Evaluating new Chilean National Regulations on the Food Supply *By: Dr. Camila Corvalán, INTA, U Chile, Chile Report Type: Final technical report *Date: September 2019 Published by: Full Name of Publisher Location: Santiago, Chile Series Name: Number of Series part: *IDRC Project Number: 108180-001 *IDRC Project Title: Evaluating new Chilean National Regulations on the Food Supply *Country/Region: Santiago, Chile *Full Name of Research Institution: Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile; Universidad Diego Portales, Santiago, Chile; University of North Carolina, USA

*Address of Research Institution: El Líbano 5524, Macul, Santiago, Chile *Name(s) of Researcher/Members of Research Team: Dr. Camila Corvalán, INTA, U Chile, Chile Dr. Marcela Reyes, INTA, U Chile, Chile Teresa Correa, Universidad Diego Portales, Chile Barry Popkin, University of North Carolina, USA Lindsey Smith-Tailler, University of North Carolina, USA Francesca Dillman, University of North Carolina, USA *Contact Information of Researcher/Research Team members:

Camila Corvalán, Institute of Nutrition and Food Technology (INTA); Mailing Address: Av. El Líbano 5524, Macul, Santiago; Chile Phone: 56 229781506; mobile cell # +56 977571632; Email: ccorval@gmail.com or ccorvalan@inta.uchile.cl

Teresa Correa, Diego Portales University; Mailing Address: Manuel Rodriguez Sur 415, Santiago, Chile; Email: teresa.correa@udp.cl

Barry M. Popkin, University of North Carolina at Chapel Hill; Mailing Address: Carolina Population Center CB # 81 20 University Square; Phone: 27516-3997; Email: popkin@unc.edu

*This report is presented as received from project recipient(s). It has not been subjected to peer review or other review processes. *This work is used with the permission of ______________________(name of copyright holder) *Copyright _______ (year), ___________________________ (name of copyright holder)

Contents

i. Abstract

ii. The Research Problem

iii. Objectives

iv. Methodology

v. Project Activities

vi. Project Outputs

vii. Project Outcomes

viii. Overall Risk and Recommendations

ix. Annexes

i Tracking program level indicators

ii Sociodemographic questionnaire

iii Media exposure, food knowledge, attitudes and perceptions questionnaire

I. ABSTRACT The project had the objective of assessing the impact of a set of regulations aimed to make a healthier food environment (i.e., warning labelling, restrictions on children-targeted marketing, prohibition of sales in schools for unhealthy foods, and an increase in the tax for sugar-sweetened beverage) implemented in Chile 2016 (2014 for SSB tax) to halt the ongoing obesity epidemic. Since March 2016, we have evaluated two cohorts of low-middle socioeconomic status (SES), from Santiago Chile: 962 preschoolers and their mothers from the Chilean Cohort of Food Environment –FECHIC– (83% follow-up) and 770 adolescents from the Growth and Obesity Cohort Study –GOCS– (89% follow-up) regarding understanding and perceptions about foods and the regulation, diet and weight status. We also conduced 9 focus groups of 7-10 mother of children <14y with different SES, in order to explore deeper in their perceptions of the regulation. Briefly, our results suggest that the policy has been understood, valued and used for informing food-related decisions. Qualitative data suggests we are experiencing a change in social norms towards healthier diets, which is mainly driven by young children. During these 2.5y we have strengthened our collaboration with the team at University of North Carolina, USA and locally, between INTA and Diego Portales University. Under the umbrella of this project we have started or consolidated networking with important local, regional and global actors, from civil society, policymakers, health authorities, and other scholars. Concrete outcomes of this project include: students guide (3 master, 2 student stays, 1 postdoc), invitations to oral presentations related to this topic (>12), interviews by press (>25), articles (2 published, 12 submitted or under review, 3 in late stages of writing process). This funding has given the team the opportunity to evaluate the Chilean regulation, which will help locally and globally improving food environments and heath. Keywords: Regulation, Food environment, warning labels, marketing, children obesity, Chile.

II. RESEARCH PROBLEM Chile has experienced an important rise in nutrition-related non-communicable chronic diseases (NCDs) prevalence and mortality in the last three decades. Approximately over 80% of all deaths in Chile are caused by NCDs. Like in most Latin American countries, obesity, diabetes mellitus and high blood pressure are now some of the most difficult health challenges in the country. Chile has one of the highest prevalence of overweight, reaching 75% in adults and more than 50% in first grade school-aged children. Data based on household expenditure suggest an important shift on dietary habits from traditional home-made dishes to ready-to-eat food and beverages, which is likely to be triggered by an increase on the availability and marketing of such food products. It is estimated than almost 30% of population’s calories come from ultra-processed foods, and the dietary share is even greater among children. Starting 10-15y ago, the Chilean Ministry of Health has been trying to implement actions to promote healthier diets and increase physical activity. However, most of these actions have been at a small scale, poorly integrated, not evaluated, and not sustained over time. Beginning October 2014, the government implemented an 8% tax on sugar-sweetened beverages relative to other beverages. On June 26th 2016, a new Law including mandatory front-of-package (FOP) warning labels and prohibition of marketing targeted to children ≤14y for foods with high content of sugars, saturated fats, sodium and energy was implemented, and on June 27th 2018, the second phase of the Law was implemented too, where the regulation is stricter with respect to the values of the critical nutrients allowed (our estimations are that the proportion of regulated products from prepackaged foods have increased in about 10 percental points). The cut-off for the content of critical nutrients will become increasingly stringent over a 3-year period. The staggered implementation of this regulation provides an ideal natural experimental setting to test the individual and joint impact of these regulations. Our overarching goal is to understand how these regulations will affect diet (intake of both regulated and non-regulated packaged foods and beverages, including the shift away from ultra-processed food and sugar-sweetened beverages (SSBs) towards fresh and minimally processed foods. This research will provide the data and understanding to lay the groundwork for a more extensive evaluation of how these regulations affect food purchases, dietary patterns and ultimately, obesity and related NCDs. III. OBJECTIVES General objective: The goal of the entire research effort was to understand the separate and joint impact of the SSB, the FOP/marketing regulations on what people buy and eat, including the healthfulness and sustainability of diets, thought two longitudinal cohort studies: Chilean Cohort of Food Environment (FECHIC) (4-6 years old cohort), Growth and Obesity Cohort Study (GOCS) (12-15 years old cohort). Specific objective 1: Examine shifts in children's exposure to food and beverage advertising and in the attitudes towards regulated food products. 1a. Examine shifts in regulated and unregulated food and beverage advertising (frequency, type of appeals used, nutritional quality of products advertised) on popular children’s and general audience television programming. Two reconstructed weeks (18h/channel/day) were sampled in April and May of every year (2016-2018). For 2016 and 2017 data, content analysis was performed for food related ads, coding food group, Food Company, and marketing strategies; nutritional information (from nutrient fact panel) was linked (see methodology). Data for 2018 is being currently processed. A manuscript reporting the 2016 baseline data is under the second round of peer-review (Correa 2018, under review), and a new one reporting the changes after the implementation of the regulation if being drafted. Briefly, food-related ads represented 16% of all TV advertising; 34% of food related ads featured at least one product high in energy, saturated

fats, sugars and/or salt (HEFSS), according to thresholds defined in the Chilean regulation (first phase). Preliminary results of the comparative analyses of the content analyses 2016 (pre-regulation) and 2017 (post-regulation) show similar number of food/beverages ads on TV (16% in 2016, 15% in 2017); the number of HEFSS ads per day have decreased in almost 50%; the same was observed with the HEFSS ads child-directed (approximately 40% less, p<0.001); the ads without HEFSS food/beverages increased from 61% in 2016 to 80% in 2017. The 2018 TV data collection is currently being coded. 1b. Examine children's exposure to television programming at each data collection point (frequency, specific programs). Participants of both cohorts provided detailed information on TV exposure (see methodology), which was then linked to TV content analyses for assessing children’s individual-level exposure to unhealthy food advertising on television; a manuscript reporting those results is currently under review (Carpentier et al. 2018, under review). Briefly, the results show high levels of exposure to HEFSS advertising and high levels of HEFSS child-directed advertising for a significant proportion of both preschoolers and adolescents; products above the threshold in sugars were the most prevalent in most of those HEFSS ads, followed closely by products high in energy. Whereas about half of the youth across both cohorts were estimated to have little to no exposure, the other half ranged up to about half an hour per week. Children can be heavily exposed to HEFSS advertising, and especially ads with child-directed marketing strategies, from both their direct television use and from incidental exposure to other household members’ television viewing. A new manuscript is been drafted in order to describe changes in TV content analyses and exposure in 2016 and 2017. Preliminary results show that the preschoolers average weekly TV hours was steady while the adolescents decreased the TV exposure; nevertheless, adolescents still watched about two more hours per week than the children. Both preschoolers and adolescents’ exposure to HEFSS ads decreased about 50%, mainly in the heavily exposed subgroup; similar decreases were shown for HEFSS child-directed ads. 1c. Examine shifts in regulated and unregulated specific food groups (i.e. breakfast cereals, yogurts, and sweet beverages other than sodas) advertising on food packaging in specific point-of-sales. We coded the baseline marketing data (2016) from packages of non-alcoholic beverages (including dairy-based ones), the results of this descriptive analysis have been published (Mediano et al 2017, Public Health Nutrition). Marketing data from packages of over 350 breakfast cereal collected in 2016 and 2017 were coded during the last semester and changes after the implementation of the regulation are being currently under analysis. A manuscript of this work should be submitted at the end of 2018. 1d. Examine children's exposure to specific point-of-sales at each data collection point (frequency) As far as we know, there is no well described or standard method to assess exposure to marketing on packaged foods, and thus we developed a set of questions regarding the frequency that preschoolers and adolescents go to retailers (i.e. supermarkets, convenience stores, kiosks) and may be potentially exposed to packaged products, as well as how much they are attracted by marketing strategies of such foods (see methodology). We have analyzed FECHIC mothers’ responses (baseline data). Briefly: 40% of preschoolers visited convenience stores more than 5 times/week, 38% visit the stores 1-5 times/week, whereas 22% almost never went to them. Compared to the rest of the sample, mothers of highly exposed children (>5 times/week) reported their children asking more frequently something to eat or drink, especially if the food package had children-targeted strategies. Highly exposed children also had a higher prevalence of overweight/obesity. Results of this analysis were accepted as a poster presentation for nov-18 SLAN meeting (Sánchez et al) and analyses of follow up data is planned, together with the analyses on the association between the exposure indicators and relevant outcomes.

1e. Examine shifts in children's attitudes of food advertising, and nutritional perceptions and desirability of regulated products. Participants were asked about attitudes and perceptions toward foods, sources of information for deciding purchases and healthiness of the foods, attitudes toward the regulation, among others. Analyses are currently being performed to evaluate changes on those indicators after the implementation of the regulation, according to educational level and other sociodemographic indicators. An article on this topic is currently being drafted and will be submitted for peer-review process at the end of 2018. Preliminary results show that mothers and adolescents understand the stop signs; the presence of stop signs improve classification of healthiness of foods in mother and adolescents (beverages and breakfast cereals with stop signs shown in 2017 were indicated as less healthy by a greater number of mothers and adolescents comparing with 2016; whereas among yogurts, a category that did not display warning labels in the first phase, the classification of the healthiness did not improve compared to 2016). Moreover, mothers and adolescents are using the stop signs for informing their decision when they buy foods (Figure 1). Figure 1. Changes on aspects of the food packages considered when deciding for the healthiness of a food (2016-2017)

Specific objective 2: Examine shifts in children’s dietary intake of regulated and unregulated foods. 2a. Examine shifts in the usual intake of SSBs, other regulated and unregulated beverages, plain water, and bottled water for the pre-SSB taxes implementation period (GOCS only); SSB taxes implementation but pre-FOP/marketing (GOCS only); and year 1 of the FOP/marketing (GOCS and FECHIC). We collected 24-hour recall (24HR) data on participants from both cohorts, with specific information on products brands, source of beverages, place where they were drunk, including tap water and milk-based ones. The 24HR data management has been more intensive than expected, as well as grouping of food/beverages as regulated or non-regulated. Moreover, the lack of information about our basal dietary patterns became a relevant gap to fulfill, which would help in turn leading the relevant changes that could be expected after the implementation of the different regulation. Thus, we are working on descriptive data based on 2016 recalls. Briefly, in preschoolers the greatest contribution to beverage calories came from dairy beverages and substitutes, followed by fruit and vegetables drinks with added sugars; beverages accounted for 28% of total calories. In adolescents the greatest contribution came from carbonated sugary sodas, dairy beverages and substitutes with added sugars, and coffee and tea; beverages accounted for 14% of total energy). A manuscript with 2016 descriptive data on FECHIC and GOCS beverages intake is under preparation (Essman 2018, submitted). We aim examining shifts on beverages intake during the first semester of 2019.

WHAT DO YOU CHECK FIRST FOR DECIDING THAT A FOOD IS HEALTHY?

Preeschool’s Mothers Adolescents

2b. Examine shifts in usual intake of regulated/unregulated (FOP/marketing) key food groups (including fruits/vegetables, candy and sweets, ready-to-eat cereals, chips and savory snacks) with regards to calories, sugars, sodium, and saturated fat for the same periods described above (GOCS and FECHIC). Challenges detected for beverage’s analyses also apply to solid foods, and thus we have proceeded similarly, aiming to better understand the baseline dietary patterns. This way, future analysis will focus on looking for changes on specific food groups, meal times or food sources that might be more relevant in the dietary share of critical nutrients. Some of the results related to these analyses show a high prevalence (90-95%) of snacking among participants (2.3 snacks/day on average), contributing to about 30% of the total calorie intake among snackers. In both preschoolers and adolescents, 80-90% of the total calories, saturated fats, sugars and sodium consumed daily came from foods that were present at home, with a minor relevance of foods obtained from school or other sources. FECHIC participants had a high intake of ultraprocessed food (about 50% of their total energy intake); this food group was also an important source of sugars (75% of total intake), saturated fats (55% of total intake), and 40% of sodium intake. Part of the results are currently under review (Jensen 2018, under review), and we plan to submit 2 more manuscript on baseline dietary analyses at the end of the year. Moreover, a manuscript on non-caloric sweeteners (NCS) intake among preschoolers (Venegas 2018, under preparation) should be submitted in the following months. 2c. Link shifts in beverage and food intake to changes in exposure to food advertising (GOCS and FECHIC). As part of the effort on better understanding aspects related to baseline diet, we are currently planning an analysis on the potential associations between TV food marketing exposure and dietary pattern or critical nutrient intake (2016 data). This analysis, together with the study of changes in exposure to food advertising, will allow responding this aim. Specific objective 3: Examine perceptions and behaviors of adults around the food regulations. This objective was evaluated using a qualitative methodology. Nine focus groups of 7-10 mothers of children aged 2-14 (84 in total) with different socioeconomic status backgrounds were conducted in Santiago in 2017, with the purpose of explore how adults perceive the food environment before and after the implementation of the Law, and to investigate their understanding, attitudes, discourses, buying decisions and eating behaviors after the food regulation is in the last phase of coauthors review. A manuscript is currently under review (Correa 2018, under review). Briefly, in all the focus groups, mothers understood the new regulation was a policy to fight the child obesity and related diseases in the country; everybody was aware that products with more logos were less healthy; many mothers said that they changed their purchase habits only when the buy a new products, nevertheless the attention and use of logos was greater particularly in mother from middle and upper SES; besides the regulation in schools, mothers said that the school has become a key promoter of food behavioral change by explaining what is healthy or unhealthy; the mothers were less aware that the law also regulated food marketing and advertising in the media or on product packages. We are currently drafting another manuscript derived from focus group results, focusing on the perception of mothers regarding the nutrition transition that they have experienced during their lives. IV. METHODOLOGY This specific project is part of a major evaluation effort, which has different sources of data that enable achieving the purposes. This project increased the scope of an already existing adolescent cohort (GOCS) by adding data on marketing exposure, attitudes towards foods and the regulation to the existent anthropometric data, and it also provided funding for the dietary data collection, which was not funded for the data collection of this last years. IDRC funding also allowed the co-funding (together with our

national scientific agency CONICYT, #1161436 PI Corvalan) of new preschooler cohort, which participants were recruited in a similar way that what was done 10 years earlier with GOCS participants (ie. public nurseries/schools from low and middle SES neighborhoods in the south-east area of Santiago). Beside the questionnaires applied to the participants or their mothers, data on marketing exposure and dietary information were informed with data derived from the monitoring of food environments (ie. nutrition labels of packaged foods and content analyses on food packages and TV ads), which were collected with funding from another IDRC-funded project (#107731-002 PI Corvalan) and Bloomberg Philanthropies. Table 3 shows a resume of methods used to answer each specific objective. Data sources

1. Chilean Cohort of Food Environment (FECHIC): This cohort was recruited specifically for this project and it included 962 preschools children (4-6y old) recruited from more than 50 schools of South East area of Santiago (low-middle SES) between March and April 2016 ( >3,000 invited, 2625 interested). The first follow up was done in the first semester 2017, 889 participants and their mothers were evaluated (92% follow-up). The second follow up (February-June 2018) assessed 794 dyads (83% follow-up). The recruitment phase was very challenging given the short time elapsed between the funding and the implementation of the regulation. Currently, our main challenge is increasing the retention rate of participants. Currently we have a retention rate of 90% (considering participants who were evaluated and those who were not evaluated for different reasons such as: difficulties to schedule, living out of the city, request to be evaluated during the year). Table 1 and 2 show the follow up details and general characteristic of the cohort, respectively. Within this cohort we collect information at different levels: sociodemographic, marketing exposure, attitudes toward foods and the regulation, diet, anthropometry (see below, under Assessments). Due to the extra funding (CONICYT local funding, PI Reyes), visits of FECHIC participants included new measurements. With legal tutor’s participant consent, we included: body composition evaluation using Dual Energy X-Ray Absorptiometry (DXA) scans in a subsample of 300 participants and electric bio-impedance using a TANITA equipment in most participants (n=693); tanner stage assessments only in girls (n=398); biological age measured by a wrist ultrasound equipment (Bon Age Sunlight Medical®) to 690 participants; blood sample in 654 preschoolers; and a physical activity questionnaire to all the preschool sample evaluated.

