Restricting the marketing of foods and non-alcoholic beverages to children in South Africa: are all nutrient profiling models the same?

Wicks, Mariaan; Wright, Hattie H; Wentzel-Viljoen, Edelweiss

doi:10.1017/s0007114516004244

Cited by 14 publications

(14 citation statements)

References 42 publications

(76 reference statements)

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“…The development of these other WHO models underwent similar testing using country-specific food databases in their respective regions ( 43 – 45 ) . Our findings related to the EURO and Ofcom models were consistent with other studies in that there was overall ‘moderate’ agreement ( 46 ) , and that fats/oils and fruit juices were often classified differently by the models ( 10 ) . For example, there was only ‘slight’ agreement ( κ =0·08) between the EURO and Ofcom model with a high level of discordance for 62·7 % ( n 682 of 1088) of the fruit/fruit juices, the majority of which were fruit juices specifically (63·0 %, n 430 of 682).…”

Section: Discussionsupporting

confidence: 90%

Comparison of nutrient profiling models for assessing the nutritional quality of foods: a validation study

et al. 2018

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Nutrient profiling (NP) is a method for evaluating the healthfulness of foods. Although many NP models exist, most have not been validated. This study aimed to examine the content and construct/convergent validity of five models from different regions: Australia/New Zealand (FSANZ), France (Nutri-Score), Canada (HCST), Europe (EURO) and Americas (PAHO). Using data from the 2013 UofT Food Label Information Program (n15342 foods/beverages), construct/convergent validity was assessed by comparing the classifications of foods determined by each model to a previously validated model, which served as the reference (Ofcom). The parameters assessed included associations (Cochran–Armitage trend test), agreement (κ statistic) and discordant classifications (McNemar’s test). Analyses were conducted across all foods and by food category. On the basis of the nutrients/components considered by each model, all models exhibited moderate content validity. Although positive associations were observed between each model and Ofcom (all P trend<0·001), agreement with Ofcom was ‘near perfect’ for FSANZ (κ=0·89) and Nutri-Score (κ=0·83), ‘moderate’ for EURO (κ=0·54) and ‘fair’ for PAHO (κ=0·28) and HCST (κ=0·26). There were discordant classifications with Ofcom for 5·3 % (FSANZ), 8·3 % (Nutri-Score), 22·0 % (EURO), 33·4 % (PAHO) and 37·0 % (HCST) of foods (all P<0·001). Construct/convergent validity was confirmed between FSANZ and Nutri-Score v. Ofcom, and to a lesser extent between EURO v. Ofcom. Numerous incongruencies with Ofcom were identified for HCST and PAHO, which highlights the importance of examining classifications across food categories, the level at which differences between models become apparent. These results may be informative for regulators seeking to adapt and validate existing models for use in country-specific applications.

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Section: Discussionsupporting

confidence: 90%

Comparison of nutrient profiling models for assessing the nutritional quality of foods: a validation study

et al. 2018

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“…These models could also be relevant for other regions in Latin America, but do not represent a complete view of all NPS available globally. Few studies have compared the use of NPS in low- and middle-income countries and to our knowledge this study is the first to compare the seven selected models [ 27 , 28 , 42 ]. Another limitation is the fact that due to the diversity of the selected models, the way in which they classify foods is not directly comparable (e.g., HSR assigns between 1 and 5 stars, whereas the PAHO model classifies foods as containing “excessive” or “not excessive” amounts of critical nutrients).…”

Section: Discussionmentioning

confidence: 99%

“…For example, the PAHO model has one of the strictest criteria. To our knowledge, few studies have compared the application of different NPS across settings [ 26 , 27 , 28 ]. The objective of this paper is to compare the ability of the PAHO model and other NPS to identify processed and ultra-processed products containing excessive amounts of critical nutrients (sodium, total sugars, added sugars, saturated fat, total fat, and trans fat), applying their criteria in a sample of products commercialized in Mexico.…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Classification of Food Products in the Mexican Market According to Seven Different Nutrient Profiling Systems

et al. 2018

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Nutrient profiling systems (NPS) are used around the world. In some countries, the food industry participates in the design of these systems. We aimed to compare the ability of various NPS to identify processed and ultra-processed Mexican products containing excessive amounts of critical nutrients. A sample of 2544 foods and beverages available in the Mexican market were classified as compliant and non-compliant according to seven NPS: the Pan American Health Organization (PAHO) model, which served as our reference, the Nutrient Profiling Scoring Criterion (NPSC), the Mexican Committee of Nutrition Experts (MCNE), the Health Star Rating (HSR), the Mexican Nutritional Seal (MNS), the Chilean Warning Octagons (CWO) 2016, 2018 and 2019 criteria, and Ecuador’s Multiple Traffic Light (MTL). Overall, the proportion of foods classified as compliant by the HSR, MTL and MCNE models was similar to the PAHO model. In contrast, the NPSC, the MNS and the CWO-2016 classified a higher amount of foods as compliant. Larger differences between NPS classification were observed across food categories. Results support the notion that models developed with the involvement of food manufacturers are more permissive than those based on scientific evidence. Results highlight the importance of thoroughly evaluating the underlying criteria of a model.

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“…Different countries are developing and adapting their own nutrient profiling models to best meet specific national issues and recommendations [27]. For example, Chile has been known for its extensive approach to child marketing regulation [28]; in a number of other countries, a variety of different approaches is also being investigated [29,30,31]. While details of the used nutrient profile models vary, it is very important that models used in regulations are adopted to the specific situation in each country [32].…”

Section: Introductionmentioning

confidence: 99%

Marketing of Foods to Children through Food Packaging Is Almost Exclusively Linked to Unhealthy Foods

Lavriša

Pravst

2019

Nutrients

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The nutritional composition of foods marketed to children is important, as it can significantly influence children’s preferences. The objective of this research was to evaluate the presence of child-oriented food products in the food supply and to investigate their nutritional composition. The sample included 8191 prepacked foods in the Slovenian food supply available in the market in 2015. The nutrient profile (World Health Organisation Regional Office for Europe nutrient profile model) of the products with child-targeted promotions was compared to the nutrient profile of those without child-targeted promotions. Food categories with the highest proportion of products with child-focused promotions were “Breakfast Cereals” (17%), “Chocolate and Sugar Confectionery” (15%) and “Edible Ices” (13%). Altogether, 93% of all products with child-focused promotions and 73% of products without such promotions were classified as “not permitted”. The proportion of “not permitted” foods was significantly higher in products with child-targeted promotions, compared with products without child-targeted promotions (p < 0.0001), and this trend was observed in a majority of food categories. To protect children from exposure to the marketing of foods with less favourable nutritional compositions, public health strategies should be focused also towards limiting promotions of unhealthy foods to children on product packaging, not only in media.

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Restricting the marketing of foods and non-alcoholic beverages to children in South Africa: are all nutrient profiling models the same?

Cited by 14 publications

References 42 publications

Comparison of nutrient profiling models for assessing the nutritional quality of foods: a validation study

Comparison of nutrient profiling models for assessing the nutritional quality of foods: a validation study

Comparative Analysis of the Classification of Food Products in the Mexican Market According to Seven Different Nutrient Profiling Systems

Marketing of Foods to Children through Food Packaging Is Almost Exclusively Linked to Unhealthy Foods

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