Gastón Ares’s research while affiliated with Universidad de la República de Uruguay and other places

Understanding parental decision-making during complementary feeding is essential for designing effective interventions that address deviations from nutritional recommendations and support optimal growth and development. However, there is no consensus on the key factors shaping the characteristics of complementary feeding, particularly in Africa, Asia, and Latin America. In this context, the present work aimed to identify factors influencing parental decision-making on what foods to offer their child during complementary feeding in Uruguay, a Latin American country. Semi-structured interviews with 21 parents of children aged 6 to 15 months were conducted. Interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis, integrating inductive and deductive coding approaches. Several deviations from national and international complementary feeding recommendations were identified, including limited dietary diversity, focus on soft textures, delayed introduction of nutrient-dense foods like meat, and early introduction of ultra-processed dairy products high in sugar, such as yogurt and dairy desserts. A multifaceted range of factors influencing parental feeding practices during the complementary feeding period were identified. Health-related goals played a central role in parents’ decisions about which foods to offer during complementary feeding. However, insecurity, misconceptions about food healthiness, fears of adverse health outcomes, and economic constraints often led to deviations from nutritional recommendations. In addition, parental decisions were also shaped by the external food environment and macro-level factors, such as the health system, childcare centers, and social norms. These findings underscore the need for comprehensive, multifaceted approaches to improve complementary feeding practices, extending beyond simply enhancing parental knowledge.

Objectives To evaluate the prevalence of advertisements of ultra-processed products outside food outlets in Montevideo (Uruguay) and to explore the patterns of these advertisements across areas with different socio-economic status. Design Cross-sectional field survey of advertisements of ultra-processed products outside food outlets. The percentage of outlets featuring any type of advertisement of ultra-processed products on the exterior part of the outlets was calculated, at the aggregate level and separately by type of outlet and type of product. Comparisons were made considering the socio-economic status of the tract where outlets were located. Setting 106 census tracts in Montevideo, differing in geographical location and socio-economic status. Participants Outlets selling foods and beverages, located within the selected census tracts. Results 30.7% of the 1,217 food outlets identified in the field survey featured some type of exterior advertisement of ultra-processed products. Sweetened beverages (specifically soda) was the most frequently advertised ultra-processed product category, followed by ice-cream. After adjusting for the type of outlet, medium SES tracts exhibited the highest prevalence of ultra-processed product advertisements outside food outlets (36.0%). Differences in the prevalence of advertisements of specific categories with SES were also found, which may reflect variations in the types and characteristics of food outlets. Conclusions Results from the present work suggest frequent exterior advertisements of ultra-processed products and highlight the need to develop effective policies to reduce their use as part of a comprehensive set of strategies to discourage consumption of ultra-processed products.

The World Health Organization (WHO) has recently published a guideline that recommends against the use of nonsugar sweeteners. Food labels are a key source of information for consumers, to enable them to make informed decisions regarding the consumption of food additives. However, discrepancies in the concepts and categorizations of sweeteners in labeling recommendations and regulations may influence the results of studies on the prevalence of sweeteners in foods. This study aimed to analyze the scientific literature related to the declaration of sweeteners on food labels. Focus was placed on methodological issues related to data collection and analysis, including the categorization of sweeteners, as well as on the reported prevalence of sweetener declaration on food labels. A scoping review was conducted based on a search for terms related to sweeteners, food labeling, and packaged foods. Nine studies, published between 2012 and 2022, were included. Variability among studies was observed in terms of data collection methods, approaches for identifying the sweeteners declared on food labels, the criteria for categorizing sweeteners, and the definitions underlying the categorization. Moreover, there was a lack of standardization in the bibliographic sources consulted in formulating the categorization, and failure to report specific sources, leading to heterogeneity in the substances regarded as sweeteners. The prevalence of the declaration of sweeteners in food labeling ranged from less than 1% to 43.6%. The findings of the present work emphasize the need to standardize the methodologies used for the identification of sweeteners declared on food labels and the criteria for their categorization.

Foods are frequently marketed to children through the inclusion of a wide range of elements on the packages. Several studies conducted in different countries around the globe have shown that products marketed to children are usually high in sugar and other nutrients associated with non-communicable diseases. The present exploratory cross-sectional study aimed at providing additional evidence on the composition of products marketed to children by analysing the disclosure of additives in such products. Data were collected at nine supermarkets in two Uruguayan cities between August and October 2021. All packaged products available in each supermarket were surveyed using a cell phone app, except for culinary ingredients. All the information from the labels was extracted. Products marketed to children were identified based on the presence of indicators of child-directed marketing on the package. The disclosure of additives was analysed based on the information available in the ingredient list. The prevalence of food additive disclosure was calculated. Of the 7,343 products included in the database, 573 (7.8%) were classified as marketed to children. Candies and cookies were the categories with the largest number of products marketed to children. The great majority of the products marketed to children disclosed at least one food additive (93.5%). These products tended to more frequently notify colourings, antioxidants, acidity regulators, raising agents, stabilisers, humectants, anticaking agents, and glazing agents compared to products not marketed to children. These findings underscore the need to expand the current scope of regulations on marketing targeted at children beyond nutrients to include additives potentially linked to adverse health effects, such as artificial colourings.

Creating supportive food environments has been identified as one of the most effective strategies to promote healthy diets. In this context, the present work aimed to characterize the retail food environment in a low-income area of the city of Montevideo (Uruguay). The study relied on a mixed-methods approach. A survey of food retail outlets was conducted. All the outlets were geocoded, and service areas were created considering a 600 m threshold. Quantitative information was supplemented with qualitative information from semi-structured interviews with residents and grocery store owners. A total of 415 outlets selling a variety of foods were identified. Adequate physical access to the foods recommended by the Uruguayan dietary guidelines was found in most of the residential areas. Small behind-the-counter grocery stores were identified as the key source of healthy foods in the area. However, the accounts of residents highlighted problems related to the price, variety and quality of the foods sold by the local grocery stores. Therefore, strategies to ensure access to healthy food in the study area should go beyond physical access and tackle food affordability, variety and quality. The promotion of short food supply chains in the area should be a key element of the strategies to achieve sustainable urban food systems in Montevideo.

Healthier eating is crucial to tackle the rapid rise of obesity and noncommunicable diseases worldwide. This research examined two nudging interventions intended to decrease food consumption: price display and serving utensils. Forecasting experiments showed that people predicted displaying the price of the food per kg (vs. hg) should decrease the amount of food purchased (Study 1A), but that using tongs (vs. spoon) would be ineffective (Study 1B). In contrast to these results, a high-powered preregistered field study (Study 2) at a university canteen revealed that price display had no notable effect; however, tongs (vs. spoon) reliably decreased the average amount of food purchased per meal by 14 g or 3.1%, also when compared to weeks when both types of serving utensils were available. Study 3 replicated the results regarding tongs (vs. spoon) for a particularly unhealthy category (candy), while highlighting a psychological mechanism driving the effect. Using tongs required more effort, which decreased satisfaction tied to using said serving utensils, thereby reducing people’s willingness to consume candy. Given the simplicity and cost effectiveness of swapping spoons with tongs, combined with the behavioral evidence underscoring its practical relevance, these findings might aid in steering consumers to healthier food decisions, ultimately benefiting public health.