Use of the WHO Nutrient Profile Model in Germany: feasibility and public health implications

Abstract

Abstract Background Exposure to marketing for foods high in sugar, salt, and fat is considered a key risk factor for childhood obesity. To support efforts to limit such marketing, the World Health Organization Regional Office for Europe has developed a nutrient profile model (WHO NPM), published as second edition in March 2023. The German government plans to use this model in new food marketing legislation, but it has not yet been tested in Germany. Methods We applied the WHO NPM to a random sample of 660 food and beverage products across 22 product categories on the German market from Open Food Facts, a product database. We calculated the share of products permitted for marketing to children under current market conditions and for hypothetical reformulation scenarios. We assessed practical challenges in applying the WHO NPM and the effects of model adaptations. Results The median share of products permitted for marketing to children across the 22 categories was 20% (interquartile range (IQR) 3-59%) and increased to 38% (IQR 11-73%) with model adaptations proposed by the German government. With targeted reformulation (i.e. a 30% reduction in fat, sugar, sodium, and/or energy) the share increased substantially (defined as a relative increase by at least 50%) in several product categories (including bread, processed meat, yogurt, convenience foods, and savoury plant-based foods), but changed less in others. Practical challenges included the ascertainment of the trans-fatty acid content of products, among others. Conclusions The application of the WHO NPM in Germany was found to be feasible. Its use in the proposed legislation on food marketing in Germany seems likely to serve its intended public health objective of limiting marketing in a targeted manner specifically for less healthy products. It seems plausible that it may incentivise reformulation in some product categories. Practical challenges could be addressed with adaptations and procedural provisions. Key messages • The practical application of the WHO Europe Nutrient Profile Model 2023 edition to a random sample of food and beverage products on the German market was found to be feasible. • With targeted reformulation, the share of products permitted for marketing to children under the WHO Europe Nutrient Profile Model increases substantially.