Evaluating nutrition labeling policy changes in the US and Mexico.

项目总结 美国和墨西哥是世界上肥胖率最高的国家。在美国，拉丁裔， 他们是最大的少数民族群体，饮食质量差、肥胖、 以及与饮食相关的健康结果。食品标签是一种低成本、广泛传播的干预手段 向消费者提供营养信息，以便他们能够做出更知情、更健康的食品选择。2020年至 2021年，美国正在改变预包装食品的营养事实标签(NFL)，这将增加 在介绍有关添加糖的信息的同时，了解卡路里数量和服务份量。NFL已经被 然而，由于其复杂性和包装背面的位置而受到批评。包装正面(FOP) 营养标签为食品的营养价值提供了更直观和简化的信息，从而使 消费者在选择产品时可以轻松地比较各种选择。在2020至2021年间，墨西哥将 以醒目的“停车标志”的形式，对高含量的包装食品实施强制性FOP警告 卡路里、钠、糖、饱和脂肪或反式脂肪，以及添加咖啡因或不含热量的产品 甜味剂。为了评估美国和墨西哥这些新政策的相对有效性，目前的提案 利用国际粮食政策研究(IFPS)的数据，该研究每年调查约 自2018年以来，有4000名美国成年人和4000名墨西哥成年人。为墨西哥提供的资金将于2020年结束，尽管资金是为 美国将持续到2024年。受教育程度较低的墨西哥人和美国拉丁裔-主要群体 肥胖率高得不成比例，FOP警告可能对谁最有效-一直是 在IFPS调查中代表性不足。这项拟议的研究将继续对墨西哥消费者进行年度调查 到2024年(n=4000/年)，同时提供美籍墨西哥裔美国人的超额样本(mas；n=2000/年) 他们约占美国拉丁裔人口的三分之二。我们将招募更多的墨西哥人样本 (n=1500/年)和(n=1500/年)受教育程度较低的男性。这项前/后研究将在-和 -随着时间的推移，国与国之间要解决两个目标。目标1将评估强制性FOP的影响 墨西哥对美国NFL变化的警告。我们假设，人们对 墨西哥的营养标签、营养知识和健康饮食行为将比美国更多， 包括美国的MAS。目标2将评估这些营养标签政策效果的差异。我们 假设了解和使用FOP警告、营养知识和健康饮食行为将 墨西哥弱势群体从政策实施前到政策实施后的增幅高于美国，这是因为 墨西哥FOP警告更加突出和简单。最后，我们期望在实施后 在弱势群体中标签效应的趋势将有利于墨西哥人而不是美国的政策。结果来自于 这项研究将为美国和全球的政策发展提供信息，以及指导 推广健康行为的产品标签。

PROJECT SUMMARY The United States (US) and Mexico have the highest prevalence of obesity in the world. In the US, Latinxs, who comprise the largest ethnic minority group, have disproportionately high rates of poor diet quality, obesity, and diet-related health outcomes. Food labeling is a low-cost, wide-reaching intervention for communicating nutrition information to consumers so they can make more informed, healthier food choices. Between 2020 and 2021, the US is changing the Nutrition Facts Label (NFL) on pre-packaged foods, which will increase the visibility of calorie amounts and serving sizes while introducing information on added sugar. NFLs have been criticized, however, for their complexity and location on the back of packaging. Front-of-package (FOP) nutrition labels provide more visible and simplified information on the nutritional value of foods, enabling consumers to easily compare options at the point of product selection. Between 2020 and 2021, Mexico will implement mandatory FOP warnings in the form of prominent “stop signs” on packaged foods that are high in calories, sodium, sugar, saturated fat, or trans fats, as well as products with added caffeine or non-caloric sweeteners. To evaluate the relative effectiveness of these new US and Mexican policies, the current proposal leverages data from the International Food Policy Study (IFPS), which has annually surveyed approximately 4000 US and 4000 Mexican adults since 2018. Funding for Mexico ends in 2020, though funding is secured for the US through 2024. Mexicans and US Latinxs with lower educational attainment – key groups with disproportionately high obesity rates and for whom the FOP warnings may be most effective – have been under-represented in IFPS surveys. The proposed study will continue annual surveys of Mexican consumers through 2024 (n=4000/year) while providing an oversample of US Mexican Americans (MAs; n=2000/year) who comprise approximately two-thirds of all US Latinxs. We will recruit additional samples of Mexicans (n=1500/year) and MAs (n=1500/year) with lower education. This pre/post study will compare within- and between-countries over time to address two aims. Aim 1 will evaluate the impact of the mandatory FOP warnings in Mexico relative to NFL changes in the US. We hypothesize that increases in awareness/use of nutrition labels, nutrition knowledge, and healthy dietary behaviors will be greater in Mexico than in the US, including US MAs. Aim 2 will evaluate disparities in the effects of these nutrition labeling policies. We hypothesize that awareness and use of FOP warnings, nutrition knowledge, and healthy dietary behaviors will increase more from pre- to post-policy among disadvantaged groups in Mexico than in the US due to the greater prominence and simplicity of the Mexican FOP warnings. Finally, we expect that post-implementation trends in labeling effects among disadvantaged groups will favor the Mexican over US policy. The results from this study will inform policy development in the US and globally, as well as communication theories that guide product labeling to promote healthy behaviors.