A comparison of four different Nutritional Profile models in their scoring of critical nutrient levels in food products targeted at Brazilian children

Abstract

AbstractThe implementation of front‐of‐pack labelling to assist consumers in making healthier food choices requires an appropriate Nutritional Profile Model (NPM) to be defined. However, four different models have been proposed in Brazil: the Pan American Health Organization (PAHO), the Brazilian Association of Food Industries (ABIA) and National Health Surveillance Agency (ANVISA) less (1) and more restrictive (2) models. The present study aimed to use the information provided on the labels of eight ultra‐processed food categories selected from the most popular group of foods targeted at Brazilian children, to score critical nutrient levels according to the four different NPMs and compare the proportion of products categorised as ‘high’, ‘medium’ or ‘low’ according to each one. Labels (n = 409) were collected in supermarkets in Belo Horizonte‐MG, Brazil. Data were tabulated, and a comparison of the ‘high’ content of the four nutrients, total sugars, total and saturated fats and sodium, according to the four NPMs, was performed. Agreement between ‘high’, ‘medium’ and ‘low’ scores according to the different NPMs, in comparison with the PAHO model, was performed using the Kappa test. Of all ‘fruit’ drinks, 95% were considered as ‘high’ in total sugars by the PAHO model, while only 5% were categorised as ‘high’ by the ABIA and ANVISA 1 models. For total sugars, no product in the cakes, breakfast cereals and yogurts categories and only 5.7% of the sandwich cookies were categorised as ‘high’ by the ABIA model, while 100% of sandwich cookies were categorised as having a ‘high’ total sugars content by the PAHO and ANVISA models. Similar findings were observed for breakfast cereals, yogurts and corn snacks for the proportion of products scoring ‘high’ for saturated fats and sodium. Kappa's concordance analysis showed moderate to excellent agreement between the PAHO and ANVISA 2 models. It was observed that the PAHO model indicated more foods with a ‘high’ content of critical nutrients. We conclude that the ABIA model is more permissive when compared to the other models and the PAHO model more restrictive.