The Federal Government’s Health Star Rating claims to “take some of the guess work out of shopping” and help consumers “make smarter choices” when it comes to buying food.
But when Milo, a chocolate powder that’s almost 50 per cent sugar, clinches 4.5 (out of 5) stars, how much can we trust the system?
Alexandra Jones from the George Institute for Global Health in Sydney told AM that the food industry is intentionally prolonging a review of the scheme’s rules.
“It’s a well known tactic of the food industry to ask for more evidence and consultation as a way of delaying meaningful public health policy,” Ms Jones said.
The Health Star Rating Advisory Committee (HSRAC) is meeting today in Melbourne to reconsider the scheme’s so-called “as prepared” rule.
That’s a provision that allows companies to rate products based on their suggested recipe for preparation, rather than on their standalone nutritional value.
Ms Jones said if the powder was assessed on its own merits, it would only get 1.5 stars.
“We really just need a blanket rule that every product has to display health stars based on what’s in the packet.”
Nestle says it welcomes the “as prepared” rule review and it doesn’t have a view on whether it should change. Its industry body, the Australian Food and Grocery Council (AFGC), which is on the HSRAC, is more forthright. They don’t want a change.
“Milo is intended to be consumed with skim milk and the company is following the direction of Food Standards Australian and New Zealand, and the regulations that require that nutrition labelling reflects the product as intended to be consumed,” said the council’s deputy chief executive Geoffrey Annison.
“The timeline for the review of the ‘as prepared’ rule was agreed to by the health star rating committee that includes public health representatives.”
But public health experts say the “as prepared” rule isn’t the only loophole undermining public confidence in the health star rating system.
So how does it work?
The rating is based on nutritional composition
The system is designed to give you an “at-a-glance overall health rating” of packaged and processed foods.
Foods are rated from half-a-star to five stars, depending on their composition of “healthy nutrients” and “risk nutrients”.
“How the rating is determined is that seven nutrients are taken in to account. You lose points for energy, saturated fat, sugar, and salt … and gain some points for fruit and vegetable content, for protein and for fibre,” Ms Jones said.
“All these things get combined together to spit out an overall score.”
She added that an analysis of more than 34,000 products by the George Institute found the rating system was “getting it pretty right on most products”.
But Professor Mark Lawrence from Deakin University said the stars have some “major flaws”.
“If you look at nutrients in isolation, you mispresent nutrition. We’ve moved away from thinking about nutrients to food groups and dietary patterns.
“The core, fundamental problem of the health star rating system is that it doesn’t differentiate between whole foods and junk foods,” said Professor Lawrence, from Deakin’s Institute for Physical Activity and Nutrition.
He said putting health stars on foods irrespective of whether they are “discretionary” (or junk) foods directly undermines messages in the Australian Dietary Guidelines.
Jane Martin from the Obesity Policy Coalition agreed that improvements could be made to ensure that foods with lots of sugar, salt or saturated fat can’t get a high star rating. But on the whole, she said the scheme is working.
“As a tool to help people make a healthier choice … it does help guide consumers.”
It doesn’t distinguish natural from added sugars
One of the major concerns about the food labelling system is that added sugars are treated the same as naturally occurring sugars.
“It’s really important we distinguish between naturally occurring intrinsic sugars, like your fructose in fruit or lactose in milk, and added sugars, predominantly in discretionary foods,” Professor Lawrence said.
Naturally occurring sugars are an integral part of a healthy diet, while added sugars are a major contributing factor to obesity.
“Products that have a lot of added sugars don’t get penalised in a way they ought to,” Ms Martin said.
Research shows seven out of 10 packaged foods contain added sugar, but food manufacturers are only required to list total sugar (which includes both natural and processed) on the packaging.
“We’ve got ridiculous examples now of really high-added-sugar foods getting relatively high star ratings,” Professor Lawrence said.
“Some muesli bars which have a lot of added sugar end up scoring pretty well, while some dairy products with lots of natural sugar can get an unreasonably low score,” Ms Martin said.
Researchers at the George Institute have modelled how separating added sugar would affect the health star scoring, and say it would improve the percentage of things that get categorised correctly.
“It would do a better job of marking the foods that have sugar in them but are good, intrinsic sugars, versus the ones that are highly processed and have all this unnecessary sugar added,” Ms Jones said.
The Australian Food and Grocery Council, representing manufacturers and suppliers, says if there’s a “good reason to change” current labelling, “then obviously [they] will”.
“The advice from the regulator is that there’s no requirement at the moment for added sugars, and they gave that advice to the ministerial council, and we are generally in agreement with that,” Mr Annison said.
“We’ll take the advice of the regulator as we always do, and also the body of scientific evidence.”
It’s designed to compare foods within categories
According to the health star rating website, the system is designed to provide “a quick, easy, standard way to compare similar packaged foods”.
It should, for example, help you compare two tubs of yoghurt, or two loaves of bread.
“The calculations used to determine each product’s rating are specific to each of the six food categories,” the website states.
However, Ms Jones said this message hasn’t been made clear.
“The campaign has tried to give the message out but it hasn’t reached many people.
“Ideally, the algorithm could be improved to work better so you could use it across everything,” she said.
The system is voluntary
Most experts agree that the star ratings, which are currently voluntary, would work better if they were mandatory.
“As long as it remains voluntary, we’re probably not going to see it on the products that it would be most useful to see it on — the things we should be avoiding,” Ms Jones said.
At present, food manufacturers can elect to put the star rating on some, all or none of their products.
“You can pick and choose,” said Professor Lawrence. “If it suits your interest, you would put the stars on. But if it doesn’t, then you can fly under the radar.”
Both Coles and Woolworths have committed to putting the stars on all their branded products, which Ms Jones said “encourages other companies … to start to disclose too”.
“We’re always arguing that we need to be guided by — and the terms of reference are — how to make this work as a public health measure, not as just a marketing tool for industry,” she said.
There is no silver bullet
According to Ms Jones, there is lots of evidence to show the health star rating system does help people make healthier choices, but that it shouldn’t be used as a standalone source of dietary advice.
“And those are things that you know from the Australian Dietary Guidelines – like we need to eat more fruits and vegetables.
“If you use the two in combination, things would work quite well. Unfortunately, many Australians still don’t know the main messages of the Dietary Guidelines, so we’re sort of trying to catch up on a few fronts.”
Ms Martin said when it came to food policy, an interpretive front-of-pack labelling system is “world’s best practice”, and that Australia “came out very well”.
“It can’t do everything. It can be improved. But to throw it out and start again, I think that’s not going to be helpful.”
It’s being reviewed and it’ll take time
The three experts all agreed that addressing the “as prepared” rule and separating added sugars were key priorities.
Ms Jones said that even if the system is “not doing well on a few products” it was important not to undermine consumer trust.
“If consumers don’t trust it, it doesn’t work overall,” she said.
Professor Lawrence said the system still required “major design reforms”, one of which could be to apply caps to discretionary foods — for example, so they couldn’t get above 1.5 stars.
“That way you are clearly demarcating between the five food groups and junk food,” he said.
Warning symbols on discretionary foods could also work, he added.
According to Ms Jones, all those ideas are on the table. “They are being considered as part of the five-year review,” she said.
The findings of the review will be presented to the Australia and New Zealand Ministerial Forum on Food Regulation in mid-2019.