JMIR Publications

ABSTRACT

Background:

Overweight and obesity are a public health problem worldwide and have a multifactorial origin. One of these factors is obesogenic environments, which promote ultra-processed foods, characterized by being high in calories, saturated fats, added sugars, and sodium. In Mexico, it has been estimated that 30% of the total energy consumed comes from processed foods. The Modification to the Official Mexican Standard provides nutritional information through black octagonal seals that alert about products with an excess of some components for a better food selection in the population. However, it is unknown what is the effect of the warning labeling on processed food selection and purchase in children.

Objective:

Evaluate the effect of a digital educational intervention of front-of-package warning labeling on the selection and purchase of food in elementary school children and their caregivers.

Methods:

Randomized Controlled Trial, children from 4 elementary schools in Mexico City will participate, two publics and two privates. The schools will be chosen by simple random sampling. Schools will be randomized in two groups: intervention and control. In the control group, the dyads (caregiver-schoolchildren) will receive general nutritional education and in the separate intervention group, they will receive guidance on reading labels and raising awareness about the impact of consuming ultra-processed products on health. The educational intervention will be carried out through a website, baseline measurements will be made in both groups, at 3 and 6 months. All participants will be exposed to a virtual store through the website so that they can carry out food and beverage selection and purchasing exercises. In addition, other measures will be carried out such as a brief 5-question exam to evaluate theoretical understanding, a 24-hour reminder, a survey of food habits and consumption, a food preference scale will be applied, anthropometric measurements, and the school lunch will be recorded.

Results:

Registration and funding have been authorized in 2022 and we are set to begin data collection in March 2024. Recruitment has not yet taken place, but the status of data analysis and expected results will be published in April 2025.

Conclusions:

It is expected that the study will contribute to evaluating whether reinforcing frontal warning labeling with education enhances and makes its effects more sustainable. Carrying out this study will allow us to propose whether or not it is necessary to develop new intervention strategies related to frontal labeling for a better understanding of the population, better food choices, and better health outcomes.