Interpretive nutrient profiling algorithms are a limited tool for assessing the healthiness of countries' packaged food and beverage supplies, and the conclusions are not substantiated by the data

Lawrence, Mark; Lawrence, A. Wilfred; Stanton, Rosemary; Pollard, Christina; Pulker, Claire Elizabeth; Woods, Julie; Ashton, Bronwyn

doi:10.1111/obr.12957

Cited by 2 publications

(3 citation statements)

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“…The current study found the implemented Health Star Rating system is misaligned with NOVA and the ADGs, logically based on the majority of 'less healthy' foods failing on the 10-point scale. The limited predictive validation, and findings from this research, indicate the need for caution not only on the continued use of NP models for nutrition policy actions, but also for the evaluation of national food supplies [59]. This is the first study to conduct an independent analysis of the HSR implementation to coincide with the completion of its five-year implementation period.…”

Section: Discussionmentioning

confidence: 88%

“…One of the earliest analyses of the HSR system reported that the majority (79%) of recommended ADG five food group foods in New South Wales public settings scored an HSR ≥ 3.5, and 86% of discretionary foods scored an HSR < 3.5 [49]. Subsequently, an HSR cut off value of 3.5 has been assumed to be a valid standard and adopted in many research activities [48,[50][51][52], and dubiously argued to provide a reference standard for annual surveys comparing countries' food supplies [59]. Menday et al reported 16.3% disagreement with FFG foods and 27.5% disagreement with discretionary foods [50], and Jones et al reported 9.5% disagreement with FFG foods, and 17.4% disagreement for discretionary foods, both studies concluding broad alignment with the ADGs.…”

Section: Discussionmentioning

confidence: 99%

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Evaluating Nutrient-Based Indices against Food- and Diet-Based Indices to Assess the Health Potential of Foods: How Does the Australian Health Star Rating System Perform after Five Years?

et al. 2020

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Nutrient-based indices are commonly used to assess the health potential of individual foods for nutrition policy actions. This study aimed to evaluate the nutrient profile-informed Australian Health Star Rating (HSR), against NOVA and an index informed by the Australian Dietary Guidelines (ADGs), to determine the extent of alignment. All products displaying an HSR label in the Australian marketplace between June 2014 and June 2019 were extracted from the Mintel Global New Product Database, and classified into one of four NOVA categories, and either as an ADG five food group (FFG) food or discretionary food. Of 4451 products analysed, 76.5% were ultra-processed (UP) and 43% were discretionary. The median HSR of non-UP foods (4) was significantly higher than UP foods (3.5) (p < 0.01), and the median HSR of FFG foods (4) was significantly higher than discretionary foods (2.5) (p < 0.01). However, 73% of UP foods, and 52.8% of discretionary foods displayed an HSR ≥ 2.5. Results indicate the currently implemented HSR system is inadvertently providing a ‘health halo’ for almost ¾ of UP foods and ½ of discretionary foods displaying an HSR. Future research should investigate whether the HSR scheme can be reformed to avoid misalignment with food-and diet-based indices.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Evaluating Nutrient-Based Indices against Food- and Diet-Based Indices to Assess the Health Potential of Foods: How Does the Australian Health Star Rating System Perform after Five Years?

et al. 2020

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“…It also recommended a package of reforms. These include refinements to HSR’s algorithm for scoring foods in response to multiple rounds of public consultation and modelling to address outliers and ‘anomalies’ in product scores, the limitations of which have been the subject of high profile media attention and peer-reviewed publications [ 5 , 6 , 7 , 8 ]. With respect to HSR’s graphic design, improvements include removal of the non-interpretive ‘energy icon only’ variant of the HSR label ( Appendix A — Figure A5 ) as an option for manufacturers to use on pack.…”

Section: Introductionmentioning

confidence: 99%

Uptake of Australia’s Health Star Rating System 2014–2019

2020

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In June 2014, Australia and New Zealand adopted a voluntary front-of-pack nutrition label, the Health Star Rating (HSR) system. Our aim was to assess its uptake in Australia in the five years following adoption and examine the feasibility of proposed targets for future uptake. Numbers and proportions of products eligible to carry a HSR were recorded each year between 2014 and 2019 as part of an annual survey of four large Australian retail outlets. Uptake was projected to 2024. Mean HSR values were determined for products that were, and were not labelled with a HSR logo, and summary data presented overall, by HSR score, by major food category, by manufacturer and manufacturer group. Differences in mean HSR were assessed by independent samples t-test. HSR uptake continues to increase, appearing on 7118/17,477 (40.7%) of eligible products in 2019. Voluntary display of the HSR logo was increasing linearly at 6.8% annually. This would need to be maintained to reach 70% by 2024. Of those products displaying a HSR logo, more than three quarters (76.4%) had a HSR ≥ 3.0. Products displaying a HSR logo had a significantly higher mean HSR (3.4), compared to products not displaying a HSR logo (2.6) (p < 0.001). One hundred and thirty-nine manufacturers were using HSR, but retailers Coles, Woolworths and ALDI were together responsible for the majority of uptake (55.9%). Manufacturer members of the Australian Food and Grocery Council were responsible for 28.6% of uptake. Our findings illustrate the limits of commercial goodwill in applying HSR voluntarily. Ongoing implementation must pair clear targets and timelines for uptake with a firm pathway to make HSR mandatory if sufficient progress is not achieved.

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Interpretive nutrient profiling algorithms are a limited tool for assessing the healthiness of countries' packaged food and beverage supplies, and the conclusions are not substantiated by the data

Cited by 2 publications

References 3 publications

Evaluating Nutrient-Based Indices against Food- and Diet-Based Indices to Assess the Health Potential of Foods: How Does the Australian Health Star Rating System Perform after Five Years?

Evaluating Nutrient-Based Indices against Food- and Diet-Based Indices to Assess the Health Potential of Foods: How Does the Australian Health Star Rating System Perform after Five Years?

Uptake of Australia’s Health Star Rating System 2014–2019

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