Chile must place front of package labels on packaged foods or beverages that are high in specific nutrients of concern, including added sugars, saturated fats, sodium, and or energy. This law was implemented in three stages, starting in June 2016. The last stage was implemented in June 2019. So, it has been already six or seven years since the full implementation of the regulation. Specifically talking about the school component because this, yeah, it relates to children and adolescents. The law mandates that foods and beverages with at least one front of pack warning label cannot be sold, promoted, or marketed inside schools. And this includes the cafeteria, the school kiosks, and even events that are happening inside the schools. And additionally, food and beverages that have at least one front pack warning label cannot be offered as part of school meal programs. In addition to this front of pack warning label regulation, Chile also implemented voluntary eco labels starting in 2022 that provide information about the recyclability of food packages specifically. There is a certification process behind this labeling regulation and the eco label can be displayed if the food or beverage package is at least 80% recyclable.

Wow. This is a really comprehensive set of policies to encourage healthier food choices, both at the school and then also outside of the school. I’m excited to discuss further what this may do to food choices among children. Sean, that really brings up the question, why is it important to look at young consumers and their food choices and what makes them unique compared to adults?

Thanks for asking Norbert. This is an area where I’ve been interested in for a while. You know, young consumers play a crucial role in shaping the demand for food and long-term dietary habits. And young consumers might be more open to incorporating dietary advice into those long-term habits than adults might be. Just perhaps kids are less set in their ways. Children and adolescents are both current, but also future consumers with growing autonomy in what they choose around food as they get older. To marketers, we sometimes would say they might represent a three-in-one market. First, they spend their own money on snacks. What you could think of as the primary market. And how children spend money autonomously is really something that hasn’t been studied enough by researchers. Although it’s an area where I have tried to make a contribution. Second, kids influence household purchases. This is sometimes called pester power. You can think of a kid in the supermarket begging a parent to buy a favorite snack or a certain brand of cereal. But this can also be more socially positive in that kids might be agents of change within their households. Encouraging perhaps other family members to buy healthier food items if they get more interested in that. And third, this three-in-one market is rounded out by the fact that children represent future purchasing power as future adults. So, the habits that they’re forming now might influence what they do when they’re older.

Despite this importance for marketers, but also for pro-social behavior change, there really hasn’t been a lot of research on youth food purchasing behaviors. And this question that we are looking at here of how kids might respond to front to package labels has been particularly limited.

In this project, we wanted to understand how Chilean adolescents might respond both to nutrition warning labels, but also eco labels, and how they consider price when choosing snacks. We were lucky to be able to recruit a sample of over 300 kids, aged 10 to 14, to participate in these experiments. I know we’re going to chat a bit more about what we found, but in general, our results suggest that while price is perhaps the biggest factor in explaining what the kids chose in our experiment, that some of these youth showed preferences for the eco labels, which could be indicative of an emerging interest in sustainability issues.

But overall, understanding these behaviors is really important because the food choices made during childhood and adolescence can persist in adulthood. And this can be really something that helps change long-term health outcomes.  

Gabi, let’s talk a little bit more about eco labels for a moment. What are they, and how do these echo labels influence children’s snack choices? What did they tell us about their awareness of sustainability?

That’s a great question, Norbert. Thanks. In our study specifically, we found that eco labels, had a greater influence on adolescents’ snack choices than nutrition warning labels these black and white octagons that are displayed on the front of the package of products in Chile. And this suggests that some young consumers are becoming more aware of environmental issues, or at least in our sample. One possible explanation for this could be that eco labels suggest positive emotions rather than warnings, as with the nutrition labels. Which might feel more restrictive. Unlike the nutrition labels that tell consumers what not to eat, eco labels, on the other hand, highlight a product’s benefits, making it more appealing. This could be one of the reasons. Related to that, adolescents may also associate eco-friendly products with social responsibility aligning with increasing youth-driven environmental movements that are very prevalent around the world.

