Background: In the context of a high obesity prevalence and increasing consumption of fast food, the Chilean Ministry of Health is exploring to expand the current regulation of front-of-package warning labelling, using the “high-in” symbols in fast-food restaurants, as a mean to modify the consumption behaviour.
Objectives: To inform MoH nutrition policymakers using evidence brief for policy and stakeholder engagement on the best strategies to locate or implement the warning labels in fast-food restaurants.
Methods: An initial priority-setting process was carried out with nutrition experts to identify policy options to tackle obesity in Chile. An evidence brief for policy (EBP) was conducted following WHO/EURO EVIPNet guidelines, on the effectiveness of distinct locations of nutritional labels in restaurants. The search strategy was performed using Epistemonikos in six updated databases at the time of search. Cross-referencing, evidence matrix and expert consultation completed the literature search. Selection of systematic reviews (SR) and data extraction were performed by 2 authors independently. The AMSTAR-2 (A MeaSurement Tool to Assess SR) was used to assess the quality of the selected SR. Later, a citizen brief was elaborated using plain language to present the EBP findings. Finally, we organized 3 citizen panels and a stakeholder dialogue informed by the citizen brief.
Results: Twelve studies (6 randomized controlled trails) from eleven SRs were reported. Six policy options on different labelling locations in restaurants were identified: (1)on the menu, (2)on shelves and trays, (3)on shelves/trays combined with labelling on the environment (hanging posters or blackboards), (4)environment labelling combined with labelling food/drink container or wrapping, (5)environment + shelves/trays + food/drink container, and (6)virtual labelling for online shopping. The outcomes evaluated were consumption, purchases/sales, label visibility, understanding and acceptability, provider or consumer behaviour changes.
Conclusions: The evidence on nutritional labelling of restaurants is scarce. The menu and the shelves/trays labelling were the most evaluated, showing mixed results. The stakeholder engagement provided relevant information to policymakers, filling evidence gaps regarding location preferences and implementation barriers and enablers.
Patient, public and/or healthcare consumer involvement: Around 30 citizens and stakeholders were engaged in dialogues to discuss the evidence and raise their opinions and preferences.