Search

We investigated the extent of alignment between 'healthiness' defined by a food classification system that classifies foods and beverages primarily by their nutrient composition, the Health Star Rating (HSR) and a system that considers only the degree of processing of the product, the NOVA classification system. We used data for 25 486 products contained within the George Institute for Global Health's Australian 2022 FoodSwitch Dataset. Agreement between the two systems in the proportion of products classified as 'healthier' (HSR ≥3.5 or NOVA group 1–3) or 'less healthy' (HSR <3.5 or NOVA group 4) was assessed using the κ statistic. There was 'fair' agreement (κ = 0.30, 95%CI: 0.29–0.31) between both systems in the proportion of all products classified as healthier or less healthy. Approximately one‐third (n = 8729) of all products were defined as 'discordant', including 34.3% (n = 5620) of NOVA group 4 products with HSR ≥3.5 (commonly convenience foods, sports/diet foods, meat alternatives, as well as products containing non‐sugar sweeteners) and 34.1% (n = 3109) of NOVA group 1–3 products with HSR <3.5 (commonly single‐ingredient foods such as sugars/syrups, full‐fat dairy and products specially produced to contain no ultra‐processed ingredients). Our analysis strengthens the evidence for the similarities and differences in product healthiness according to a nutrient‐based classification system and a processing‐based classification system. Although the systems' classifications align for the majority of food and beverage products, the discordance found for some product categories indicates potential for confusion if systems are deployed alongside each other within food policies. [ABSTRACT FROM AUTHOR]

Aim: To assess the nutritional quality of plant‐based meat analogues in Australia, compared to equivalent meat products, and to assess levels of micronutrient fortification in meat analogues. Methods: This cross‐sectional study used nutrition composition data for products collected in 2021 from major supermarkets in Australia. Nutritional quality was assessed using the Health Star Rating, energy (kJ), protein (g), saturated fat (g), sodium (mg), total sugars (g), and fibre content (g) per 100 g, and level of food processing using the NOVA classification. Proportion of products fortified with iron, vitamin B12 and zinc were reported. Differences in health star rating and nutrients between food categories were assessed using independent t‐tests. Results: Seven hundred ninety products (n = 132 plant‐based and n = 658 meat) across eight food categories were analysed. Meat analogues had a higher health star rating (mean 1.2 stars, [95% CI: 1.0–1.4 stars], p < 0.001), lower mean saturated fat (−2.4 g/100 g, [−2.9 to −1.8 g/100 g], p < 0.001) and sodium content (−132 mg/100 g, [−186 to −79 mg/100 g], p < 0.001), but higher total sugar content (0.7 g/100 g, [0.4–1.1 g/100 g], p < 0.001). Meat analogues and meat products had a similar proportion of ultra‐processed products (84% and 89%, respectively). 12.1% of meat analogues were fortified with iron, vitamin B12 and zinc. Conclusion: Meat analogues generally had a higher health star rating compared with meat equivalents, however, the nutrient content varied. Most meat analogues were also ultra‐processed and few are fortified with key micronutrients found in meat. More research is needed to understand the health impact of these foods. [ABSTRACT FROM AUTHOR]

Unhealthy diets are underpinned by the over-consumption of packaged products. Data describing the ingredient composition of these products is limited. We sought to define the ingredients used in Australian packaged foods and beverages and assess associations between the number of ingredients and existing health indicators. Statements of ingredients were disaggregated, creating separate fields for each ingredient and sub-ingredient. Ingredients were categorised and the average number of ingredients per product was calculated. Associations between number of ingredients and both the nutrient-based Health Star Rating (HSR) and the NOVA level-of-processing classification were assessed. A total of 24,229 products, listing 233,113 ingredients, were included. Products had between 1 and 62 ingredients (median (Interquartile range (IQR)): 8 (3–14)). We identified 915 unique ingredients, which we organised into 17 major and 138 minor categories. 'Additives' were contained in the largest proportion of products (64.6%, (15,652/24,229)). The median number of ingredients per product was significantly lower in products with the optimum 5-star HSR (when compared to all other HSR score groups, p-value < 0.001) and significantly higher in products classified as ultra-processed (when compared to all other NOVA classification groups, p-value < 0.001). There is a strong relationship between the number of ingredients in a product and indicators of nutritional quality and level of processing. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions To modify the Australian and New Zealand Health Star Rating to account for ultra‐processing and compare the alignment of the modified ratings with NOVA classifications and the current Australian Dietary Guidelines classifications of core (recommended foods) and discretionary (foods to limit).Data was cross‐sectionally analysed for 25 486 products. Four approaches were compared to the original Health Star Rating: (1) five ‘negative’ points added to ultra‐processed products (modification 1; inclusion approach); (2) ultra‐processed products restricted to a maximum of 3.0 Health Stars (modification 2; capping approach); (3 and 4) same approach used for modifications 1 and 2 but only applied to products that already exceeded 10 ‘negative’ points from existing Health Star Rating attributes (modifications 3 and 4, respectively; hybrid approaches). Alignment occurred when products (i) received <3.5 Health Stars and were NOVA group 4 (for NOVA comparison) or discretionary (for Dietary Guidelines comparison), or (ii) received ≥3.5 Health Stars and were NOVA groups 1–3 or core.All Health Star Rating modifications resulted in greater alignment with NOVA (ranging from 69% to 88%) compared to the original Health Star Rating (66%). None of the modifications resulted in greater alignment to the Dietary Guidelines classifications overall (69% to 76%, compared with 77% for the original Health Star Rating), but alignment varied considerably by food category.If ultra‐processing were incorporated into the Australian and New Zealand Health Star Rating, consideration of ultra‐processing within the broader dietary guidance framework would be essential to ensure coherent dietary messaging to Australians. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions The Australian Dietary Guidelines are currently being revised and ultra‐processed foods have been identified as a high priority action area. To better understand how well the current Dietary Guidelines align with level of processing classifications, the aim of this study was to assess the alignment between the Australian Dietary Guidelines and the NOVA classification system for classifying the healthiness of packaged foods.Data were sourced from the Australian FoodSwitch dataset, which included 28 071 packaged food and beverage products available in major Australian supermarkets in 2022. Products were classified as (i) core or discretionary (Australian Dietary Guidelines) and (ii) non‐ultra‐processed or ultra‐processed (NOVA). Agreement between the two systems (core vs. non‐ultra‐processed and discretionary vs. ultra‐processed) was evaluated using the kappa statistic.There was ‘moderate’ agreement (κ = 0.41, 95% CI: 0.40–0.42) between the Australian Dietary Guidelines and the NOVA system, with 69.8% of products aligned across the two systems. Alignment was more common for discretionary foods (80.6% were ultra‐processed) than core foods (59.9% aligned were not‐ultra‐processed). Food categories exhibiting the strongest levels of alignment included confectionary, foods for specific dietary use, and egg and egg products. Discordance was most common for convenience foods, sugars, honey and related products, and cereal and grain products.Despite moderate alignment between the Australian Dietary Guidelines and NOVA, the discordance observed for almost one‐third of products highlights the opportunity to develop recommendations for ultra‐processed foods within the guidelines to advise Australians how these foods should be considered as part of a healthy diet. [ABSTRACT FROM AUTHOR]