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The role of octagonal warning labels in transforming the health landscape

Published 12 October 2023


Buckie Got It Media Source

Diet-related noncommunicable diseases (NCDs) are an urgent concern in the Caribbean, taking a significant toll on public health and straining already fragile economies. High blood pressure, elevated fasting blood sugar levels, and the prevalence of overweight and obesity are primary contributors to this alarming trend. These conditions not only affect physical health but also have profound implications for mental well-being. Unhealthy dietary patterns, characterised by excessive consumption of sugars, fats, and sodium, are inextricably linked to the burden of overweight, obesity and NCDs in this region. A key driver of these diets is the widespread availability, affordability, and marketing of hyperpalatable ultra-processed products (UPPs) high in sugars, fats and sodium.

Unhealthy diets are the single greatest risk factor for overweight, obesity and diet-related NCDs. In response to obesogenic, health-harming environments, the World Health Organisation (WHO), the Pan American Health Organization (PAHO), and the Caribbean Public Health Agency (CARPHA) have called for a comprehensive package of healthy food policies including at the centre – front of package nutrition labelling (FOPL) systems. 

In contrast to the often complex back of package nutritional facts panel, front-of-package labels on pre-packaged foods and beverages provides quick and easily understood information to help consumers distinguish between healthy and unhealthy options. There are many different FOPL systems however the octagonal front-of-package warning label (FOPWL) stands out as the best model backed by scientific evidence free of conflict of interest. 

Research conducted across the Americas and most recently in Jamaica and Barbados demonstrates that the ‘high-in’ octagonal warning label (OWL) consistently outperforms all other labels including the magnifying glass, the UK traffic light system, and the facts up front system, in empowering consumers to correctly, easily, and quickly identify foods high in sugars, fats and sodium[1]. Moreover, OWL saves lives and a study just conducted in Barbados found that OWL has the potential to avert 16% of NCD deaths while saving governments 732 million dollars in mortality costs[2].

In 2018, CARICOM Heads of Government endorsed FOPL as a crucial step toward healthier diets. The CARICOM Regional Organisation for Standards and Quality (CROSQ) initiated an extensive regional consultation process to revise the  Draft of the CARICOM Regional Standard for the Labelling of Pre-packaged Foods (DCRS 5) to include front-of-package labeling. In 2021, CARICOM member states voted on the FInal Draft Standard (FDCRS 5), which included the OWL and the Pan American Health Organisation (PAHO) Nutrient Profile Model (NPM) to inform labeling thresholds. In an effort to build public and policymaker support for the Standard, the HCC and partners including PAHO, UNICEF, and the OECS implemented a regional digital campaign, aptly titled “Now More Than Ever: Better Labels, Better Choices, Better Health”. This strategic campaign sought to garner widespread support for OWL, emphasizing its pivotal role in promoting healthier food choices through improved labelling. This dedicated effort successfully mobilized nearly 400 signatures of support from Caribbean academics and public health professionals, complemented by the endorsement of 45 regional organisations.  As a result of the strong regional advocacy and support for the Standard, six CARICOM countries voted in favour of OWL, six abstained and three opposed leading to only 66% in favour (6/9) –  ultimately failing to reach the required 75% for adoption. The final draft was relegated to a draft standard once again and went out for member state consultation.

At the same time as the Jamaica FOPL study was taking place, the recently formed Caribbean Private Sector Organisation (CPSO), an official Associate Institute of CARICOM, led on their own study of the various front-of-package labels. The study was met with strong opposition from the public health community including academia and in 2022 a Joint Statement outlining challenges with study including conflict of interest was issued to the COHSOD/COTED by the HCC, PAHO, CARPHA, UNICEF, OECS Commission, UWI Law and Health Research Unit (LHRU), and the Heart Foundation of Jamaica.  The Joint Statement was shared with all National Standards Bureaus as part of the second round of voting in addition to the CPSO FOPL study findings. 

After yet another round of consultations over 2022 and early 2023, CARICOM Member States are once again voting on the adoption of the FDCRS-5 and HCC with the support of PAHO, GHAI and in collaboration with partners, CARPHA, UNICEF, and the OECS, have launched a campaign to raise public awareness and garner support for Octagonal FOPWL. The digital campaign – Octagonal Warning Labels help consumers #Acton Facts will be implemented from September 25 – October 31, 2023 across the Caribbean.

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