2. Growth and Obesity Cohort Study (GOCS): This cohort is an ongoing study that was initiated in 2006 (current PI Corvalan) with the collaboration of the Chilean National Preschool Program and National School Board Program (JUNAEB), with children aged 2.6 to 4.0y (n=1,195) from public nursery of South East area of Santiago (low-middle SES); the main aim was to assess the association between early weight and linear growth and BMI trajectories in preschool children. With the purpose of this project, 770 participants (currently adolescents) were evaluated face-to-face during the first semester 2016. The first follow up was done in the first semester 2017, when 729 adolescents were evaluated (95% follow-up). The second follow up (February-June 2018) assessed 683 adolescents (89% follow-up). The retention rate is 95% (considering participants who were evaluated and those who were not evaluated for different reasons such as: difficulties to schedule and participants living out of the city. Table 1 and 2 show the follow up details and general characteristic of this cohort, respectively. Sociodemographic information, marketing exposure, attitudes toward foods and the regulation, diet, anthropometry (see below, under Assessments), have been collected annually through direct interview with the adolescent.

3. Focus Groups: Nine focus groups of between 7 and 10 mothers of children aged 2 to 14 were conducted in July 2017, one year after the introduction of the regulation. Mothers (n = 84) were recruited from 20 out of 35 districts of Santiago. A focus group recruiting company was hired to get access to mothers from different neighborhoods and socioeconomic profiles, to make sure they did not know each other. The filter questionnaire included questions such as: participants’ age, marital status, district where they live, children’s age, gender and type of daycare or school (public, semi-private, private), occupation, level of education, education and occupation of head of household, family income and possession of material goods (i.e., car, house, current bank account, domestic service, internet connection and type of healthcare system). People who had worked in the marketing and food-related industries (e.g., supermarkets, restaurants, retail companies) were excluded from the study. Focus groups were stratified by SES (lower, middle, upper) and children’s age (2-6; 7-10; 11-14). This stratification intended to obtain a diversity of views and experiences regarding the law. Focus groups questions, used as a semi-structure interview, guiding the discussion were elaborated by an interdisciplinary group of scholars from epidemiology, nutrition, public health and communication who have been evaluating the regulation from a variety of angles.

4. Other data sources that contribute to this project and the general evaluation effort:

Data base on ingredients and nutrient information (as reported by manufacturers), as well as general labelling information from prepackaged foods. Since 2015, we have been collecting pictures of food packages available at supermarkets from high and low-middle level neighborhood from Santiago, Chile, according to the ongoing protocols, with a field team previously trained. More than 10,000 products were collected in 2015, >15,000 in 2016, >20,000 in 2017 and >40,000 in 2018 (estimation according to the number of pictures collected). Data from nutrient fact panels (NFP), ingredient lists and basic labelling features were entered to an electronic database, from photos collected in 2015, 2016 and 2017 (only from high SES neighborhood). The number of products available in data bases per year is 6,163, 12,198 and 11,680, respectively. One of the major benefits of tracking the composition of foods is to evaluate the impact of industry reformulation and public health policies. Food pictures were also used to do the food packaging content analysis characterizing the marketing strategies among breakfast cereals, and beverages including the dairy-based ones.

Data base on TV content analysis. Since 2016, content analysis of four broadcast (Mega, Chilevisión, TVN and Canal 13) and four cable channels (Discovery Kids, Disney, Cartoon Network and Fox) spanning 6am to 12am (18 hours per day), has been collected during two randomly-selected composite weeks in April and May, provided by Chile’s National Television Council. These channels include the 50 television programs with the highest ratings among the general audience, as well as among children age 4-12 and adolescents age 13-17, enabling analyses based on variations in audience composition. After data collection, more than 6,000 food and beverages-related advertisements (ads) were coded each year (2016, 2017 and 2018). For all ads in the sample, the host network (channel), air date, start and end times (used to calculate ad duration), and host program name were recorded. Audience exposure and audience composition data for each host program were then obtained from Kantar Ibope Media, which measures television use via a people meter system, sampling from 7 regions covering 51% of Chile’s urban population.

Food/beverage purchases Kantar database: >2,000 households from main cities in Chile are included in this data base, which includes purchases (at the level of brand) of packaged foods from most food groups, as long as they are taken to the house (it does not foods that were bought and eaten away-home).

Table 1. Follow up of FECHIC and GOCS participants from 2016 to 2018 FECHIC GOCS

Participants n % n %

Baseline 2016 962 100.0% 770 100.0%

First follow up 2017 889 92.4% 729 94.7%

Abandon 33 3.4% 0 0.0%

Lost 11 1.1% 0 0.0%

Deceased 1 0.1% 0 0.0%

Participants requested not to be evaluated in 2017 28 2.9% 41 5.3%

Second follow up 2018 794 82.5% 683 88.7%

Abandon 27 2.9%* 26 3.4%

Lost 26 2.8%* 10 1.3%

Participants with problems to schedule 49 5.3%* 41 5.3%

Participants who live outside the evaluation are 17 1.9%* 10 1.3%

Participants requested not to be evaluated in 2018 4 0.4%* 0 0.0% *In FECHIC second follow up 2018, the percentage numbers were given considering the potential number of participants to be evaluated during 2018 (889 who has the first follow up + 28 who requested not to be evaluated in 2017: n=917).

Table 2. General characteristic of FECHIC and GOCS

FECHIC GOCS

Baseline 2016 n=962

1st Follow up 2017 n=889

2nd Follow up 2018 n=794

Baseline 2016 n=770

1st Follow up 2017 n=729

2nd Follow up 2018 n=683

Children characteristics

Age [y] 4.8 5.7 6.7 13.6 14.6 15.5

Sex [% female] 51.9 51.5 51.5 50.7 49.7 49.9

BMI z-score 1.04 1.02 1.05** 0.95 0.82 0.76

Overweight [%] 28.8 27.3 27.78** 30.3 26.8 25.8

Obesity [%] 18.4 18.6 21.46** 19.0 16.9 15.1

Mother characteristics

Age [y] 31.8 32.8 33.9 40.9 41.9 42.8

Marital status [% single] 40.2 44.1 29.7 32.2 29.7 31.5

Education [% < 12y] 10.7 10.9 9.3 12.2 15.0 13.2

Mother nutritional status* n=922 n=861 n=758 n=630 n=373 n=383

BMI 28.8 28.8 29.2 29.4 29.3 29.3

Overweight [%] 38.7 39.0 38.8 40.1 39.4 42.3

Obesity [%] 35.6 35.5 38.1 40.3 38.3 38.1 * The presence of the mother is not mandatory for adolescent assessment / some mothers rejected the nutritional evaluation in FECHIC

Assessments

I. Derived from both cohorts Every year, prior to the data collection, we recruited 16-24 dietitians after careful interviews. Professionals selected then underwent a 2 weeks training process including theoretical and practical training, in order to standardize the application of each instrument. We made sure that dietitians were allowed to go into the field only after achieving adequate reliability for carrying anthropometric, food attitudes and dietary assessments. Data is reviewed regarding completeness and plausibility daily. Adolescents are the

respondent of questionnaires and diet recalls; preschooler mothers are the respondent of questionnaires and diet recalls (the child can help for the dietary survey).

1. General information and socio-economic questionnaire (annex 2): Information on age, gender, family structure is asked in every data collection, as well as socio-economic data (eg. head of household education, occupation and marital status, mother’s education level, mother occupation and marital status, mother’s employment status).

2. Media exposure questionnaire (annex 3): We developed and piloted structured questionnaires for assessing child/adolescent exposure to TV within three-day parts, representing morning viewing, daytime viewing and prime time viewing periods during the weekdays and during the weekend (per period: amount of time watching TV and the channels name). The measures considered both intentional (the children/adolescents focus on watch TV) and incidental (TV was on but children/adolescents do not pay attention to it) exposure. General question regarding frequency of visits to supermarkets and convenience stores, use of internet and social networks are also asked.

3. Food attitudes, knowledge and food perceptions questionnaire (annex 3): We developed and piloted structured questionnaires aimed exploring knowledge of the regulation (awareness and recognition of warning labels), aspects used for informing food purchases, ability to classify foods according to their nutritional quality, among others.

4. Diet: Dietary intake was measured using a computerized semi-automated multi-pass 24-hour recall (24HR). At the time when this project started our research team was already collecting 24HR on adolescents from GOCS, but this was done in a non-computerized way, and thus the data analyses became very challenging. Dietary recalls for the current project were done using a software especially developed by our team (SER24H), which includes portion sizes from an adaptation of the Food Atlas of the National Consumption Survey, and nutrient composition data from USDA database, based on information obtained from local recipes, Chilean nutrient composition table and nutrient fact panels from packaged foods. Surveys are repeated on 20% of the sample evaluated in order to estimate usual intake of key foods and nutrients.

5. Anthropometry: Body weight is measured in participants and their mothers without shoes and in light clothing (SECA weight scale, precision 100g), as well as height (SECA portable, precision 1 mm), and waist circumference (Lufkin Tape W 606 PM, USA; precision 0.1 cm), using standardized procedures. Body mass index (BMI= weight [kg]/ height [m2]) is then calculates and BMI z-scores for age and sex are computed for children and adolescents (WHO standards).

II. Derived from food environment monitoring

1. Nutrient and ingredient content of foods: Food packages information collected through photos in supermarket was entered in data bases using REDCAP platform (Information from 2015, 2016 and 2018 from high income level). We developed standardized methods for data entry of information contained in photos of food and beverage packages. The overarching goals of this process are to monitor the food supply before and after implementation of food policies, e.g. sugary beverage tax, junk food tax, marketing controls, etc. We are interested in understanding a number of elements, including: (1) Nutrition facts panel (NFP) information; (2) Product reformulation; (3) Front-of-package labeling; (4) Front-of-package marketing; (5) Using the ingredients to identify foods or beverages that are taxed (e.g. added sugar). The following forms has been created in order to enter information orderly:

a. Basic information: general identifying information for the product such as name of the product, food sub-category and category, barcode number, the factory that made the product, packaged size, the number of photos taken per product and any observation.

b. Nutrition Facts Panel: portions size and nutrient information per 100 g/ml of product. c. Ingredients information: full ingredient list(s) d. Reconstitution information: instruction for preparing product (if applicable) e. Sweeteners information: presence/absence of sweeteners f. Front of packaged information: presence/absence of warning labels.

2. TV content analysis: A quantitative content analysis was conducted on advertisements

appearing in a sample of two weeks of television aired between 6am and 12am across eight channels (four broadcast and four cable channels) each year (2016-2017; 2018 coding is being currently done). The advertisements of food and beverages were coded including the product name and brand, presence/absence of marketing strategies targeted to children, such as the use of promotional characters, premium offers, appeals to fantasy, use of children/adolescent language, children music and voices. Audience ratings were used to indicate audience exposure. The protocol for coding was developed and tested by our team based on INFORMAS protocols and the Chilean regulation. Intercoder reliability: Cohen’s K and Scott’s π =0.98 to 0.70 across codes.

3. Food packaging content analysis: We developed and piloted a protocol for coding marketing strategies on food packages (intercoder reliability: Scott’s π=0·81, 96·99% agreement across all codes). The protocol considered what proposed by INFORMAS and what included as part of the Chilean marketing restrictions (in line with the TV coding protocol). The tool was used for content analyses of beverages and then adapted for breakfast cereal packages, in order to look at changes after the implementation of the regulation. FOP marketing appeals, promotions and incentives on the sampled packages were quantitatively assessed using categories of text and images that a team of trained mass communication scholars derived from previous marketing studies. Two coders assessed the presence or absence of marketing appeals, which were combined into seven overarching categories of marketing strategies based on their thematic similarity: (i) nutrition and health claims; (ii) nature and fruit depictions; (iii) emotion and fun appeals; (iv) Child-directed characters; (v) childhood and family situations; (vi) sports references and physical activity portrayals; and (vii) product-oriented appeals. Presence/absence assessments were made irrespective of the quantity of specific iterations of any one strategy. Presence of gifts (e.g. stickers, toys), games and contests was also initially coded, but their frequency of occurrence was minimal. Therefore, gifts, games and toys as marketing strategies were excluded from the reported analyses.

Table 3. Outcomes and methodology Outcomes Definition (Unit of Observations) Data sources Instruments of collection

Aim 1a & 1b, TV media exposure

Reported amount of time exposed to television during different day parts. Amount and type of food and beverage advertising in highly-viewed television programming.

FECHIC and GOCS cohorts TV content analysis

Media exposure questionnaire. Content analysis of four broadcast and four cable channels spanning 6am to 12am during two randomly-selected composite weeks in April and May (2016-2018).

Aim 1c & 1d Food packaging media exposure

Frequency of children-targeted marketing strategies on food packages. Reported frequency exposed to specific point-of-sale. Mother- or self-reported influence of marketing strategies in food purchases.

Food packaging content analysis 2015-2017 FECHIC and GOCS cohorts

Food packaging content analysis Food attitudes and food knowledge questionnaire.

Aim 1e attitudes and perceptions

Awareness and recognition of warning labels, aspects used for informing food purchases, ability to classify foods according to their nutritional quality.

FECHIC and GOCS cohorts

Food attitudes, knowledge and food perceptions questionnaire.

Aim 2a & 2b Dietary Intake

Usual intake (ie. units, portions, % kcal, grams, or mL) and nutrient outcomes (ie. energy, sugars, total/saturated/trans fats, sodium, fiber and other positive nutrients.

