tag:theconversation.com,2011:/ca/topics/star-rating-food-labelling-9036/articlesStar rating food labelling – The Conversation2021-03-24T01:07:39Ztag:theconversation.com,2011:article/1575812021-03-24T01:07:39Z2021-03-24T01:07:39ZNew Zealand needs urgent action to tackle the frightening rise and cost of type 2 diabetes<figure><img src="https://images.theconversation.com/files/391047/original/file-20210323-17-164z2xb.jpg?ixlib=rb-1.1.0&rect=23%2C79%2C3087%2C1981&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock/Kwangmoozaa</span></span></figcaption></figure><p>Type 2 diabetes has reached epidemic proportions in New Zealand and will get much worse unless action is taken now, according to a new <a href="https://healthierlives.co.nz/2021/03/15/cot2dlaunch/">report</a> on the economic and social cost of the disease. </p>
<p>Already 228,000 New Zealanders (4.7% of the population) have type 2 diabetes. The estimated annual cost is NZ$2.1 billion — a staggering 0.67% of GDP. </p>
<p>The report projects that if nothing is done to change the current trajectory, the number of people with type 2 diabetes will increase by 70-90% (to 6.6%-7.4% of the population) in 20 years. Costs are expected to rise by 63% to $3.5 billion by 2040.</p>
<p>Hospital care is the biggest cost to the public purse but losses from tax revenue, personal income and unpaid labour contribute to overall economic losses. The human cost of lives cut short cannot be quantified. Māori, Pacific and Asian communities bear the brunt of the <a href="https://healthierlives.co.nz/2021/03/15/cot2dlaunch/">disease burden</a>.</p>
<p>The scale of New Zealand’s type 2 diabetes epidemic underscores the urgent need for prevention at a population level. It is a societal problem that needs a societal solution. </p>
<p>While individuals’ lifestyles must change if their health is to improve, New Zealanders need a supportive environment to make changes that stick. </p>
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<h2>A public health approach</h2>
<p>A range of approaches would help to reduce the risk of developing type 2 diabetes. Re-introducing a national healthy eating and activity policy for schools and young people would likely also benefit parents and carers. At school, children should be free from harmful drinks and foods which are packed with sugar, fat and salt. Our children must be protected from being bombarded by junk food advertising in their homes and neighbourhoods.</p>
<p>More effective food labelling would help consumers to better understand what they are putting in their supermarket trolleys, and encourage food producers to forge ahead with reformulating products so they contain less harmful ingredients.</p>
<p>Many other countries have introduced policies to protect their populations, including the UK’s 2018 <a href="https://www.legislation.gov.uk/uksi/2018/41/contents/made">soft drinks industry levy regulations</a>. It’s time for New Zealand, which has among the highest rates of <a href="https://www.oecd.org/health/obesity-update.htm">adult</a> and <a href="https://bmjopen.bmj.com/content/11/2/e044205#F1">childhood obesity</a> in the western world, to catch up with our international peers.</p>
<p>We must not forget that in some parts of New Zealand, families experience <a href="https://www.cpag.org.nz/news/new-paper-series-aotearoa-land-of-the-long/">food scarcity and insecurity</a> and buy cheaper, less healthy foods. We must remedy this by tackling the root causes of poverty.</p>
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Read more:
<a href="https://theconversation.com/a-disease-that-breeds-disease-why-is-type-2-diabetes-linked-to-increased-risk-of-cancer-and-dementia-139298">A disease that breeds disease: why is type 2 diabetes linked to increased risk of cancer and dementia?</a>
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<h2>Cost-effective health programmes</h2>
<p>In addition to public health measures, there are also things we can do immediately to improve the treatment and care of people who already have type 2 diabetes and to prevent people with pre-diabetes from progressing further. </p>
<p>The report recommends rolling out four cost-effective programmes which could help thousands of New Zealanders:</p>
<ul>
<li>lifestyle interventions that reduce the risk of progression from pre-diabetes to type 2 diabetes (sustained changes in diet and exercise)</li>
<li>intensive lifestyle interventions to achieve remission of type 2 diabetes (clinical nutrition therapy) </li>
<li>“gold standard” medications to better manage type 2 diabetes</li>
<li>optimal foot screening and protection services.</li>
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Read more:
<a href="https://theconversation.com/got-pre-diabetes-heres-five-things-to-eat-or-avoid-to-prevent-type-2-diabetes-80838">Got pre-diabetes? Here's five things to eat or avoid to prevent type 2 diabetes</a>
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<p>Two new medications for managing type 2 diabetes have recently been <a href="https://pharmac.govt.nz/news-and-resources/consultations-and-decisions/decision-to-fund-two-new-medicines-for-type-2-diabetes/">funded</a> by New Zealand’s medicines-funding agency PHARMAC. This is a great start but we can do much more.</p>
<p>Pre-diabetes is being identified in many New Zealanders as part of screening for heart disease risk factors. Healthy lifestyle support programmes have been shown to halve the risk of <a href="https://healthierlives.co.nz/2021/03/15/cot2dlaunch/">progressing to type 2 diabetes</a>. Culturally appropriate support should be made widely available to people with pre-diabetes. </p>
<p>International <a href="http://eprints.gla.ac.uk/180894/">evidence</a> has recently shown that it is possible to achieve remission of type 2 diabetes through clinical nutrition therapy. Investment in such services could save our hospital system from becoming overwhelmed by serious medical complications arising from type 2 diabetes, including kidney failure, heart attacks, stroke and blindness.</p>
