Eye-opening global obesity milestone calls for revamped nutritional policy interventions

After decades on the rise, global obesity has crossed the billion-person threshold. Published on 29 February, new Lancet research analysing data drawn from thousands of studies conducted between 1990 and 2022 reveals that 880 million adults and 159 million children around the world now live with obesity, with the rates for children, women and men roughly quadrupling, doubling and tripling, respectively, during this period.

Given the stunning acceleration of the global obesity crisis as well as its well-documented contribution to a host of severe health conditions, including heart disease, type 2 diabetes and certain cancers, World Health Organization (WHO) Director General Tedros Adhanom Ghebreyesus has rightly emphasised “the importance of preventing…obesity” starting “from early life” using “diet, physical activity and adequate care.”

Moreover, The Lancet’s scientific team has highlighted the need for an urgent overhaul of the anti-obesity agenda – an undertaking which should involve a rethink of the misguided nutritional policy interventions emerging worldwide in recent years.

Latin America’s dubious nutritional label pioneers

In Latin America, sharp, world-leading rises in overweight and obesity rates over the past two decades have put this public health crisis high on the region’s policy agenda. According to a newly-published study, a significant portion of the its population now lives with overweight or obesity, including 74% of adults in Chile, 68% Argentina and 57% in Colombia, as well as nearly 40% of children in Mexico and 30% in Brazil.

Latin American governments have adopted a range of market-based measures to encourage healthier dietary practices, most notably pioneering the widespread implementation of front-of-package (FOP) nutrition labelling – interventions perhaps well-intentioned, yet ill-conceived. Chile’s introduction of a mandatory FOP label in 2016 sparked a wave that has since spread to countries including Mexico, Colombia and Argentina, all of which have adopted a shared black octagonal label warning consumers of products high in sugar, calories, fats and sodium.

Yet in instigator Chile, nutrition labelling has failed to curb obesity and overweight, particularly in children, whose rates actually increased several percentage points between implementation in 2016 and 2020. On a regional level, a Lancet study published  last year concluded that “while causal studies indicate that” these “policies enhance diet quality to some extent, recent national statistics suggest that they are insufficient to address obesity” in Latin America.

As UCLA researcher Esmeralda Melgoza has noted, the region’s nutritional label-heavy approach lacks the holistic, structural nutrition, physical activity and anti-poverty policies needed to effectively tackle obesity – a reality underscored by a recent United Nations report finding that Latin America is home to the world’s highest costs for healthy diets.

EU following same road to nowhere

Following several years behind Latin America, Europe has equally looked to nutritional labelling to reverse its deteriorating public health picture. As the WHO cautioned in 2022, the continent faces an ‘obesity epidemic’, with the European rate nearly tripling since 1975, leaving one in six Europeans living with obesity, over half of adults overweight and roughly one-third of children living wither either obesity or overweight.

Launched in 2020 as the healthy food pillar of its ‘Farm to Fork’ strategy, the European Commission’s policy initiative for a mandatory, bloc-wide FOP label has failed to reach even the proposal stage, with ever-elusive political and scientific consensus causing ongoing delays. France’s Nutri-Score label has consistently remained at the centre of the controversy, attracting wide-ranging criticism for its algorithm’s overly-simplistic evaluation of food products.

In reproducing the Latin American ‘octagon’ label’s narrow focus on “bad” components like sodium, fat and sugar, Nutri-Score overlooks crucial factors, from a product’s place within a broader diet to key micronutrients like vitamins and minerals. Indeed, despite a recent algorithm update – reflecting its founders’ recognition of the system’s flaws – Nutri-Score’s shortcomings in guiding consumers towards products “with certain nutrients whose intake is insufficiently covered in the population,” such as vitamin D, was prominently highlighted by France’s ANSES last December.

Adding to its recent woes, a study published in February notably found “no real-life evidence of any beneficial effects” from Nutri-Score’s use in a supermarket setting. The label’s supermarket impact is unlikely to improve, with major food companies including Berief Food and Bjorg recently dropping the label due to frustrations over their products’ newly-lowered Nutri-Scores and Coca-Cola Germany decrying how the system’s “constantly changing” evaluate standards generate consumer confusion, thus undermining Brussels’s public health goals.

US at a nutritional crossroads

A similar abandonment of an unreliable FOP system has notably occurred in the United States, where supermarkets began axing the NuVal label after its updated algorithm left many products with less flattering scores – but not before the new label drove down prices of poorly-rated foods, making healthier products even less affordable for lower-income families.

Roughly a decade later, the US Government’s Food and Drug Administration (FDA) is actively exploring a new FOP label to address its dire obesity crisis – over 40% of American adults and nearly 20% of children now live with obesity according to the CDC. First unveiled at the White House’s landmark Conference on Hunger, Nutrition, and Health in September 2022, an FDA-hosted public meeting held last November has given early indications of the standardised US nutrition label proposal’s possible final form.

Predictably, leading US public health officials and NGOs are looking closely at Nutri-Score and Latin America’s octagon to inform their own nutrition labelling approach, with their contributions at the event revealing a wrongly favourable view of these systems. Of particular concern, civil society organisations are calling for the development of a mandatory label employing overly-simplistic, colour-coded product assessment and a reductive focus on the same three “nutrients of concern” as its inspirations.

With the US featuring in the global top ten of The Lancet’s watershed ‘billion-plus’ obesity study, its government’s emerging public health response has little margin for error. Learning from mistakes overseas, Washington should steer clear of the international nutrition labelling trend and cast its net much wider, focusing its policy efforts on boosting access to affordable nutritious foods, expanding dietary education and transforming built environments to facilitate physical activity – in short, empowering all communities to lead healthier lifestyles.