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How Media Helped Build the Case for Front-of-Package Warning Labels

Using the media to inform people about what’s in their food to help reduce obesity rates.

Focus Area

FOOD POLICY

Location

BRAZIL

Video Mapping along a main street in São Paulo, with the text “Will you open your mouth?”. Source: Idec
Video mapping along a main street in São Paulo, with the text “Will you open your mouth?” Source: idec

Nearly one in five Brazilians are obese.
Unlabeled, processed foods are partly to blame.

Video Mapping along a main street in São Paulo, with the text “Take part in Anvisa's public consultation about nutritional labeling”. Source: Idec
Video mapping along a main street in São Paulo, with the text “Take part in Anvisa’s public consultation about nutritional labeling” Source: idec
Out-of-home ad at a bus station in São Paulo with the text, “When you open your mouth, don’t close your eyes.” Source: Idec
Out-of-home ad at a bus station in São Paulo with the text, “When you open your mouth, don’t close your eyes.” Source: idec
Campaign tent in the city of Salvador demonstrates how the black triangle warning labels would appear on products. Source: Idec
Campaign tent in the city of Salvador demonstrates how the black triangle warning labels would appear on products. Source: idec
In 2006, 11.8% of Brazilians were considered obese. By 2018 that number had risen to 19.8%, one in five people. It was essential to reverse the trend, and informing people of what was in the processed food they ate was key. Vital Strategies partnered with local health groups and Brazil’s main regulatory body, ANVISA, to encourage the public to understand what’s in their food. Campaigns reached more than 23 million people via television, newspapers, billboard, radio and digital media. In 2020 ANVISA approved a model for flagging high sugar, fat and sodium content prominently on the front of food packaging.
“One of every five Brazilian adults is obese, and new legislation mandating front-of-package nutrition labels is set to counter the trend.”
André Corrêa
Former idec Communication Manager
An individual providing their information to support nutritional labeling at a Campaign tent in the city of Salvador.
1 in 5
19.8% of people were obese in Brazil in 2018, up from 11.8% just a decade earlier.
A person providing their information to support nutritional labeling at a campaign tent in the city of Salvador.

Front-of-package labeling mandates went into effect in 2022.

After six years of policy advocacy via public-information campaigns, Brazil’s regulatory agency ANVISA approved front-of-package labeling to flag high levels of sodium, sugar and saturated fat. Efforts encouraged members of the public to question what was in their food, and showed the link between those ingredients and obesity.

Poor Diets Contribute to 70% of Global Deaths

$2T
The global cost of the obesity epidemic.
11 M
The number of deaths directly caused by poor diets that could be prevented each year.
300%
Global prevalence of obesity nearly tripled between 1975 and 2016.
Newspaper ad with the text “When you open your mouth, don’t close your eyes.” Source: Idec

Newspaper ad with the text “When you open your mouth, don’t close your eyes.” Source: idec

Introducing Front-of-Package Nutrient Labels

Prominent labels now alert consumers to high quantities of saturated fat, sodium and sugar.

The rapid transition from traditional diets to diets high in ultra-processed foods and beverages has fueled a massive increase in obesity rates in Brazil.

In 2014 a working group started meeting to seek a solution. The country’s public health officials and civil society partners agreed upon the need for a system that informs the public and warns them about the health risks of processed foods high in sodium, saturated fat and sugar. Yet how to fulfill that need was far less clear.

Vital Strategies, as part of the Bloomberg Philanthropies Food Policy Program, was called in to support the Brazilian Institute of Consumer Rights (idec) to develop communication campaigns that were a critical component of the policy advocacy effort. Idec, in collaboration with partners from the Brazilian Alliance for Healthy and Adequate Food, a coalition of civil society groups, led a series of campaigns to promote effective front-of-package labels and maintain momentum for an initiative by ANVISA, the regulatory branch of the Brazil Health Ministry, to force manufacturers to label foods.

 

A Strategic Media Campaign to Promote Public Consultation

Demonstrating public support for the initiative was key, and a strategic media campaign did just that. Outreach to consult with members of the public — in other words, those who were actually buying and eating the food in question — started in 2014. ANVISA approved a model for front-of-package labeling in October 2020.

 

Rise in Obesity Rates Creates a Public Health Crisis

Obesity rates in Brazil have increased from 11.8% in 2006 to 19.8% in 2018, affecting nearly one in every five people. Against this backdrop, Brazil’s Health Surveillance Agency (ANVISA) convened stakeholders from civil society and the food industry, among others, to be part of a working group to develop a new food labeling system.

The effort was fraught with challenges posed by competing interests, with ANVISA navigating between the two. On the one hand were civil society groups and health advocates pressing for strong warning labels. On the other was the food industry, which favored a more scaled-down approach that stopped short of warning the public. It was critical to keep the issue in the public eye and keep people engaged throughout the process.

The campaign aimed to show the public what the labeling process entailed and get them involved in the ANVISA public consultation process.

 

Primary Audience

Since ANVISA’s public consultations usually have a complex format that demands a certain level of education and expertise, partners agreed to focus on target audiences who were more likely to contribute. This led them to focus on several groups: parents; anyone interested in health, including health professionals, healthy people and those who search for health subjects online; and youth aged 20-30. All groups comprised men and women of middle to high socioeconomic status and education level.

