Implementation and impact of the ban on the sale of ultra-processed foods to minors in Mexico

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Childhood obesity continues to be a public health issue globally therefore, it is necessary to test and evaluate new prevention policies and interventions. This study will evaluate both the implementation and impact of a new and unprecedented law that bans the sale of ultra-processed foods to minors in the state of Oaxaca, Mexico. In a first stage we will survey and conduct interviews with implementation actors including ministry of health officials, municipal authorities and school directors. We will measure implementation outcomes, specifically whether the policy is acceptable to actors, perceived feasible to implement and relevant. Simultaneously, we will conduct a mystery client study where children and adolescents will attempt to purchase a banned product from selected community retailers and school canteens. With this study component we will be able to objectively measure adoption of the policy and whether it is being implemented with fidelity. If we find that over 20% of food retailers and schools have adopted the law (i.e. they do not sell ultra-processed foods to minors), then the study will progress to stage 2 where we will measure the impact of the law on children's diet and obesity prevalence. To do this, we will leverage data from from six waves of Mexico's National Health and Nutrition Surveys to estimate ultra-processed food consumption and obesity prevalence before and after the law came into effect (2020). This will be done for Oaxaca and comparison states where a similar policy has not been approved. The results of this study will show whether the policy is effective, whether it can be successfully implemented and potentially rolled-out to other geographies.