The Healthfulness of the US Packaged Food and Beverage Supply: A Cross-Sectional Study.

Linda V Van Horn,Fraser Taylor,Abigail S Baldridge,Dagan Xavier,Bruce Neal,Elizabeth Dunford,Mark D Huffman,Brooke Bright

doi:10.3390/nu11081704

Linda V Van Horn, Fraser Taylor + Show 6 more

Open Access

https://doi.org/10.3390/nu11081704

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Abstract

The US food supply is dominated by highly-processed packaged food and beverage products that are high in energy, saturated fat, sugar, and salt. We report results of a cross-sectional assessment of the 2018 US packaged food and beverage supply by nutritional composition and indicators of healthfulness and level of processing. Data were obtained through Label Insight’s Open Data database, which represents >80% of all food and beverage products sold in the US over the past three years. Healthfulness and the level of processing, measured by the Health Star Rating (HSR) system and the NOVA classification framework, respectively, were compared across product categories and leading manufacturers. Among 230,156 food and beverage products, the mean HSR was 2.7 (standard deviation (SD) 1.4) from a possible maximum rating of 5.0, and 71% of products were classified as ultra-processed. Healthfulness and level of processing varied substantially by category (range: HSR 1.1–3.9; 0–100% ultra-processed) and manufacturer (range: HSR 0.9–4.6; 26–100% ultra-processed). The US packaged food and beverage supply is large, heterogeneous, highly processed, and generally unhealthy. The wide variability in healthfulness and level of processing demonstrates that opportunities exist, through reformulation or replacement, for large-scale improvements to the healthfulness of the US packaged food and beverage supply.

Highlights

The central role of the food supply in the development of chronic disease is well recognized [1,2].The US food supply is dominated by packaged food and beverage products, with around 80% of total calories consumed coming from store-bought foods and beverages [3,4]
Products ineligible for analyses included: products with duplicate Universal Product Code (UPC), products categorized as non-food and products that did not display a nutrition facts panel (NFP), and products that differed only by package size
After removal of ineligible products, including products with duplicate UPCs (n = 77), products categorized as non-food and products that did not display an NFP (n = 31,679), products that differed only by package size (n = 17,728), and 47,704 (17%) products missing nutrient information required to calculate the Health Star Rating (HSR), the final sample included 230,156 food and beverage products

Summary

Introduction

The central role of the food supply in the development of chronic disease is well recognized [1,2].The US food supply is dominated by packaged food and beverage products, with around 80% of total calories consumed coming from store-bought foods and beverages [3,4]. The central role of the food supply in the development of chronic disease is well recognized [1,2]. Even small changes in levels of these nutrients of concern in the food supply have the potential to produce large health gains at relatively low cost, and these changes are being promoted by public health experts as priority actions to address the growing global chronic disease crisis [5]. Food and beverage manufacturers play an important role in creating a healthier food environment, and through health promotion efforts that seek to improve population diets. The World Health Organization (WHO) has recommended limiting the levels of nutrients of concern in products to ensure that consumers can access and afford healthy food choices through manufacturers’ product portfolios [6]

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