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Industrially produced trans fat (iTFA) is a harmful compound created as a substitute for animal and saturated fats. Estimated to cause up to 500,000 deaths per year, it is replaceable. In 2018, Resolve to Save Lives, the World Health Organization (WHO), Global Health Advocacy Incubator, and NCD Alliance partnered to achieve global trans fat elimination. The WHO Director-General called for the elimination of trans fat by 2023 through best practice policies outlined in the WHO REPLACE package. Since the accelerated global efforts in 2018, 43 countries have adopted best practice regulations protecting an additional 3.2 billion people and building momentum toward global elimination. Current coverage will prevent 66% of deaths estimated to be caused each year by trans fat in foods. Despite producing and selling iTFA-free products in many countries, companies continue to sell iTFA-containing products in unregulated markets. Global incentives, accountability mechanisms, and regional policies will help achieve the elimination goal., Competing Interests: Funding Support and Author Disclosures Funders include Bloomberg Philanthropies, the Bill & Melinda Gates Foundation, Chan Zuckerberg Initiative, Founders Pledge, and Lyda Hill Philanthropies. The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: To identify the front-of-package scheme-Multiple Traffic Light (MTL), Nutri-Score (NS), and black octagon Warning System (WS)-most effective in reducing purchase intention and perceived product healthfulness of drinking yogurts, cookies and cheese spreads, and to assess the joint influence of nutrient claims on the effects., Methods: Randomized-controlled experiment. A within-subjects factorial design was used to evaluate the influence of three independent factors on perceived product healthfulness and purchase intention. A total of 704 adults in Argentina were shown three mock-up products and asked to indicate which product they would buy choosing between pairs of products from different categories and to rate product healthfulness on a 7-point Likert scale., Results: The WS was the most effective in reducing purchase intention in drinking yogurts (OR:0.16, 95%CI: 0.09;0.28), cookies (OR:0.10, 95%CI: 0.05;0.18) and cheese spreads (OR:0.10, 95%CI: 0.05;0.18), and the perception of healthfulness (WS Mean score 3,63 vs No label 4,24, p<0.001), regardless of the participants' gender, age, and level of education. NS was inefficacious in reducing product healthfulness perception, while MTL had significantly increased how healthful the product was perceived (p<0.001). Nutrient claims increased purchase intention and perception of healthfulness, thus reducing the effectiveness of front-of-package labels (p<0.001)., Conclusions: In line with growing evidence, our findings support that WS perform better than NS and MTL in reducing purchase intention and healthfulness perception of products with excessive amounts of critical nutrients associated with the greatest burden of diseases. Front-of-package WS are expected to facilitate the population in Argentina to make healthier decisions.

Objective: To understand the factors influencing the implementation of salt reduction interventions in low- and middle-income countries (LMIC)., Design: Retrospective policy analysis based on desk reviews of existing reports and semi-structured stakeholder interviews in four countries, using Walt and Gilson's 'Health Policy Triangle' to assess the role of context, content, process and actors on the implementation of salt policy., Setting: Argentina, Mongolia, South Africa and Vietnam., Participants: Representatives from government, non-government, health, research and food industry organisations with the potential to influence salt reduction programmes., Results: Global targets and regional consultations were viewed as important drivers of salt reduction interventions in Mongolia and Vietnam in contrast to local research and advocacy, and support from international experts, in Argentina and South Africa. All countries had population-level targets and written strategies with multiple interventions to reduce salt consumption. Engaging industry to reduce salt in foods was a priority in all countries: Mongolia and Vietnam were establishing voluntary programs, while Argentina and South Africa opted for legislation on salt levels in foods. Ministries of Health, the WHO and researchers were identified as critical players in all countries. Lack of funding and technical capacity/support, absence of reliable local data and changes in leadership were identified as barriers to effective implementation. No country had a comprehensive approach to surveillance or regulation for labelling, and mixed views were expressed about the potential benefits of low sodium salts., Conclusions: Effective scale-up of salt reduction programs in LMIC requires: (1) reliable local data about the main sources of salt; (2) collaborative multi-sectoral implementation; (3) stronger government leadership and regulatory processes and (4) adequate resources for implementation and monitoring.

