Research
projects
Policies, interventions
and governance
Co-creating strategies to increase fruit and vegetable consumption and reduce food waste in Uruguay
Principal researcher: Gastón Ares
Funding: INIA FPTA
Period: 2024-2027
Fruits and vegetables are a fundamental component of a healthy diet. Their consumption has been associated with a lower risk of non-communicable diseases, including cardiovascular disease and several types of cancer, as well as reduced overall mortality. However, consumption of these food groups in Uruguay remains below nutritional recommendations. At the same time, available evidence indicates that fruits and vegetables are the food groups that contribute most to food loss and waste, both during production and retail and at the household level. Against this backdrop, the aim of this project is to generate knowledge on the perceptions and behaviours of Uruguayan consumers to inform the design of marketing and communication strategies that increase fruit and vegetable consumption while reducing food waste in the country. Adopting a participatory research approach, the project places Uruguayan consumers at its core, involving them in all research activities to obtain direct insights into how their behaviour can be changed. A mixed-methods, multi-method approach is proposed, combining a range of quantitative and qualitative techniques that will be used in continuous dialogue. This research design makes it possible to address the complexity of consumer behaviour related to fruit and vegetable consumption and food waste. The project has the potential to benefit Uruguayan society as a whole by generating short-, medium-, and long-term impacts for consumers, food policy decision-makers, producers, retail food businesses, and other actors across the food value chain, while also strengthening research capacity within the academic sector.
Strategies to reduce energy drink consumption among adolescents and young adults
Principal researcher: Lucía Antúnez
Funding: ANII
Period: 2025-2027
The increasing consumption of energy drinks has become a growing public health concern, both nationally and internationally, due to their potential adverse health effects. Against this backdrop, the overall aim of the project is to generate evidence to inform the design of strategies to increase risk perception and reduce energy drink consumption among adolescents and young adults. The project focuses on generating evidence to support the development of two complementary strategies: (i) a regulatory policy based on warning labels, and (ii) a communication campaign aimed at increasing perceived risk. The project adopts a mixed-methods approach, enabling the identification of patterns in participants’ behaviours and attitudes while also exploring the underlying reasons for these patterns. A co-creation approach will be used to design both the warning labels and the communication materials. Through a collaborative process, this approach supports the development of culturally relevant interventions that anticipate and address the factors influencing the behaviour of the target population, while also fostering trust in the proposed measures and encouraging critical reflection. The effectiveness of the warning labels and communication materials will be evaluated through randomized controlled trials. The project is expected to generate evidence that will contribute to the design of strategies to reduce energy drink consumption and its potential adverse health effects in Uruguay.
Public policy learning from the Philip Morris v. Uruguay investor–State dispute settlement case
Principal researcher: Anne-Marie Thow (University of Sydney)
Funding: National Health and Medical Research Council (Australia)
Period: 2024-2025
International Investment Agreements (IIAs) are part of governments’ efforts to attract foreign investment by creating a stable policy environment that respects and protects investors’ rights. However, IIAs have also been used by industry actors to challenge public health measures in critical areas such as tobacco control and access to medicines. Recognizing the potential threat to public health, the World Health Organization has identified the protection of public health policy within IIAs as a priority. One approach is the inclusion of health-related provisions that either exempt public health measures from dispute settlement or explicitly clarify that IIA provisions should not prevent countries from adopting legitimate public health measures. Nevertheless, the adoption of such health safeguards in IIAs has been limited. Research suggests that governments’ approaches to IIAs may be shaped by their previous experience with investor–State arbitration. Against this backdrop, the objectives of this project are to: (i) examine the use of health-related provisions in Uruguay’s IIAs, and (ii) analyse how the Philip Morris v. Uruguay case has influenced the adoption of such provisions. The study will employ a case study design, with a particular focus on qualitative policy and governance analysis. Data will be collected from publicly available documentary sources and through in-depth interviews with policymakers and officials involved in international treaty negotiations and public policy in Uruguay. The project’s findings will contribute to: (i) identifying best practice options for effectively safeguarding public health in IIAs, and (ii) developing strategies to support public health stakeholders in advocating for the inclusion of health safeguards in future IIAs.