<p>We could avoid around <a href="https://healthierlives.co.nz/2021/03/15/cot2dlaunch/">600 diabetes-related amputations</a> each year if all District Health Board foot screening and protection services were operating at an optimal level. Some are already close to achieving this.</p>
<p>Such measures, along with a public health approach to disease prevention, are essential if we are to prevent health costs from escalating out of control and our healthcare system from being overwhelmed.</p>
<h2>Lessons from the COVID-19 response</h2>
<p>New Zealand’s response to the COVID-19 pandemic has shown us how effective a co-ordinated, government- and science-led approach can be in tackling a major health problem. </p>
<p>In New Zealand we have seen how aiming high — for elimination of an infectious disease — has saved lives and livelihoods. Excellent communication has been key to New Zealanders’ enthusiasm for playing their part.</p>
<p>We need a similar approach and resolve to tackle the type 2 diabetes epidemic.
This problem is too big to leave to individual district health boards, which are dealing with competing health problems on strained budgets. </p>
<p>We urgently need a national strategy for tackling type 2 diabetes to change the trajectory New Zealand is currently on. If we don’t act now the scale of the problem in 20 years’ time is almost unimaginable.</p><img src="https://counter.theconversation.com/content/157581/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jim Mann is Director of Healthier Lives - He Oranga Hauora National Science Challenge (funded by MBIE, hosted by the University of Otago), and Co-Director of the Edgar Diabetes and Obesity Research Centre at the University of Otago, and receives some research funding from the Riddet Institute.</span></em></p>Almost a quarter of a million New Zealanders have type 2 diabetes. If nothing is done to change the current trajectory, the number will increase by 70-90% within 20 years, warns a new report.Jim Mann, Professor of Medicine and Director, Healthier Lives National Science Challenge and the Edgar Diabetes and Obesity Research Centre, University of OtagoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/429112015-07-12T20:25:13Z2015-07-12T20:25:13ZA year on, Australia’s health star food-rating system is showing cracks<figure><img src="https://images.theconversation.com/files/86958/original/image-20150701-4117-1pq8in2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The health star rating food labelling system is failing consumers.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-232194364/stock-photo-man-reading-label-on-the-bottle-in-supermarket.html?src=rDPLRfBzSjS2icy4SyjrsQ-1-51">www.shutterstock.com</a></span></figcaption></figure><p>The government has <a href="http://www.foodmag.com.au/News/Health-Star-Rating-awareness-campaign-enters-secon">started the second phase of its awareness campaign</a> for Australia’s year-old health star food-rating system. The A$2.1 million campaign is aimed at educating grocery buyers about how to shop for healthy food and encouraging the food industry to adopt the voluntary system. </p>
<p>But it’s unlikely the campaign will fulfil its first aim because health stars are predominantly being used by the food industry to market highly processed food products. It would be unfortunate if it was successful in its latter aim because unless we change the way the system currently works, consumers will be the losers. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/88131/original/image-20150712-17470-drbo24.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/88131/original/image-20150712-17470-drbo24.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/88131/original/image-20150712-17470-drbo24.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/88131/original/image-20150712-17470-drbo24.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/88131/original/image-20150712-17470-drbo24.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/88131/original/image-20150712-17470-drbo24.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/88131/original/image-20150712-17470-drbo24.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Even though it is clearly healthy, this yoghurt gets only one and a half stars.</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>A good purpose</h2>
<p>It has only been a year since the federal government finally introduced the <a href="https://www.healthstarrating.gov.au">health star rating system</a> after a long and <a href="https://theconversation.com/food-labels-are-about-informing-choice-not-some-nanny-state-23320">fraught process</a>. The industry is implementing the system over five years and a review is planned for next year. </p>
<p>Under the system’s nutrient profiling criteria, individual packaged foods are rated on their composition. Foods receive “baseline” (or negative) points for the amount (per 100 grams or 100 millilitres) of saturated fat, total sugars, sodium and energy. And they receive “modifying” (or positive) points for the amount (again, per 100g or 100mL) of protein, fibre, fruit and vegetables they contain. Points are then converted to a star rating, from half to five stars.</p>
<p>The system is supposed to help consumers discriminate between similar foods within the same food category that contain different amounts of undesirable ingredients. It should, for instance, help compare two loaves of bread in terms of their salt content. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/88130/original/image-20150712-17428-1idhkca.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/88130/original/image-20150712-17428-1idhkca.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/88130/original/image-20150712-17428-1idhkca.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/88130/original/image-20150712-17428-1idhkca.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/88130/original/image-20150712-17428-1idhkca.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/88130/original/image-20150712-17428-1idhkca.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/88130/original/image-20150712-17428-1idhkca.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">While liquorice gets two and a half stars.</span>
