Observational studyBMJ global health2026
Peru's front-of-package warning label policy and changes in the healthfulness of the food supply: a pre-post observational study.
Observational study in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Prevalence of overweight and obesity and the burden of high body-mass index in Latin America: a systematic analysis for the Global Burden of Disease Study 2023.Lancet regional health. Americas · 2026Article
- Integrating Policies that Enable Minimally Processed Foods with Policies that Restrict Ultra-Processed Foods for Obesity and Noncommunicable Disease Prevention.Current obesity reports · 2026Review
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionIn 2019, Peru implemented the first phase of a front-of-package warning label (FOPWL) policy requiring packaged foods and beverages exceeding thresholds for total sugars, sodium, saturated fats or containing trans fats to display warning labels. While intended to inform consumers, such policies may also incentivise product reformulation. This study assessed differences in the proportion and nutrient content of regulated ('high in') products in the Peruvian food supply after FOPWL policy implementation.
methodsProduct-level nutritional information was collected from packaged foods and beverages during two periods: pre-implementation (T0: March-June 2019; n=2481) and post implementation (T1: March 2020-February 2021; n=3018). The proportion of products exceeding thresholds for nutrients of concern (sugars, sodium and saturated fats) and shifts in nutrient distributions across quartiles were compared pre-implementation and post implementation of the law in repeated cross-sectional samples and a longitudinal subsample (products collected in both periods, n=1694). Generalized estimating equations and logistic regression assessed differences in the proportion of 'high in' products, while quantile regression evaluated shifts in nutrient distributions.
resultsIn cross-sectional analyses over T1-T0 period, the proportion of 'high in' products declined by 6 percentage points (61% to 55%) among foods and by 11 percentage points (31% to 19%) among beverages. Relative reductions were observed in products 'high in' sugars (10% among foods; 37% among beverages), sodium (16% among foods) and saturated fats (7% among foods). Reductions varied across product categories and were greatest in those where thresholds were set below the prepolicy 75th percentile of baseline nutrient distributions. Longitudinal results were largely consistent with cross-sectional findings.
conclusionPeru's first FOPWL policy phase was associated with reductions in the proportion of products 'high in' nutrients of concern, suggesting reformulation occurred across diverse product categories. These findings highlight the potential of mandatory FOPWL policies to improve the nutritional quality of the food supply and support efforts to reduce diet-related diseases.
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