Poor diets, including those that incorporate foods high in calories, sugar, and salt, are a major risk factor for cardiovascular disease, cancer, and general mortality.
In 2019, a study found that poor diets account for 18.2% of heart disease, stroke, and type 2 diabetes costs in the United States, which equates to $50.4 billion.
There has been little research on how reformulation targets influence the nutritional values of products by individual companies. Monitoring this could help policymakers develop better ways to improve public health.
Scientists from the University of Oxford in the U.K. recently conducted a study investigating how the nutritional value of products from the top 10 global food and drinks companies changed in response to voluntary reformulation targets in the U.K.
â€œOur study shows it is possible to monitor the overall healthiness of company product portfolios and chart changes over time,â€ says Dr. Lauren Bandy of the University of Oxfordâ€™s Nuffield Department of Population Health.
â€œWe saw little evidence that the recommended current targets have made a significant difference, and we believe that without more policy action and a transparent monitoring and evaluation system, it is unlikely there will be meaningful change.â€
The scientists used Euromonitor International to identify the 10 largest food and soft drink manufacturers and examine the sales data for their brands and products between 2015 and 2018.
Altogether, these companies accounted for 24% of the Â£71.3 billion in sales generated in the U.K. in 2018. They included names such as Coca-Cola, Mondelez International, and Premier Foods.
The researchers also used Edge by Ascential, a private analytics company, to collect nutrition data on all brands that the companies sold between 2015 and 2018.
They then applied a nutrient profile model â€” which the Food Standards Agency developed for the Office for Communications (Ofcom) â€” to each product to rate their healthiness.
The team awarded the products points based on their energy, saturated fat, total sugar, sodium level, fiber, and protein, as well as their fruit, nut, and vegetable (FNV) contents.
Between 2015 and 2018, the number of products that the companies manufactured decreased slightly from 3,471 to 3,273.
The researchers also noted a small increase in the proportion of healthy products that the companies offered. In 2015, 46% of products met the criteria for a healthy classification, compared with 48% of products in 2018.
They also found an increase in the proportion of healthy sales from 44% in 2015 to 51% in 2018. However, this change was largely due to an increase in sales of bottled water, low or no-calorie drinks, and fruit juice.
Overall, the researchers found that voluntary reformulation targets led to no significant changes in product nutritional values among the top 10 food and drink companies between 2015 and 2018.
They also found that the average nutritional values of these products collectively fell below the Ofcom threshold for broadcast advertising.
Sugar levy for soft drinks
To explain their results, the researchers say that the introduction of the Soft Drinks Industry Levy (SDIL) in 2018 likely drove the small increase in more healthy soft drink sales.
The SDIL works by charging companies for excess sugar in their drinks. There is a tax of Â£0.24 per liter on drinks with 8 grams (g) or more of sugar per 100 milliliters (ml), with a lower tax of Â£0.18 for those with 5â€“8 g per 100 ml, and no tax for those with less than 5 g per 100 ml.
â€œWhen you compare the lack of overall change we saw in foods with the reductions we saw in the sugar content of soft drinks, it would be easy to draw the line between the voluntary nature of the food reformulation targets and the mandatory and fiscal nature of the soft drinks tax,â€ Dr. Bandy recently told ishonest.
â€œOther than for acting in a responsible way and to enable consumers to eat more healthily, manufacturers have little incentive to reformulate their products to meet the reformulation targets set out by PHE,â€ she continued.
The researchers conclude that transparent monitoring and evaluation of food nutritional values could make it easier for policymakers to work with companies to improve public health.
What can we do?
MNT also spoke with Kristin Kirkpatrick, MS, RDN, manager of Wellness Nutrition Services at the Cleveland Clinic Wellness Institute in Cleveland, OH. We asked whether the results of the study were surprising. she said:
â€œNo â€” especially since font of package claims, which promise â€˜healthierâ€™ and â€˜naturalâ€™ on many known brands have been confusing consumers for years in making them think their products are nutrient dense when in fact they often are not.â€
Speaking about how these issues might be addressed, Kirkpatrick told MNT, â€œPolicy is one aspect, of course, but education is another. We need to do a better job of educating on what nutrient density means, what whole foods are, and what a balanced diet looks like. Itâ€™s OK to have non nutrient foods some of the time, but most of the time, we need to focus on nutrient dense [foods].â€
The researchers say that their results are limited due to missing data, as 32% of the products did not include values for fiber, and 67% had insufficient ingredient information to calculate FNV accurately.
Their results also do not account for U.K. retailers, including Tesco, Sainsburyâ€™s, and Asda, whose own-label brands represented 21% of sales in 2018. Future studies, say the researchers, should also include retailers and a wider range of companies.
â€œThe voluntary reformulation targets for sugar, calories, and salt set out by PHE are quite comprehensive and cover a wide range of products,â€ Dr. Bandy told MNT, â€œHowever, given that they are voluntary and there is no incentive for manufacturers to reformulate, it is perhaps not surprising that we did not see any overall improvement in the healthiness of the top 10 companiesâ€™ product portfolios.â€
â€œI think the Government is moving in the right direction with the new restrictions on price promotions and marketing to children that have been recently announced. Targeting another category with an industry levy or tax, like confectionery, might also help reduce sugar intakes, especially among children. Better promotion of fruits and vegetables, potentially through the form of subsidies, would also help increase the consumption of healthy foods,â€ she added.
Looking forward, Kirkpatrick told us, â€œwe need to help consumers understand how to shop better. How to read the ingredients and nutrition facts labels, and not the health halo claims on the front of the package.â€
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