However, not all adolescents in our sample responded equally to the eco labels that were presented to them in the snacks. Our study specifically found that those who receive pocket money were more likely to choose eco label snacks. And this could be possibly because they have more autonomy over their purchases and their personal values could be playing a bigger role in their choices. If eco labels are really influencing children and adolescents with choices, one intervention that could be potentially beneficial could be to incorporate sustainability messaging in school food and nutrition education in order to reinforce those positive behaviors. And make them part of the daily food choices that they make. In making sustainable food more affordable, government incentives or retailer promotions could encourage youth to choose more eco-friendly snacks. Given that price, as we saw in our study, remains a key factor for choice. Lastly, not all eco labels are created equal. And this suggests that clear standardization and regulation are needed to prevent misleading claims. And ensure that adolescents receive accurate information about the sustainability of their food choices.

Ultimately, the eco labeling, of course, is not a silver bullet. It’s not going to solve all the environmental issues, but it represents a promising tool to nudge consumers. So our better dietary and environmental behaviors.

Gabi, you talked about how the eco labels have a bigger effect than nutrition warning. And overall, the nutrition warning labels didn’t really have that big of an effect on snack food choices. Why do you think that’s the case?

Yes, this was really one surprising finding in our study. That front of pack nutrition warning labels did not significantly impact children’s and adolescents’ snack choices. And this kind of contradicts some previous research suggesting that warning labels can help consumers make healthcare choices. And there are several possible explanations for why this could be happening. The first one could be just lack of interest. So compared to adults, children and adolescents may be just more responsive to positive rather than negative messaging. Because negative messages related to nutrition might not seem relevant to them because they feel healthy in the present. They just are not interested in those kinds of messages. The second could be label fatigue. We discuss this in our paper and basically it is because Chile’s regulation was already introduced in 2016. Given that it has been already some time since implementation, young consumers may have become habituated to seeing the warning labels on food products. So, like how adults also experience label fatigue, and this is documented in the evidence, children and adolescents might no longer pay attention or pay less attention to the warning. Third possible explanation is it relates to taste and brand loyalty. For this point, research shows that for youth specifically, taste remains the top priority when they choose food. So often outweighing any other factors including health concerns. If a favorite snack, for example, has warning labels but remains tasty and familiar to the kid, the label alone may not discourage them from choosing that snack. And lastly, social and environmental factors. Our study found, as we already mentioned, that eco labels had a stronger influence that nutrition warnings, and this could indicate that children and adolescents are just more responsive to messages about sustainability than to warnings, which they may perceive as less immediate.

Thank you for sharing that. And at this moment in the US there is a conversation about front of pack labels. And the work that you are showing in this paper may even point to some of the things that may happen if we see similar front of pack labels here in the US. I’ll be looking forward to see what happens with that effort right now. Sean, I want to turn to you and ask an economist type question. What role does price play in adolescent food choices? Not only price, but the availability of pocket money? And how do you think that should influence policy?

Our study shows that price is the most significant factor influencing the snack choices of the kids in our study. And higher prices definitely reduce the likelihood of seeing a certain product being selected. It was kind of interesting. Interestingly, this effect was consistent regardless of whether the kids regularly received pocket money. Suggesting that even those that don’t receive spending money still are paying attention to price. And this was a little bit different from what we found in some other studies that I’ve been able to work on, in the US and Germany, that suggested that previous experience with pocket money, or getting an allowance, was really important for understanding which kids might be most careful about spending their own money. I don’t know if that’s something different in the Chilean context than those other contexts. Or if that was just about what the kids in this particular study were paying attention to because we’re asking about different things.

But when we look more closely at the kids in our Chilean study, we found some important differences. As Gabi already mentioned, those kids who received pocket money were the ones who were more positively inclined to choosing products with the eco labels. And that suggests that they might be valuing sustainability a little bit more when making their own choices. Perhaps because they’re already a little bit more familiar with some of those dynamics of spending their own money. Whereas those without pocket money were more likely to choose cheaper options or sometimes the healthier options like the apples that we provided as an option in our study. And suggesting they’re focused more on affordability or health.

