Obesity prevalence worldwide almost doubled between 1980 and 2014, making it a serious public health problem . According to the World Health Organization (WHO), by 2014, 39% of adults 18 years and older were overweight. According to United Nations International Children’s Emergency Fund (UNICEF), the overall prevalence of overweight and obesity in children under 5 years of age has increased from about 5% in 2000 to 6% in 2010 and 6.3% by 2013 .
Two key factors have contributed to the increase in the prevalence of obesity: a deficient access to public health information, as well as, an increased exposure to highly processed foods . Unfortunately, overweight and obesity do not act as particular pathologies, however, they correlate and lead to different comorbidities among non-communicable diseases .
Regarding Ecuador, the WHO describes a prevalence of overweight and obesity for adults of 54.1 and 18.7%, respectively on 2014, compared with 51.6 and 16.8% respectively on 2010 . On the other hand, country-specific data published by the National Health and Nutrition Survey in 2012, indicate that the prevalence of overweight in children under 5 years has increased from 4.2% in 1986 to 8.6% in 2012. In the case of scholar children, a combined national prevalence of 29.9% between overweight and obesity was found, which means that 3 out of 10 students in the country present overweight and/or obesity problems .
Different strategies have been developed to reduce the morbidity and mortality that these diseases cause globally, among them, the implementation of policies that promote healthy nutritional practices, as well as the promotion of nutritional labeling of products as a measure of information and health promotion to the population .
Nutritional labels provide the energetical and chemical content of processed foods for the consumer. Moreover, these labels are used to raise awareness and promote appropriate nutritional habits in people. This tool could be useful if the consumers understand and use the information for the purchase and consumption of the products .
Regarding labels, those that emphazise on nutritional facts rather than schemes and colors are best undestood , however, nutritional information based on colors showed greater impact on consumers, helping them choosing their products on a better way . Moreover, the more complex the label is, the most difficult to understand its content was [10, 11], althoug no significant differences were found between label schemes and their understanding level by the consumer .
Thus, the Nutritional Traffic Light Label (NTLL) is the most effective strategy in terms of guiding consumers towards healthier consumption, compared to other labeling systems [8, 13]. One of the first countries to implement this scheme was the United Kingdom, which by 2006 through the Food Standards Agency (FSA) implemented this strategy as a voluntary measure for the food industry, in order to help consumers to understand the nutritional information and thus make better decisions when making their purchases . The greener the nutritional traffic light, the healthier its content , consequently, this initiative incresead the demand for products with healthier composition and influencing changes in eating behavior’s with real consequences in people’s diet .
In Ecuador, the Ministry of Public Health, on August 29, 2014 issued the “Health Regulation for Processed Food Labeling”, which includes the mandatory use of NTLL. The objective of the Ministry was to “regulate and control the labeling of processed foods, to guarantee the constitutional right of individuals to receive, clear, precise and non-misleading information about the content and characteristics of these foods, allowing consumers to take the right choice for their acquisition and consumption” .
However, there is no evidence about the effectiveness that this regulation has had as a public health strategy to alleviate and prevent the health problems mentioned above. The present study aims to evaluate the use and knowledge of nutritional traffic light label and its effectiveness as a public health promotion strategy in an urban population from Quito, Ecuador.