Cargando…

Incorporating Added Sugar Improves the Performance of the Health Star Rating Front-of-Pack Labelling System in Australia

Background: The Health Star Rating (HSR) is an interpretive front-of-pack labelling system that rates the overall nutritional profile of packaged foods. The algorithm underpinning the HSR includes total sugar content as one of the components. This has been criticised because intrinsic sugars natural...

Descripción completa

Detalles Bibliográficos
Autores principales: Peters, Sanne A. E., Dunford, Elizabeth, Jones, Alexandra, Ni Mhurchu, Cliona, Crino, Michelle, Taylor, Fraser, Woodward, Mark, Neal, Bruce
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537816/
https://www.ncbi.nlm.nih.gov/pubmed/28678187
http://dx.doi.org/10.3390/nu9070701
_version_ 1783254252110479360
author Peters, Sanne A. E.
Dunford, Elizabeth
Jones, Alexandra
Ni Mhurchu, Cliona
Crino, Michelle
Taylor, Fraser
Woodward, Mark
Neal, Bruce
author_facet Peters, Sanne A. E.
Dunford, Elizabeth
Jones, Alexandra
Ni Mhurchu, Cliona
Crino, Michelle
Taylor, Fraser
Woodward, Mark
Neal, Bruce
author_sort Peters, Sanne A. E.
collection PubMed
description Background: The Health Star Rating (HSR) is an interpretive front-of-pack labelling system that rates the overall nutritional profile of packaged foods. The algorithm underpinning the HSR includes total sugar content as one of the components. This has been criticised because intrinsic sugars naturally present in dairy, fruits, and vegetables are treated the same as sugars added during food processing. We assessed whether the HSR could better discriminate between core and discretionary foods by including added sugar in the underlying algorithm. Methods: Nutrition information was extracted for 34,135 packaged foods available in The George Institute’s Australian FoodSwitch database. Added sugar levels were imputed from food composition databases. Products were classified as ‘core’ or ‘discretionary’ based on the Australian Dietary Guidelines. The ability of each of the nutrients included in the HSR algorithm, as well as added sugar, to discriminate between core and discretionary foods was estimated using the area under the curve (AUC). Results: 15,965 core and 18,350 discretionary foods were included. Of these, 8230 (52%) core foods and 15,947 (87%) discretionary foods contained added sugar. Median (Q1, Q3) HSRs were 4.0 (3.0, 4.5) for core foods and 2.0 (1.0, 3.0) for discretionary foods. Median added sugar contents (g/100 g) were 3.3 (1.5, 5.5) for core foods and 14.6 (1.8, 37.2) for discretionary foods. Of all the nutrients used in the current HSR algorithm, total sugar had the greatest individual capacity to discriminate between core and discretionary foods; AUC 0.692 (0.686; 0.697). Added sugar alone achieved an AUC of 0.777 (0.772; 0.782). A model with all nutrients in the current HSR algorithm had an AUC of 0.817 (0.812; 0.821), which increased to 0.871 (0.867; 0.874) with inclusion of added sugar. Conclusion: The HSR nutrients discriminate well between core and discretionary packaged foods. However, discrimination was improved when added sugar was also included. These data argue for inclusion of added sugar in an updated HSR algorithm and declaration of added sugar as part of mandatory nutrient declarations.
format Online
Article
Text
id pubmed-5537816
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-55378162017-08-04 Incorporating Added Sugar Improves the Performance of the Health Star Rating Front-of-Pack Labelling System in Australia Peters, Sanne A. E. Dunford, Elizabeth Jones, Alexandra Ni Mhurchu, Cliona Crino, Michelle Taylor, Fraser Woodward, Mark Neal, Bruce Nutrients Article Background: The Health Star Rating (HSR) is an interpretive front-of-pack labelling system that rates the overall nutritional profile of packaged foods. The algorithm underpinning the HSR includes total sugar content as one of the components. This has been criticised because intrinsic sugars naturally present in dairy, fruits, and vegetables are treated the same as sugars added during