Development of international criteria for a front of package food labelling system: the International Choices Programme

Abstract

Background: A global push to reduce the amount of saturated and trans-fatty acids, added salt and sugar in processed food, and to enhance fruit, vegetable and whole grain intake, while limiting energy intake, exists for most populations.

Objectives: To redesign the International Choices Program (note: this is unrelated to the US Smart Choices Program), initially Netherlands focused, by an international board of scientists to create a generic, global front-of-pack nutrition logo system that helps consumers make healthier food choices and stimulates product reformulation.

Methods: The Programme is a product-group-specific-nutrient-profiling approach with a distinction between basic and discretionary foods. The basic product groups are main contributors of essential and beneficial nutrients, and are based on food-based dietary guidelines from more than 20 countries across the globe. Generic criteria are derived from international nutrient recommendations for trans-fatty acids, saturated fatty acids, sodium, added sugar, fibre and energy, and evaluated against food composition data from 12 countries across Europe and market reality (actual foods on the market). Selected debates such as the source of fibre are also presented.

Results: Generic criteria and a decision framework were developed to further define food categories, so as to meet the unique country- and region-specific dietary needs. The result is a complete set of criteria that is evaluated on a regular basis to ensure its alignment with international dietary patterns, new scientific insights and current developments within the food market.

Conclusions: These guidelines are currently used in a number of countries across the globe, and are being evaluated for effectiveness. Completed studies have demonstrated an increase in consumer awareness, a positive effect on product innovation and a potential impact on nutrient intakes.

Figure 1

Decision framework for defining new product groups or new product-group-specific criteria. ¹In this question, we assume that people choose within a product group. Example: a new product group ‘Rice' was derived from ‘Grains and cereal products' by defining a product-group-specific criterion for fibre, so that some high fibre rice can comply. ²Examples: product-group-specific criterion for sodium was defined for soups, because of taste reasons (as a generic sodium criterion would lead to soups without a salty taste), whereas for sodium in cheese and bread it was defined according to technological constrains (that is, salt is needed for the preparation of bread and cheese). ³Example: a product-group-specific criterion for SAFA was defined for the product group ‘Fish products' to allow more products to comply, which are important for unsaturated fatty acid intake. ⁴Within the Israeli diet, soft white cheese is an important source of calcium and protein. As previous criteria for ‘Cheese' were too lenient and not encouraging innovation, it was therefore adapted (see Supplementary Appendix 1).

Figure 2

Description of the test database on food composition for the product group bread: number and type of products. This database consists of 7000 foods from the following sources: 21% of the foods come from the limited EU database (EFSA, 2008), in the following quantities: France (29%), Spain (17%), Germany (12%), Italy, Sweden, UK, Denmark (each 8%), Ireland (7%) and Norway (6%). Foods from other databases are as follows: the Netherlands (20%) (Stichting Nederlands Voedingstoffenbesluit, 2006), the United Kingdom (17%) (Food Standards Agency, 2002), Belgium (Rijksadministratief Centrum, 2004) and Denmark (Danish Institute for Food and Veterinary Research, 2005) (both 14%), Poland (13%) (National Food and Nutrition Institute (IZZ, 2005).

Figure 3

Product group bread: the percentage of complying and non-complying products are given: overall product score and a score per nutrient. Examples of complying foods (eligible to use the logo): rye bread, average^b; wholemeal bread average^c, crisp bread rye 18% fibre Ryvita Morkt (dark)^d; examples of foods that do not comply (including non-complying nutrients): white bread, premium^c (sodium, fibre), crackers^e (TFA, SAFA, sodium, fibre); crisp bread, knackerbrot, wheat, fine^f (SAFA, fibre). Sources: ^bStichting Nederlands Voedingstoffenbesluit (2006); ^cFood Standards Agency (2002); ^dEFSA (2008); ^eRijksadministratief Centrum (2004); ^fDanish Institute for Food and Veterinary Research (2005). SAFA, saturated fatty acids; TFA, trans-fatty acids; en%, for a specific food: energy delivered by added sugar (kcal), divided by the total energy content (kcal) of the food and multiplied by 100.

Figure 4

Percentages of products that comply based on the test database. Results are shown per product group, for basic foods and discretionary foods.