So, what this means for policy, given the strong influence of price, it means that policy interventions that focus on price, like taxes on unhealthy foods or perhaps subsidies for healthier options, might be effective tools in guiding better choices for these kids. But also, programs promoting budgeting skills and food literacy might help adolescents make more informed decisions both about the nutrition and the sustainability of the foods they’re eating. Finally, since some kids are responding positively to eco labels, integrating sustainability messages with the nutrition education could enhance the impact of food labeling policies. Overall, combining price policies and education labeling strategies could be really effective in driving meaningful changes in children and adolescent food choices.

Sean, thank you. And it’s really important to appreciate the differences that may occur when we think about a country like Chile versus the US or in some of your other work in Germany. And understanding that youth culture may be different and may be shaping these behaviors. But it’s very clear that all people, it sounds like, are responding to price. And that’s a constant that we’re seeing here. Sean, here’s my final question for you. What is the take home implications of this study?

Well, first and foremost, our findings here suggest that nutrition labeling alone isn’t necessarily going to be enough to drive healthier choices among children and adolescents. It can be part of an answer, but policymakers looking to promote healthier food choices might need to compliment labeling with education campaigns that reinforce the meaning of these warnings and integrate them into school-based nutrition programs. That said, I think that Chile has already been a leader in this regard, because the food items that get the warning labels in the Chilean context are the same ones that are subject to different restrictions on marketing or sales in schools, as well. I do think that we’re going to see kids and eventually adults just become more familiar with these categorizations because of the consistency in the Chilean law. Also, on the eco label side, leveraging that kind of eco labeling alongside nutrition messaging might be an effective combination to help promote both healthier and more sustainable food choices. And finally we’ve been talking about new front to pack labeling schemes here in the United States. And it’s really important to make sure we learn as much as possible from the experiences with such policies in other countries. Chile’s really been a world leader in this regard and so I’m very happy to have tried to contribute to an understanding of how people use these labels through this study and through some of the other projects that Gabi, you and I have all been involved in.

E203: It works – Chile’s Law on Food Labeling and Marketing

Interview Summary

Sean, let’s set the stage for this conversation. When crafting food policy, what should policymakers consider with respect to children and adolescents, both as current and future consumers in the food system?

I would argue that children and adolescents should be a priority, if not the priority in how we consider dietary policy for a few reasons. In the United States and elsewhere, we often argue quite heatedly about the proper role of government, with the arguments for health-promoting policies seemingly running into conflict with concerns about paternalistic interventions and restrictions on personal choice. These are important and perhaps unavoidable discussions to have. But when it comes to kids, we’ve already long had standards for school meals, what packaged snacks can be sold in schools, etc. We don’t treat children as legally independent in other ways. So while there’s still a lot of room for disagreement, it may be less daunting to actually keep child nutrition in the forefront when we consider how food policies around diet need to evolve. Perhaps more importantly, I would note that food marketers have long seen children as an important three-in-one market. One, kids have influence over food choices within their households. Think of a kid shopping with a parent in a supermarket and pointing at things she’d like mom or dad to buy. We sometimes call this pester power. Two, kids have their own spending money, and much of what they choose to spend it on is food. Often the types of energy-dense, nutrition-poor snack foods that are exactly the foods subject to labeling under the Chilean law we’re talking about today. And three, kids grow up to be adult consumers, and their preferences and knowledge are heavily influenced by the things to which they’re exposed in childhood. For the same reasons that food marketers are interested in children, policymakers should be. Kids have influence in in their households now. They’re buying food on their own now. What they do now will influence their future behaviors and future health.

Thank you, Sean. I have got to say, I went grocery shopping with my child yesterday and I appreciate your thoughts on how we should think about what policymakers should engage, not just in the U.S. but anywhere when we are thinking about helping kids make good choices that will have long-term implications. Thank you for that. I want to turn our attention to the research paper that we’re discussing now, titled, “Changes in Children’s and Adolescent’s Dietary Intake “After the Implementation of Chile’s Law “of Food Labeling, Advertising, and Sales in Schools.” So, Gabi, my question to you is this. One of the key components of the Chilean law was regulating food offerings in schools. Can you explain the focus of that policy and how it is intended to work?