<span class="attribution"><span class="source">Author</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>The health star rating system is also supposed to provide an incentive for manufacturers to reformulate their products. In terms of our previous example, it should encourage manufacturers to provide bread with less salt. But because it was developed through compromise between government, industry, public health and consumer groups, it has some inevitable design and implementation limitations. </p>
<h2>Badly designed</h2>
<p>Its main design limitation is that it simplistically frames the cause of, and solution to, dietary imbalances in terms of nutrients. This is fundamentally at odds with the <a href="https://www.eatforhealth.gov.au/guidelines">latest nutrition advice</a>, which uses a food-based approach. </p>
<p>Consider the <a href="https://www.eatforhealth.gov.au/guidelines">Australian Dietary Guidelines</a>, a nuanced set of eating rules based on the latest nutrition research. <a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">These encourage</a> enjoyment of a variety of nutritious foods from all five major food groups (see below), and limiting or avoiding highly processed, energy-dense and nutrient-poor “discretionary” or junk foods and drinks. </p>
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<a href="https://images.theconversation.com/files/88035/original/image-20150710-16911-ypm6xy.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/88035/original/image-20150710-16911-ypm6xy.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/88035/original/image-20150710-16911-ypm6xy.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=849&fit=crop&dpr=1 600w, https://images.theconversation.com/files/88035/original/image-20150710-16911-ypm6xy.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=849&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/88035/original/image-20150710-16911-ypm6xy.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=849&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/88035/original/image-20150710-16911-ypm6xy.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1067&fit=crop&dpr=1 754w, https://images.theconversation.com/files/88035/original/image-20150710-16911-ypm6xy.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1067&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/88035/original/image-20150710-16911-ypm6xy.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1067&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="attribution"><span class="source">https://www.eatforhealth.gov.au/food-essentials/five-food-groups</span></span>
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<p>Food consists of a complex matrix of nutrients and non-nutrient components, which interact in multiple ways to influence health. Because people eat foods rather than nutrients in isolation, it makes more sense to give <a href="https://www.eatforhealth.gov.au/guidelines">nutrition advice based on whole foods</a>.</p>
<p>But the health star rating system looks at nutrients in isolation. And simply awarding stars irrespective of whether a food is from the “discretionary” category is resulting in instances where foods, such as confectionery, are getting higher ratings than five-food-group foods, such as yoghurt. </p>
<h2>Badly implemented</h2>
<p>The system’s main implementation limitation is that because it’s voluntary, food manufacturers can decide whether a product will display health stars or not. Understandably, although manufacturers might be happy to display stars on foods that attract between two and five stars, they are less likely to put one or half a star on their products. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/88129/original/image-20150712-17439-1h6l814.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/88129/original/image-20150712-17439-1h6l814.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/88129/original/image-20150712-17439-1h6l814.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/88129/original/image-20150712-17439-1h6l814.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/88129/original/image-20150712-17439-1h6l814.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/88129/original/image-20150712-17439-1h6l814.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/88129/original/image-20150712-17439-1h6l814.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Are chips really healthy enough to attract four stars?</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>So what the health star rating system ends up doing is encouraging marketing of unhealthy or discretionary foods, as healthy options. Discretionary foods are packaged and highly processed and can have their nutrient composition reformulated to increase stars. Manufacturers of potato chips, for instance, might lower their fat or salt content to gain a higher star rating. But chips with half an extra star are still a discretionary food. </p>
<p>Part of the problem is that the campaign’s main message – “the more stars the better” – is misleading. Many of the items from the five food groups (see above) are not packaged, so they don’t display health stars. The actual health message is to eat more of <em>these</em> foods; it’s not that we should try to eat food with more stars.</p>
<p>What the health star rating system ends up doing is communicating a de facto approval or giving a halo effect to the labels of products that carry stars. People tend to view <em>any</em> visual health information on food as at least suggesting it’s healthy. So packaged foods that carry the star symbol, even if only half a star, could be implied to be healthy.</p>
<h2>Making it better</h2>
