Does the Australian Health Star Rating System Encourage Added Sugar Reformulation? Trends in Sweetener Use in Australia.

Cherie Russell,Sarah Dickie,Phillip Baker,Mark Lawrence

doi:10.3390/nu13030898

Abstract

Dietary risk factors, including excess added sugar intake, are leading contributors to Australia’s burden of disease. An objective of the Australian Health Star Rating (HSR) system is to encourage the reformulation of packaged foods. Manufacturers may improve a product’s HSR by replacing added sugar with non-nutritive sweeteners (NNS). Concerns have been raised regarding the potential substitution effects of ultra-processed foods containing NNS for whole foods, and the long-term impact this may have on population health. The aim of this study was to determine whether the implementation of the HSR system has impacted the use of added sugars and NNS in the food supply. Four product categories were used: products with no added sweetener, products containing added sugar only, products containing NNS only, and products containing a combination of added sugar and NNS. Of 6477 newly released products analyzed displaying a HSR in Australia between 2014–2020, 63% contained added sugars. The proportion of new products sweetened with added sugars increased over time, while NNS use did not, despite a higher average and median HSR for products sweetened with NNS. These findings suggest that at the current time, the HSR system may not discourage the use of added sugars in new products or incentivize the reformulation of added sugar with NNS. As the health risks of NNS are questioned, increased reformulation of products with NNS to reduce the presence of added sugar in the food supply may not address broader health concerns. Instead, supporting the promotion of whole foods and drinks should be prioritized, as well as policy actions that reduce the proliferation and availability of UPFs.

Highlights

Dietary risk factors are among the leading contributors to Australia’s burden of disease [1]
Within the Australian food supply, an increasing number of new products released with a Health Star Rating (HSR) contained added sugar, while the use of nutritive sweeteners (NNS) has remained consistent over time
The HSR system may not incentivize the reformulation of added sugar with NNS or discourage the addition of any added sugar in new products

Summary

Introduction

Dietary risk factors are among the leading contributors to Australia’s burden of disease [1] This includes excess intake of added sugar, defined as caloric sweeteners added to foods during processing, preparation or at the table [2]. The Healthy Food Partnership (the Partnership) was established in Australia in 2015 to address dietary risks associated with obesity and NCDs, including excess added sugar consumption [8]. Despite a broad suite of potential policy actions available to reduce added sugar consumption and improve diet quality, including taxation of SSB, education and food environment interventions [9], the Partnership has focused predominantly on policies that promote nutrient reformulation, including voluntary targets for packaged, processed foods the Health Star Rating (HSR) labelling system and controlling the portion size of certain products [10]. Reformulation can be either overt, in which nutrient-profile changes are advertised to the consumer, or covert, in which compositional changes are not promoted [11]

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