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Nutrient profiles: options for definitions for use in relation to food promotion and children's diets
Project Code: Q02057
Centre for Social Marketing, University of Strathclyde
Rayner, M ;
British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford
Scarborough, P; Stockley, L
Diet and obesity are important factors in determining risk of cancer, stroke and coronary heart disease. Health promotion targeted solely at individuals has not been successful in arresting the ongoing rise in prevalence of obesity, and this has led the Food Standards Agency to consider new approaches which have the potential to reinforce healthy eating advice, and make it easier for consumers to make healthy choices. The Agency’s Action Plan on Food Promotions and Children’s Diets, for example, seeks to address the imbalance in the way foods are currently promoted to children and their carers.
Although many would argue that the overall balance of the diet is more important than the individual foods consumed, it is the “imbalance” in the consumption of individual foods that can contribute to health problems. In addition, dietary surveys provide clear evidence of the areas in which children’s diets in particular need to improve, i.e., by reducing their consumption of fat (especially saturated fat), salt and sugar, and increasing their consumption of fruit and vegetables. It is therefore appropriate to consider nutrient profiling, which can be defined as “the science of categorising foods according to their nutritional composition”, to enable interventions that differentiate between foods on this basis. Various nutrient profiling systems have been developed throughout the world, and applied in a variety of consumer information and regulatory contexts. However, there is often a lack of detail available about the criteria underpinning these systems, or the scientific rationale on which they have been based.
The purpose of this project was to develop a nutrient profiling model to support the Agency's work to redress the current imbalance in the way foods are currently promoted to children. This will include advice on nutrition and health claims aimed specifically at children, and advice on the balance of TV advertising for foods during children’s programming. The work was based on existing Government healthy eating advice, and built on modelling work carried out in connection with the Department of Health’s 5 A DAY initiative. The models developed focused on children aged from 11 to 16, although they are likely to be applicable to other age groups, and work extending the principle is this way is in hand.
The work was overseen by an Expert Group, comprising nutrition scientists; dieticians; food industry and consumer organisation representatives; and policy makers. The research took a systematic approach to developing models, taking account of public health recommendations, basing criteria on Guideline Daily Amounts and Dietary Reference Values. The expert group assessed the success of each model on its overall performance against three factors:
A statistical test of accuracy, based on the model correctly classifying indicator panels of approximately 200 “healthier” and “less healthy” foods.
The proportion of a database of around 1000 foods, that was classified by the model as “less healthy”, “intermediate”, or “healthier”.
The report recommends one model that, with further refinement, could form the basis of a workable system. This is a scoring model that takes account of energy, saturated fat, non-milk extrinsic sugars, and sodium; and the degree to which these nutrients are balanced by calcium, iron, long chain n-3 polyunsaturated fatty acids, and fruit and vegetable content. The model therefore identifies foods high in fat, salt or sugar, while recognising the important contribution of dairy, meat, fish, and fruit and vegetable based products to a balanced diet. The flexibility provided by the scoring system means that the model could be adapted to suit a range of applications
The Expert Group’s qualitative assessment of how the models categorised approximately 100 key “example indicator foods”, representing the food groups on which healthy eating advice (the Balance of Good Health) is based.
Further work will be required to refine the model; to test it against a wider range of foods; and to consider how it might be applied in practice and communicated to stakeholders. The expert group was particularly keen for the model to be tested against a wider range of foods. The report therefore recommends:
- the development of a database of food composition data with which to test the preferred model;
- devising further panels of ‘healthier’, ‘intermediate’ and ‘less healthy’ indicator foods, across a wider range of food groups;
- considering what modifications to the proposed model would be necessary for its use for other age groups;
In summary, this work represents a significant step forward beyond nutrient profiling previously used in the UK or elsewhere. The model that has been developed has potential for use to underpin a range of interventions, including some involving consumer information and public health messages. The approach used delivers the opportunity to encourage product formulation and innovation with public health benefits. Although further work on the model will be required before it is ready for use in these contexts, the results of this work demonstrate that nutrient profiling can be made to work in practice.
Assessing the acceptability of the model to both experts and consumers; and considering communication and support issues for consumers, health and other professionals, and the food industry as appropriate.
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