<p>Fixing the system’s design limitations will require placing nutrient profiling within the context of the whole food so consumers are encouraged to choose predominantly from the five food groups. In practice this would mean stars should be available for only five-food-group foods. Health warning symbols should be displayed on discretionary foods. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/85184/original/image-20150616-5838-1758jqu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/85184/original/image-20150616-5838-1758jqu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=195&fit=crop&dpr=1 600w, https://images.theconversation.com/files/85184/original/image-20150616-5838-1758jqu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=195&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/85184/original/image-20150616-5838-1758jqu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=195&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/85184/original/image-20150616-5838-1758jqu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=245&fit=crop&dpr=1 754w, https://images.theconversation.com/files/85184/original/image-20150616-5838-1758jqu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=245&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/85184/original/image-20150616-5838-1758jqu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=245&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Part of the problem is that the campaign’s main message – ‘the more stars the better’ – is misleading.</span>
<span class="attribution"><a class="source" href="http://healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/content/home">heath star rating website</a></span>
</figcaption>
</figure>
<p>This change would provide food manufacturers with stronger incentive to reformulate discretionary foods to avoid attracting health warning symbols on their product labels. </p>
<p>And fixing its implementation limitations <a href="http://ac.els-cdn.com/S0140673614617475/1-s2.0-S0140673614617475-main.pdf?_tid=c28f7948-13ec-11e5-8bdd-00000aacb360&acdnat=1434434510_fdbacc3d25d466f595d49c4610e2a392">will require mandating</a> the health star rating system – and warning symbols – across all foods that carry a label. We would also need a regulatory body to manage the system’s operation.</p>
<p>These remedies would help make the system consistent with the latest evidence from nutrition science. And it would make the education message simpler. Most importantly, consumers will be able to have confidence that they can use the health star rating system to compare all foods for their relative healthy properties.</p><img src="https://counter.theconversation.com/content/42911/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mark Lawrence receives funding from the National Health and Medical Research Council, the Australian Research Council, VicHealth, Department of Health Victoria.</span></em></p><p class="fine-print"><em><span>Christina Pollard is the principal investigator on Curtin University's Healthway-funded Food Law and Communications to Protect Public Health grant. Curtin University has received five years of funding to assist the translation of research into practice through the project. She works part-time at the WA Department of Health as nutrition policy advisor for the chronic diseases prevention directorate. She has co-written this article as an academic, not as a public servant and not representing the views of the WA health department.</span></em></p>Rather than informing consumer choice, Australia’s year-old health star food rating system is failing customers, and allowing food manufacturers to give an aura of health to junk foods.Mark Lawrence, Professor of Public Health Nutrition, Deakin UniversityChristina Mary Pollard, Research Fellow, School of Public Health, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/321132014-09-26T06:13:59Z2014-09-26T06:13:59ZSalt overload – it’s time to get tough on the food industry<figure><img src="https://images.theconversation.com/files/60135/original/spf95hn7-1411702648.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Reducing Australians' salt intake by 30% could save 7,000 lives a year.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-112846465/stock-photo-baked-pasta-ready-meal-with-spiral-pasta-chicken-bacon-and-cheese-family-size-pack.html?src=pp-photo-91857014-cBQ8OJxe-Eb6lAYfRZ48MA-3">Joe Gough/Shutterstock</a></span></figcaption></figure><p>While other nations have successfully reduced their sodium intake, Australians are still eating too much salt. And we’re paying the price with our health; a high-salt diet can lead to high blood pressure, one of the key contributors to heart disease. </p>
<p>Reducing Australians’ daily salt intake by 30% (from nine grams to six) <a href="http://www.heartfoundation.org.au/SiteCollectionDocuments/RapidReview_FoodReformulation.pdf">could save</a> around 7,000 lives a year, through lowered blood pressure and fewer heart attacks. </p>
<p>It’s time for the Commonwealth government to get tough on the food industry to reduce the salt content of processed foods. </p>
<p>So, what’s the best way to make this happen?</p>
<p>For countries where the majority of salt is already hidden in processed foods, the most effective way to achieve reductions in salt intake is for the food industry to gradually take salt out of processed foods. </p>
<p>But some controversy exists about whether this <a href="https://www.mja.com.au/journal/2014/200/2/systematic-interim-assessment-australian-government-s-food-and-health-dialogue">requires legislation</a> (and penalties for companies that don’t comply) or whether <a href="http://www.ncbi.nlm.nih.gov/pubmed/21546876">voluntary agreements</a> are enough to get the food industry to act. </p>
<p>A <a href="http://www.mdpi.com/2072-6643/6/8/3274">recent review</a> showed that 59 countries already have food industry salt-reduction programs in place. Some of the countries reviewed are meeting with food companies and asking them to reduce salt in products where they can. But almost two-thirds (38) have established specific targets for reducing salt levels in different foods. </p>
