health & science

Sugar: to label or not to label

Knowing how much sugar is in a muesli bar, bowl of cereal or pot of yoghurt may become easier, but on its own may not be a “magic bullet” to cure rising obesity levels.

The body responsible for New Zealand and Australia’s food labelling laws is asking for public feedback on how food labelling could be improved. One option under discussion is a visual guide on the front of packaged food showing how many teaspoons of sugar a product contains.

“We want food labels to provide clear, contextual information about sugars to allow consumers to make informed choices in support of the dietary guidelines,” said Food Safety Minister Damien O’Connor.

“Effective labelling contributes to the Government’s objective to improve the health and well-being of New Zealanders through healthy eating.”

The Australia and New Zealand Ministerial Forum on Food Regulation feels food labels aren’t providing enough contextual information to consumers when it comes to sugar. Its goal is for labels to provide information to help people stick to dietary guidelines.

Currently it can be hard for consumers to calculate the total amount of sugar in a product as added sugars may have names such as isoglucose which are not recognised by some as sugar. Product claims that no sugar has been added to an item already high in natural sugar can also mislead some consumers.

The current voluntary Health Star Rating which calculates the overall healthiness of a product based on a number of factors has not been widely picked up by the food industry. It has also faced criticism for giving foods with large amounts of sugar a high star rating because of high fibre levels and for assumptions made about the way a consumer will prepare the food - like assuming the use of low-fat milk.

Growing obesity levels

A University of Otago study has shown New Zealand adults consume around 15 teaspoons of sugar a day. The World Health Organisation recommends approximately six teaspoons of sugar a day for adults and three for children.

Excessive sugar consumption can lead to weight gain and cavities. Currently 32 percent of New Zealand adults are obese, ranking us as the third most obese country in the OECD. Tooth decay is one of the leading causes for hospital admissions of New Zealand children.

The seven options public feedback is sought on range from doing nothing, to providing education on how to help people understand labels, to better identifying sugars on ingredient labels, to front-of-pack labels with a visual depiction of how much sugar is in a product.

Opinions are also being sought on the pros and cons of how changes might be implemented, from being a voluntary labelling requirement such as the current Health Star Rating system or a change mandated by law.

“The Health Star Rating is already dead in the water. The algorithm is flawed in the combination of fat, salt and sugar. The food industry brought this to us, we were suckered in. Perversely, very high sugar foods can get 4+ health stars.”

Labelling options

University of Auckland Professor Cliona Ni Mhurchu is a member of the Health Star Rating Advisory Group.

Her personal view is the sugar labelling debate is timely.

“Current food labels mean it is impossible for consumers to distinguish between added and natural sugars or understand just how much added sugar is in some core foods like yoghurts and breakfast cereals. These changes to labels would improve transparency and may incentivise food manufacturers to reduce the added sugar content of their products.”

She would like to see improvements made to nutrition information panels on foods.

Whatever the final recommendation is, she hopes it will strengthen the Health Star Rating system.

“Better information on added sugars on labels could be used to strengthen the Health Star Rating. Research has shown that incorporating added sugars improves the performance of the Health Star Rating and increases its alignment with dietary guidelines.”

With space on packaging often limited, a shift mandating a visual depiction of teaspoons of sugar on the front of products could mean the star rating is dropped from packaging.

AUT professor of public health and diet book author Grant Schofield thinks the star rating system has problems.

“The Health Star Rating is already dead in the water. The algorithm is flawed in the combination of fat, salt and sugar. The food industry brought this to us, we were suckered in. Perversely, very high sugar foods can get 4+ health stars.”

He thinks food labelling decisions need to be removed from the food industry and wants to see mandatory front-of-pack labelling.

“That would ideally be in teaspoons pictures on the front, with a big number (grams of free sugars) as well.”

University of Auckland Professor of population nutrition and global health Boyd Swinburn also sees the star rating system as struggling to get the “increasingly complex algorithm” right.

