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Dear editor: Currently, Mexico’s labeling regulation, the Official Mexican Norm 051 (NOM-051), is under modification to migrate to a warning labeling system. Also, there are efforts to strengthen specifications in which inconsistencies have been detected; one of them is the use of health or nutritional endorsements.
Under article 32 of the Federal Consumer Protection Law, the information related to products that are disseminated in any media must be truthful, verifiable, explicit, and the use of images and misleading brands that induce confusion in the consumer are forbidden. It also prohibits legends or information that indicates endorsement by professional associations or societies, when they lack scientific evidence to support them. Besides, there is evidence that consumers prefer shorter and simple messages, and pictograms to make choices at the point of sale. Consequently, it is not recommended to use more than one front of pack label (FOPL) on a product package, such as health endorsements, along with warning labels.1
For this reason, the new norm recommends restricting endorsements when the products exceed the established limits of nutrients of concern. There is evidence that products with claims and endorsements can generate misperceptions about the general quality of the product, making them appear healthier without considering the amount of other critical nutrients.2 In New Zealand and Chile, the use of health and nutrition claims are conditioned by a nutrient profile model.
To evaluate how many labels present endorsement as a marketing strategy, we collected information on the package (nutrition facts table, list of ingredients, claims, and endorsements) of 18 558 products available in 117 supermarkets in Mexico City during 2017. Of these products, we evaluated the nutritional quality using the nutrient profile based on the proposed norm, which was designed using the Pan American Health Organization recommendations.
The proportion of endorsed products was relatively low (<1%), mostly from professional associations related to: 1) Diabetes (68.3%), 2) Nutrition (17.9%), 3) Cardiology (9%), and 4) Pediatrics (7%). Regarding nutritional quality, 60.7% of the products were classified as “unhealthy” for an excess of sodium (60%), saturated fats (18.2%) sugars (14.3%), and calories (13.1%) (table I). Most products correspond to the category of sugar-sweetened beverages (33.8%) and sweet snacks (24.8%). Additionally, we found that products with endorsements also had nutrition or health claims (i.e., “suitable for diabetics” and “high in fiber”).
Table I: Nutritional quality and type of association of products with health endorsement (N=145)*
| Percentage of compliance with the Mexican nutrient profile | n | % |
| Excessive in one or more‡ | 88 | 60.7 |
| Excessive in calories | 19 | 13.1 |
| Excessive in sugars | 21 | 14.3 |
| Excessive in saturated fats | 26 | 18.2 |
| Excessive in trans fats | 0 | 0 |
| Excessive in sodium | 87 | 60 |
| Type of associations related to: | ||
| Diabetes | 99 | 68.3 |
| Nutrition | 26 | 17.9 |
| Cardiology | 13 | 9 |
| Pediatrics | 7 | 4.8 |
* Based on a sample of 18 558 products available at retail stores in Mexico City from January to March 2017 of which, less than 1% presented use of health endorsements.
‡ According to this nutrient profile, when a pro- duct is excessive in one or more criteria, it is considered as unhealthy and should not use health endorsement.
Our results show that the NOM-51 project criteria would prevent endorsement of 60.7% of the products currently in the market supported by a professional organization. The current norm, will contribute to more accurate information in the front-of-pack labels of industrialized food products. Therefore, if the endorsement regulation were not included, the impact of the policy would decrease, having a smaller contribution to healthier diets.
