The increasing availability of packaged foods plays a key role in nutritional transition. This study examined the healthiness of the Australian packaged food supply using a range of different metrics; 40,664 packaged products from The George Institute's FoodSwitch database were included. Median and interquartile range (IQR) were determined for each measure of nutrient composition; mean and standard deviation (SD) for the measure based upon Health Star Rating (HSR); and proportions (%) for the measures based upon products with a higher HSR, classification of foods as either core or discretionary, extent of processing and proportions of foods that met reformulation targets for sodium, saturated fat and total sugars. Overall median (IQR) values were 1093 (1256) kJ/100 g for energy, 1.7 (6.3) g/100 g for saturated fat, 5.3 (21.4) g/100 g for total sugars, 163 (423) g/100 g for sodium and 50 (100) g or mL for serving size. Overall mean (SD) HSR was 2.8 (1.4), proportion with HSR < 3.5 was 61.8%, proportion of foods defined as discretionary was 53.0% and proportion of foods defined as highly processed was 60.5%. There were sodium targets set for 21,382/40,664 (53%) foods and achieved for 14,126/40,664 (35%). Corresponding figures for saturated fat were 328/40,664 (0.8%) and 130/40,664 (0.3%). Nutrient profiling, dietary guidelines and the extent of food processing provided comparable assessments of the nutritional quality of Australia's packaged food supply. Individual measures of nutrient composition did not, but may be of value for identifying specific foods of concern.

/pdf/measuring-the-healthiness-of-the-packaged-food-supply-in-20b7owomrc.pdf

Measuring the Healthiness of the Packaged Food Supply in Australia.

We compared the healthiness of packaged foods and beverages between selected countries using the Health Star Rating (HSR) nutrient profiling system. Packaged food and beverage data collected 2013-2018 were obtained for Australia, Canada, Chile, China, India, Hong Kong, Mexico, New Zealand, Slovenia, South Africa, the UK, and USA. Each product was assigned to a food or beverage category and mean HSR was calculated overall by category and by country. Median energy density (kJ/100 g), saturated fat (g/100 g), total sugars (g/100 g) and sodium (mg/100 g) contents were calculated. Countries were ranked by mean HSR and median nutrient levels. Mean HSR for all products (n = 394,815) was 2.73 (SD 1.38) out of 5.0 (healthiest profile). The UK, USA, Australia and Canada ranked highest for overall nutrient profile (HSR 2.74-2.83) and India, Hong Kong, China and Chile ranked lowest (HSR 2.27-2.44). Countries with higher overall HSR generally ranked better with respect to nutrient levels. India ranked consistently in the least healthy third for all measures. There is considerable variability in the healthiness of packaged foods and beverages in different countries. The finding that packaged foods and beverages are less healthy in middle-income countries such as China and India suggests that nutrient profiling is an important tool to enable policymakers and industry actors to reformulate products available in the marketplace to reduce the risk of obesity and NCDs among populations.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/obr.12879

A comparison of the healthiness of packaged foods and beverages from 12 countries using the Health Star Rating nutrient profiling system, 2013-2018.

Objectives (1) To assess the changes in the salt content of sauces in the UK in the past 10 years; (2) to compare the salt content of sauces in China with equivalent products sold in the UK and (3) to calculate the proportion of sauce products meeting the salt targets set by the UK Department of Health (DoH). Design Cross-sectional surveys from the nutrition information panels of sauces. Setting Major retailers in London, Beijing and Shijiazhuang operating at data collection times. Main outcome measure Salt content of sauces. Results Relative change in the median salt content of UK products ranged from −70.6% to +3.0% in sauces for which salt targets were set, whereas it ranged from −27.1% to +111.5% in sauces without targets. Median salt contents were on average 4.4-fold greater in Chinese sauces compared with their UK equivalents surveyed during the same period (2015–2017). Only 13.4% of the Chinese products met the UK 2017 salt targets, compared with 70.0% of UK products. Conclusion In the UK, the target-based approach contributed to the reduction in the salt content of sauces over the course of the past 10 years. Currently, large variations in salt content exist within the same categories of sauces and 70% of the products have met DoH’s 2017 targets, demonstrating that further reductions are possible and lower salt targets should be set. In China, salt content of sauces is extremely high with similarly large variations within same categories of sauces, demonstrating the feasibility of reducing their salt content. As processed foods (including sauces) are expected to become an important contributor to salt intake in China, national salt reduction efforts such as setting salt targets would be a valuable, proactive strategy.