FECHIC and GOCs cohorts

24-hours-recalls (24HR)

Aim 3a Response to regulations

Understanding and knowledge, perceptions, attitudes, barriers, individual decision-making and incorporation of regulations into food purchasing

Focus group Semi-structured interview

V. PROJECT ACTIVITIES During these 2.5 years of work we have performed activities related directly with data collection (ie. preparation of fieldwork, data collection, data cleaning, data analyses, manuscript preparation and publication), which have been complemented policy incidence at the local and global level and knowledge dissemination. Table 4 describe the activities supported under the project and the timeline. Given our previous experience with challenges associated to dietary assessments, at the time of initiating this project, we had already started an effort in automatizing the 24HR by developing a software. This was a key for the success on the massive data collection on dietary intake performed during the last few years. A similar challenge has become evident regarding the nutrient and ingredient information from nutrient fact panels, both, in terms of decreasing the cost of massive data transcription and facilitating complex data managing (ie. building longitudinal database, linking information form the database with pictures, among others). Given that, we are currently working on developing an application (INTAPIC) that will optimize the capture and managing of photos, the subsequent data entry and data linking (from consecutive waves of data collection). We expect this app to be available for data entry later this year, and we expect to use it for photo collection at the supermarket in 2019. The implementation of this project challenged our research team and helped us reshaping the team into a more operative one. When starting this project, we have just installed a new way of working, based on

task rather than specific projects (ie. data collection team (at the supermarket or participants houses) instead of teams for specific projects (food environment monitoring or GOCS project). The current project took advantage of this new work organization, but also stressed the new structure and thus helped us to early reconsiderations of important changes needed.

Table 4. Activities description supported under the project Activities Details 2016,

1st sem 2016, 2nd sem

2017, 1st sem

2017, 2nd sem

2018, 1st sem

PREPARATION OF FIELD WORK

Developing instruments of data collection Questionnaires to be used among FECHIC and GOCS participants X

Coding protocol for marketing analyses (TV and food packages) X X X

Interviews to be used for focus groups X

Planning data collection Each year, prior the data collection (FECHIC and GOCS) we review and update instruments if needed, and we plan the logistics of data collection (location to be done, how to contact participants, etc).

X X X

Selection and training of field workers Dietitians assessing both cohorts X X X

Dietitians doing photo collection in supermarkets X X X

Dietitians transcribing nutrient fact panel information X X X

Communication professionals for TV content analysis X X

DATA COLLECTION OR FIELD WORK

FECHIC & GOCS Surveys, dietary recalls, anthropometry on 962 preschoolers and their mothers, and 770 adolescents.

X X X

Focus group Mother of children and adolescents 2-14-year-old (9 groups, 7-10 mothers per group) from low and middle SES backgrounds.

X

Food and beverages packages (photos) Food packages information collected through photos at supermarkets from high income (n=6) and low-middle income (5-8), from 5 different supermarket chains

X X X

DATA ENTRY OR CODE

TV content We coded TV content collected each year X X X

Focus group Data transcription were conducted after data collection using the notes and audio taped by two trained research assistants

X

Food packages content analyses Beverages (2015-2016 data) X

Breakfast cereals (2015-2017 data) X

Transcription of nutrient and ingredient information

Food packages information collected through photos at supermarkets was entered in databases using REDCAP platform (data from 2015, 2016 and 2018 from high income).

X X

DATA CLEANING AND MANAGING

FECHIC & GOCS, dietary intake, marketing content analysis, nutrient/ ingredients form food packages

All data are collected using REDCAP, in the case of dietary data collection we use SER24H software. Data are backup every year. Pictures from food packages and videos from TV are labeled, stores and backup. Our research team includes professionals who work constantly in the data cleaning and managing, checking inconsistencies, implausible values, and incompleteness during the data collection period. At the end of every data collection wave, research assistants perform a more detailed data quality control, based on data from previous waves and biological plausibility. Every data user (ie. students, coinvestigators) report any potential mistake they found, which is checked and edited if needed.

X X X X X

DATA ANALYSIS

TV content and media exposure analysis After coding marketing strategies of TV ads, several further analyses are needed: food grouping; linking TV content analysis and nutritional information; assignation of regulation status for foods. Furthermore, we have done statistical analyses on descriptive baseline data and changes after regulation.

X X X X

Regarding the exposure data to TV marketing, scores based on TV exposure and TV content analyses of the reported TV channels are computed at the individual level. Descriptive baseline data and changes after the implementation of the regulation have been done.

X X X X

Food attitudes, knowledge and perceptions analysis

Analyses on baseline data and changes after the implementation of the first phase of the regulations have been already done

X X

Dietary intake analysis Postprocessing of dietary data are more complex that other type of data given that new foods or recipes (ie. the ones that have not appeared in previous data collection waves and thus are not part of the SER24H database) need to be provided with information of nutrient content, serving sizes and others. Currently, we have undergone descriptive analyses on the baseline data: food sources and location of FECHIC and GOCs baseline; snaking patterns among children and adolescents, food sources of critical nutrients, non-caloric sweeteners intake among preschoolers, ultra-processed food intake among preschoolers.

X X X

Focus group analysis Descriptive analysis of how mothers of children <14y perceive the food environment before and after the implementation of the regulation, as well as their understanding, attitudes, discourses, buying decisions and eating behaviors after the food regulation.

X

LATE STAGES OF MANUSCRIPTS WRITING / PUBLISHED ARTICLES

TV content analyses Manuscripts writing X X

First manuscript in the second round of R&R X

TV exposure Manuscript writing X

First manuscript under review X

Food packages content analyses Manuscript writing X

First manuscript published X

Dietary intake Manuscripts writing X X X

One manuscript under review and one submitted manuscript X

Focus Group Manuscript writing X X

First manuscript under review X

Attitudes, knowledge & perceptions Manuscript writing X X

POLICY INCIDENCE

At the local level Local Influences: technical support in nutritional aspects of potential new policies associated with healthier food environment; preliminary results regarding implementation and evaluation of the regulation and meetings with health authorities; others

X X X

Networks: with other Chilean scholars, policy makers, and members of NGOs from civil society

X X X X X

At the global level Global Influences: technical assistance in different aspects related to the regulation (development, political challenges, implementation and evaluation)

X X X X X

Networks: with other Chilean scholars, policy makers, and members of NGOs from civil society

X X X X X

DISSEMINATION

Scientific meetings and invited conferences Abstracts submitted for presentation in different formats (oral or poster) in peer review scientific meetings + invited conferences to scientific or other type of dissemination meetings

X X X X X

Technical meetings Besides the meetings and networking associated with policy incidence, members of the team participate in different technical committees and meetings

X X X X X

Media dissemination We have done an important effort in accepting all the interviews to which we have been invited to

X X X X X

VI. PROJECT OUTPUTS I. OUTPUTS

During the project period we have had several outputs related to the evaluation of the Chilean regulation, as publication of scientific articles, book chapters, oral presentations or posters submitted to scientific meetings, invited conferences, media presence, technical meetings/ assistance. Scientific articles Currently we have 17 scientific writing outcomes related to the overall evaluation project. Two have been already published, four are under review and two just submitted (to be probably published in 2018), six that should be submitted before the end of the year, and three that should be submitted early next year. During this year, we have also been able to write and submit important pending articles related to the topic: an update of the regulation (as finally implemented; Corvalan et al, manuscript under 2nd round of peer review); and the process of development of the Chilean warning label (Reyes et al, submitted). Table 5 shows the details of the scientific writing outcomes. Table 5. Scientific articles in different stages of the writing/ publication process

No. Name of the manuscript/article Status

1 Prevalence of child-directed and general audience marketing strategies on the front of beverage packaging: the case of Chile

Mediano et al, 2017; Public Health Nutrition

2 Chile's 2014 sugar-sweetened beverage tax and changes in prices and purchases of sugar-sweetened beverages: An observational study in an urban environment

Caro et al, 2018; PLoS Medicine

3 Structural responses to the obesity and non-communicable diseases epidemic: update on the Chilean Food Labeling and Advertising Law

Corvalan et al, accepted

4 Food Advertising in Chile: Presence, Strategies, Nutritional Quality and Audience Exposure

Correa et al; manuscript under 2nd round of peer review

5 The Prevalence and Audience Reach of Food and Beverage Advertising on Chilean Television According to Marketing Tactics and Nutritional Quality of Products

Carpentier et al; manuscript under peer review

6 Snacking Patterns among Chilean Children and Adolescents: Is There Potential for Improvement?

Jensen et al, manuscript under peer review

7 Sugary beverage intake by Chilean children in context of a sugary beverage tax, marketing controls, and warning label regulations: a cross-sectional analysis from 2016

Essman el at, manuscript submitted

8 Development of the Chilean front-of-package food warning label Reyes et al, manuscript submitted

9 Where are low - middle income Chilean children and adolescents getting their nutrients?

Rebolledo et al, manuscript under late stages of the writing process

10 Non-caloric sweeteners (NCS) intake among preschoolers Venegas et al, manuscript under late stages of the writing process

11 Changes in food marketing on TV and children exposure after the implementation of the regulation

Correa et al, manuscript under late stages of the writing process

12 Changes in food marketing on packages of breakfast cereals after the implementation of the regulation

Mediano et al, manuscript under late stages of the writing process

13 Changes in food attitudes and perceptions, and the use of warning labels as a way to inform healthy food selection

Corvalán et al, manuscript under late stages of the writing process

14 Intake of ultra-processed foods among Chilean preschoolers Araya et al, manuscript under late stages of the writing process

15 Differences in the food intake among children with more exposure to TV than children with less exposure

Tallie-Smith et al, under preparation

16 Adults’ perception on how the food environment has changed after the implementation of the regulation

Correa et al, manuscript under preparation

17 Evaluating New Chilean National Regulations on the Food Supply Lopez et al, manuscript under preparation

Book chapter We have been requested to write a revision on food labelling in Latin America (LA). We have written a chapter reviewing the mandatory front-of-package initiatives of the LA Region: Reyes M & Corvalán C. “South American food labelling: Review and recent development”. In: Dr. Sian Astley (Ed.) Health Claims and Food Labelling. The Royal Society of Chemistry, United Kingdom, 2018 (under editor’s review). Summaries published for oral or poster presentations Preliminary results of our work have been submitted for oral or poster presentations in peer-reviewed scientific meetings. We here list them, independently of the presentation format or whether they have not been presented yet (but are accepted).

Corvalán C, Kanter R, Martinez A, Mediano F, Reyes M. The chilean case: the set of marketing, front of package and tax actions. Archivos Latinoamericanos de Nutrición 2015; 65(Supl. 1). ISSN: 0004-0622. http://www.alanrevista.org/ediciones/2015/suplemento-1/art-150/

Oliva D, Kanter R, Reyes M. Are healthier yogurts more expensive? Evidence form a pilot study in Chile. World Nutrition. Cape Town, Sudáfrica. 30 de agosto al 2 de septiembre de 2016.

Corvalán C y Reyes M. Base line for the evaluation of the Chilean Labelling Law. World Nutrition Knowledge Policy Action, Cape Town, South Africa. 30 de agosto al 2 de septiembre de 2016.

Quintiliano, D; Arroyo, AM; Jara, M; Cornejo, C; Avendaño, R; Pereira, A; Reyes, M. Development

of a new tool for dietary data collection: SER-24h, software for 24-hours recall (poster). IUNS 21st

International Congress of Nutrition, Buenos Aires. October 15–20, 2017. Annals of Nutrition and

Metabolism 2017; 71(Suppl. 2):1123. doi: 10.1159/000480486. ISSN: 0250-6807

Barquera S, Sanchez-Bazan K, Nieto C, Tolentino L, Kroker MF, Corvalán C, Vandevijvere S. The Food Environment Policy Index (Food-EPI), in some Latin American countries: results and process evaluation. IUNS 21st International Congress of Nutrition, Buenos Aires. 15 – 20 de Octubre de 2017. Annals of Nutrition and Metabolism 2017; 71(Suppl. 2):212. doi: 10.1159/000480486. ISSN: 0250-6807

Corvalán C, Reyes M, Correa T, Dillman Carpentier F, Mediano F, Popkin BM, Smith-Tallie L. The Chilean marketing Laws: initial studies. IUNS 21st International Congress of Nutrition, Buenos Aires. 15 – 20 de Octubre de 2017. Annals of Nutrition and Metabolism 2017; 71(Suppl. 2):82. doi: 10.1159/000480486. ISSN: 0250-6807

Corvalán C, Garmendia ML, Pereira A, Uauy R. Critical windows for prevention of obesity and associated conditions: the GOCS and CHIMINO chilean cohorts. IUNS 21st International Congress of Nutrition, Buenos Aires. 15 – 20 de Octubre de 2017. Annals of Nutrition and Metabolism 2017; 71(Suppl. 2):231. doi: 10.1159/000480486. ISSN: 0250-6807

Mujica MF, Navarro-Rosenblatt D, Lopez-Arana AS, Corvalán C. Is inequality affecting the nutritional status of adult Chilean population? Nutritional Status in Adult Chilean population: inequalities in a post-transitional country. IUNS 21st International Congress of Nutrition, Buenos Aires. 15 – 20 de Octubre de 2017. Annals of Nutrition and Metabolism 2017; 71(Suppl. 2):240. doi: 10.1159/000480486. ISSN: 0250-6807

Navarro-Rosenblatt D, Mujica-Coopman MF, Lopez S, Corvalán C. Malnutrition in all its forms and socio-economic status in Chile. IUNS 21st International Congress of Nutrition, Buenos Aires. 15 – 20 de Octubre de 2017. Annals of Nutrition and Metabolism 2017; 71(Suppl. 2):243. doi: 10.1159/000480486. ISSN: 0250-6807

Smith-Tallie L, Corvalán C, Reyes M, Silva A, Caro C, Popkin B. Chile: Impact of the SSB tax. IUNS 21st International Congress of Nutrition, Buenos Aires. 15 – 20 de Octubre de 2017. Annals of Nutrition and Metabolism 2017; 71(Suppl. 2):82. doi: 10.1159/000480486. ISSN: 0250-6807

Reyes M, Corvalán C, Correa T, Dillman F, Mediano F, Popkin B, Smith-Taillie L. The Chilean Experience of FOP Development, Implementation and Impact. IUNS 21st International Congress of Nutrition, Buenos Aires. 15 – 20 de Octubre de 2017. Annals of Nutrition and Metabolism 2017; 71(Suppl. 2):102. doi: 10.1159/000480486. ISSN: 0250-6807

Kanter R, Reyes M, Corvalán C. Implementation of the advertising and labelling law in Chile: early results of impact on food reformulation. IUNS 21st International Congress of Nutrition, Buenos Aires. 15 – 20 de Octubre de 2017. Annals of Nutrition and Metabolism 2017; 71(Suppl. 2):223. doi: 10.1159/000480486. ISSN: 0250-6807

Kanter R, Reyes M, Corvalán C. Potential of monitoring food environments for improving accountability and policy. IUNS 21st International Congress of Nutrition, Buenos Aires. 15 – 20 de Octubre de 2017. Annals of Nutrition and Metabolism 2017; 71(Suppl. 2):231. doi: 10.1159/000480486. ISSN: 0250-6807

Kanter R, Reyes M, Swinburn B, Vandevijvere S, Corvalán C. Changes in the composition of the food supply in anticipation of the implementation of the Chilean Law of Food Labeling and Advertising: an INFORMAS-based approach. IUNS 21st International Congress of Nutrition, Buenos Aires. 15 – 20 de Octubre de 2017. Annals of Nutrition and Metabolism 2017; 71(Suppl. 2):328. doi: 10.1159/000480486. ISSN: 0250-6807

Cediel G, Reyes M, da Costa Louzada ML, Martinez Steele E, Monteiro CA, Corvalán C, Uauy R. Ultra-processed foods and added sugars in the Chilean diet (2010). IUNS 21st International Congress of Nutrition, Buenos Aires. 15 – 20 de Octubre de 2017. Annals of Nutrition and Metabolism 2017; 71(Suppl. 2):1120. doi: 10.1159/000480486. ISSN: 0250-6807

Essman M, Popkin B, Corvalán C, Reyes M, Smith-Taillie L. Baseline sugary beverage intake by Chilean youth in context of marketing controls and warning labels. Obesity Week, Washington, DC. 29 de Octubre al 2 de Noviembre de 2017.

