Abstract
BackgroundConcern has been raised that the coexistence of multiple front-of-pack (FOP) nutrition rating systems in a marketplace may mislead consumers into believing that a specific food with a FOP is ‘healthier’ than foods without the symbol. Eleven summary indicator FOP systems are in use in Canada, including one non-profit developed system, the Heart and Stroke Foundation’s Health Check™, and ten manufacturer-developed systems, like Kraft’s Sensible Solutions™. This study evaluated FOP’s potential to mislead consumers by comparing the number of products qualifying to carry a given FOP symbol to the number of products that actually carry the symbol.MethodsThe nutritional criteria for the Health Check™ and the Sensible Solutions™ systems were applied to a 2010–2011 Canadian national database of packaged food products. The proportion of foods qualifying for a given FOP system was compared to the proportion carrying the symbol using McNemar’s test.ResultsCriteria were available to categorize 7503 and 3009 of the 10,487 foods in the database under Health Check™ and Sensible Solutions™, respectively. Overall 45% of the foods belonging to a Health Check™ category qualified for Health Check’s™ symbol, while only 7.5% of the foods carried the symbol. Up to 79.1% of the foods belonging to a Sensible Solutions™, category qualified for Sensible Solutions’s™ symbol while only 4.1% of the foods carried the symbol. The level of agreement between products qualifying for and carrying FOP systems was poor to moderate in the majority of food categories for both systems. More than 75% of the products in 24 of the 85 Health Check™ subcategories and 9 of 11 Sensible Solution™ categories/subcategories qualified for their respective symbols based on their nutritional composition.ConclusionsFOP systems as they are currently applied are not, in most instances, a useful guide to identifying healthier food products in the supermarket as many more products qualify for these systems than the number of products actually displaying these symbols on FOP, and the level of agreement between qualifying and carrying products is poor to moderate. The adoption of a single, standardized FOP system would assure consumers that all products meeting certain nutritional standards are designated by the symbol.
Highlights
Concern has been raised that the coexistence of multiple front-of-pack (FOP) nutrition rating systems in a marketplace may mislead consumers into believing that a specific food with a FOP is ‘healthier’ than foods without the symbol
Sensible SolutionsTM criteria are based on the same nutrients and food components as Health CheckTM [10], and include criteria related to calories, cholesterol, added sugars, serving size, and functional nutritional benefits [9]
The findings from the present study showed that significantly more products met the Health CheckTM and Sensible SolutionsTM nutrition rating systems’ definition of ‘healthy/healthier’ than carried either of these FOP symbols in most food categories
Summary
Concern has been raised that the coexistence of multiple front-of-pack (FOP) nutrition rating systems in a marketplace may mislead consumers into believing that a specific food with a FOP is ‘healthier’ than foods without the symbol. Mandatory nutrition labels have been adopted in more than 20 countries, including the European Union member states, Mexico, and China, and voluntary nutrition labels have been adopted in at least 11 more [2]. In Canada, regulations mandating nutrition labelling on most packaged foods were adopted 2003 in response to mounting evidence of the contribution of diet to chronic disease [3]. At the same time the Nutrition Facts table was adopted, Canada updated regulations for the use of nutrient content claims and established rules for the use of diet-related health claims on food products. Canada is just one of many countries, including Japan, China, Australia and New Zealand, European Union member states, and the United States, permitting some form of nutrient or health claims on food labels [4]
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