Abstract

To compare the degree of strictness and agreement of different nutrient profiling models (NPM) used to identify which foods would be required to show front-of-package (FOP) warning labels. Using data of 11434 packaged foods found in the five largest food retailers in Brazil, we used two published NPM: the Pan American Health Organization (PAHO) model and the NPM used in the Chilean nutritional FOP labelling policy, and compared them with a NPM proposed by the Brazilian National Health Surveillance Agency (Anvisa). The proportion of foods that would be required to show FOP warning labels was calculated overall and by food category. We also tested whether a modified version of the PAHO NPM would behave similarly to the original version. Brazil. Two-thirds of the packaged products (62 %) would receive FOP warning labels under the PAHO NPM, as compared with 45 % of products using the proposed Anvisa NPM and 41 % if the Chilean NPM was applied. The PAHO NPM identified more foods high in critical nutrients such as sweetened dairy and non-dairy beverages, canned vegetables and convenience foods. Overall agreement between models was considered good with kappa coefficient ranging from 0·57 to 0·92 but was lower for some food categories. We found variations in the degree of strictness and agreement between assessed NPM. The PAHO NPM identified more foods and beverages high in sugar which are among the top contributors to sugar and energy intake in Brazil.

Highlights

  • Comparison of the nutrient profiling models We determined the degree of strictness of each NPM by the number and proportion of foods and beverages that had a high content of the critical nutrients assessed in each model and, that would be considered unhealthy and receive FOP warning labels

  • The proportion of foods in each food category is presented in Table 2, as well as the proportion of products in each category that contain a high content in at least one of the critical nutrients, according to different NPM

  • Two-thirds of the packaged Brazilian food supply would be eligible to receive FOP warning labels for any critical nutrient if the Pan American Health Organization (PAHO) NPM was adopted (62·2 %; 95 % CI 61·3, 63·1) as compared with 45·1 % of the foods if the NPM proposed by Anvisa was adopted and 41·7 % of the assessed foods in Brazil considering the Chilean NPM

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Summary

Introduction

Comparison of the nutrient profiling models We determined the degree of strictness of each NPM by the number and proportion (percentage and 95 % CI) of foods and beverages that had a high content of the critical nutrients assessed in each model and, that would be considered unhealthy and receive FOP warning labels. The PAHO NPM considers free sugars, this information is not available on food labels of products sold in Brazil.

Results
Conclusion
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