food processing. We assessed whether the HSR could better discriminate between core and discretionary foods by including added sugar in the underlying algorithm. Methods: Nutrition information was extracted for 34,135 packaged foods available in The George Institute’s Australian FoodSwitch database. Added sugar levels were imputed from food composition databases. Products were classified as ‘core’ or ‘discretionary’ based on the Australian Dietary Guidelines. The ability of each of the nutrients included in the HSR algorithm, as well as added sugar, to discriminate between core and discretionary foods was estimated using the area under the curve (AUC). Results: 15,965 core and 18,350 discretionary foods were included. Of these, 8230 (52%) core foods and 15,947 (87%) discretionary foods contained added sugar. Median (Q1, Q3) HSRs were 4.0 (3.0, 4.5) for core foods and 2.0 (1.0, 3.0) for discretionary foods. Median added sugar contents (g/100 g) were 3.3 (1.5, 5.5) for core foods and 14.6 (1.8, 37.2) for discretionary foods. Of all the nutrients used in the current HSR algorithm, total sugar had the greatest individual capacity to discriminate between core and discretionary foods; AUC 0.692 (0.686; 0.697). Added sugar alone achieved an AUC of 0.777 (0.772; 0.782). A model with all nutrients in the current HSR algorithm had an AUC of 0.817 (0.812; 0.821), which increased to 0.871 (0.867; 0.874) with inclusion of added sugar. Conclusion: The HSR nutrients discriminate well between core and discretionary packaged foods. However, discrimination was improved when added sugar was also included. These data argue for inclusion of added sugar in an updated HSR algorithm and declaration of added sugar as part of mandatory nutrient declarations. MDPI 2017-07-05 /pmc/articles/PMC5537816/ /pubmed/28678187 http://dx.doi.org/10.3390/nu9070701 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Peters, Sanne A. E.
Dunford, Elizabeth
Jones, Alexandra
Ni Mhurchu, Cliona
Crino, Michelle
Taylor, Fraser
Woodward, Mark
Neal, Bruce
Incorporating Added Sugar Improves the Performance of the Health Star Rating Front-of-Pack Labelling System in Australia
title Incorporating Added Sugar Improves the Performance of the Health Star Rating Front-of-Pack Labelling System in Australia
title_full Incorporating Added Sugar Improves the Performance of the Health Star Rating Front-of-Pack Labelling System in Australia
title_fullStr Incorporating Added Sugar Improves the Performance of the Health Star Rating Front-of-Pack Labelling System in Australia
title_full_unstemmed Incorporating Added Sugar Improves the Performance of the Health Star Rating Front-of-Pack Labelling System in Australia
title_short Incorporating Added Sugar Improves the Performance of the Health Star Rating Front-of-Pack Labelling System in Australia
title_sort incorporating added sugar improves the performance of the health star rating front-of-pack labelling system in australia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537816/
https://www.ncbi.nlm.nih.gov/pubmed/28678187
http://dx.doi.org/10.3390/nu9070701
work_keys_str_mv AT peterssanneae incorporatingaddedsugarimprovestheperformanceofthehealthstarratingfrontofpacklabellingsysteminaustralia
AT dunfordelizabeth incorporatingaddedsugarimprovestheperformanceofthehealthstarratingfrontofpacklabellingsysteminaustralia
AT jonesalexandra incorporatingaddedsugarimprovestheperformanceofthehealthstarratingfrontofpacklabellingsysteminaustralia
AT nimhurchucliona incorporatingaddedsugarimprovestheperformanceofthehealthstarratingfrontofpacklabellingsysteminaustralia
AT crinomichelle incorporatingaddedsugarimprovestheperformanceofthehealthstarratingfrontofpacklabellingsysteminaustralia
AT taylorfraser incorporatingaddedsugarimprovestheperformanceofthehealthstarratingfrontofpacklabellingsysteminaustralia
AT woodwardmark incorporatingaddedsugarimprovestheperformanceofthehealthstarratingfrontofpacklabellingsysteminaustralia
AT nealbruce incorporatingaddedsugarimprovestheperformanceofthehealthstarratingfrontofpacklabellingsysteminaustralia