<p>While the majority of these are based on voluntary agreements with the food industry, nine countries have introduced legislation on salt levels.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/60154/original/849bpj29-1411709819.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/60154/original/849bpj29-1411709819.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/60154/original/849bpj29-1411709819.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/60154/original/849bpj29-1411709819.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/60154/original/849bpj29-1411709819.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=565&fit=crop&dpr=1 754w, https://images.theconversation.com/files/60154/original/849bpj29-1411709819.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=565&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/60154/original/849bpj29-1411709819.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=565&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Bread factory in Mongolia where salt was reduced by 12%.</span>
<span class="attribution"><span class="source">Jacqui Webster.</span></span>
</figcaption>
</figure>
<p>The United Kingdom was the <a href="https://www.food.gov.uk/scotland/scotnut/salt/salttimeline">first country</a> to introduce targets for a range of foods, in March 2006, after a three-year period of research and public consultation. Seven years later, by 2013, the UK had successfully reduced the population’s salt intake by 15%. </p>
<p>Parallel <a href="http://www.bmj.com/content/343/bmj.d4995">reductions in blood pressure</a> are estimated to be saving around 8,000 lives a year. </p>
<p>Other countries, including the United States and Canada, have since adopted similar voluntary measures. </p>
<p>But there is a <a href="http://www.mdpi.com/2072-6643/6/8/3274">growing trend</a> towards legislation, with mandatory maximum salt standards being established for bread in a number of countries, including Belgium, Greece, Hungary, The Netherlands, Portugal and Paraguay. </p>
<p>Bulgaria has extended the legislation from bread, to milk products and lutenica (a vegetable relish), and Argentina has legislated salt levels for a range of products, including bread and processed meats.</p>
<p>South Africa first started consulting on salt targets in 2011, and in just two years <a href="http://www.heartfoundation.co.za/sites/default/files/articles/South%20Africa%20salt%20legislation.pdf">passed legislation</a> for salt levels across the range of food products. </p>
<p>A number of factors influenced this decision. Salt reduction was gaining a higher profile internationally. Also very important was the local research that provided context-specific data on the feasibility of salt reduction on commonly consumed foods in the South African population supported the case for legislation. </p>
<p>It is too early to know whether South Africa will realise the full potential of these measures, but it has <a href="http://www.mdpi.com/2072-6643/6/9/3672">been estimated</a> they could save 7,000 lives a year. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/60137/original/jmskrhcs-1411702794.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/60137/original/jmskrhcs-1411702794.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/60137/original/jmskrhcs-1411702794.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/60137/original/jmskrhcs-1411702794.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/60137/original/jmskrhcs-1411702794.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/60137/original/jmskrhcs-1411702794.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/60137/original/jmskrhcs-1411702794.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Salt-reduction targets and legislation are saving lives.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-159566738/stock-photo-mother-foiling-a-sandwich-for-her-child-for-a-school-meal.html?src=cBQ8OJxe-Eb6lAYfRZ48MA-1-71">Photographee.eu/Shutterstock</a></span>
</figcaption>
</figure>
<p>Back in Australia, the results are mixed. The government has taken <em>some</em> action <a href="http://www.foodhealthdialogue.gov.au/internet/foodandhealth/publishing.nsf">to address</a> the population’s salt intake by establishing a dialogue with the food industry to reach agreements about limits for salt levels in some food products. And <a href="http://www.mdpi.com/2072-6643/6/9/3802">recent research</a> has shown that progress has been made been made across some food categories to reduce salt. </p>
<p>But a review of the <a href="https://www.mja.com.au/journal/2014/200/2/systematic-interim-assessment-australian-government-s-food-and-health-dialogue">Australian Food and Health Dialogue</a> (FHD) concluded it was inefficient and more focus was needed. The pace has also been slow: it took four years for the FHD to set targets for just 11 food categories (compared to three years for 80 voluntary targets in the UK, and two years for legislation on 14 targets in South Africa). </p>
<p>There is no doubt that food industry <a href="http://theconversation.com/seeing-stars-ministers-poised-to-approve-new-food-rating-system-but-industry-seeks-a-delay-15163">lobbying</a> contributed to the slow progress of the FHD to date and the stalling of decisions on its future. </p>
<p>The food lobby may have also played a role in the <a href="http://theconversation.com/seeing-stars-ministers-poised-to-approve-new-food-rating-system-but-industry-seeks-a-delay-15163">government’s backtracking</a> on its Health Start ratings website, which went live and was then taken down. The Star rating website will one day outline how much salt, fat and sugar products contain and this will also be displayed on front-of-pack labels. </p>
<p>It is now over a year since member states of the World Health Organization <a href="http://apps.who.int/iris/bitstream/10665/94384/1/9789241506236_eng.pdf?ua=1">committed to targets</a> to reduce average salt intake by 30% by 2025, and Australia is lagging. </p>
