Comparison of the Choices criteria with national logo criteria in Sweden and Singapore

Abstract Background Food-based dietary guidelines often do not consider processed food products and typically do not address the rising popularity of plant-based meat and dairy alternatives or non-nutritive sweeteners. Multi-level nutrient profiling systems, such as the Choices 5-level criteria, can surmount these limitations and support nutrition policies, including the development and enhancement of national front-of-pack labeling systems. Nevertheless, new criteria for plant-based meat and dairy alternatives, as well as for foods containing non-nutritive sweeteners, must be established. Methods This study investigates the comparison of the Choices criteria with the Keyhole logo used in Sweden and the Healthier Choice Symbol employed in Singapore and proposes adaptations to align with food-based dietary guidelines. Additionally, scoping literature reviews on the health effects of non-nutritive sweeteners and international policies guiding their use were conducted. Alignment was evaluated by determining whether foods categorized as healthy by Choices (i.e., classified as level 1 or 2) were also eligible for a national logo in Sweden and Singapore. Results The results demonstrated that Choices can serve as a foundation for national endorsement of logo criteria. Qualifying criteria for plant-based meat and dairy alternatives, as well as for non-nutritive sweeteners, were also developed. Conclusions The Choices 5-level criteria can support stimulating and restrictive nutrition policies and facilitate a desirable transition to a healthier, more plant-based diet. Key messages • Food-based dietary guidelines often do not consider processed food products and typically do not address the rising popularity of plant-based meat and dairy alternatives or non-nutritive sweeteners. • The Choices 5-level criteria can support stimulating and restrictive nutrition policies and facilitate a desirable transition to a healthier, more plant-based diet.