• 29Jun

    Food nutritional information: transparency and public health

    Article in The Lancet Diabetes & Endocrinology:

    The labelling of food is a politically contested space and has become a bellwether for the priority of public health versus the power of vested commercial interests. Efforts are needed at a population level to improve diet and nutrition and thereby counter the growing burden of diet-related chronic diseases including obesity, type 2 diabetes, and cardiovascular disease. Ensuring that populations are provided with adequate information and guidance to make healthier choices is therefore a crucial step.
    In May, 2018, the US Food and Drug Administration (FDA) announced that food manufacturers had received an 18 month extension on compliance with updated nutrition information on product labels—originally due to come into effect on July 26 this year for companies with US$10 million or more in annual food sales. These manufacturers now have until Jan 1, 2020, while the deadline for smaller companies has been extended from July 26, 2019, to Jan 1, 2021. The updated information panels are designed to better inform consumers about the nutritional makeup of food products, including more realistic serving size estimates, more clearly displayed calorie counts, updated percentage daily intake values, and reporting of added sugar content.

    Although the delay is disappointing news for consumer organisations and public health advocates, the fact that the agency is pressing ahead with updated labelling—as well as other Obama-era nutrition policies—is a welcome development, particularly in light of the Trump administration’s antipathy towards regulation and public health policies. Notably, another policy requiring chain restaurants to post the calorie content of dishes on their menus (originally mandated as part of Obama’s Affordable Care Act) was implemented on May 7, despite opposition from industry groups.

    In Europe, meanwhile, developments in food labelling have focused on the use of front-of-pack labelling. Unlike the basic required nutrient information labels, front-of-pack labelling has an interpretive function, providing consumers with easily understandable guidance that rates the nutritional value of foods. In France, following a process that lasted several years and faced intense lobbying from industry, a colour-coded front-of-pack labelling system called Nutri-Score was successfully introduced in late 2017. In the UK, a traffic light system has been in place since 2013, in which food products are given colour-coded ratings based on levels of fat, saturated fat, sugar, and salt, with information about how much a portion contributes to adult daily reference intakes.

    However, the systems in both France and the UK remain voluntary and are not universally applied. As part of their Food Upfront campaign, the charity Diabetes UK has called on the UK Government to commit to introducing mandatory front-of-pack traffic light labelling for all pre-packaged food and drink. Diabetes UK has also backed mandatory calorie information on restaurant menus and other information to be made available online or when requested on premises—including carbohydrate content, which is of particular relevance to people with insulin-treated diabetes. Notably, the Local Government Association has also supported calls for mandatory traffic light food labelling in the UK, highlighting that the country’s exit from the European Union could allow a stronger policy to be implemented than at present.

    Improving food labelling increases transparency about the food we eat and could help to make diets healthier, both by helping individuals to make informed choices and by incentivising producers to reformulate existing products and to develop healthier alternatives. This agenda should therefore be advanced and supported through robust regulation and mandatory standards. However, nutritional labelling has inherent limitations: the focus on total calories and macronutrient content cannot take into account differences in food quality, and other avenues are necessary to improve understanding of evidence-based nutritional recommendations focused on foods and dietary patterns, rather than energy and macronutrients alone.

    Crucially, tackling the growing burden of obesity and diet-related chronic diseases will require concerted strategies to improve the food environment and overcome structural barriers to healthy eating, particularly in socioeconomically disadvantaged populations. Policies are needed both to reduce consumption of unhealthy foods (including improved nutrition labelling, restrictions on marketing, and targeted taxation) and to ensure that healthy, minimally processed foods are more accessible and affordable for poorer communities. While such policies will often be contested by vested economic interests, it is vital that public health takes priority.

    Read the full article here: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30176-1/fulltext