Analysis of the implementation process of the Decree No. 38.072
Principal researcher: Gastón Ares
Funding: Intendencia de Montevideo
Period: 2023-2024
Policies aimed at improving the availability of healthy foods through changes to retail food environments have gained increasing attention worldwide. One component of these policies is the introduction of nutrition standards for institutions that sell or provide food to their employees, namely the establishment of criteria regarding the nutritional quality of foods purchased, sold, or served within an institution. In 2022, Montevideo city approved Decree No. 38,072, in line with the recommendations of the World Health Organization. The decree aims to improve the food environments of public institutions across the department. To achieve this, it establishes a set of nutrition standards for the food offered in cafeterias operated by state and parastatal institutions serving public employees, allowing them to obtain accreditation as “Healthy Canteens.” Following the implementation of the decree, there was a need to examine its implementation process and evaluate its impacts. The overall objective of this project was to analyse the implementation of Decree No. 38,072 in food services serving public employees in Montevideo. The project comprised two components. The first assessed food service managers’ awareness of the provisions of Decree No. 38,072 and their decisions regarding accreditation as a Healthy Canteen. The second component aimed to characterise the food offer and document the presence and characteristics of food marketing within food services serving public employees.
Co-creation of messages aimed at reducing discretionary salt use: Contributions to the design of communication strategies
Principal researchers: Lucía Antúnez, Cecilia Marrero
Funding: CSIC, Udelar - Programa I+D
Period: 2021-2023
The sustained increase in the prevalence of hypertension, one of the main risk factors for the development of non-communicable diseases, is a growing global concern. To address this situation, countries have been urged to take urgent action aimed at improving population health. Reducing sodium intake at the population level has been shown to be a cost-effective strategy to achieve this goal, given the strong association between sodium consumption and the prevalence of hypertension. Within this framework, efforts in Uruguay have focused primarily on removing salt shakers from restaurants, reducing the salt content of bakery products, and implementing front-of-package nutrition labelling on packaged foods. However, limited attention has been given to discretionary salt (salt added during food preparation or at the table), which represents an important source of dietary sodium among the Uruguayan population. In this context, the present proposal aims to co-create culturally relevant messages to reduce discretionary salt use that take into account the characteristics of different consumer groups. In the first stage, a qualitative and quantitative approach will be used to explore salt-use practices among the population, both within and outside the home. Information will be collected on the prevalence of these practices and the effect of different psychographic and sociodemographic variables on salt-use behaviours. The information obtained during this first stage will provide guidance on the direction that efforts to promote changes in discretionary salt consumption habits should take. In the second stage of the project, a co-creation approach will be used to develop visual communication materials (including text and images) to inform the design of communication strategies aimed at reducing salt use both within and outside the home. The co-creation process will involve members of the general population and an interdisciplinary group of specialists. Finally, the impact of the selected visual communication materials on Uruguayan consumers’ attitudes and behaviours regarding discretionary salt use will be evaluated. The results will contribute to the development of strategies aimed at modifying population salt consumption habits, promoting a comprehensive approach to the challenges associated with excessive sodium intake, and ultimately contributing to improved health outcomes among the Uruguayan population.
Monitoring of the Food Support Programme (ABC Plan)
Principal researcher: Gastón Ares
Funding: Intendencia de Montevideo
Period: 2020-2021
The objective of this project was to monitor the status of food (in)security and dietary characteristics among beneficiaries of the Food Support Programme of the Basic Citizen Support Plan of the Municipality of Montevideo between April 2021 and June 2023. A longitudinal study was conducted, including children and women who entered the programme between April 2021 and June 2022 as the study population. A telephone-based questionnaire comprising four modules was administered: (i) characterization of the respondent and the beneficiary, (ii) weekly consumption of a range of food groups, (iii) food (in)security, and (iv) housing and household characteristics. In addition, beneficiaries’ perceptions and experiences regarding the programme were qualitatively explored through in-depth interviews.