Jensen M, Corvalan C, Reyes M, Popkin B, Sminth-Tallie L. Snacking Patterns among Chilean Children and Adolescents: is there potential for improvement? American Society of Nutrition, Boston. 9-12 Junio de 2018

Venegas C, Reyes M, González CG, Corvalán C. Consumo de edulcorantes en preescolares chilenos y su asociación con antecedentes sociodemográficos, antropométricos y maternos (poster). XVIII Congreso latinoamericano de Nutrición (SLAN), Guadalajara, México. 11 – 15 de noviembre de 2018.

Sánchez MF, Correa T, Dillman F, Smith-Taillie L, Corvalán C, Reyes M. Visita a tiendas de conveniencia como medida de exposición a publicidad en envases de alimentos (poster). XVIII Congreso latinoamericano de Nutrición (SLAN), Guadalajara, México. 11 – 15 de noviembre de 2018.

Cediel G, Corvalán C, Rauber F, Reyes M, Louzada ML. Consumo de alimentos ultraprocesados y de nutrientes claves para enfermedades crónicas en 9 países (Simposio). XVIII Congreso latinoamericano de Nutrición (SLAN), Guadalajara, México. 11 – 15 de noviembre de 2018.

Da Silva F, Ares G, Bortoletto AP, Reyes M. Evidencias y avances en el etiquetado frontal de advertencia en América Latina (Simposio). XVIII Congreso latinoamericano de Nutrición (SLAN), Guadalajara, México. 11 – 15 de noviembre de 2018.

Corvalán C, Reyes M, Tallie-Smith L. Evaluation of the Chilean Law of Food Labelling and Marketing (Simposio). XVIII Congreso latinoamericano de Nutrición (SLAN), Guadalajara, México. 11 – 15 de noviembre de 2018.

Popkin B, Monteiro C, Corvalán C. Prevención de obesidad en Amércia Latina, avances y desafíos (Simposio). XVIII Congreso latinoamericano de Nutrición (SLAN), Guadalajara, México. 11 – 15 de noviembre de 2018.

Bortoletto AP, Corvalán C, Barquera. Reunión INFORMAS. XVIII Congreso latinoamericano de Nutrición (SLAN), Guadalajara, México. 11 – 15 de noviembre de 2018.

Rebolledo N, Reyes M, Corvalán C, Popkin BM, Smith-Taillie L. Where Are Chilean Children and Adolescents Getting Their Food? Dietary Intake by Source and Location. Obesity Week, Nashville, Tennessee. 11 – 15 de noviembre de 2018.

Media diffusion We have given several interviews and helped informing different reports form written and oral press, in Chile and abroad, as listed in Table 6 (and detailed in Annex 1). In the case of local press, this has been especially important when the second implementation phase was about to start. Table 6. Description of local and foreign media diffusion

CHILE Press Resumen.cl, Noticias Universidad de Chile, La Nación, Radio Cooperativa, Publimetro, Cooperativa Noticias, El mostrador, TELE13, Radio Bio Bio, 24 Horas Nacional, Radio ADN 91.7, El Mercurio, La Tercera, La Cuarta, El desconcierto, HoyxHoy, El Mercurio, Alimentación Saludable, Nota La Cuarta.

Radio La Justa Medida, Radio Cooperativa, Programa El Semáforo, Radio Infita, Radio Concierto, Un día perfecto, La prueba ADN, 13c Radio, Radio Futuro, Radio Uchile

TV Noticiero Central 24h, Mega, CNN Chile FOREIGN MEDIA

Press Big Food (Sao Paulo, Brasil), Do Campo a Mesa (Brasilia, Brasil),

Semanario Brecha Uruguay (Uruguay), O joio e o trigo (Río de Janeiro, Brasil), New York Times (USA), Uypress (Uruguay)

Radio ConCriterio (Guatemala) UNI Radio (Uruguay, not public yet)

TV Hoy Nos Toca (Buenos Aires, Argentina) Social network AJ+ Español (México)

Dissemination During the project execution we have been actively involved in presenting the study design and preliminary results on different settings. We have also participated with invited talks in several national and international academic activities:

A. Invited Presentations:

Reyes M. Workshops about food labelling and structural regulations for improving nutrition, Guatemala City, Guatemala, September 2016

Corvalan C. Ministry of Health’s Seminar “Evaluation of the Labelling and Food Marketing Law”, Santiago, Chile, January 2017

Corvalan C. Seminar:"Obesidad un problema país: Evaluación de la Ley sobre Composición Nutricional de los Alimentos y su Publicidad”, Ministry of Health, Chile, January 2017

Reyes M. Nutrition Conference, Sociedad Chilena de Pediatría (one conference) “El problema de los azúcares dietarios en la población infantil”. Santiago, Chile, June 2017

Reyes M. Second Course on Infant Nutrition, Universidad de la Frontera, two conferences: “Rol de los ambientes alimentarios en la dieta de los niños”; “¿Que, como, cuanto deberían comer los niños y los adolescentes?”. Temuco, Chile, August 2017

Reyes M. Workshops about food labelling and structural regulations for improving nutrition, Guatemala City, Guatemala, September 2016 and September 2017

Corvalán C y Reyes M. “Experiencia nacional e internacional de prevención de cáncer por medio de nutrición y alimentación. Informar para escoger mejor: Experiencia de Chile en el etiquetado de alimentos”. Congreso INCA 80 AÑOS: Desafíos y perspectivas para el control de cáncer. 29 y 30 de septiembre de 2017.

Reyes M. Front-of-package labelling seminary, Guatemala City, September 2017

Reyes M. Front-of-Package Labeling Technical Panel, Brasilia, “Modelo de Estudios Chilenos”. Brasil, November 2017.

Reyes M. XII Jornadas de Nutrición Clínica, Obesidad y Metabolismo, “Impacto del etiquetado nacional”. Santiago, Chile. May 2018

Reyes M. El dulzor en la alimentación infantil. XIV Curso de Pediatría Ambulatoria 2018. Viña del Mar, Chile. 16 de junio de 2018.

Chile’s Food Act: Can we regulate our way out of obesity? Session: “Tackling obesity through reformulation. With a global food industry, how much can a single nation state achieve?” Public Health England Annual Conference. Coventry, UK. September, 2018

B. Technical assistance: We have also participated from several technical meetings, in Chile and

abroad: - Local: During Bachelet’s government, we had a good relationship with authorities from Ministry

of Health, which resulted in different minor technical meetings. Besides, we were asked for technical assistance regarding specific items: (i) academic support for the Regional network initiative REALISA (Americas Action Network for Healthy Food Environments), (ii) academic support regarding the agreement between CARICOM, and Chilean Authorities for supporting the development of labelling regulation in the Caribbean countries, and (iii) being member of the expert committee that recommends how to implement a tax for solids foods based on nutritional criteria. Last March Piñera’s government started; we have also been invited by new health authorities to present the results of the new taxation proposal (April 2018) and the preliminary results of the evaluation of the regulation (July 2018). We are also part of the working groups of the local codex committee of Food Labelling and on Nutrition and Foods for Special Dietary Uses

­ Regional or global: o Reyes M. The Chilean regulatory experience. Partnership meeting hosted by Bloomberg

Philanthropies, New York, USA, June 2017. o Corvalán M. Case Study: Chilean marketing and labelling regulations. Obesity prevention

expert meeting, New York, USA, May 2017. o Reyes M. Technical Consultation on Front-of-Package Labeling of Food and Drink

Products, PAHO/WHO meeting in Washington DC. USA, November 2017. o Reyes M. Regional Meeting on Research to Support Front-of-Package (FOPL) Labeling

Regulation, in where we did two presentations: “FOPL systems, Arguments and Counter-

Arguments” and “Measuring the impact of FOPL: from compliance to nutrition outcomes”. Bridgetown, Barbados. May 2018

o Corvalan C. Breakfast prior the World Health Assembly with heath minister from different countries aiming to pass food labelling-related regulations, Geneva, May 2018.

Besides the formal presentations listed above, our team has been contacted by different foreign governments for technical assistance regarding different aspects of the regulation. We have had telephone, online or face-to-face conferences with health authorities, public health/ nutrition scholars and civil society NGOs from different countries.

Health Authorities from Canada, United Kingdom, Caribbean countries, Israel, Peru, Argentina, Singapore, Bolivia, and Mexico.

Scholars from Colombia, Peru, Guatemala, Brazil, Uruguay.

Civil society associations from Colombia (Red Papaz), Mexico (El Poder del Consumidor), United Kingdom (Jamie Oliver Foundation), USA (Resolve), Uruguay (CLAS members), Brazil (IDEC).

Additionally, beside the inclusion of topics related to this project in teaching classes and different academic presentations to scholars, we have held a workshop about healthier food systems, taking advantage of professor Collin Bell’s visit, from Deakin University, Australia. Scholar and students form INTA and other departments from University of Chile, as well as other universities of the country, have participated of the meeting (held at INTA, May 2018). Regarding specifically health authorities and policy makers, besides the meetings with congressmen from the health committee of the senate, we will have a formal presentation of preliminary findings of the evaluation of the regulation, in a meeting that will be done shortly at the Public Studies Center (CEP), a relevant and very influential local think tank (october 2018).

II. CAPACITY BUILDING In order to conduct this study, we have conformed a strong team of work that meets regularly and that includes nutrition epidemiology experts from INTA (Marcela Reyes, Maria Luisa Garmendia and Camila Corvalan), one economist (Juan Carlos Caro), an expert in mass communications (Teresa Correa, U Diego Portales of Chile), an expert in health psychology (Fernanda Mediano), and biochemistry expert in public health nutrition (Rebecca Kanter). We have also aimed to expand our collaboration network with researchers from other cities, in order to be able to implement -at least in part- an expanded monitoring of food the environment. Angela Martínez a dietitian from University of Valparaiso, Mirta Crovetto from Valparaiso, University of Playa Ancha, Valparaiso, and Jacqueline Araneda from University of BioBio, Chillan. In specific topics, we have also interacted with public health (Cristobal Cuadrado, School of Public Health University of Chile), agriculture experts (Sofia Boza, Agricultural Sciences of University of Chile), and economy experts (Guillermo Paraje, Adolfo Ibañéz University). We have also explored new collaborations with young researchers interested in the policy, as Cristobal Otero from Berkley, Grace Melo from Catholic University (collaborative grant submitted). On the other hand, we have established a collaborative relationship with non-governmental organization EPES (popular health education). Besides the international collaborative work done with researchers from Mexico and Guatemala for implementing this project, during this 4 years we have also built/strengthened international collaborations with other groups, including researchers from University of North Carolina (UNC, USA: Prof Barry Popkin expert in economy, Lindsey Tallie-Smith expert nutritional epidemiology, and Francesca Dillman, expert in mass communications), University of La República (Uruguay: Gastón Ares expert in food labelling Gastón Ares), Interamerican Heart Foundation (FIC-Argentina, Lorena Allemandi expert in public health and policy), Peruvian Studies Institute (Peru: Peter Buse expert in mass communication) and

CRONICAS (Peru: Jaime Miranda expert in public health and policy, Javeriana University (Colombia: Mercedes Mora, Luis Fernando Gomez experts on nutrition), El Poder del Consumidor (México: Alejandro Calvillo and Fiorella Espinosa, civil society), Aldo Castañeda Foundation (Guatemala: Joaquin Barnoya and Violeta Chacón, experts in public health), and researchers form different institutions from Brazil (Carlos Monteiro, Ana Clara Durán and Neha Khandpur, experts in nutritional epidemiology from University of Sao Paulo, Ana Paula Bortoletto expert in public health from IDEC, Carla Espindola expert in design from National University of Lujan). Part of the international network has been busted by IDRC-supported meetings, for instance in South Africa (2016 WN meeting), Brazil (Healthier Food Systems in Latin America and Caribbean Seminar Program, Sao Paulo Brazil, June 2017), and Argentina (2018 IUNS meeting). Shortly, we will have and shortly in Mexico (for 2018 SLAN meeting). Similarly, both Expert Committee Meetings hosted by Bloomberg Philanthropies (Mexico City 2017 and NYC 2018 have helped in this purpose). Dr. Corvalán has been invited to present different in most of those meetings. Currently, we are being part of 3 research network initiatives at the regional level. We are working on the submission of a concept note leaded by IDEC team, which would be funded by IDRC: “Development of the field of food systems for NCD prevention in Latin America and the Caribbean”, aimed to establish a regional consortium for studying and influencing policies linked to the field of food system, as front of package labelling, food-based dietary guidelines and fiscal measures. We are also working on building a research network on front of package labelling, which would be supported by PAHO and would assist them as expert advisors on the topic. Finally, we are working in agreeing the best instruments to be used as evaluation tools after implementing a labelling regulation with countries of the region that are advancing in policies associated to warning labels, as Uruguay, Peru and Canadá. This research provides a unique opportunity for student training in areas that are currently underdeveloped in the country. We had 2 master students from INTA´s Master Program on Food and Nutrition, who carried out their thesis work within this project (Carolina Araya and Carolina Venegas, both have already ended, both thesis on preschooler’s diet). A new master student (Camila Rodriguez) is performing statistical analyses, looking at use and understanding of nutrition labels among preschooler’s mothers before the implementation of the regulation. A doctoral student (Carmen Gloria González) is writing her thesis project in the context of this study (dietary patterns according to sweetness among GOCS’ adolescents). In addition, three future scholars are undergoing a doctoral training at UNC: Fernanda Mediano (mass media communication), Juan Carlos Caro (Public policies), and Natalia Rebolledo (Nutritional epidemiology). Finally, as part of an NIH T32 training program, the UNC team has two doctoral students (Mike Essman and Melissa Jenssen) working on dietary data; they have already come to a short visit to INTA in our local winter and are planning to do a longer stay during 2019. VI. PROJECT OUTCOMES As mentioned before, during the last 2,5 years working on this project we have had several concrete outcomes as published articles, students that have ended their training, strengthening of local and regional research networks, dissemination of the preliminary results with health authorities and policy makers at the local and global level, presence in several channels of dissemination as conferences, symposiums, writing and oral press releases. As a result of this, we are confident the team is now considered at the local and regional level as an important actor for informing policies decisions on matters associated with the labeling and marketing regulations, which is an important opportunity to influence policies associated with healthier food environments and diets.

During the process we have had important challenges, related to the lack of local information on diet, food purchases behavior or other important parameters that could have helped us to better plan our data collection and analysis on the changes associated with the regulation. Time and effort related to the collaborative and interdisciplinary work and to the dissemination objective have also been very challenging, but have helped us to better organize our work in a more efficient way, which will help us for future works. Regarding innovations, we were able to finish, strengthen and validate the development of a software for diet data collection (SER-24H) and we have started the development of a software that allows us to better collect photos, enter information and manage the data regarding massive NFP information. Both will speed the data collection process and increase the reliability of the data, increasing our local capacities; they could also be used by other research teams. Main outcomes are to be seen in the following months yet, when the articles on changes after the regulation implementation will be published, the regulation is fully implemented and other countries implement similar policies. VII. OVERALL ASSESSMENT AND RECOMMENDATIONS Evaluating the Chilean regulation on food labelling and food marketing to children was pivotal for informing health and dietary policies at the local, regional and global level. This massive data collection and data processing/analysis work was possible given the experience and data that we had with the previous IDRC funding (#107731-002) which allowed us to implement a monitoring of the food environment, together with this current funding. The evaluation has been also funded by other local (ie, CONICYT) and international (ie, Bloomberg Philanthropies) agencies, which has helped us in maximizing results. Thus, IDRC funding has been key enabling our research team to be able to undergo this important challenge, and allowing the evaluation itself. Moreover, the relevance IDRC provides to policy incidence has probably helped us to understand the need of investing an important amount of time and energy on that issue, which is of course extremely important in this particular case. Overall, this has been our most challenging research project, but in the process, we have increased enormously our research and disseminations skills, becoming during the process in an important research team at the local and regional level. IDRC support has been key for making this happen.