Yes. Before we speak about schools, we should speak about Chile’s law in general. Chile’s law of food labeling and advertising includes three main components. The first one being mandatory front-of-package warning labels on packaged foods and beverages. The second being restrictions on all forms of food marketing directed to children younger than 14 years. The third one is school regulations at the preschool, elementary, and high school levels. Briefly, food manufacturers must place front-of-pack warning labels on packaged foods and beverages that are high in added total sugars, saturated fats, sodium, and energy. This law was implemented in stages starting in June, 2016. The law mandates that food and beverages with at least one front-of-pack warning label cannot be sold, promoted, or marketed inside schools. That includes school kiosks, cafeterias, and events that happen inside schools. Additionally, food and beverages with front-of-pack warning labels cannot be offered as part of the school meals program or as free samples or gifts. Chile’s set of regulations is unique because it includes a package of interventions covering several aspects of the school food environments, such as the availability of foods for sale inside schools, school meal program standards, and restrictions on food marketing directed to children.

Wow, Gabi, this is a very comprehensive law. So what did the team hope to test in the longitudinal study? Could you explain the main findings?

Yes. So with this study, our team aimed to assess if children and adolescents’ intake of total sugars, saturated fats, and sodium consumed at school changed after the initial implementation of the regulation. The team was also interested in exploring how children navigated different food environments. We also evaluated changes in intake at home and different settings from home and school. So, what did we find? Intake of most nutrients of concern, those nutrients under the scope of Chile’s law, including total sugars, saturated fats, and sodium significantly declined at school both for kids and adolescents. At home, we also found significant declines in kids’ total sugar intake, but not changes for adolescents. What makes this more interesting even is that we found evidence of partial compensatory behavior at restaurants, corner stores, street food, among others. Which means that kids and adolescents were consuming less healthy foods outside their school and home.

Thank you, Gabi. I want to now turn to Camila. I’m really curious about this compensatory behavior. The study found this evidence of students compensating somewhat for the healthy foods at school by eating more sugars, saturated fats, and sodium at other locations outside of school. Why do you think this happened?

Norbert, I believe this is a very interesting finding, and there are probably three main reasons why we observed this result in the study. First of all, we know that children, as they age, start to consume much more food from places outside of home. This is something that has been shown previously. We know that when kids start to age, they start to get more sugar, more saturated fat, more energy from restaurants and fast food outlets. This is something that we would expect in a longitudinal study such as the one that we conducted. Secondly, the Chilean law did not include regulation around the schools – so in the neighborhoods that surround the school. This was originally part of the regulation. But, during the discussion and designing, we had to drop this component of the regulation. Basically what we approved is that there were restrictions in the schools, but outside there was no restriction in terms of marketing or the offer of unhealthy foods to children. Finally, it’s likely that the regulation influenced some kids in a positive way. They really changed their behavior. But it’s also possible that other kids did not really change their behavior. Once they had the opportunity of going outside of the school, they just kept buying unhealthy foods with high content of sugar, saturated fat, and sodium.

Thank you so much for that. It does reflect the complexity of the decision patterns that children have in terms of how they eat. I think this is true for all of us. If we are trying to improve in one area, there may be some changes in other areas. But I want to pick up on something you said about why you believe the result occurred the way it did. It had to do with dialogue that went on in Chile about the law. So, I want to ask now, how can we best center the needs and voices of communities in the development of similar regulations? It sounds like some of this happened in Chile. Could you share your thoughts about this?

Yes. So, during the process of developing the regulation in Chile, the Ministry of Health held some participatory discussion throughout the country with families, parents, school teachers, and different stakeholders to actually get their ideas and also assess their concerns about the different components of the regulation. We do believe it’s very important to include the community’s views when we define this kind of policies or programs because what we actually want to modify is people’s behaviors. We really want to understand what is the best way of actually achieving that transformation. We really need to get their view for doing that. In Chile, we did not have a very strong civil society organization that could coordinate these views, and that is why the Ministry of Health had to actively engage the community through participatory dialogues that actually delay a little bit the implementation of the law. But, we believe that certainly strengthened their application.