<p>Because of the strength of the food industry lobby, a strong government role is crucial to the success of any efforts to reduce the population’s salt intake. </p>
<p>With the support of the new evidence to show that the targets are having an impact, the government must lead the FHD, expedite the target-setting process, and establish clear mechanisms for monitoring progress. And if the food industry doesn’t respond with adequate reductions in the next few years, then the government should legislate.</p>
<p>Only in this way can Australia fully realise the health benefits of salt reduction. </p>
<p><em>The author would like to thank Karen Charlton, Paul Kowal and Kathy Trieu for their contributions to this article.</em></p><img src="https://counter.theconversation.com/content/32113/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jacqui Webster receives funding from the NHMRC, The World Health Organization and The Victorian Health Promotion Foundation for work on salt reduction.</span></em></p>While other nations have successfully reduced their sodium intake, Australians are still eating too much salt. And we’re paying the price with our health; a high-salt diet can lead to high blood pressure…Jacqui Webster, Head of World Health Organization Collaborating Centre on Population Salt Reduction, George Institute for Global HealthLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/257942014-06-27T04:39:47Z2014-06-27T04:39:47ZAfter three-year saga, health star rating labels finally ready to go<figure><img src="https://images.theconversation.com/files/52438/original/2yc54krf-1403842370.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The health star rating system aims to provide convenient and easily understood nutritional information on food packs.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/ed_welker/4076939458">eddie welker/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Assistant health minister Fiona Nash has announced that Australian and New Zealand ministers responsible for food policy and regulation have <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/mr-yr14-dept-dept006.htm">signed off on the health star rating system</a> for front-of-pack labelling. </p>
<p>The culmination of years of negotiation between health and consumer groups, government and the food industry, the announcement signals the start of the labelling system’s implementation phase.</p>
<p>The <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/foodsecretariat-front-of-pack-labelling-1">health star rating system</a>, which echoes the one already in use for choosing energy- or water-efficient refrigerators and washing machines, as well as rating films and hotels, aims to provide convenient and easily understood nutritional information on food packs to assist consumers. Put simply, the more stars, the healthier the food. </p>
<p>It was developed by a <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/frontofpackobjectives">project committee</a> of industry, government, health and consumer organisations convened by the secretary of the health department. </p>
<p>The system was settled on as a compromise after the <a href="https://theconversation.com/states-should-stand-up-to-the-food-industry-on-traffic-light-labelling-4504">traffic-light system</a>, which uses red, yellow and green spots to indicate nutritional value and was preferred by health and consumer groups, was rejected by the food industry.</p>
<h2>Two small compromises</h2>
<p>Today’s announcement includes compromises on two other contentious issues around food labelling. Food and drink packaging will now feature both health star rating and the industry’s preferred daily intake guide.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=448&fit=crop&dpr=1 600w, https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=448&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=448&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=563&fit=crop&dpr=1 754w, https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=563&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=563&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The industry-preferred daily intake guide: energy 675 kg; DI* 8%.</span>
</figcaption>
</figure>
<p>Food manufacturers have been using this system since 2006 and it remains popular despite <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/foodsecretariat-food-labelling.htm">an independent review</a> finding it didn’t meet the requirements of an “interpretive” system. </p>
<p>Daily intake guide values are based on an average adult’s daily requirement of 8,700 kilojoules (kJ) and intended as a <a href="http://digwebsite.squarespace.com/basics">set of reference values</a> for acceptable intakes of energy and a variety of nutrients. It currently features on about 7,200 products but there’s no evidence that it’s effective.</p>
<p>Another compromise is on the timeline for implementing the new labelling system. </p>
<p>People who have been following this issue will be scratching their heads about todays’ announcement because it appears to replicate one made in June 2013. The health star rating system was actually approved by ministers then but the project committee hadn’t quite finalised a few anomalies in the schema they’d created.</p>
<p>Time was needed to further develop the health star rating calculator, which is used to determine product ratings. The calculator is based on a system designed by Food Standards Australia New Zealand to allow industry to make health claims, and the evidence underpinning the <a href="https://www.nhmrc.gov.au/guidelines/publications/n55">2013 Australian Dietary Guidelines</a> and the <a href="http://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">Guide to Health Eating</a>.</p>