“That degree of technical complexity, the fact it has been too permissive on sugar, has led to a bit of a loss of faith in the Health Star Rating system,” he said.

Swinburn said labelling showing teaspoons of sugar hasn’t been implemented anywhere.

“It’s got much less research behind it and it doesn’t have any empirical research where it has been implemented and the effects have been measured.

“The situation we are left in is New Zealand and Australia have invested many years of trying to work with industry to get a comprehensive, valid measure of a front-of-pack labelling scheme and essentially we have now been overtaken by other countries that have gone ahead with much better systems.”

He favours a shift to warning labels and gives the example of Chile where products can have up to four large black warning labels if they exceed a government set target for sugar, salt, saturated fat or calories.

Chile's example

In Chile, where over half of six-year-olds are overweight or obese, the shift to warning labels on foods has been complemented by a range of other measures.

An 18 percent tax was placed on sugary drinks and a range of measures aimed at curbing children’s exposure or attraction to unhealthy foods were implemented.

“We’ve got an obesity epidemic that is rising out of control, we are third out of the OECD countries. We need to seriously pick our act up if we want to turn around the obesity epidemic and there are no magic bullets."

Cartoon characters were removed from the packaging of sugar-loaded cereals, the sale of items such as Kinder Surprise eggs which include trinkets were banned - as was the sale of junk food in schools. Heavy restrictions were placed on the advertising of unhealthy food to children.

Chile’s measures have resulted in industry opposition. PepsiCo has filed a court case claiming the law infringes on intellectual property rights. It argues cartoon characters on products such as the cheetah on Cheetos form part of a product’s brand identity and when sitting on a shop shelf they are branding, not advertising.

However, at the same time the Chilean food industry has voluntarily reformulated thousands of products to make them healthier.

New Zealand industry

The trans-Tasman consultation is asking the food industry to weigh in with their feedback on sugar labelling.

Change to the status quo would likely impact the industry as new calculations of total sugar may need to be completed and packaging would need to be redesigned and printed.

Questions include supplying an estimation of the additional cost a labelling change would incur, and whether the cost would be passed on to consumers.

The New Zealand Beverage Council spokesperson Stephen Jones said members were still discussing the consultation.

He expects any submission would favour the option of increased education for consumers so they can understand labels better and possibly changes to the nutrition information panel on the back of products.

Jones said the council’s members are big supporters of the Health Star Rating system.

“It is a good system which gives consumers information about total kilojoules in a product. We’re not saying it can’t be refined and we are open to a discussion around that.”

He warns switching to messaging solely focusing on sugar could lead people to consume products with even higher calories.

“Berkeley in the US introduced a sugar tax a few years ago on soft drinks. What they found was consumers changed their purchasing behaviour from some soft drinks and started buying fruit-based smoothies and flavoured milks which weren’t taxed. They have more calories in them, so the actual calorific intake of the consumers increased.

Other industry members, including the New Zealand Food and Grocery Council, said the council and Kelloggs are still reviewing the consultation document before deciding if and what to submit.

University of Auckland's professor Swinburn warns education and labelling changes on their own won’t be enough to shift New Zealand's obesity rates.

"In general it [labelling] will only have influence on those people who are already health aware. If people don’t give a toss ... it’s not going to shift their behaviours.

He said education too was unlikely to work unless other measures are in place.

“We are going to need sugar taxes, we are going to need the best labelling system we can, we’re going to need other healthy food policies. It’s not just a one-man show.”

Swinburn lists a range of measures, similar to Chile's, which could be used including rules around advertising and the availability of junk food in schools and government facilities. Industry targets similar to the United Kingdom's 20 percent reduction of calories in popular foods by 2024 could also play a part.

“We’ve got an obesity epidemic that is rising out of control, we are third out of the OECD countries. We need to seriously pick our act up if we want to turn around the obesity epidemic and there are no magic bullets."

The consultation runs until September 19, 2018 and a preferred option will be provided to the next Australia and New Zealand Ministerial Forum on Food Regulation later this year.