Strategies to promote healthy dietary habits through informed food choices
Principal researcher: Gastón Ares
Funding: CSIC, Udelar
Period: 2019-2021
Overweight and obesity during adolescence have increased at an accelerated pace and have become one of the main public health challenges worldwide and nationally. One of the key determinants of this issue is the high consumption of ultra-processed products. These products are characterized by low nutritional value, excessive levels of sugars, total fats, saturated fats, and sodium, as well as the presence of additives. Frequent consumption of these products has been associated with an increased risk of overweight, obesity, dyslipidaemia, metabolic syndrome, cancer, and higher all-cause mortality. Marketing is one of the factors contributing to the high consumption of ultra-processed products among adolescents. Most research on the effects of food marketing has focused primarily on television advertising and, to a lesser extent, on marketing strategies used on food packaging. However, in recent years, there has been a substantial increase in digital marketing through websites and social media platforms. Due to its characteristics, this type of marketing may have a greater influence on the meanings attributed to foods and on dietary habits than traditional marketing approaches. In this context, the overall objective of this project is to evaluate the prevalence and impact of digital marketing of ultra-processed products targeting adolescents. A qualitative and quantitative approach will be used to assess the prevalence and impact of digital marketing of ultra-processed products directed at adolescents. This mixed-methods approach combines the strengths of qualitative and quantitative methods, enabling the identification of patterns and trends related to the prevalence and impact of digital marketing, while also exploring the attitudes and motivations that explain the influence of digital marketing on ultra-processed product consumption among adolescents. To achieve the proposed objectives, the project will involve four types of studies. The project will begin with an assessment of the digital marketing strategies targeting adolescents used by ultra-processed product companies. Subsequently, questionnaires will be used to evaluate adolescents’ exposure to marketing and its influence on ultra-processed product consumption. Group interviews will be conducted to explore adolescents’ attitudes towards ultra-processed product marketing, particularly digital marketing, and their perceptions of its influence on product selection. Finally, experiments will be conducted to evaluate the effect of digital marketing on adolescents’ decision-making processes. The results of this project will provide relevant evidence to support the development of regulations on the marketing of ultra-processed products targeting adolescents in Uruguay. Such regulation is necessary to protect the health of children and adolescents and to ensure compliance with the rights established in the Convention on the Rights of the Child.
Communication campaign to promote the use of front-of-package nutrition labelling among Uruguayan families
Principal researcher: Gastón Ares
Funding: UNICEF Uruguay
Period: 2018-2020
Uruguay is facing an alarming situation regarding non-communicable diseases, including obesity, cancer, cardiovascular diseases, hypertension, and diabetes. One of the factors contributing to this situation is the population’s dietary habits, which are characterized by low consumption of fruits, vegetables, and other minimally processed foods, and high consumption of processed foods with excessive levels of sugars, fats, and sodium. This situation highlights the need to implement educational and regulatory measures aimed at modifying population dietary habits. The inclusion of front-of-package nutrition information on packaged foods is one of the policies recommended by the World Health Organization to promote informed decision-making among citizens and encourage healthier diets, thereby helping to combat non-communicable diseases. Uruguay recently approved a front-of-package nutrition labelling decree, which came into force in February 2020. A key determinant of the success of this policy is the communication campaign designed to inform and motivate citizens to use the information when purchasing food. This project will design and evaluate a communication campaign aimed at maximizing Uruguayan consumers’ understanding of the front-of-package nutrition labelling system, as well as their intention to use this information when selecting foods.
