The effectiveness of mandatory v. voluntary food reformulation policies: a rapid review

Abstract

While reformulation policies are commonly used to incentivise manufacturers to improve the nutrient profile of the foods and beverages they produce, only a few countries have implemented mandatory reformulation policies. This paper aimed to review evidence on the design, implementation challenges and effectiveness of mandatory reformulation policies and compare them to voluntary reformulation policies. The systematic search retrieved seventy-one studies including twelve on mandatory reformulation policies. Most mandatory reformulation policies were aimed at reducing trans-fatty acids or sodium in foods. Overall, mandatory reformulation policies were found to be more effective than voluntary ones in improving dietary intakes. Mandatory policies were implemented when voluntary policies either failed or were found to be insufficient to improve the composition of foods. Typical features of mandatory policies could also improve the design of voluntary policies. Examples include strict but attainable targets and a tight monitoring of compliance.

Keywords: Evidence review; Food policies; Food reformulation.

Fig. 1.

Flow chart showing the screening of records from the two search strategies (adapted from PRISMA⁽²⁹⁾).

Fig. 2.

Numbers of studies available and effectiveness¹ of different incentives promoting reformulation on improving the food environment, consumer purchases, intakes or health. ¹The percentages indicate the proportion of studies included in this review showing successful results. Changes in the outcomes were rated as success, failure or mixed results. Success was defined as a significant change in average nutrient density or a change in nutrient intake going in the direction of an improvement for public health (e.g. reduction for sodium, TFA, energy or sugar and increase in fibre), or a reduction in disease risk or mortality. Failure was defined as an absence of change, or a change in the unexpected direction. Mixed results mean both success and failure (e.g. for different categories). TFA, trans-fatty acids.