Chile: A Model for Anti-Obesity Policies?

Five years ago, Chile adopted innovative regulations of food marketing to combat the rising problem of obesity there. A year later, Rand’s Debra Cohen wrote that Chile’s programs are a model for anti-obesity policies:

“Nearly 30 years into the ongoing global epidemic of obesity and chronic diseases, Chile has taken the lead in identifying and implementing obesity-control strategies that could prove to be the beginning of the end of the epidemic.”

But in a new pre/post study, researchers have found no evidence these policies have affected the dietary behaviors of the youth they targeted. So what are we to think. Is this a model effort that has yet to bear fruit? Or should we try to learn from a null result?

The Impact of TV Food Advertising

The object of this study was to assess the effects of Chile’s regulations on exposure for unhealthy foods to young teens, and to see if any changes led to changes in dietary behavior. The researchers studied television use by a cohort of these teens, advertising exposures, and 24-hour diet recall data.

They found a significant drop in exposure to these unhealthy products, dubbed “high-in” foods and beverages. That’s because they are high in calories, sodium, sugars, or saturated fat. But that drop in exposures did not lead to a change in what these teens ate.

Of course, food marketing happens in many channels. Especially for young people, TV has declining importance – something that these authors acknowledge. It’s also true that Chile’s marketing regulations will continue to evolve. The authors of this study conclude, quite appropriately:

“Continued monitoring of how overall marketing restrictions relate to dietary changes as the law progresses to further stages is warranted.”

A Successful Model?

This is clearly a model that needs further study. When Cohen declared that the U.S. should follow the example of Chile, her strongest point was that health policies cannot wait for complete information on what works and what does not.

However, it’s also important to distinguish between suppostions and facts. Cohen tells us that obesity is primarily the result of too much sugar, salt, and fat in ultra-processed foods. This is a reasonable supposition, not a fact. Many other factors may also contribute in important ways. The fact is that we do not know precisely which factors are most important.

So constructing policies to control factors that may be important – as Chile has done – is a fine thing to do. But careful study is necessary to distinguish what works from what doesn’t. And so far, in Chile, we have no evidence that these model anti-obesity policies are moving the needle on obesity.

Click here for the study and here for an enthusiastic description of anti-obesity policies in Chile. For a detailed review of the health challenge that obesity presents in Chile, click here.

Carved Bowl, Hanga Roa, Chile; photograph © Dennis Jarvis / flickr

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June 3, 2021