Abstract
In June 2014, Australia and New Zealand adopted a voluntary front-of-pack nutrition label, the Health Star Rating (HSR) system. Our aim was to assess its uptake in Australia in the five years following adoption and examine the feasibility of proposed targets for future uptake. Numbers and proportions of products eligible to carry a HSR were recorded each year between 2014 and 2019 as part of an annual survey of four large Australian retail outlets. Uptake was projected to 2024. Mean HSR values were determined for products that were, and were not labelled with a HSR logo, and summary data presented overall, by HSR score, by major food category, by manufacturer and manufacturer group. Differences in mean HSR were assessed by independent samples t-test. HSR uptake continues to increase, appearing on 7118/17,477 (40.7%) of eligible products in 2019. Voluntary display of the HSR logo was increasing linearly at 6.8% annually. This would need to be maintained to reach 70% by 2024. Of those products displaying a HSR logo, more than three quarters (76.4%) had a HSR ≥ 3.0. Products displaying a HSR logo had a significantly higher mean HSR (3.4), compared to products not displaying a HSR logo (2.6) (p < 0.001). One hundred and thirty-nine manufacturers were using HSR, but retailers Coles, Woolworths and ALDI were together responsible for the majority of uptake (55.9%). Manufacturer members of the Australian Food and Grocery Council were responsible for 28.6% of uptake. Our findings illustrate the limits of commercial goodwill in applying HSR voluntarily. Ongoing implementation must pair clear targets and timelines for uptake with a firm pathway to make HSR mandatory if sufficient progress is not achieved.
Highlights
The World Health Organisation (WHO) recommends front-of-pack nutrition labelling (FoPL) on packaged foods and beverages as part of its suite of evidence-informed measures aimed at promoting healthier diets and preventing non communicable diseases (NCDs) [1,2]
In-store surveys of all foods and beverages in these stores are conducted by trained data personnel who capture images of key information including product barcode, product name, FoPLs, health and nutrient content claims, package size, ingredients list, manufacturer and brand names, and the Nutrition Information Panel (NIP)
If use of the energy icon variant is removed from valid Health Star Rating (HSR) uptake, use of the HSR logo has been increasing 6.8% per year, suggesting uptake could reach approximately 70% by the year 2024
Summary
The World Health Organisation (WHO) recommends front-of-pack nutrition labelling (FoPL) on packaged foods and beverages as part of its suite of evidence-informed measures aimed at promoting healthier diets and preventing non communicable diseases (NCDs) [1,2]. FoPLs summarise the nutritional quality of a product to assist consumers in making healthier choices. The uptake of FoPLs continues to expand globally, with over 30 countries currently using some form of government-led FoPL system [3]. In 2014, Australia and New Zealand adopted the Health Star Rating (HSR) system as a voluntary. FoPL, following a period of development led by federal, state and territory governments and involving consumer, industry and public health groups [4]. The HSR system summarises the nutritional quality of a product and assigns it a rating from 0.5 stars (least healthy) to 5.0 stars (most healthy) in ten half star increments. Food Ministers from both countries agreed to a formal five-year
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