Abstract
South Africa (SA) is facing a rising prevalence of obesity and diet-related chronic diseases. The government is seeking to develop effective, evidence-based policy measures to address this. A well-designed, fit-for-purpose nutrient profiling model (NPM) can aid policy development. The aim of this study was to develop a fit-for-purpose NPM in SA. Steps included: (1) determining the purpose and target population; (2) selecting appropriate nutrients and other food components to include; (3) selecting a suitable NPM type, criteria and base; and (4) selecting appropriate numbers and thresholds. As part of the evaluation, the nutritional composition of packaged foods containing nutritional information (n = 6747) in the SA food supply chain was analyzed, a literature review was undertaken and various NPMs were evaluated. Our findings indicated that it is most appropriate to adapt an NPM and underpin regulation with a restrictive NPM that limits unhealthy food components. The Chile 2019 NPM was identified as suitable to adapt, and total sugar, saturated fat, sodium and non-sugar sweetener were identified as appropriate to restrict. This NPM has the potential to underpin restrictive policies, such as front-of-package labelling and child-directed marketing regulations in SA. These policies will support the fight against obesity and NCDs in the country.
Highlights
There is global consensus that better policies are needed to address the obesity pandemic [1,2]
The nutrient profiling model (NPM) development process was informed by the internationally accepted seven-step approach developed by Scarborough, Rayner and Stockley [32] and the six steps recommended for NPM development or adaptation in the World Health Organization (WHO) draft guidelines on front-of-pack labelling (FOPL) [33]
The 2016 South Africa (SA) Demographic and Health Survey (SADHS) reported that overweight, obesity and hypertension prevalence have been on the rise since 1998, with 31% of men and 68% of women overweight or obese [35]
Summary
There is global consensus that better policies are needed to address the obesity pandemic [1,2]. Comprehensive, operationalizable and solidly designed food policies have the capacity to substantially improve diets at a local, national and international level. These benefits are for a select few, and reach disadvantaged, lower socioeconomic groups [3]. NPMs developed together with industry are more lenient and permit more foods than those grounded with scientific evidence [5], resulting in little progress, if any, in addressing rising rates of malnutrition in all its forms and NCDs. As such, the development of an NPM should be independent of industry involvement
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