ANNEX 1: TRACKING PROGRAM LEVEL INDICATORS

INSTRUCTIONS: Please provide answers to the questions below based on actual achievements and outcomes. If this is the first time you are completing this questionnaire, please include all achievements since the inception of the project. If you have submitted this questionnaire in the past, please add any new achievements or progress since your last report. In some cases, your responses to these questions may repeat achievements mentioned earlier in the technical report. If this is the case, please extract (copy and paste is acceptable) the information here. Please keep your answers brief, limiting to one to two paragraphs per question. Projects are not expected to document achievements for each of the questions; it is normal that some questions may not apply to your project and remain blank.

This column left blank for internal purposes

Please provide identifying project information below:

Project number: 108180-001 Project title: Evaluating new Chilean National Regulations on the Food Supply Date this report was prepared: September 2018

1a. What innovations is your project testing, assessing or adapting to reduce the burden of chronic or infectious diseases? A definition of an innovation is provided in the footnotes for your reference.1 If your project has been contributing to multiple innovations, please describe them individually. Please describe briefly (limit to 1-2 paragraphs) It does not apply

Ind. #2

Year 1:

0

Year 2

Year 3

Year 4

1b. Of the innovations described in 1a), have any of them been applied at scale? For example, has the innovation been adopted for wide-scale use by a large population, by government, or applied in different contexts, countries, or markets? Explain how this innovation is being applied at scale and what processes have enabled wide-spread use and/or scale-up. Please describe briefly (limit to 1-2 paragraphs)

Ind. #3

1 Innovations can be understood as new and significantly improved ways of doing or organizing something, and include the adaptation of existing products or processes to new contexts. They include: products (a market and/or publically distributed good); processes or practises (a new method, skill or behaviour that creates positive change); programs (organizational arrangements or system of services that meets a need for a defined community). Examples of innovations related to reducing the burden of infectious and chronic diseases could include testing: the use of screens in preventing Dengue and other Aedes mosquito transmitted diseases; the potential of community kitchens to provide healthier meals to low-income populations; applying a new methodology to assess food policies and food environments.

It does not apply

Year 1:

0

Year 2

Year 3

Year 4

1c. Approximately how many individuals are benefiting from the innovation? Please indicate the approximate number of beneficiaries, if this information is known It does not apply

Ind. #3

Year 1:

0

Year 2

Year 3

Year 4

2. Is your project assessing policy effectiveness? If yes, please list and briefly describe what policies the project is assessing, and briefly comment on the relevance and potential impact. Please describe briefly (limit to 1-2 paragraphs) The project is assessing changes after the implementation of a tax increase for SSB and the new Chilean food labelling and marketing Law. The Chilean law is unique given it includes warning labels in prepackaged unhealthy foods, restrictions to child-targeted children, and healthier school food environment. As a pioneer regulation, the impact evaluation is highly relevant both, at the local and global level.

Ind. #4

Year 1:

0

Year 2

Year 3

Year 4

3a. List and describe the key activities/mechanisms your project engaged in to inform/influence practice or policy (e.g. multi-stakeholder and community processes, participation in policy dialogues or policy-setting processes, engagement in making policy recommendations, or other relevant actions). Please describe briefly (limit to 1-2 paragraphs) In order to effectively inform/ influence local and global policies, we have actively worked on setting up meetings with local health authorities, policy makers, and civil society organizations.

Ind. #5

Moreover, we have allocated an important amount of time in accepting every invitation/request for technical support, interviews, disseminations, etc both in Chile and from abroad.

Year 1:

Choose an item.

Year 2

Year 3

Year 4

3b. Have any of the efforts described in 3a) contributed to new practices or policies being implemented or existing policies/practices being changed based partly or wholly on the work of the project? How were strategic stakeholders involved in these processes? Please describe briefly (limit to 1-2 paragraphs) Even if it is still too early to know how influential our activities were/will be, we believe our data have helped our local health authorities to advance in the staggered implementation of our regulation. Our results may have been more influential in other countries that are planning similar policies, as the case of Peru, Uruguay, Brasil, Canada, Israel, among others.

Ind. # 5

Year 1:

0

Year 2

Year 3

Year 4

3c. What was the level of jurisdiction of the policy/policies implemented or changed?

Ind. 5

Identify the policy e.g. regulation of TV food advertising to children in Peru

Select level of jurisdiction 1= local/municipal/district 2= provincial/sub-national 3= national 4= multinational/international

1.

2.

3.

Choose an item.

4a. Did your project intend to specifically benefit women, men, boys or girls or a marginalized group?

Ind. 3

Please place an x in the box corresponding to the target group:

Intended to benefit mostly men/boys

Intended to benefit mostly women/girls

Choose an item.

Intended to equally benefit women/girls and men/boys

Intended to primarily benefit a marginalized group (name of the group): children and their mothers, together with adolescents from low-middle income background

X

No intentional focus on gender or a marginalized group

Not applicable

4b. Did you investigate how sex, gender, age, education, income, ethnicity, social standing, or other social determinants impact the health of your target population? What did you do to address these factors (for example: collecting disaggregated data, conducting gendered analyses, considering differential impacts to women, men, girls, and boys, using participatory research approaches, etc.)? How did these approaches influence the results and impacts (e.g. research, policies, and innovations)? Please describe briefly (limit to 1-2 paragraphs) We perform our analyses considering differences in sex, age, and education level (from participants’ mothers) or disaggregating results by those variables. We are especially interested in studying whether the regulations decrease already existent health status differences by SES or educational level, which should be informed on time to pertinent authorities.

Ind. 6

Year 1:

0

Year 2

Year 3

Year 4

5. Did your project include economic analyses/modeling (e.g. costing, cost-benefit analysis, etc.)? If yes, what was the purpose of including these elements and how are they contributing to achieving your project objectives? Please describe briefly (limit to 1-2 paragraphs) As part of the main evaluation project, we obtained household purchases databases that allowed analyzing changes in SSB purchases after the tax increase; we are planning to use that data set for modelling the impact of a greater tax to solid unhealthy foods.

Ind. #1

Year 1:

0

Year 2

Year 3

Year 4

6. List all peer-reviewed articles that your project has published? Please do not include other types of publications here.

Ind. #11,12

Please list:

Title Journal name Primary author Open access

Choose an item.

(Yes/ No)

1. Chile's 2014 sugar-sweetened beverage tax and changes in prices and purchases of sugar-sweetened beverages: An observational study in an urban environment

PLoS Medicine Caro JC Yes

2. Prevalence of child-directed and general audience marketing strategies on the front of beverage packaging: the case of Chile

Public Health Nutrition Mediano F No

3.

4.

5.

6.

7. Have individuals involved in your project accomplished one of the following achievements listed below, due in part to their involvement in this project? Is yes, please list the name and sex of the individual and describe the accomplishment. Indicate if any of these individuals are Canadian placing an ‘x’ in the box labelled ‘CAD’. a) received awards and other honours; b) influenced or advised policies; c) expanded the adoption of effective practices, including in new settings/populations; d) other significant achievements

Ind. #10 a, 10b, 10c

Please list:

Name Female/ Male

CAD Brief description of accomplishment

1.

2.

3.

4.

5.

6.

0

8. Has your project supported any Masters students, PhD students, or post-doctoral fellows? If yes, please list the name, sex, and nationality of the individuals, and their status as Master’s students, PhD students or post-docs. Indicate if any of these individuals are Canadian by placing an ‘x’ in the box labelled ‘CAD’.

Ind. #8,9

Please list:

Name Female/ Male

CAD Master/PhD/Post-doc

1. Carolina Venegas (Chile) female Master

2. Carolina Araya (Chile) female Master

3. Camila Rodríguez (Chile) female Master

4. Carmen Gloria González (Chile) female PhD

5. Fernanda Mediano (Chile) female PhD

0

6. J Natalia Rebolledo (Chile) female PhD

7. J Juan Carlos Caro (Chile) male PhD

9. Has your project or its findings been cited in the media? Please provide the title of the media citation and an accompanying web-links for the most relevant citations linked to important achievements of the project.

Please list:

Title Website link

1. A un año de la implementación de la Ley de etiquetado

http://www.uchile.cl/noticias/134534/a-un-ano-de-la-ley-de-etiquetado-su-aplicacion-y-evidencia

2. IUNS interview (recorded in Buenos Aires Argentina) http://outraspalavras.net/

3. Os rótulos estão gritando a mensagem errada

https://www.youtube.com/watch?v=bLVMocEcsU0

4. La queja de los fabricantes de gordos (artículo por pagar)

https://brecha.com.uy/la-queja-los-fabricantes-gordos/

5. El 95% ciento de las madres están de acuerdo con que se indique qué alimentos no son saludables

http://lanacion.cl/2017/06/28/el-95-ciento-de-las-madres-estan-de-acuerdo-con-que-se-indique-que-alimentos-no-son-saludables/

6. ¿Ha funcionado la Ley de Etiquetado? (título del audio en la página).

http://www.cooperativa.cl/noticias/pais/salud/la-justa-medida-ha-funcionado-la-ley-de-etiquetado-/2017-10-01/094212.html

7. "Segunda etapa de la Ley de Etiquetado llama a modificar los niveles de nutrientes de los alimentos"

http://www.cnnchile.com/noticia/2017/12/12/segunda-etapa-de-la-ley-de-etiquetado-llama-modificar-los-niveles-de-nutrientes

8. How Latin America became the terror of Big Food

http://outraspalavras.net/ojoioeotrigo/2018/01/how-latin-america-became-the-terror-of-big-food/

9. In Sweeping War on Obesity, Chile Slays Tony the Tiger

https://www.nytimes.com/2018/02/07/health/obesity-chile-sugar-regulations.html

10.

Obesidad mórbida en escolares

https://www.cooperativa.cl/noticias/pais/salud/experta-obesidad-morbida-en-escolares-es-una-mala-novedad-y-con/2018-03-08/102426.html

11. In Nafta Talks, U.S. Tries to Limit Junk Food Warning Labels

https://www.nytimes.com/2018/03/20/world/americas/nafta-food-labels-obesity.html

12. Las vienesas costarían $10 mil y la mayonesa $4 mil: expertos chilenos proponen subir impuestos a alimentos ricos en grasa, azúcar y sodio

https://www.publimetro.cl/cl/noticias/2018/04/04/las-vienesas-costarian-10-mil-la-mayonesa-4-mil-expertos-chilenos-proponen-subir-impuestos-alimentos-ricos-grasa-azucar-sodio.html

13. Proponen subir impuestos a la "comida chatarra" para combatir la obesidad en Chile

https://www.cooperativa.cl/noticias/pais/salud/alimentos/proponen-subir-impuestos-a-la-comida-chatarra-para-combatir-la/2018-04-05/160538.html

0

14. Académicos chilenos proponen aumentar precio de la comida chatarra para combatir altos índices de obesidad

http://www.elmostrador.cl/noticias/pais/2018/04/05/academicos-chilenos-proponen-aumentar-precio-de-la-comida-chatarra-para-combatir-altos-indices-de-obesidad/

15. Académicos chilenos proponen subir impuesto a alimentos altos en grasa, sodio y azúcar

http://www.t13.cl/noticia/nacional/academicos-chilenos-proponen-subir-impuesto-alimentos-altos-grasa-sodio-y-azucar

16. El kilo de vienesa a $10 mil: proponen impuesto a alimentos ricos en grasa, sodio y azúcar

https://www.biobiochile.cl/noticias/nacional/chile/2018/04/05/el-kilo-de-vienesa-a-10-mil-proponen-impuesto-a-alimentos-ricos-en-grasa-sodio-y-azucar.shtml

17. Académicos apuestan por subir impuesto a alimentos ricos en grasa, sodio y azúcar

http://www.uchile.cl/noticias/142235/academicos-apuestan-por-subir-impuesto-a-nutrientes-daninos

18. Proponen aumentar impuestos a la comida no saludable

http://www.24horas.cl/nacional/proponen-aumentar-impuestos-a-la-comida-no-saludable-2681614#

19. Científicos chilenos proponen subir impuestos a alimentos ricos en grasa, sodio y azúcar

http://www.adnradio.cl/noticias/nacional/cientificos-chilenos-proponen-subir-impuestos-a-alimentos-ricos-en-grasa-sodio-y-azucar/20180404/nota/3732460.aspx

20. Segunda fase de la implementación de la Ley: la norma se renueva este 27 de junio de 2018

http://www.uchile.cl/noticias/144318/cambio-a-los-sellos-de-los-alimentos-la-norma-se-renueva

21. 7 claves que debes saber de la ley de etiquetado

http://www.uchile.cl/noticias/144625/las-7-claves-que-debes-saber-de-la-ley-del-etiquetado

22. "La Implementación y recepción de esta Ley por parte de la población han sido exitosas"

http://impresa.elmercurio.com//pages/NewsDetail.aspx?PaginaID=1&dt=26-06-2018%200:00:00&BodyID=17&SupplementID=32

23. "Segunda fase de Ley de Etiquetados alzaría en 10% productos con rótulos"

http://www.latercera.com/nacional/noticia/segunda-fase-ley-etiquetados-alzaria-10-productos-rotulos/220402/

24. El aniversario de la Ley de Etiquetado se celebra con más alimentos con sellos negros

https://www.publimetro.cl/cl/noticias/2018/06/25/el-aniversario-de-la-ley-de-etiquetado-se-celebra-con-mas-alimentos-con-sellos-negros.html

25. "Estos son los nuevos cambios de la Ley de Etiquetados"

http://www.lacuarta.com/noticia/cambios-ley-etiquetados/

26. "Ahora con estándares mas duros: las 7 claves de la Ley de Etiquetado que cumple 2 años"

http://www.eldesconcierto.cl/2018/06/27/ahora-con-estandares-mas-duros-las-7-claves-de-la-ley-de-etiquetado-que-cumple-2-anos/

27. "Sepa en que consiste la segunda fase de la Ley de Etiquetado"

http://www.hoyxhoy.cl/2018/06/28/full/cuerpo-principal/11/

28. "Los sellos de advertencia aseguran el acceso a información clara y visible

http://impresa.elmercurio.com/Pages/NewsDetail.aspx?dt=2018-07-10&dtB=10-07-

respecto de la composición de los alimentos".

2018%200:00:00&PaginaId=2&SupplementId=22&bodyid=17

29. "Consumo de endulzantes producto de la restricción / la campaña que busca disminuir el consumo de azúcar entre los chilenos"

30. Cuando la obesidad no es solo un problema sanitario, la información es un derecho ciudadano http://www.uypress.net/auc.aspx?88819

31. Ley Chilena de Alimentos

http://emisorasguatemala.com/radio-infinita-1001-fm

32.

Obesidad mórbida en escolares: opciones naturales no costosas

http://www.cooperativa.cl/noticias/pais/salud/alimentos/camila-corvalan-sobre-obesidad-infantil-hay-opciones-naturales-que-no/2018-03-08/090300.html

33. Investigadores U.de Chile proponen alza de impuestos a alimentos no saludables

http://radio.uchile.cl/2018/04/04/investigadores-de-la-u-de-chile-proponen-aumentar-impuestos-a-alimentos-no-saludables/

34. Audio: Ley de etiquetado de alimentos: 27 de junio aumentan las exigencias

https://www.concierto.cl/2018/06/ley-de-etiquetado-de-alimentos-el-27-de-junio-aumentan-las-exigencias/

35. "Los límites en los alimentos se ponen un poco más estrictos (...) para los alimentos que antes no tenían sellos, ahora lo tendrán".

http://www.pauta.cl/programas/un-dia-perfecto/un-dia-perfecto-27-de-junio

36.

"La Ley se implementó de buena forma"

http://www.adnradio.cl/noticias/nacional/academica-sobre-ley-de-etiquetado-de-alimentos-la-ley-se-implemento-de-buena-forma/20180628/nota/3768178.aspx

37.

No tenemos nada para alertar sobre los endulzantes

https://www.futuro.cl/2018/06/marcela-reyes-doctora-en-nutricion-y-academica-del-inta-de-la-universidad-de-chile-no-tenemos-nada-para-alertar-sobre-los-endulzantes/

38.

