A nutrient profiling assessment of packaged foods using two star-based front-of-pack labels

Objective: To compare two front-of-pack nutrition labelling systems for the assessment of packaged foods and drinks with Australian Dietary Guidelines. Design: A cross-sectional nutrient profiling assessment. Food and drink products (n 20 225) were categorised into scoring levels using criteria for the Institute of Medicine (IOM) three-star system and the five-star Australian Health Star Rating (HSR). The effectiveness of these systems to categorise foods in accordance with Australian Dietary Guidelines was explored. Setting: The study was conducted in Australia, using a comprehensive food database. Subjects: Packaged food and drink products (n 20 225) available in Australia. Results: Using the IOM three-star system, the majority (55%) of products scored the minimum 0 points and 25.5% scored the maximum 3 points. Using HSR criteria, the greatest proportion of products (15.2%) scored three-and-a-half stars from a possible five and 12.5 % received the lowest rating of a half-star. Very few products (4.1 %) scored five stars. Products considered core foods and drinks in Australian Dietary Guidelines received higher scores than discretionary foods in all food categories for both labelling systems (all P < 0.05; Mann-Whitney U test), with the exception of fish products using IOM three-star criteria (P=0.603). The largest discrepancies in median score between the two systems were for the food categories edible oils, convenience foods and dairy. Conclusions: Both the IOM three-star and Australian HSR front-of-pack labelling systems rated packaged foods and drinks broadly in line with Australian Dietary Guidelines by assigning core foods higher ratings and discretionary foods lower ratings.