In 2015, the Pan American Health Organization (PAHO) published sodium targets for packaged foods, which included two distinct levels: one "regional" and one "lower" target. Changes to the sodium content of the food supply in Latin American Countries (LAC) has not been evaluated. A repeated cross-sectional study used food label data from 2015 ( n = 3859) and 2018 ( n = 5312) to determine changes in the proportion of packaged foods meeting the PAHO sodium targets and the distribution in the sodium content of foods in four LAC (Argentina, Costa Rica, Paraguay, Peru). Foods were classified into the 18 food categories in the PAHO targets. The proportion of foods meeting the regional targets increased from 82.9% to 89.3% between 2015 and 2018 ( p < 0.001). Overall, 44.4% of categories had significant decreases in mean sodium content. Categories with a higher proportion of foods meeting the regional and lower targets in 2018 compared to 2015 ( p < 0.05) were breaded meat and poultry, wet and dry soups, snacks, cakes, bread products, flavored cookies and crackers, and dry pasta and noodles. While positive progress has been made in reducing the sodium content of foods in LAC, sodium intakes in the region remain high. More stringent targets are required to support sodium reduction in LAC.

Background: Pervasive marketing of unhealthy foods is a contributing factor to the growth of the global epidemic of childhood and adolescent overweight and obesity. Sex and gender differences come into play in the design of and responses to these marketing strategies, contributing to the perpetuation of stereotyped behavior and generating disparities in food choices and health. The purpose of this paper is to review the current literature regarding gender differences in food marketing design and perception among children and adolescents to facilitate evidence-based policy dialogues to address gender-based health disparities in NCD prevention., Methods: Scoping review of articles published in scientific journals in English and Spanish, from 2003 to 2018, that addressed the influence of food marketing among children and adolescents including a gender perspective. The methodological quality of each article was assessed following criteria specific to each study design., Results: From a total of 37 articles (39 studies) included in the review, 17 were experimental and 22 had descriptive, cross-sectional designs. Twenty-one studies were found to have low methodological quality, while 10 and 8 were of medium and high quality, respectively. A total of 23 studies among children and adolescents found gender-based differences. Differences were found in the following dimensions: food marketing on intake; responses to specific marketing; perceptions and attitudes towards food marketing and marketing regulation initiatives; exposure to food advertising and gendered marketing content. The evidence was not conclusive in any of the dimensions., Conclusions: The evidence suggests that food marketing has a similar impact on the consumption of unhealthy foods on boys and girls, but boys were found to be exposed to food advertising more intensively and their preferences to be more affected by this exposure, coinciding with a male-dominant advertising content. Limitations of these studies include taking gender as an unproblematic construct equivalent to biological sex and the lack of studies focused on developing countries. As gender is a cross-sectional dimension that interacts with other factors driving health disparities, an integrated gender perspective is needed to develop effective, evidence-based policies to control food marketing and tackle the childhood overweight and obesity pandemic.

Background: Food cost and affordability is one of the main barriers to improve the nutritional quality of diets of the population. However, in Argentina, where over 60% of adults and 40% of children and adolescents are overweight or obese, little is known about the difference in cost and affordability of healthier diets compared to ordinary, less healthy ones., Methods: We implemented the "optimal approach" proposed by the International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support (INFORMAS). We modelled the current diet and two types of healthy diets, one equal in energy with the current diet and one 6.3% lower in energy by linear programming. Cost estimations were performed by collecting food product prices and running a Monte Carlo simulation (10,000 iterations) to obtain a range of costs for each model diet. Affordability was measured as the percentage contribution of diet cost vs. average household income in average, poor and extremely poor households and by income deciles., Results: On average, households must spend 32% more money on food to ensure equal energy intake from a healthy diet than from a current model diet. When the energy intake target was reduced by 6.3%, the difference in cost was 22%. There are no reasonably likely situations in which any of these healthy diets could cost less or the same than the current unhealthier one. Over 50% of households would be unable to afford the modelled healthy diets, while 40% could not afford the current diet., Conclusions: Differential cost and affordability of healthy vs. unhealthy diets are germane to the design of effective public policies to reduce obesity and NCDs in Argentina. It is necessary to implement urgent measures to transform the obesogenic environment, making healthier products more affordable, available and desirable, and discouraging consumption of nutrient-poor, energy-rich foods.