Las etiquetas que informan...

https://www.facebook.com/ajplusespanol/videos/1932971416755198/

39. Académica del INTA por Ley de Etiquetados: “Es necesario que se comiencen a cambiar los hábitos alimenticios”

https://www.cnnchile.com/pais/academica-del-inta-por-ley-de-etiquetados-es-necesario-que-la-gente-comience-a-cambiar-los-habitos-alimenticios_20180627/

ANNEX 2: SOCIODEMOGRAPHIC QUESTIONNAIRE ANNEX 3: MEDIA EXPOSURE QUESTIONNAIRE / FOOD ATTITUDES, KNOWLEDGE AND FOOD PERCEPTIONS QUESTIONNAIRE

25-09-2018 12:44 www.projectredcap.org

ConfidentialPROYECTO FECHIC FINAL

Page 1 of 5

Socioeconomico

Folio __________________________________

Formulario socio Se hizoNo se hizoRechazaPendiente

Porque? __________________________________

Numero de habitantes del hogar (incluyendo a __________________________________[evaluacion_1_arm_1][nombre_child])

Cuantos de los integrantes mencionados son menores de __________________________________18 anos (incluyendo a[evaluacion_1_arm_1][nombre_child])

Cuantos de los integrantes mencionados son menores de __________________________________15 anos (incluyendo a[evaluacion_1_arm_1][nombre_child])

Cuantos de los integrantes mencionados son menores de __________________________________12 anos (incluyendo a[evaluacion_1_arm_1][nombre_child])

[evaluacion_1_arm_1][nombre_child] comparte pieza con Siotro nino menor de 18 anos No

Con cuantos ninos menores de 18 anos comparte pieza 12345mas de 5

Edad del nino 1 con quien comparte pieza __________________________________

Edad del nino 2 con quien comparte pieza __________________________________

Edad del nino 3 con quien comparte pieza __________________________________

Edad del nino 4 con quien comparte pieza __________________________________

Edad del nino 5 con quien comparte pieza __________________________________

Edad del nino 6 con quien comparte pieza __________________________________

Edad del nino 7 con quien comparte pieza __________________________________

Edad del nino 8 con quien comparte pieza __________________________________

Edad del nino 9 con quien comparte pieza __________________________________

Edad del nino 10 con quien comparte pieza __________________________________

[evaluacion_1_arm_1][nombre_child] se atiende en Siconsultorio? No

En que consultorio? __________________________________(solicitar y tomar foto del carne del nino si aplica)

25-09-2018 12:44 www.projectredcap.org

ConfidentialPage 2 of 5

Comuna del Consultorio CERRILLOSCERRO NAVIACONCHALIEL BOSQUEESTACION CENTRALHUECHURABAINDEPENDENCIALA CISTERNALA FLORIDADLA GRANJALA PINTANALA REINALAS CONDESLO BARNECHEALO ESPEJOLO PRADOMACULMAIPUNUNOAPADRE HURTADOPEDRO AGUIRRE CERDAPENALOLENPIRQUEPROVIDENCIAPUDAHUELPUENTE ALTOQUILICURAQUINTA NORMALRECOLETARENCASAN BERNARDOSAN JOAQUINSAN JOSE DE MAIPOSAN MIGUELSAN RAMONSANTIAGOVITACURAREGIONES

El padre de [evaluacion_1_arm_1][nombre_child] vive Noen el hogar? Si

Por periodos

Quien es el jefe de hogar? (La persona que aporta mas Madre del ninoal hogar) Pareja de la madre ( sea o no el padre biologico

del nino)Abuela/o del ninoTio/a del ninoHermano/a del ninos ( sea o no biologicamente)Otros familiares o no familiares

Nivel de escolaridad del jefe de hogar (La persona Sin estudiosque aporta mas al hogar) Pre-Escolar

Basica incompletaBasica completaMedia incompletaMedia completaInstituto profesional incompletoInstituto profesional completoUniversitaria incompletaUniversitaria completaPostgradoEducacion Especial

25-09-2018 12:44 www.projectredcap.org

ConfidentialPage 3 of 5

Ocupacion del Jefe del hogar (no dar las Trabajos menores ocasionales e informales (lavado,alternativas, clasificar la ocupacion segun lo que aseo, servicio domestico ocasional, otros)le respondan). Oficio menor, obrero no calificado, jornalero,

servicio domestico con contratoObrero calificado, capataz, micro empresario(kiosco, taxi, comercio menor, ambulante).Empleado administrativo, vendedor, secretaria,jefe de seccion. Tecnico especializado.Profesional independiente de carreras tecnicas(contador, analista de sistemas, disenador,musico). Profesor Primario o SecundarioEjecutivo medio (gerente, sub-gerente), gerentegeneral de empresa media o pequena. Profesionalindependiente de carreras tradicionales (abogado,medico, arquitecto, ingeniero, agronomo)Alto ejecutivo (gerente general) de empresagrande. Directores de grandes empresas.Empresarios propietarios de empresas medianas ygrandes. Profesionales independientes de granprestigio.No trabaja pero recibe pension/jubilacionNo trabaja actualmente

Preguntas sobre la madre del nino

Estado civil de la madre de Casada[evaluacion_1_arm_1][nombre_child] Conviviente

SolteraViudaSeparada/Divorciada

Nivel de escolaridad de la madre de Sin estudios[evaluacion_1_arm_1][nombre_child] Pre-Escolar

Basica incompletaBasica completaMedia incompletaMedia completaInstituto profesional incompletoInstituto profesional completoUniversitaria incompletaUniversitaria completaPostgradoEducacion Especial

Edad de la madre de __________________________________[evaluacion_1_arm_1][nombre_child]

La madre de [evaluacion_1_arm_1][nombre_child]trabaja fuera de hogar

No Si Por periodos

25-09-2018 12:44 www.projectredcap.org

ConfidentialPage 4 of 5

Ocupacion de la madre (no dar las alternativas, Trabajos menores ocasionales e informales (lavado,clasificar la ocupacion segun lo que le respondan) aseo, servicio domestico ocasional, otros)

Oficio menor, obrero no calificado, jornalero,servicio domestico con contrato.Obrero calificado, capataz, micro empresario(kiosco, taxi, comercio menor, ambulante)Empleado administrativo, vendedor, secretaria,jefe de seccion. Tecnico especializado.Profesional independiente de carreras tecnicas(contador, analista de sistemas, disenador,musico). Profesor Primario o SecundarioEjecutivo medio (gerente, sub-gerente), gerentegeneral de empresa media o pequena. Profesionalindependiente de carreras tradicionales (abogado,medico, arquitecto, ingeniero, agronomo)Alto ejecutivo (gerente general) de empresagrande. Directores de grandes empresas.Empresarios propietarios de empresas medianas ygrandes. Profesionales independientes de granprestigio.Duena de casa/ no recibe remuneracionNo trabaja

Cuantos dias a la semana?

Lunes Martes Miercoles Jueves Viernes Sabado DomingoPor turnos

En que jornadas trabaja el dia lunes Jornada completaMedia jornadaJornada Parcial (algunas horas)

En que jornadas trabaja el dia martes Jornada completaMedia jornadaJornada Parcial (algunas horas)

En que jornadas trabaja el dia miercoles Jornada completaMedia jornadaJornada Parcial (algunas horas)

En que jornadas trabaja el dia jueves Jornada completaMedia jornadaJornada Parcial (algunas horas)

En que jornadas trabaja el dia viernes Jornada completaMedia jornadaJornada Parcial (algunas horas)

En que jornadas trabaja el dia sabado Jornada completaMedia jornadaJornada Parcial (algunas horas)

En que jornadas trabaja el dia domingo Jornada completaMedia jornadaJornada Parcial (algunas horas)

Quien cuida a [evaluacion_1_arm_1][nombre_child] __________________________________durante ese rato en que esta trabajando?

La casa en la que habita es propia Si No

Paga arriendo Si No

25-09-2018 12:44 www.projectredcap.org

ConfidentialPage 5 of 5

Tiene automovil de uso particular Si No

Observaciones sociodemografico __________________________________________

26-09-2018 16:26 www.projectredcap.org

ConfidentialPROYECTO FECHIC FINAL

Page 1 of 24

Exposicion

Folio __________________________________

Exposicion Se hizoNo se hizoRechazaPendiente

Porque? __________________________________

A continuacion voy a realizarle una encuesta que tiene por objetivo:1.Conocer que tan expuesto esta su hijo/a a la publicidad de los alimentos en distintos medios(internet, TV, alimentos presentes en supermercados y/o almacen de barrio)2. Conocer su opinion frente a cierto grupo de alimentos

La encuesta se divida en varias secciones: TV, internet y alimentos. Nosotros queremos saberlo que ocurre la mayoria de las veces, es decir lo que es habitual o parte de la rutina de suhijo/a.

Utilizaremos cartillas que le ayudaran a responder las preguntas

1 Cuantos televisores hay en su hogar? __________________________________

2 Hay alguno de estos televisores a los que No[evaluacion_1_arm_1][nombre_child] no tiene acceso Si(por ejemplo uno que este en una habitacion en la No sabe/no respondeque [evaluacion_1_arm_1][nombre_child] no puedeentrar)?

Para responder todas las preguntas que siguen, piense solo en los televisores a los que[evaluacion_1_arm_1][nombre_child] si tiene acceso, y en los horarios en que [evaluacion_1_arm_1][nombre_child]puede verlos (que no esta durmiendo ni en el colegio).

3 Cual de las siguientes alternativas representa El televisor se prende menos de 1 vez a la semanamejor lo que sucede en su casa con el/los El/ los televisor(es) se prende(n) solo para vertelevisor(es)? (Mostrar Cartilla No.1) algun/algunos programa(s) especifico(s)

Hay momentos del dia en que a lo menos uno de lostelevisores esta prendido, aun cuando no hay nadiemirando un programa especificoNo sabe/no responde

4 Cuantos dias a la semana? menos de un dia a la semana1 dia2 dias3 dias4 dias5 dias6 dias7 diasNo sabe/no responde

5 Cuantas horas en total en el dia esta encendida la __________________________________tv?

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 2 of 24

6 Cual de las siguientes alternativas representa [evaluacion_1_arm_1][nombre_child] esta poniendomejor la conducta habitual de atencion al televisor (aun cuando pueda estar[evaluacion_1_arm_1][nombre_child] cuando el/los jugando tambien a otra cosa)televisor(es) esta(n) prendido(s)? (Mostrar Cartilla A pesar que el/los televisor(es) esta(n)No.2) prendido(s), no esta poniendo atencion (por

ejemplo estas haciendo otra cosa en la misma piezau en otra parte de la casa/ jardin)A veces, [evaluacion_1_arm_1][nombre_child] estaatento(a) al televisor, otras veces esta haciendootras cosasNo sabe/ no responde

Ahora le haremos preguntas acerca de los dias de semana habituales de[evaluacion_1_arm_1][nombre_child] (lo que pasa mas de la mitad de los dias de semana), noacerca de los fines de semana.

7 A que hora se despierta __________________________________[evaluacion_1_arm_1][nombre_child]?

8 A que hora sale [evaluacion_1_arm_1][nombre_child] __________________________________de la casa al colegio/jardin?

diferencia ex7 ex8 __________________________________

LA HORA DE SALIDA DE LA CASA NO PUEDE SER MENOR A LA HORA EN QUE SE DESPIERTA, POR FAVOR VERIFICAR

9 En ese periodo entre que se despierta y se va al Nocolegio/ jardin, habitualmente Si[evaluacion_1_arm_1][nombre_child] mira No sabe/no respondedirigidamente algun programa de television?

10 Por cuantas horas? Menos de una horaEntre una y dos horasMas de dos horasNo sabe/no responde

11 En que canal(es)? Canales de la lista(Mostrar cartilla No.3 "Canales", escoger hasta 5) Otros canales no mencionados en la lista

ZappingNo sabe/ no responde

12 Cuantos canales de la lista estan encendidos __________________________________

13 canal 1 __________________________________

14 canal 2 __________________________________

15 canal 3 __________________________________

16 canal 4 __________________________________

17 canal 5 __________________________________

18 En cuantos canales que no estan en la lista __________________________________

19 Otro canal 1 __________________________________

20 Otro canal 2 __________________________________

21 Otro canal 3 __________________________________

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 3 of 24

22 Otro canal 4 __________________________________

23 Otro canal 5 __________________________________

24 Piense en ese mismo horario, hay algun televisor Noprendido al que tenga acceso Si[evaluacion_1_arm_1][nombre_child] y no lo vea No sabe/no respondedirigidamente?

25 Piense en todos esos televisores que pueden estar Canales de la listaprendidos, en que canal(es) estan habitualmente? Otros canales no mencionados en la lista(Mostrar cartilla No.3 "Canales", escoger hasta 5) Zapping

No sabe/ no responde

26 Cuantos canales de la lista estan encendidos __________________________________

27 canal 1 __________________________________

28 canal 2 __________________________________

29 canal 3 __________________________________

30 canal 4 __________________________________

31 canal 5 __________________________________

32 En cuantos canales que no estan en la lista __________________________________

33 Otro canal 1 __________________________________

34 Otro canal 2 __________________________________

35 Otro canal 3 __________________________________

36 Otro canal 4 __________________________________

37 Otro canal 5 __________________________________

38 A que hora [evaluacion_1_arm_1][nombre_child] __________________________________regresa del colegio/jardin?

39 A que hora [evaluacion_1_arm_1][nombre_child] se __________________________________duerme?

diferencia ex38 ex39 __________________________________

LA HORA DE VUELTA DE CLASES NO PUEDE SER MENOR A LA HORA EN QUE SE DUERME, POR FAVOR VERIFICAR

40 En el periodo entre que llega del colegio/jardin y Nolas 10 de la noche, habitualmente Si[evaluacion_1_arm_1][nombre_child] mira No sabe/no respondedirigidamente algun programa de television (ya seaen su casa o en otro lado)?

41 Por cuantas horas? Menos de una horaEntre una y dos horasMas de dos horasNo sabe/no responde

42 Que canales estan encendidos (Mostrar cartilla Canales de la listaNo.3 "Canales", escoger hasta 5) Otros canales no mencionados en la lista

ZappingNo sabe/ no responde

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 4 of 24

43 Cuantos canales de la lista estan encendidos __________________________________

44 canal 1 __________________________________

45 canal 2 __________________________________

46 canal 3 __________________________________

47 canal 4 __________________________________

48 canal 5 __________________________________

49 En cuantos canales que no estan en la lista __________________________________

50 Otro canal 1 __________________________________

51 Otro canal 2 __________________________________

52 Otro canal 3 __________________________________

53 Otro canal 4 __________________________________

54 Otro canal 5 __________________________________

55 Piense en ese mismo horario, hay algun televisor Noprendido al que tenga acceso Si[evaluacion_1_arm_1][nombre_child] y no lo vea No sabe/ no respondedirigidamente?

56 Piense en todos esos televisores que pueden estar Canales de la listaprendidos, en que canal(es) estan habitualmente? Otros canales no mencionados en la lista(mostrar cartilla No.3, escoger hasta 5) Zapping

No sabe/ no responde

57 Cuantos canales de la lista estan encendidos __________________________________

58 canal 1 __________________________________

59 canal 2 __________________________________

60 canal 3 __________________________________

61 canal 4 __________________________________

62 canal 5 __________________________________

63 En cuantos canales que no estan en la lista __________________________________

64 Otro canal 1 __________________________________

65 Otro canal 2 __________________________________

66 Otro canal 3 __________________________________

67 Otro canal 4 __________________________________

68 Otro canal 5 __________________________________

69 Seguimos en los dias de semana habitual, despues Node las 10 de la noche (si esque aun no esta Sidurmiendo), habitualmente No responde, nino durmierdo[evaluacion_1_arm_1][nombre_child] mira no sabe/ no respondedirigidamente algun programa de television (ya seaen su casa o en otro lado)?