Parents

Middle to high socioeconomic status and educational level (known in Brazil as “AB socioeconomic status”); male and female; 30-45 years old

Adults Interested in Health

Health professionals; healthy people; those who search for health subjects online; middle to high socioeconomic status and educational level (known in Brazil as “AB socioeconomic status”); male and female; 25-60 years old

Youth

Young people engaged in social issues; middle to high socioeconomic status and educational level (known in Brazil as “AB socioeconomic status”); male and female; 20-30 years old

Interventions

The advocacy efforts started in 2014, and the partners’ communication efforts, which began in 2017, finally paid off in October 2020.  That is when ANVISA approved a model for front-of-package labels to warn consumers about high levels of sugar, saturated fat or sodium in foods.

Prior to the beginning of the official ANVISA public consultation, partners used mainstream, offline and digital media to highlight the need for front-of-package labeling among decision-makers, and to prepare audiences for the upcoming consultation. The goal of the offline media component was to raise the campaign’s profile among decision-makers in critical cities — Rio de Janeiro, São Paulo and Brasília — and increase the decision-makers’ receptivity to the campaign once it was launched on digital media.

The ultimate goal of the campaign was to drive traffic to ANVISA’s public consultation website to generate participation and support for the black triangles containing the nutrition warnings proposed by Idec and partners. After the public consultation was launched, partners dramatically increased digital campaign visibility to maximize impact and build support. This was done three ways:

Driving Public Engagement Via Digital Display

Campaign messaging worked to drive public engagement and response via digital media such as banners, search engines and social media (Instagram and Facebook). Precise targeting via cookies enabled the campaign to respond to audience reactions in real time.

Tailoring Media Response to Individual Audience Profiles

Because partners were able to see immediately which segments of the audience were responding and what media they were responding to, the strategy was adjusted whenever a certain media was not performing as expected. Partners identified those who were and weren’t clicking through to ANVISA’s website to complete the consultation. Those who did not access ANVISA’s website were targeted with additional campaign messages to get them to do so.

Aware that ANVISA’s website was not user-friendly, partners also developed a tutorial video with step-by-step instructions on how to complete the consultation form and shared it extensively via partners’ social media channels and on the “Right to Know” website. Partners also realized that more people were participating in the consultation through desktop or laptop computers because ANVISA’s unwieldy website was particularly hard to navigate via mobile phone and adjusted their investments accordingly.

Boosting the Campaign Through Influencers and Community Actions

Partners worked closely with influencers and celebrities to boost campaign awareness. These were anyone from celebrity chefs to actors, many of whom shared the campaign on their social media platforms. Community-level activities also helped boost the campaign’s profile and generate media coverage.

Research and Evaluation

Three main concepts were developed and tested to determine which was most effective with the target audience.

Concept A

Concept A showcased testimonials from people suffering ill health related to a lack of adequate nutritional information, with the clarion call, “Everything could have been different if I had been warned before eating.”

Concept B

Concept B took the popular phrase “Open your mouth and close your eyes” and tweaked it into a warning: “When you open your mouth, don’t close your eyes.”

Concept C

Concept C took the common catchphrase “Don’t swallow this,” which usually applies to vetting information rather than accept things without questioning, and applied it to food, telling people not to swallow processed food without knowing if it is unhealthy.

Each concept was evaluated by the number of impressions, views, clicks, visits to the campaign website and time spent viewing. “When you open your mouth, don’t close your eyes,” achieved the highest number of impressions, clicks and website visits across multiple pages and was the cornerstone of the digital media campaign.

 

Concepts A, B, and C reflecting different approaches to see which concept was most effective in getting the target audience to support the proposed model for front-of-package labels.
Concepts A, B, and C reflecting different approaches to see which concept was most effective in getting the target audience to support the proposed model for front-of-package labels.
Concepts A, B, and C reflecting different approaches to see which concept was most effective in getting the target audience to support the proposed model for front-of-package labels.

Concepts A, B, and C reflecting different approaches to see which concept was most effective in getting the target audience to support the proposed model for front-of-package labels.

Labels Everywhere

The campaign was able to set the public agenda for food labels. As a result, Brazil witnessed an unprecedented number of contributions from individuals during the public consultation. Idec and Alliance partners managed not only to attract 27,400 people to its “Right to Know” website but were also responsible for the majority of the 23,400 participants who completed ANVISA’s public consultation — a national record.

Although partners believe that the selected magnifying glass label is not as effective as the black triangle model proposed, they were pleased that ANVISA moved forward with the “high in…” front-of-package labels.

Since October 2023, the labels have been on packages of unhealthy food in Brazil. It is early as far as assessing their public health or sales impact, but Brazilian consumers now have the means to make more informed choices about the foods they choose to eat.

DOWNLOAD CASE STUDY

Our Impact

The successful communication campaigns developed by the Brazilian Institute of Consumer Rights (idec) with support from Vital Strategies as part of the Bloomberg Philanthropies Food Policy Program were a critical component of the policy advocacy effort that got ANVISA to mandate front-of-package labeling.

27,400

People visited the “Right to Know” website and 63% of those contributions showed a preference for the Alliance’s black triangle model.

741.4 M

Campaign materials were seen 741.4 million times.

153

News stories were generated about the campaign.

US$ 550,000

In earned media.

95%

Of the campaign results were delivered by digital media.

Front-of-package labeling reduces the burden on health systems.

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How Media Helped Build the Case for Front-of-Package Warning Labels