As children are particularly vulnerable to marketing, this study analyzes marketing techniques and health/nutrition claims in food packaging and evaluates the nutritional quality in three food categories: sweet biscuits, breakfast cereals and dairy-based desserts. This descriptive study analyzed marketing techniques and claims included in food packaging (n = 301) in one of the largest retailers in Argentina. Trained researchers coded data following an adapted version of the INFORMAS protocol to account for local food packaging regulations. Nutritional quality was assessed using both Pan American Health Organization Nutrient Profile (PAHO NPM) and the WHO Regional Office for Europe Nutrient Profile (WHO Euro NPM) models. Under the PAHO model, 87% (n 262) of the product sample presented excess content of at least one nutrient ("less healthy" products), and 91% (n = 273) should not be marketed to children according to the WHO Euro model. Almost 40% of less healthy food products displayed nutrition claims on their package. Characters or celebrity endorsements, which are particularly attractive to children, featured in 32% of less healthy products, being more frequent in less healthy food products than in healthier ones. Results indicate that packaging for food products with low nutritional value often includes powerful marketing elements in Argentina, which renders young children very vulnerable to obesogenic influence. Moreover, the real nutritional value of the products analyzed were often at odds with the health claims shown on its package. Food labeling policies must be improved in Argentina to guarantee people's health protection against deceptive advertising.

Restricting children's exposures to marketing of unhealthy foods and beverages is a global obesity prevention priority. Monitoring marketing exposures supports informed policymaking. This study presents a global overview of children's television advertising exposure to healthy and unhealthy products. Twenty-two countries contributed data, captured between 2008 and 2017. Advertisements were coded for the nature of foods and beverages, using the 2015 World Health Organization (WHO) Europe Nutrient Profile Model (should be permitted/not-permitted to be advertised). Peak viewing times were defined as the top five hour timeslots for children. On average, there were four times more advertisements for foods/beverages that should not be permitted than for permitted foods/beverages. The frequency of food/beverages advertisements that should not be permitted per hour was higher during peak viewing times compared with other times (P < 0.001). During peak viewing times, food and beverage advertisements that should not be permitted were higher in countries with industry self-regulatory programmes for responsible advertising compared with countries with no policies. Globally, children are exposed to a large volume of television advertisements for unhealthy foods and beverages, despite the implementation of food industry programmes. Governments should enact regulation to protect children from television advertising of unhealthy products that undermine their health., (© 2019 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.)

Sodium intake in Argentina has been estimated to be at least double the dose of 2000 mg/day recommended by WHO, mostly coming from processed foods. Argentina is one of the few countries in the world that have regulated sodium content in certain food products. This study presents an assessment of sodium content in a selection of food groups and categories as reported in the nutrient information panels. We surveyed 3674 food products, and the sodium content of 864 and 1375 of them was compared to the maximum levels according to the Argentinean law and the regional targets, respectively. All food categories presented high variability of sodium content. Over 90% of the products included in the national sodium reduction law were found to be compliant. Food groups with high median sodium, such as condiments, sauces and spreads, and fish and fish products, are not included in the national law. In turn, comparisons with the lower regional targets indicated that almost 50% of the products analyzed had sodium contents above the recommended values. This evidence suggests that enhancing sodium reduction in processed foods may be a necessity for public health objectives and it is also technically feasible in Argentina.

Objective: To describe the number of processed and ultra-processed food (PUPF) advertisements (ads) targeted to children on Argentinean television (TV), to analyse the advertising techniques used and the nutritional quality of the foods advertised, and to determine the potential exposure of children to unhealthy food advertising in our country., Design: Five free-to-air channels and the three most popular children's cable networks were recorded from 07.00 to 22.00 hours for 6 weeks. Ads were classified by target audience, type of product, advertised food categories and advertising strategies used. The NOVA system was used to classify food products according to industrial food processing level. Nutritional quality was analysed using the Pan American Health Organization's nutrient profile model., Setting: Buenos Aires, Argentina. Results are considered applicable to most of the country., Subjects: The study did not involve human subjects., Results: Of the sample of food ads, PUPF products were more frequently advertised during children's programmes (98·9 %) v. programmes targeted to the general audience (93·7 %, χ 2=45·92, P<0·01). The top five food categories were desserts, dairy products, non-alcoholic sugary beverages, fast-food restaurants, and salty snacks. Special promotions and the appearance of cartoon characters were much more frequent in ads targeting children. Argentinean children are estimated to be exposed to sixty-one ads for unhealthy PUPF products per week., Conclusions: Our study showed that Argentinean children are exposed to a high number of unhealthy PUPF ads on TV. The Argentinean Government should build on this information to design and implement a comprehensive policy to reduce exposure to unhealthy food marketing that includes TV and other communication channels and places.