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 5 of 24

70 Por cuantas horas? Menos de una horaEntre una y dos horasMas de dos horasNo sabe/no responde

71 En que canales? (Mostrar cartilla No.3 "Canales", Canales de la listaescoger hasta 5) Otros canales no mencionados en la lista

ZappingNo sabe/ no responde

72 Cuantos canales de la lista estan encendidos __________________________________

73 canal 1 __________________________________

74 canal 2 __________________________________

75 canal 3 __________________________________

76 canal 4 __________________________________

77 canal 5 __________________________________

78 En cuantos canales que no estan en la lista __________________________________

79 Otro canal 1 __________________________________

80 Otro canal 2 __________________________________

81 Otro canal 3 __________________________________

82 Otro canal 4 __________________________________

83 Otro canal 5 __________________________________

84 Piense en ese mismo horario, hay algun televisor Noprendido al que tenga acceso Si[evaluacion_1_arm_1][nombre_child] y no lo vea No responde, nino durmierdodirigidamente? No sabe/ no responde

85 Piense en todos esos televisores que pueden estar Canales de la listaprendidos, en que canal(es) estan habitualmente? Otros canales no mencionados en la lista(Mostrar cartilla No.3 "Canales", escoger hasta 5) Zapping

No sabe/ no responde

86 Cuantos canales de la lista estan encendidos __________________________________

87 canal 1 __________________________________

88 canal 2 __________________________________

89 canal 3 __________________________________

90 canal 4 __________________________________

91 canal 5 __________________________________

92 En cuantos canales que no estan en la lista __________________________________

93 Otro canal 1 __________________________________

94 Otro canal 2 __________________________________

95 Otro canal 3 __________________________________

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 6 of 24

96 Otro canal 4 __________________________________

97 Otro canal 5 __________________________________

Ahora piense en los dias de fines de semana habituales (mas de la mitad de los dias de finesde semana de un mes)

98 [evaluacion_1_arm_1][nombre_child] mira Nodirigidamente algun programa de television (ya sea Sien su casa o en otro lado) antes de medio dia? No sabe / no responde

99 Por cuantas horas? Menos de una horaEntre una y dos horasMas de dos horasNo sabe/no responde

100 Que canales estan encendidos (Mostrar cartilla Canales de la listaNo.3 "Canales", escoger hasta 5) Otros canales no mencionados en la lista

ZappingNo sabe/ no responde

101 Cuantos canales de la lista estan encendidos __________________________________

102 canal 1 __________________________________

103 canal 2 __________________________________

104 canal 3 __________________________________

105 canal 4 __________________________________

106 canal 5 __________________________________

107 En cuantos canales que no estan en la lista __________________________________

108 Otro canal 1 __________________________________

109 Otro canal 2 __________________________________

110 Otro canal 3 __________________________________

111 Otro canal 4 __________________________________

112 Otro canal 5 __________________________________

113 Piense en ese mismo horario, hay algun televisor Noprendido al que tenga acceso Si[evaluacion_1_arm_1][nombre_child] y no lo vea No sabe / no respondedirigidamente?

114 Piense en todos esos televisores que pueden estar Canales de la listaprendidos, en que canal(es) estan habitualmente? Otros canales no mencionados en la lista(Mostrar cartilla No.3 "Canales", escoger hasta 5) Zapping

No sabe/ no responde

115 Cuantos canales de la lista estan encendidos __________________________________

116 canal 1 __________________________________

117 canal 2 __________________________________

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 7 of 24

118 canal 3 __________________________________

119 canal 4 __________________________________

120 canal 5 __________________________________

121 En cuantos canales que no estan en la lista __________________________________

122 Otro canal 1 __________________________________

123 Otro canal 2 __________________________________

124 Otro canal 3 __________________________________

125 Otro canal 4 __________________________________

126 Otro canal 5 __________________________________

127 Ahora piense en los fines de semana, entre medio Nodia y las 10 de la noche, Si[evaluacion_1_arm_1][nombre_child] mira No sabe / no respondedirigidamente algun programa de television (ya seaen su casa o en otro lado)?

128 Por cuantas horas? Menos de una horaEntre una y dos horasMas de dos horasNo sabe/no responde

129 En que canal(es)? Canales de la lista(Mostrar cartilla No.3 "Canales", escoger hasta 5) Otros canales no mencionados en la lista

ZappingNo sabe/ no responde

130 Cuantos canales de la lista estan encendidos __________________________________

131 canal 1 __________________________________

132 canal 2 __________________________________

133 canal 3 __________________________________

134 canal 4 __________________________________

135 canal 5 __________________________________

136 En cuantos canales que no estan en la lista __________________________________

137 Otro canal 1 __________________________________

138 Otro canal 2 __________________________________

139 Otro canal 3 __________________________________

140 Otro canal 4 __________________________________

141 Otro canal 5 __________________________________

142 Piense en ese mismo horario, hay algun televisor Noprendido al que tenga acceso Si[evaluacion_1_arm_1][nombre_child] y no lo vea No sabe / no respondedirigidamente?

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 8 of 24

143 Piense en todos esos televisores que pueden estar Canales de la listaprendidos, en que canal(es) estan habitualmente? Otros canales no mencionados en la lista(Mostrar cartilla No.3 "Canales", escoger hasta 5) Zapping

No sabe/ no responde

144 Cuantos canales de la lista estan encendidos __________________________________

145 canal 1 __________________________________

146 canal 2 __________________________________

147 canal 3 __________________________________

148 canal 4 __________________________________

149 canal 5 __________________________________

150 En cuantos canales que no estan en la lista __________________________________

151 Otro canal 1 __________________________________

152 Otro canal 2 __________________________________

153 Otro canal 3 __________________________________

154 Otro canal 4 __________________________________

155 Otro canal 5 __________________________________

156 Ahora piense en los fines de semana, despues de Nolas 10 de la noche, Si[evaluacion_1_arm_1][nombre_child] mira No responde, nino durmierdodirigidamente algun programa de television (ya sea No sabe / no respondeen su casa o en otro lado, si es que no estadurmiendo)?

157 Por cuantas horas? Menos de una horaEntre una y dos horasMas de dos horasNo sabe/no responde

158 En que canales? (Mostrar cartilla No.3 "Canales", Canales de la listaescoger hasta 5) Otros canales no mencionados en la lista

ZappingNo sabe/ no responde

159 Cuantos canales de la lista estan encendidos __________________________________

160 canal 1 __________________________________

161 canal 2 __________________________________

162 canal 3 __________________________________

163 canal 4 __________________________________

164 canal 5 __________________________________

165 En cuantos canales que no estan en la lista __________________________________

166 Otro canal 1 __________________________________

167 Otro canal 2 __________________________________

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 9 of 24

168 Otro canal 3 __________________________________

169 Otro canal 4 __________________________________

170 Otro canal 5 __________________________________

171 Piense en ese mismo horario, hay algun televisor Noprendido al que tenga acceso Si[evaluacion_1_arm_1][nombre_child] y no lo vea No responde, nino durmierdodirigidamente? No sabe / no responde

172 Piense en todos esos televisores que pueden estar Canales de la listaprendidos, en que canal(es) estan habitualmente? Otros canales no mencionados en la lista(Mostrar cartilla No.3 "Canales", escoger hasta 5) Zapping

No sabe/ no responde

173 Cuantos canales de la lista estan encendidos __________________________________

174 canal 1 __________________________________

175 canal 2 __________________________________

176 canal 3 __________________________________

177 canal 4 __________________________________

178 canal 5 __________________________________

179 En cuantos canales que no estan en la lista __________________________________

180 Otro canal 1 __________________________________

181 Otro canal 2 __________________________________

182 Otro canal 3 __________________________________

183 Otro canal 4 __________________________________

184 Otro canal 5 __________________________________

Ahora le vamos a hacer algunas preguntas sobre internet

185 [evaluacion_1_arm_1][nombre_child] se mete Noregularmente (por lo menos una vez a la semana) a Siinternet (ya sea en la casa o fuera de la casa)? No sabe/no responde

186 Tiene internet en la casa? NoSiNo sabe/no responde

En cual de los siguientes aparatos se conecta Telefono[evaluacion_1_arm_1][nombre_child] a internet? Tablet

Notebook o netbookComputador fijoSmart TV,Play StationOtros (cual)

Cual? __________________________________

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 10 of 24

187 Con que frecuencia Lo usa todos los dias o casi todos los dias (al[evaluacion_1_arm_1][nombre_child] usa internet? menos 6 dias a la semana)(Mostrar Cartilla No.4) Lo usa entre 3 y 5 dias a la semana

Lo usa 2 dias o menos a la semana, por ejemplosolo los fines de semanaNo sabe/no responde

188 Por cuanto tiempo en promedio esta Menos de dos horas[evaluacion_1_arm_1][nombre_child] en internet los 2 horas o masdias que lo usa? (aqui considerar tambien el tiempo No sabe/no respondeque estime el nino que chatea por whatsapp o queescucha musica en spotify sin que este sea Premium,si es que usa estas aplicaciones)

En un dia de semana habitual, piense en todos los < de 2 horasaparatos en que se conecta a internet. de 2 a < 4 horasCuanto tiempo pasa [evaluacion_1_arm_1][nombre_child] de 4 a < de 6 horasen internet (por entretencion y/o tareas) mayor o igual a 6 horas(MOSTRAR CARTILLA 4.1)

En un dia de fin de semana habitual, piense en todos < de 2 horaslos aparatos en que se conecta a internet. de 2 a < 4 horasCuanto tiempo pasa [evaluacion_1_arm_1][nombre_child] de 4 a < de 6 horasen internet (por entretencion y/o tareas) mayor o igual a 6 horas(MOSTRAR CARTILLA 4.1)

189 Que ve [evaluacion_1_arm_1][nombre_child] A.Videos, programas, peliculas, musica, series enhabitualmente cuando usa internet? puede marcar mas alguna pagina o aplicacion (ej. netflix, spotify)de una (Mostrar Cartilla No.5) B. Juegos en linea

C. Redes sociales (facebook, instagram, whatsapp)D. Television en linea (ej. tvn online)E, Paginas para busqueda de diferentes cosasF. Pagina web de alimentos y/o bebidasG. OtroNo sabe/no responde

190 Cual/es aplicaciones o paginas utiliza para ver Youtubevideos, programas, peliculas, series, musica? (SIN NetflixCONSIDERAR EL GOOGLE) Animefly

jkanimeSpotifyOtro

Especificar __________________________________

190.a Con que frecuencia semanal? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

190.b Por cuantas horas (los dias que lo usas)? __________________________________(Recuerda registrar las horas asi: 15 min=0,25 /30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

191 Cual/es juego en linea? League of LeyendCall of Duty

(No darle opciones al participante) Agar.ioJuegos FrivOtros

Especificar __________________________________

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 11 of 24

191.a Con que frecuencia semanal? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

191.b Por cuantas horas (los dias que lo usas)? __________________________________(Recuerda registrar las horas asi: 15 min=0,25 /30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

192 Cual/es redes sociales FacebookWhatsapp

(No darle opciones al participante) InstagramTwitterSkypeSnatchatMessengerOtros

192.a Con que frecuencia semanal utiliza FACEBOOK? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

192.a Por cuantas horas utiliza FACEBOOK (los dias __________________________________que lo usas)? (Recuerda registrar las horas asi: 15 min=0,25 /

30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

192.b Con que frecuencia semanal utiliza WHATSAPP? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

192.b Por cuantas horas utiliza WHATSAPP (los dias __________________________________que lo usas)? (Recuerda registrar las horas asi: 15 min=0,25 /

30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

192.c Con que frecuencia semanal utiliza INSTAGRAM? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

192.c Por cuantas horas utiliza INSTAGRAM (los dias __________________________________que lo usas)? (Recuerda registrar las horas asi: 15 min=0,25 /

30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

192.d Con que frecuencia semanal utiliza TWITTER? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

192.d Por cuantas horas utiliza TWITTER (los dias que __________________________________lo usas)? (Recuerda registrar las horas asi: 15 min=0,25 /

30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

192.e Con que frecuencia semanal utiliza SKYPE? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 12 of 24

192.e Por cuantas horas utiliza SKYPE (los dias que __________________________________lo usas)? (Recuerda registrar las horas asi: 15 min=0,25 /

30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

192.f Con que frecuencia semanal utiliza SNATCHAT? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

192.f Por cuantas horas utiliza SNATCHAT (los dias __________________________________que lo usas)? (Recuerda registrar las horas asi: 15 min=0,25 /

30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

192.g Con que frecuencia semanal utiliza MESSENGER? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

192.g Por cuantas horas utiliza MESSENGER (los dias __________________________________que lo usas)? (Recuerda registrar las horas asi: 15 min=0,25 /

30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

Especificar __________________________________

192.h Con que frecuencia semanal utiliza ESTE OTRO 1 dia a la semana o menosMEDIO? 2 a 3 dias a la semana

4 a 6 dias a la semanatodos los dias

192.h Por cuantas horas utiliza ESTE OTRO MEDIO (los __________________________________dias que lo usas)? (Recuerda registrar las horas asi: 15 min=0,25 /

30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

193 Cual/es television en linea (ej. tvn online) Mega on lineChile vision line

(No darle opciones al participante) TVN on line13 on lineLa red on lineOtro

Otro __________________________________

193.a Con que frecuencia semanal? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

193.b Por cuantas horas (los dias que lo usas)? __________________________________(Recuerda registrar las horas asi: 15 min=0,25 /30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

194 Cual/es paginas utiliza para busqueda de Googlediferentes cosas Wikipedia

Rincon de vagoYahooOtro

Especificar __________________________________

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 13 of 24

194.a Con que frecuencia semanal? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

194.b Por cuantas horas (los dias que lo usas)? __________________________________(Recuerda registrar las horas asi: 15 min=0,25 /30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

Que paginas web de alimentos y/o bebidas __________________________________

Con que frecuencia semanal? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

Por cuantas horas (los dias que lo usas)? __________________________________(Recuerda registrar las horas asi: 15 min=0,25 /30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

195 Cual/es otro? __________________________________

195.a Con que frecuencia semanal? 1 dia a la semana o menos2 a 3 dias a la semana4 a 6 dias a la semanatodos los dias

195.b Por cuantas horas (los dias que lo usas)? __________________________________(Recuerda registrar las horas asi: 15 min=0,25 /30 min=0,50 /45 min= 0,75 /1 hora= 1 y asisucesivamente.)

