Assessing the Implementation and Effects of Front-of-Package Warning Labels in Peru: A Pre-Post Implementation Study

Currently, due to the increase in overweight and obesity, governments have implemented national policies to address them and promote healthier choices among consumers. In Peru, in 2013 the Law for the promotion of healthy eating for girls, boys and adolescents was published, but only until 2018 the Advertising Warnings Manual was promulgated and established the technical specifications to record front of package (FOP) warning advertising (octagons) in the form of Food octagons that exceed the established parameters for foods high in trans fats, sugar, sodium and that contain trans fats. Another government measure was the increase of the sweetened beverages tax in May 2018.


The general objective of the present study is to evaluate the implementation of FOP warning advertising in processed foods, as well as changes in their formulation and in food purchases of Peruvian households.
The specific objectives are:
1. To evaluate compliance of the use of FOP warnings in the package of processed foods sold in the main supermarkets of Peru and the barriers and facilitators for their implementation.
2. To analyze changes in the composition of processed foods, specifically sugar, sodium, saturated fat and energy, following the implementation of advertising warnings.
3. To analyze the impact of the implementation of FOP warnings on knowledge, attitudes and eating practices, of mothers of children aged 3 to 5 years, from different socio-economic levels of Metropolitan Lima.
4. To analyze changes in food and beverage purchases in Peruvian households after the implementation of advertising warnings, in general and by socioeconomic level.
5. Analyze changes in purchases of taxed and non-taxed beverages after the increase in the tax on sweetened beverages, in general and by socioeconomic level.


For the achievement of objectives 2, 4 and the compliance FOP warnings (objective 1) before and after the implementation, the team will take photographs of the package and nutritional information of the food and beverages sold in a chain of supermarkets of great affluence and the data of sales of foods will analyze through the database of Kantar Worldpanel. In addition, in-depth interviews will be carried out with key actors from different sectors to identify barriers and facilitators during this process and understand the views and roles of the different actors.

Regarding objective 3, a mixed methods study will be developed. Surveys will be applied to 1200 mothers of preschoolers to collect data about knowledge, attitudes and practices on eating before and after implementation. To complement the information, focus groups will be developed with mothers contacted through educational institutions (kindergartens).
Finally, to respond to objective 5, the change in prices and sales of beverages will be evaluated after the increase in the selective tax on sugary drinks that was implemented in Peru in 2018.


In process.


Francisco Diez Canseco,BA, MPH


Lima, Perú


Bloomberg Philanthropies



Research team

J Jaime Miranda, MD, MsC, PhD
CRONICAS, Universidad Peruana Cayetano Heredia.
Francisco Diez Canseco, BA, MPH
CRONICAS, Universidad Peruana Cayetano Heredia
Barry Popkin, PhD, MD
University of North Carolina at Chapel Hill, Estados Unidos.
Lindsey Taillie, PhD, MPH
University of North Carolina at Chapel Hill, Estados Unidos.