<p>The June 2013 ministerial meeting also announced the adoption of a two-year timeline for adopting the system (going beyond the project committee’s recommendations) and determined to make the system mandatory if industry hadn’t adopted it voluntarily after that time.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=409&fit=crop&dpr=1 600w, https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=409&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=409&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=514&fit=crop&dpr=1 754w, https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=514&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=514&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Ministers have approved the health star rating system, which will feature alongside the daily intake guide.</span>
<span class="attribution"><a class="source" href="http://www.choice.com.au/media-and-news/consumer-news/news/new-star-ratings-for-food-products.aspx">Choice</a></span>
</figcaption>
</figure>
<p>After the change of government in September 2013, the first meeting of the relevant ministers was in December. At that meeting, the new Assistant Minister for Health, Fiona Nash unilaterally decided to order a cost-benefit analysis of the new system.</p>
<p>Although it’s not been made public, chief executive officer of the Public Health Association of Australia and the co-chair of the Technical Design Working Group, which developed the rating system, Michael Moore, has said the analysis is complete. He has said it found quick implementation would be very expensive for industry but allowing a two or three-year phase-in would not.</p>
<p>Based on this information as well as another report ministers have called for the health star rating system to be:</p>
<blockquote>
<p>implemented voluntarily over the next five years with a review of the progress of implementation after two years with a commencement date of 27 June 2014.</p>
</blockquote>
<h2>Ups and downs</h2>
<p>Changing the food labelling system has been a long and turbulent process; health and consumer groups have been advocating a traffic-light system for over a decade. </p>
<p>But it all actually started when the <a href="http://www.foodlabellingreview.gov.au/internet/foodlabelling/publishing.nsf/content/labelling-logic">Review of Food Labelling Law and Policy</a> was commissioned by the Australia and New Zealand Food Regulation Ministerial Council in October 2009, following a request by the Council of Australian Governments (COAG).</p>
<p>Headed by former health minister Neal Blewett, the review presented its report <a href="http://www.foodlabellingreview.gov.au/internet/foodlabelling/publishing.nsf/content/48C0548D80E715BCCA257825001E5DC0/$File/Labelling%20Logic_2011.pdf">Labelling Logic</a> in January 2011. It made a total of 61 recommendations for changes to Australia and New Zealand’s food labelling laws. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=191&fit=crop&dpr=1 600w, https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=191&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=191&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=240&fit=crop&dpr=1 754w, https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=240&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=240&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Traffic-light food labelling is what health and consumer groups wanted.</span>
<span class="attribution"><a class="source" href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207588/FINAL_VERSION_OF_THE_2013_FOP_GUIDANCE_-_WEB.pdf">UK Department of Health</a></span>
</figcaption>
</figure>
<p>But food ministers rejected the front-of-pack traffic light labelling at their next meeting and called for industry, government, health and consumer groups to work together towards a sensible compromise. They asked for an easy-to-understand system providing interpretive front-of-pack information.</p>
<p>The secretary of the health department then convened and chaired a project committee that presented an agreed position to ministers, recommending the health star rating system. The system was developed over the next two years and <a href="http://ausfoodnews.com.au/2013/06/17/australian-ministers-approve-front-of-pack-labelling-system-but-dairy-products-approach-still-to-be-finalised.html">approved</a> by the ministers in June 2013.</p>
<p>In February of this year, a website explaining the health star rating system briefly went live <a href="http://www.abc.net.au/news/2014-02-08/star-rating-website-disappears-24-hours-after-being-posted/5246990">before being pulled down</a> after intervention from Fiona’s Nash’s then-chief of staff, Alistair Furnival. It was subsequently revealed that <a href="https://theconversation.com/should-the-food-industry-resign-from-the-health-department-too-23292">Furnival retained links with the food industry</a>, for which he had also previously lobbied and he ultimately resigned.</p>
<p>The <a href="http://www.healthstarrating.com.au">website provided information</a> on the new labelling system and access to the health star rating calculator. It’s unclear whether the new website will provide the same degree of transparency.</p>
<p>The Australian government knows that the type of foods people are consuming is a major reason behind the country’s <a href="http://www.aihw.gov.au/overweight-and-obesity/">high rates of obesity</a>, and it’s important we make healthy choices easy. Despite all the compromises that accompany it, today’s announcement is a step in the right direction. </p><img src="https://counter.theconversation.com/content/25794/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Steven Allender receives research funding from the National Health and Medical Research Council, the Australian National Heart Foundation, the US National Institutes of Health and the Australian Department of Health and Ageing.