Edulia - Bringing down barriers for children's healthy eating
Principal researcher: Paula Varela (Nofima, Norway)
Funding: European Union- Horizon2020
Period: 2018-2022
The Edulia project was developed in response to the need to address high rates of childhood obesity through education on healthy dietary habits. The aim of the project is to improve understanding of the multiple factors that act as barriers to children adopting healthy eating behaviours and to develop new strategies to overcome these barriers. The project was part of the Marie Skłodowska-Curie Innovative Training Networks programme and consists of a multidisciplinary training and research network involving eleven doctoral students who will conduct their thesis research on topics related to the themes addressed by the project. Within the framework of the project, the Interdisciplinary Center on Food and Wellbeing evaluated strategies to reduce the sugar content of dairy products targeted at children. The results showed that reducing the sugar content of dairy products aimed at children currently available on the Uruguayan market is feasible. A direct sugar reduction of up to 25% did not significantly affect children’s hedonic perception of three categories of dairy products. Meanwhile, the use of taste–aroma–texture cross-modal interactions helped minimize the impact of sugar reduction on the sensory characteristics of dairy desserts.
Monitoring compliance with the International Code of Marketing of Breast-milk Substitutes
Principal researcher: Gastón Ares
Funding: UNICEF Uruguay
Period: 2018-2019
An environment characterized by the widespread availability and promotion of breast-milk substitutes can undermine countries’ efforts to improve breastfeeding rates. For this reason, the International Code of Marketing of Breast-milk Substitutes, adopted by the 34th World Health Assembly in 1981, establishes a set of recommendations to ensure that the marketing of these products does not interfere with or weaken breastfeeding practices. As part of several initiatives developed by the Ministry of Public Health to protect and promote breastfeeding, a monitoring study was conducted in the city of Montevideo (Uruguay) to assess compliance with the provisions established in the Code. The monitoring was carried out using the NetCode methodology developed by the World Health Organization and UNICEF. The presence of promotional activities for breast-milk substitutes in public health facilities was assessed through visual inspections, interviews with health professionals, and interviews with mothers of children under 24 months of age. Physical retail outlets and online sales platforms were surveyed, and the labels of all products covered by the Code and marketed through these channels were evaluated. In addition, promotional activities on social media were assessed. The results showed a low prevalence of promotional activities for products covered by the Code in health facilities. However, a moderate prevalence of promotions for bottles and teats and a high prevalence of promotions for other food products covered by the scope of the Code were identified in physical retail outlets. Regarding product labels, the vast majority of infant formula products and a substantial proportion of bottles and teats did not comply with the Code’s recommendations, as they included text or images that idealized their use. Meanwhile, most products classified as other food products did not provide information on the recommended age of introduction. Promotional activities for breast-milk substitutes were also identified on social media platforms. The findings highlight several areas for action to strengthen ongoing efforts and improve compliance with the provisions of the Code in Uruguay, thereby contributing to enhanced protection and promotion of breastfeeding.
Scope and monitoring of Law No. 19140 in educational institutions in Montevideo
Principal researcher: Alejandra Girona
Funding: FAO
Period: 2017
The aim of the project was to assess the scope and level of compliance with Law No. 19140 and its implementing decree in educational institutions in the city of Montevideo. The research adopted a mixed-methods approach combining qualitative and quantitative methodologies. A representative sample of public and private primary and secondary schools in Montevideo (Uruguay) was included. In addition, the scope of the law and its implementing decree was analyzed by examining their purpose, objectives, proposed actions, and the stakeholders involved. The results showed that most educational institutions sold food through formal school canteens or through food sales during school breaks organized by school administrators, teachers, or parent associations. Many of the nutritional recommendations regarding the food and beverage offerings established in the implementing decree were not being followed, exposing children and adolescents to foods with an unfavorable nutritional profile within the school environment. In private primary schools, as well as in both public and private secondary schools, packaged processed foods that did not comply with the nutrient thresholds established by the Ministry of Public Health predominated. Furthermore, although the advertising of products exceeding the nutrient thresholds established in the implementing decree is completely prohibited, all educational institutions selling these products displayed them. These findings highlighted the need to revise the law so that, beyond providing recommendations, it clearly prohibits the sale of foods and beverages high in calories and critical nutrients.