Ahora queremos saber si [evaluacion_1_arm_1][nombre_child] acompana a comprar alimentosa alguien de la familia

196 Cuan a menudo [evaluacion_1_arm_1][nombre_child] Nunca o menos de una vez al mesla acompana a usted o a otro miembro del hogar al Una a tres veces al messupermercado? (Mostrar Cartilla No.6) Una vez a la semana

Dos a cinco veces a la semanaTodos los dias o casi todos los dias (> 5 veces ala semana)No sabe/no responde

197 Habitualmente, cuando Nunca o casi nunca[evaluacion_1_arm_1][nombre_child] va al Menos de la mitad de las veces que vamossupermercado, pide que le compren algo para comer o Mas de la mitad de las veces que vamostomar? (Mostrar Cartilla 7) Siempre o casi siempre

No sabe/no responde

198 Cuan a menudo [evaluacion_1_arm_1][nombre_child] Nunca o menos de una vez al mesla acompana a usted o a otro miembro del hogar al Una a tres veces al mesalmacen del barrio? (Cartilla No.6) Una vez a la semana

Dos a cinco veces a la semanaTodos los dias o casi todos los dias (> 5 veces ala semana)No sabe/no responde

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 14 of 24

199 Habitualmente, cuando Nunca o casi nunca[evaluacion_1_arm_1][nombre_child] va al almacen, Menos de la mitad de las veces que vamospide que le compren algo para comer o tomar? Mas de la mitad de las veces que vamos(Mostrar Cartilla No.7) Siempre o casi siempre

No sabe/no responde

200 Hay algun kiosko o carrito de comida en el patio Side recreo o a la salida del jardin/colegio de No[evaluacion_1_arm_1][nombre_child]? No sabe/no responde

201 Venden bebestibles envasados? (bebidas, nectar) SiNoNo sabe/no responde

202 Venden snacks salados envasados? (papitas, Siramitas, etc.) No

No sabe/no responde

203 Venden golosinas envasadas? (dulces, caramelos, Sichocolates? No

No sabe/no responde

204 Venden galletas, queques, alfajores envasados? SiNoNo sabe/no responde

205 [evaluacion_1_arm_1][nombre_child] lleva plata Nunca o casi nuncapara comprar algo? (Mostrar Cartilla No.8) 1-3 veces a la semana

Todos los dias o casi todos los diasNo sabe/no responde

206 [evaluacion_1_arm_1][nombre_child] pide que le Nunca o casi nuncacompren algo a la entrada o salida? (Mostrar 1-3 veces a la semanaCartilla No.8) Todos los dias o casi todos los dias

No sabe/no responde

207 Cree usted que la presencia de algunas de estas Forma del envase (ej. forma de avion, de balde,cosas en el envase le llaman la atencion a etc).[evaluacion_1_arm_1][nombre_child] y lo motivan a Los dibujos o fotos del envase que muestran elpedirle que le compre un alimento o bebida? Puede alimento o bebida que hay adentroseleccionar varias respuestas.(Mostrar cartilla Los dibujos o fotos del envase que muestranNo.9) personajes u otras cosas entretenidas (ej.

princesas, minions, peliculas, juegos, etc)Regalos (stickers, juegos coleccionables,entradas, etc)ConcursoOtroNo sabe/no responde

208 Cual? __________________________________

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 15 of 24

209 Cuando usted esta decidiendo si va a comprar un Marca o nombre del productonuevo alimento o bebestible, en que se fija para Informacion nutricional (mostrar: mensajes dedecidirse? en primer lugar? (Mostrar cartilla No.10) salud, GDA, listado de ingredientes, tabla de

composicion nutricional, signo pare)Ganchos comerciales (como presencia de personajes,presencia de regalos o concurso)PrecioLo que compran mis amigos, familiares o los amigosde mi hijoLo que me recomienda algun profesional de la salud(nutricionista, medico u otro)lo que veo en tv, internet, redes socialesAlguien de mi familia lo pidioLo que le gusta a mi hijoOtra alternativaNo sabe/no responde

210 Especifique __________________________________

211 Cuando usted esta decidiendo si va a comprar un Marca o nombre del productonuevo alimento o bebestible, en que se fija para Informacion nutricional (mostrar: mensajes dedecidirse? en segundo lugar? (Mostrar Cartilla salud, GDA, listado de ingredientes, tabla deNo.10) composicion nutricional, signo pare)

Ganchos comerciales (como presencia de personajes,presencia de regalos o concurso)PrecioLo que compran mis amigos, familiares o los amigosde mi hijoLo que me recomienda algun profesional de la salud(nutricionista, medico u otro)lo que veo en tv, internet, redes socialesAlguien de mi familia lo pidioLo que le gusta a mi hijoOtra alternativaNo sabe/no responde

212 Especifique __________________________________

213 Cuando usted esta decidiendo si va a comprar un Marca o nombre del productonuevo alimento o bebestible, en que se fija para Informacion nutricional (mostrar: mensajes dedecidirse? en tercer lugar? (Mostrar Cartilla No.10) salud, GDA, listado de ingredientes, tabla de

composicion nutricional, signo pare)Ganchos comerciales (como presencia de personajes,presencia de regalos o concurso)PrecioLo que compran mis amigos, familiares o los amigosde mi hijoLo que me recomienda algun profesional de la salud(nutricionista, medico u otro)lo que veo en tv, internet, redes socialesAlguien de mi familia lo pidioLo que le gusta a mi hijoOtra alternativaNo sabe/no responde

214 Especifique __________________________________

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 16 of 24

Ahora vamos a hablar de algunos alimentos, le hare varias preguntas sobre algunos alimentos como bebidas, yogurts, cereales para desayuno, nectares o jugos y frutas en su estadonatural. Usted tiene que responder que tan de acuerdo o desacuerdo esta con las siguientesafirmaciones.

En esta y otras preguntas, cuando decimos saludable nos referimos a aquellos alimentos queno aumentan el riesgo de causar obesidad y enfermedades como hipertension, diabetes,colesterol alto.

Mire esta bebida (mostrar lata)

Usted la conoce?(QUITAR LA LATA DESPUES DE RESPUESTA)

Si No No sabe/ no responde

Cual de los nombres de la lista es el nombre de esta Fantabebida? Coca-cola (Original)(MOSTRAR CARTILLA 10.1 y NO MOSTRAR BEBIDA.) Bilz

Coca Cola LifeFuze TeaBenedictinoCoca cola sin azucarFanta ZeroCoca cola ZeroNordicAndina del ValleCoca Cola Light

Me gusta esta bebida como alimento para Muy de acuerdo[evaluacion_1_arm_1][nombre_child] De acuerdo(Mostrar Cartilla No.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/ no responde

A las mamas de los ninos de la edad de Muy de acuerdo[evaluacion_1_arm_1][nombre_child] les gusta esta De acuerdobebida para sus hijos Indiferente(Mostrar cartilla No.11) Desacuerdo

Muy en desacuerdoNo sabe/ no responde

Yo le daria esta bebida a mi hijo Muy de acuerdo(Mostrar cartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/ no responde

Esta bebida es saludable Muy de acuerdo(Mostrar cartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/ no responde

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 17 of 24

Mi hijo ya ha tomado esta bebida antes SiNoNo sabe/ no responde

A mi hijo le ha gustado esta bebida. Muy de acuerdo(Mostrar Cartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/ no responde

Yogurts

215 Todos los yogurt son saludables (Mostrar Cartilla Muy de acuerdoNo.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

216 Digame en que cosas de los yogures se fija para Marca o nombre del productosaber si son saludables o no saludables. Puede GDA (mostrar ejemplos)marcar hasta 3 alternativas. (Mostrar cartilla Listado de ingredientes (mostrar ejemplos)No.12) Tabla de composicion nutricional (mostrar ejemplos)

La presencia o ausencia de mensajes de salud (ej.light, alto en fibra, etc)La foto o dibujo del productoLa foto o dibujo de un personajeLa presencia de regalos o concursosLa presencia de signo pareOtroNo sabe/no responde

217 Cual? Especifique __________________________________

Mire bien este yogurt, lo puede tomar y revisar (mostrar 1+1)

218 Usted lo conoce? NoSiNo sabe/no responde

219 Me gusta este yogurt como alimento para Muy de acuerdo[evaluacion_1_arm_1][nombre_child] (Mostrar Cartilla De acuerdoNo.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

220 A las mamas de los ninos de la edad de Muy de acuerdo[evaluacion_1_arm_1][nombre_child] les gusta este De acuerdoyogurt para sus hijos (Mostrar cartilla No.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 18 of 24

221 Yo le daria este yogurt a mi hijo (Mostrar Muy de acuerdocartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

222 Este yogurt es saludable (Mostrar cartilla No.11) Muy de acuerdoDe acuerdoIndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

[evaluacion_1_arm_1][nombre_child] comeria este Muy de acuerdoyogurt si yo se lo comprara De acuerdo(MOSTRAR CARTILLA 11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

Ahora mire bien este yogurt, lo puede tomar y revisar (mostrar Griego)

223 Usted lo conoce? NoSiNo sabe/no responde

224 Me gusta este yogurt como alimento para Muy de acuerdo[evaluacion_1_arm_1][nombre_child] (Mostrar cartilla De acuerdoNo.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

225 A las mamas de los ninos de la edad de Muy de acuerdo[evaluacion_1_arm_1][nombre_child] les gusta este De acuerdoyogurt para sus hijos (Mostrar cartilla No.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

226 Yo le daria este yogurt a mi hijo (Mostrar Muy de acuerdoCartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

227 Este yogurt es saludable (Mostrar cartilla No.11) Muy de acuerdoDe acuerdoIndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

[evaluacion_1_arm_1][nombre_child] comeria este Muy de acuerdoyogurt si yo se lo comprara De acuerdo(MOSTRAR CARTILLA 11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 19 of 24

228 Entre estos 2 yogurts, cual prefiere para 1+1[evaluacion_1_arm_1][nombre_child]? Griego

No sabe/no responde

Ahora vamos a hablar de los cereales para desayuno

229 Todos los cereales son saludables (Mostrar Muy de acuerdocartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

230 Digame en que cosas de los cereales se fija para Marca o nombre del productosaber si son saludables o no saludables. Puede GDA (mostrar ejemplos)marcar hasta 3 alternativas. (Ver Cartilla No.12) Listado de ingredientes (mostrar ejemplos)

Tabla de composicion nutricional (mostrar ejemplos)La presencia o ausencia de mensajes de salud (ej.light, alto en fibra, etc)La foto o dibujo del productoLa foto o dibujo de un personajeLa presencia de regalos o concursosLa presencia de signo pareOtroNo sabe/no responde

231 Cual? Especifique __________________________________

Mire bien este cereal para desayuno, lo puede tomar y revisar (mostrar VIVO CHECK)

232 Usted lo conoce? NoSiNo sabe/no responde

233 Me gusta este cereal como alimento para Muy de acuerdo[evaluacion_1_arm_1][nombre_child] (Mostrar cartilla De acuerdoNo.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

234 102 Las mamas de los ninos de la edad de Muy de acuerdo[evaluacion_1_arm_1][nombre_child] les gusta este De acuerdocereal para sus hijos (Mostrar cartilla No.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

235 Yo le daria este cereal a mi hijo (Mostrar Muy de acuerdocartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 20 of 24

236 Este cereal es saludable (Mostrar cartilla No.11) Muy de acuerdoDe acuerdoIndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

[evaluacion_1_arm_1][nombre_child] comeria este Muy de acuerdocereal si yo se lo comprara De acuerdo(MOSTRAR CARTILLA 11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

Ahora mire bien este cereal para desayuno, lo puede tomar y revisar (mostrar Milo)

237 Usted lo conoce? NoSiNo sabe/no responde

238 Me gusta este cereal como alimento para Muy de acuerdo[evaluacion_1_arm_1][nombre_child] (Mostrar cartilla De acuerdoNo.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

239 A las mamas de los ninos de la edad de Muy de acuerdo[evaluacion_1_arm_1][nombre_child] les gusta este De acuerdocereal para sus hijos (Mostrar cartilla No.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

240 Yo le daria este cereal a mi hijo (Mostrar Muy de acuerdocartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

241 Este cereal es saludable (Mostrar cartilla No.11) Muy de acuerdoDe acuerdoIndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

[evaluacion_1_arm_1][nombre_child] comeria este Muy de acuerdocereal si yo se lo comprara De acuerdo(MOSTRAR CARTILLA 11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

242 Entre estos 2 cereales para desayuno, cual Miloprefiere para [evaluacion_1_arm_1][nombre_child]? Vivo check

No sabe/no responde

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 21 of 24

Ahora vamos a hablar de los nectares o jugos

243 Todos los nectares o jugos son saludables Muy de acuerdo(Mostrar cartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

244 Digame en que cosas de los jugos o nectar se fija Marca o nombre del productopara saber si son saludables o no saludables. Puede GDA (mostrar ejemplos)marcar hasta 3 alternativas. (Mostrar cartilla Listado de ingredientes (mostrar ejemplos)No.12) Tabla de composicion nutricional (mostrar ejemplos)

La presencia o ausencia de mensajes de salud (ej.light, alto en fibra, etc)La foto o dibujo del productoLa foto o dibujo de un personajeLa presencia de regalos o concursosLa presencia de signo pareOtroNo sabe/no responde

245 A Cual? Especifique __________________________________

Mire bien este jugo, lo puede tomar y revisar (mostrar yuz)

246 Usted lo conoce? NoSiNo sabe/no responde

247 Me gusta este jugo o nectar como alimento para Muy de acuerdo[evaluacion_1_arm_1][nombre_child] (Mostrar cartilla De acuerdoNo.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

248 A las mamas de los ninos de la edad de Muy de acuerdo[evaluacion_1_arm_1][nombre_child] les gusta este De acuerdojugo o nectar para sus hijos (Mostrar cartilla IndiferenteNo.11) Desacuerdo

Muy en desacuerdoNo sabe/no responde

249 Yo le daria este jugo o nectar a mi hijo (Mostrar Muy de acuerdocartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

250 Este jugo o nectar es saludable (Mostrar cartilla Muy de acuerdoNo.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 22 of 24

[evaluacion_1_arm_1][nombre_child] tomaria este jugo Muy de acuerdoo nectar si yo se lo comprara De acuerdo(MOSTRAR CARTILLA 11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

Ahora mire bien este nectar, lo puede tomar y revisar (mostrar SOPROLE)

251 Usted lo conoce? NoSiNo sabe/no responde

252 Me gusta este jugo o nectar como alimento para Muy de acuerdo[evaluacion_1_arm_1][nombre_child] (Mostrar cartilla De acuerdoNo.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

253 A las mamas de los ninos de la edad de Muy de acuerdo[evaluacion_1_arm_1][nombre_child] les gusta este De acuerdojugo o nectar para sus hijos (Mostrar cartilla IndiferenteNo.11) Desacuerdo

Muy en desacuerdoNo sabe/no responde

254 Este jugo o nectar es saludable (Mostrar cartilla Muy de acuerdoNo.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

255 Yo le daria este jugo o nectar a mi hijo Muy de acuerdo(Mostrar cartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

[evaluacion_1_arm_1][nombre_child] tomaria este jugo Muy de acuerdoo nectar si yo se lo comprara De acuerdo(MOSTRAR CARTILLA 11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

256 Entre estos 2 jugos, cual prefiere para Yuz[evaluacion_1_arm_1][nombre_child]? Soprole

No sabe/no responde

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 23 of 24

Ahora una pregunta mas sobre frutas, pero piense en la fruta en su estado natural

257 Todos las frutas en su estado natural son Muy de acuerdosaludables (Mostrar cartilla No.11) De acuerdo

IndiferenteDesacuerdoMuy en desacuerdoNo sabe/no responde

Ahora le vamos a hacer las ultimas preguntas, sobre estos logos que se ven aca (mostrar),ademas, hay algunas afirmaciones en donde nos debera indicar que tan de acuerdo odesacuerdo esta con la afirmacion

258 Ha visto alguno de esos logos antes? NoSiNo sabe/no responde

259 En que alimentos? __________________________________

260 Imaginese que uno de estos logos esta en el Muy saludableenvase de algun alimento o bebestible, que le dice Saludableacerca de lo saludable que es ese alimento? (Mostrar Indiferentecartilla No.13) Poco saludable

Nada saludableNo sabe/no responde

261 Imaginese un alimento que tiene 3 de estos logos El que tiene 3 logos es mas saludablemientras que otro alimento tiene 1, cual alimento le Ambos alimentos son igualmente saludablesparece que es mas saludable? (Mostrar cartilla El que tiene 1 logo es mas saludableNo.14) No sabe/no responde

262 Por que? __________________________________

266. Las personas que escogen productos con uno o mas De acuerdode estos logos son personas exitosas Indiferente(MOSTRAR CARTILLA 15) Desacuerdo

No sabe / no responde

267. Las personas que escogenproductos con uno o mas De acuerdode estos logos son personas que disfrutan la vida Indiferente(MOSTRAR CARTILLA 15) Desacuerdo

No sabe / no responde

268. Las personas que escogenproductos con uno o mas De acuerdode estos logos son personas que siguen sus propias Indiferentereglas y saben lo que quieren Desacuerdo(MOSTRAR CARTILLA 15) No sabe / no responde

269. Las personas que escogen productos con este logo De acuerdoNO sepreocupan de su salud y la de su familia Indiferente(MOSTRAR CARTILLA 15) Desacuerdo

No sabe / no responde

263 A mi me parece bien que el Ministerio de Salud me Muy de acuerdoindique cuales alimentos son menos saludables De acuerdo(Mostrar cartilla No.11) Indiferente

DesacuerdoMuy en desacuerdoNo sabe/no responde

26-09-2018 16:26 www.projectredcap.org

ConfidentialPage 24 of 24

264 Comentarios (si duda de la validez o __________________________________confiabilidad de algunas respuestas en algunaseccion por favor especificar en que seccion de laencuesta)