https://bmjopen.bmj.com/content/bmjopen/9/9/e025623.full.pdf

Salt content of sauces in the UK and China: cross-sectional surveys.

Compliance of declared vs. analysed values with EU tolerance limits for mandatory nutrients in prepacked foods.

Background Front-of-pack nutrition labeling (FoPL) schemes can help consumers understand the nutritional content of foods and may aid healthier food choices. However, most packaged foods in Australia carry no easily interpretable FoPL, and no standard FoPL system has yet been mandated. About two thirds of Australians now own a smartphone. Objective We sought to develop a mobile phone app that would provide consumers with easy-to-understand nutrition information and support the selection of healthier choices when shopping for food. Methods An existing branded food database including 17,000 Australian packaged foods underpinned the project. An iterative process of development, review, and testing was undertaken to define a user interface that could deliver nutritional information. A parallel process identified the best approach to rank foods based on nutritional content, so that healthier alternative products could be recommended. Results Barcode scanning technology was identified as the optimal mechanism for interaction of the mobile phone with the food database. Traffic light labels were chosen as the preferred format for presenting nutritional information, and the Food Standards Australia New Zealand nutrient profiling method as the best strategy for identifying healthier products. The resulting FoodSwitch mobile phone app was launched in Australia in January 2012 and was downloaded by about 400,000 users in the first 18 months. FoodSwitch has maintained a 4-plus star rating, and more than 2000 users have provided feedback about the functionality. Nutritional information for more than 30,000 additional products has been obtained from users through a crowdsourcing function integrated within the app. Conclusions FoodSwitch has empowered Australian consumers seeking to make better food choices. In parallel, the huge volume of crowdsourced data has provided a novel means for low-cost, real-time tracking of the nutritional composition of Australian foods. There appears to be significant opportunity for this approach in many other countries.

FoodSwitch: A Mobile Phone App to Enable Consumers to Make Healthier Food Choices and Crowdsourcing of National Food Composition Data [invited speaker]

Increasing consumption of pre-packaged foods is likely an important driver of diet-related diseases in China. From January 2013 it became mandatory to provide a standardised nutrient declaration on pre-packaged foods in China. We collected data on pre-packaged foods from large chain supermarkets in Beijing in 2013, examined the completeness of the nutrient declaration of core required nutrients and summarised the average nutritional composition of 14 different major food groups. We also illustrated the potential use of the data by comparing sodium levels. Photos of 14,279 pre-packaged foods were collected from 16 chain supermarkets in Beijing. Data for 11,489 products were included in the evaluation of nutrient declarations and data for 10,048 in the summary analysis of average nutritional composition. Compliant nutrient declarations were displayed by 87% of products with 88% of foods displaying data for each of energy, protein, total fat, carbohydrate and sodium. Nutrients not required by the Chinese regulation were infrequently reported: saturated fat (12%), trans fat (17%) and sugars (11%). Mean sodium levels were higher in Chinese products compared to UK products for 8 of 11 major food categories, often markedly so (e.g. 1417 mg/100 g vs. 304 mg/100 g for convenience foods). There has been substantial uptake of the recently introduced Chinese nutrition labelling regulation which should help consumers to choose healthier foods. As the comparison against corresponding data about sodium from the United Kingdom shows, the nutrient data can also be used to identify broader opportunities for improvement of the food supply.

Guansheng Ma

Papers

Completeness of nutrient declarations and the average nutritional composition of pre-packaged foods in Beijing, China