Front-of-pack nutrition labelling to promote healthier diets: current practice and opportunities to strengthen regulation worldwide

Abstract

Unhealthy diets are a leading cause of death and disability globally. The WHO recommends Member States implement front-of-pack (FOP) nutrition labels to guide consumers towards healthier food choices, as part of comprehensive strategies to prevent diet-related non-communicable diseases. Interest in FOP nutrition labelling is increasing, but there is limited guidance for policymakers developing regulations necessary for effective implementation. A rapidly evolving evidence base, limited regulatory capacity and possibility of legal challenge by affected food industry stakeholders can create ‘regulatory chill’, whereby governments are dissuaded from progressive public health policymaking. We use a framework for analysing public health law and available best-practice guidance to evaluate key components of 31 FOP nutrition labelling regulations endorsed by governments up to June 2019. Analysis of regulatory form shows recent rapid uptake of label formats that are easier for consumers to understand and increasing use of mandatory legislation. However, policymakers must decide much more than whether to apply ‘stars’, ‘traffic lights’ or ‘stop signs’. The substance of effective regulation must contain strategic regulatory objectives, clear specifications for displaying the label on pack, a valid scoring mechanism and a justified scope for including foods. While there are limited data on current practice, good governance of FOP nutrition labelling regulation also requires transparency and accountability in processes of label development, implementation, evaluation and enforcement to promote continuous improvement and withstand undue commercial interference. Whether developing new FOP nutrition labels or reforming existing ones, our findings support policymakers to design and implement best-practice, evidence-informed regulation.

Evaluation of the Nutritional Quality of Processed Foods in Honduras: Comparison of Three Nutrient Profiles

“…Equally important is the updating of the dietary guide, which would be based on the results of this study and the CATRP-FLNW, and if necessary, carry out more studies to establish the usefulness of the criteria for each model of interest [ 40 , 41 ], taking into account the target population, vulnerable population and knowledge of nutritional topics (diet and food availability), focused on improving public health [ 25 ], identifying agreements with the food industry, in light of the urgent need to promote reformulation of products [ 42 ] and regulation of advertising [ 43 , 44 ].…”

Interpreters of International Economic Law: Corporations and Bureaucrats in Contest over Chile's Nutrition Label

“…Chile's nutrition labeling regulation defines high levels of added sugar, saturated fat, sodium, and calories that are considered unhealthy for the human diet, and requires all prepackaged foods and drinks that exceed these levels to be marked with front‐of‐pack warning labels (see supra Figure 1). Similar to other interpretive front‐of‐pack nutrition labeling (FOPNL) schemes, Chile's warning labels seek to make complex nutrition information more intelligible and to nudge consumers toward healthier food choices (see Jones et al 2019; Scrinis and Parker 2016). But the Chilean labeling regulation stands out as the world's strictest and most comprehensive nutrition labeling scheme.…”

An Experimental Comparison of the Impact of ‘Warning’ and ‘Health Star Rating’ FoP Labels on Adolescents’ Choice of Breakfast Cereals in New Zealand

“…However, later label formats sought not only to inform consumers, but to persuade them via a degree of evaluative content [1]. Matters have now advanced to the point that Jones (2019) based their analysis on 31 government endorsed systems, with a bewildering variety of formats that range from the purely informative to the fully evaluative [2]. This complexity increases the diversity of regulatory, calibration and domestic/international legal issues that jurisdictions have to deal with [3].…”