The Less Salt, More Life program was the first voluntary salt reduction initiative in Argentina. This article analyzes the perspectives of the stakeholders involved in this voluntary agreement between the Ministry of Health and the food industry to gradually reduce sodium content in processed foods. This exploratory case study used a qualitative approach including 29 in-depth interviews with stakeholders from the public and private sectors and identified the role of the different stakeholders and their perceptions regarding the challenges encountered in the policy process that contribute to the debate on public-private partnerships in health policies. The article also discusses the initiative's main challenges and controversies.

The objective of this study is to analyze how food advertising is perceived by mothers from different socioeconomic sectors of the Metropolitan Area of Buenos Aires, Argentina. Between May and November 2015, eight focus groups were conducted with the participation of 49 mothers of different education levels living in the study area. The results show how the purchasing decisions of mothers are influenced by the requests of their children, which are in turn prompted by food advertising and promotion. The study also shows how food advertising and promotion are combined with other environmental factors (greater supply of food products, "more demanding" children) that affect the decision-making process of mothers regarding their children's nutrition and foster the consumption of certain unhealthy products. This situation was observed in all the focus groups, without differences among education levels.

Background: Despite the body of evidence that documents the unfavorable effects of excessive sodium consumption on blood pressure and cardiovascular health, public health efforts to decrease sodium consumption have been limited to a few countries. Argentina is the first country in Latin America to regulate sodium content of processed foods by means of a national law. The objective of this cross-sectional quantitative study is to provide a baseline comparison against the reduction targets set by the national law before its entry into force., Methods: Data were collected in February 2014 in a leading supermarket chain located in Buenos Aires. Nutrient data from package labels were analysed for 1,320 products within 14 food groups during the study period. To compare sodium concentration levels with the established maximum levels we matched the collected food groups with the food groups included in the law resulting in a total of 292 products. Data analysis was conducted using SPSS version 20 software., Results: Food groups with the highest median sodium content were sauces and spreads (866.7 mg/100 g), meat and meat products (750 mg/100 g) and snack foods (644 mg/100 g). Categories with the highest sodium content were appetizers (1,415 mg/100 g), sausages (1,050 mg/100 g) and ready-made meals (940.7 mg/100 g). We also found large variability within products from the same food categories. Products included in the national law correspond to 22.1% (n=292) of the surveyed foods. From the 18 food groups, 15 showed median sodium values below the established targets. Products exceeding the established maximum levels correspond to 15.1% (n=44) of the products included in the analysis., Conclusions: This study is the first analysis of food labels to determine sodium concentrations of processed foods in Argentina and to provide a baseline against the national law standards. Upon the completion of this analysis, maximum levels have been achieved by most of the food groups included in the law. Thus, the introduction of further reductions for the existing maximum levels and the establishment of sodium targets for all relevant product categories not included in the law should be considered as the next steps in the process.

Background: Chronic diseases are the leading cause of premature death and disability in the world with overnutrition a primary cause of diet-related ill health. Excess energy intake, saturated fat, sugar, and salt derived from processed foods are a major cause of disease burden. Our objective is to compare the nutritional composition of processed foods between countries, between food companies, and over time., Design: Surveys of processed foods will be done in each participating country using a standardized methodology. Information on the nutrient composition for each product will be sought either through direct chemical analysis, from the product label, or from the manufacturer. Foods will be categorized into 14 groups and 45 categories for the primary analyses which will compare mean levels of nutrients at baseline and over time. Initial commitments to collaboration have been obtained from 21 countries., Conclusions: This collaborative approach to the collation and sharing of data will enable objective and transparent tracking of processed food composition around the world. The information collected will support government and food industry efforts to improve the nutrient composition of processed foods around the world.