It’s really interesting to hear about this deliberative process and to see what ultimately came out of that. I want to turn my attention back to Gabi. In the big picture of policymaking, what can we actually learn from Chile’s experience with the food labeling law?

Thank you, Norbert, and I think that we can learn a lot. But, I will highlight three things that we learned from this study. First, I want to say that Chile was the first country in the world that implemented front-of-pack warning labels on packaged foods and beverages high in sugar, sodium, saturated fats, and calories. So, the first thing that I want to highlight is that what’s unique about Chile is that it wasn’t only a labeling regulation but a comprehensive set of actions that included restrictions on marketing as well as school regulations. Food environments as a whole should be conducive to healthier and sustainable diets, and therefore isolated actions would be limited in scope. However, we need to acknowledge that the policy process in Chile was not without complications because there was significant pushback from the food and beverage industry. This is something that countries in the process of designing or implementing similar regulations should expect to happen. They should be prepared to respond with arguments based on evidence. The second highlight is that our results showed that the set of policy interventions may be promising to improve kids and adolescents’ diets at school, but that actions in out-of-school settings should be strengthened to improve overall diets. So for example, I will cite some actions that could complement these regulations, such as the introduction of junk food taxes, the reinforcement of nutrition education in schools and the community, particularly relevant now as we move into the post-COVID-19 era, social marketing campaigns, actions in other settings such as menu labeling in restaurants, improving the availability and acceptability of healthier foods by street vendors, among other actions. And lastly, the third point that I want to highlight is that moving forward, countries should consider equity aspects to overcome structural barriers that limit people’s ability to choose healthier foods and combine mutually-reinforcing strategies to stimulate a holistic food systems response where everyone has access to and can afford healthier foods.

Thank you for those comments, and I really do appreciate this idea of even though this was a comprehensive law, that there are some other spaces that the law could touch on or think about because of the results that we saw with this compensatory behavior. Thank you for sharing that. Sean, my last question is for you. I’m wondering if you could share your thoughts on whether Chile might serve as an example to inform the current front-of-package label discussions we’re having right now in United States.

Oh, absolutely. Chilean law has already served as a model for consideration in many other countries in the region and around the globe, including in our top food trading partner, Mexico, which enacted a Chilean-style labeling law in 2020. Several multilateral health organizations have also expressed support for the Chilean approach to be used elsewhere. And it’s hard to argue against the logic of policymakers in the United States paying close attention to what works well and what doesn’t work in other countries in considering any policies around dietary guidance that we choose to pursue here. But for me, one particularly compelling part of the Chilean law that we should pay attention to in the U.S. is how the standards are consistent, and that the same foods that bear the front-of-pack warning labels are those that are restricted in schools and cannot be marketed to children. Looking for opportunities for similar types of harmonization across different areas of dietary guidance and policy within the U.S. moving forward would certainly help with consumer education, and I think would make sense in other ways. And one interesting thing to keep in mind when talking about the use of mandatory warning labels in a U.S. context is that there are some potentially binding limits on what the government can or can’t compel food manufacturers to put on a food pack. Think of cigarette labels for a moment. We’ve long required that cigarette packages have the rather bland, plain text Surgeon General’s warning that we’re all familiar with seeing. But in the late 2000 aughts, the FDA proposed rolling out a series of graphic warning labels modeled, in part, on similar images used in other countries. And in that case, the effort was scrapped because of a widespread concern that requiring tobacco manufacturers to put a picture of a body in a morgue with a body tag on it, for example, is interpretive language that appeals to an emotional response, and that this would actually be a form of government-compelled speech that runs up against our First Amendment protections in a way that a scientifically-factual, text-only statement would not. While I personally don’t know that the Chilean labels would be interpreted in the same way here, I’m quite certain that legal challenges would be raised to clarify this question in the U.S. context. So, it might be a little bit tougher to take some warning label approaches here in the United States than what we’ve seen enacted elsewhere.