Influence of food label design strategies on food selection patterns
Principal researcher: Gastón Ares
Funding: CSIC, Udelar
Period: 2015-2017
Non-communicable chronic diseases are the leading cause of death in Uruguay and impose substantial direct and indirect costs on society. One potential strategy to reduce the burden of these diseases is to encourage healthier dietary patterns. Given that a large proportion of consumers currently purchase food in self-service retail stores, food packaging has become an important source of information that strongly influences consumers’ perceptions and purchase intentions. In this context, communication strategies implemented through food packaging may represent an effective approach to promoting healthier food choices. The project aimed to investigate the influence of two food label design strategies on food selection: the inclusion of a traffic-light front-of-pack nutrition labeling system and the design of packaging for products targeted at children.
Evaluation of the effect of sodium reduction strategies on consumer perception
Principal researcher: Ana Giménez
Funding: CSIC, Udelar
Period: 2015-2017
High sodium intake is closely associated with an increased prevalence of hypertension, while cardiovascular diseases are the leading cause of death. In this context, reducing sodium intake is considered one of the most cost-effective and easily implemented public health strategies for improving population health. Given that processed foods make a substantial contribution to sodium intake among the Uruguayan population, the development of strategies to reduce the salt content of processed foods marketed nationally should play a central role in policies aimed at lowering population sodium intake. In particular, the gradual reduction of salt content in foods could sustainably modify consumers’ preferences for salty taste, leading to a lower level of saltiness being perceived as optimal. In addition, information about the salt content of food products influences consumers’ sensory and hedonic perceptions and may therefore have important implications for the communication strategies used during the implementation of sodium reduction initiatives. One of the main challenges of gradual sodium reduction in processed foods is determining how to implement the reduction in terms of the percentage decrease, the number of reformulation steps, and the interval between successive reductions. The results of this project would generate evidence to support the design of these strategies. The project aimed to evaluate the effects of different sodium reduction strategies on consumer perception. Specifically, it proposed to examine the impact of reducing the concentration of added salt and partially replacing sodium chloride (NaCl) with potassium chloride (KCl). For each strategy, the effects on perceived saltiness would be evaluated in two food products—bread and white rice—as well as their influence on consumers’ sensory and hedonic responses. In addition, the project would investigate the effect of providing information about salt reduction on consumer perception. Finally, it would assess whether consumers’ age and gender moderate their sensitivity to changes in sodium content.
Evaluation of strategies to reduce the sugar content of dairy products targeted at children and adolescents
Principal researcher: Gastón Ares
Funding: CSIC, Udelar
Period: 2015-2017
In recent years, the prevalence of overweight and obesity among children and adolescents has increased markedly. One of the main factors contributing to this trend is unhealthy dietary habits, particularly the high consumption of foods with a high sugar content. In this context, developing strategies to reduce the amount of added sugar in foods marketed to children and adolescents is one of the most cost-effective approaches to lowering sugar intake in this population, thereby improving their health. The aim of this research project was to evaluate the effects of sugar reduction strategies on the sensory characteristics and hedonic perception of dairy products targeted at children and adolescents. The study assessed the impact of gradual reductions in sugar concentration and the use of sweetness enhancers in three dairy products commonly consumed by this population: dairy desserts (vanilla and chocolate flavors), chocolate milk, and drinkable yogurts (strawberry and peach flavors). A range of sensory evaluation methodologies was used to assess changes in the sensory properties and consumer liking of the products as their sugar content was reduced. The results confirmed the feasibility of reducing the sugar content of dairy products targeted at children and adolescents and provided evidence-based recommendations for the design of gradual sugar reduction programs.