</span></em></p><p class="fine-print"><em><span>Kyle Turner does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Assistant health minister Fiona Nash has announced that Australian and New Zealand ministers responsible for food policy and regulation have signed off on the health star rating system for front-of-pack…Kyle Turner, D.Phil. Candidate in Population Health, University of OxfordSteven Allender, Professor and Co-Director of the World Health Organization Collaborating Centre for Obesity Prevention, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/237232014-02-27T03:34:26Z2014-02-27T03:34:26ZPersonal responsibility won’t solve Australia’s obesity problem<figure><img src="https://images.theconversation.com/files/42598/original/xm2zgn95-1393457130.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The prevalence of obesity in Australia hasn't tripled in the last 30 years because we’ve all lost personal responsibility.</span> <span class="attribution"><a class="source" href="http://www.flickr.com/photos/picturesofthings/2395065912/sizes/l/">Flickr/confidence, comely.</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>Almost <a href="http://www.abs.gov.au/AUSSTATS/abs@.nsf/Latestproducts/4364.0.55.001Media%20Release12011-12?opendocument&tabname=Summary&prodno=4364.0.55.001&issue=2011-12&num=&view">two thirds</a> of Australians are now overweight or obese. In fact, obesity and unhealthy diets now contribute to <a href="http://www.healthmetricsandevaluation.org/sites/default/files/country-profiles/GBD%20Country%20Report%20-%20Australia.pdf">more disease and illness in Australia</a> than smoking. This makes finding solutions to our obesity problem a big issue for all of us.</p>
<p>The <a href="http://www.smh.com.au/federal-politics/political-news/food-rating-fiona-nash-chief-of-staff-intervened-to-have-website-removed-20140211-32g3a.html">scandalous</a> removal of the website launching the <a href="http://ourhealth.org.au/news/star-rating-scheme-packaged-food-gets-green-light">new Australian food labelling system</a> and its accompanying <a href="https://theconversation.com/big-food-lobbying-tip-of-the-iceberg-exposed-23232">conflict-of-interest concerns</a> are only weeks old. And now Liberal MP Ewan Jones <a href="http://www.heraldsun.com.au/news/mp-ewen-jones-has-demanded-a-healthy-food-rating-system-be-dropped/story-fni0fiyv-1226837702692">tells us</a> we don’t even need the scheme because
:</p>
<blockquote>
<p>It’s not the government’s fault that I’m fat, it’s my fault and I live with the consequences. </p>
</blockquote>
<p>This raises the important question of whether a reliance on personal responsibility – a key <a href="http://www.smh.com.au/federal-politics/political-news/joe-hockey-the-age-of-personal-responsibility-has-begun-20140203-31xge.html">agenda</a> of the current government, led by a prime minister who <a href="http://www.heraldsun.com.au/news/special-features/is-tony-abbott-on-track-to-become-a-world-leader-in-fitness/story-fnho52jj-1226713577559">walks the talk</a> – is really appropriate in the area of obesity prevention.</p>
<h2>Why not rely on personal responsibility?</h2>
<p>While there is an inherent truth that weight gain is heavily dependent on what we put in our own mouths, the argument for personal responsibility as the obesity solution falls down pretty quickly when we ask the question, “Has the prevalence of obesity in Australia tripled in the last 30 years because we’ve all lost personal responsibility?”. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=840&fit=crop&dpr=1 600w, https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=840&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=840&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1056&fit=crop&dpr=1 754w, https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1056&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1056&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The effects of changes in food environments have been compounded by our inactivity.</span>
<span class="attribution"><a class="source" href="http://www.flickr.com/photos/shoot-art/4939546349/sizes/l/">Josh Kenzer</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>Of course the answer is no, with all the <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960813-1/abstract">evidence</a> pointing to changes in the food environment. Since the 1980s, we have seen an ever increasing supply of cheap, tasty, energy-dense food that is very effectively marketed and widely available. </p>
<p>These changes have been the <a href="https://theconversation.com/shaping-up-a-blueprint-to-reverse-our-40-year-weight-gain-3067">primary driver of population weight increases</a>, and the effects have been heightened by our <a href="http://www.ncbi.nlm.nih.gov/pubmed/21767729">sedentary lifestyles</a>.</p>
<h2>Nanny state vs informed choice</h2>
<p>In the case of the <a href="https://theconversation.com/industry-winning-the-fight-against-better-food-labelling-22472">Health Star Rating</a> food labelling initiative, Mr Jones has mistaken the provision of useful nutrition information for a nanny state intervention. </p>
<p>A nanny state is <a href="http://www.thefreedictionary.com/nanny+state">defined</a> as one in which the government makes decisions for people that they might otherwise make for themselves. With food labelling, no personal eating decisions are actually being made by the government – these are still clearly a personal responsibility. </p>
<p>The Health Star Rating system isn’t about “telling you … everything you eat is wrong”, to use the words of the MP, it is the simple provision of nutrition information in a format that might help us all make informed choices. This is surely useful, particularly when set against the <a href="http://www.opc.org.au/paper.aspx?ID=exposing-the-charade&Type=policydocuments#.Uw2QOPmSy5I">barrage of marketing</a> for unhealthy foods. </p>
<p>The UK government has seen the sense of this argument and set up a <a href="http://www.nytimes.com/2013/12/08/business/international/britains-ministry-of-nudges.html?_r=2&">whole ministry</a> whose goal is to nudge the population toward better choices.</p>
<h2>Leaving it up to the free market</h2>
<p>The MP, some of his colleagues and their friends at the anti-nanny-state <a href="http://www.ipa.org.au/sectors/nanny-state">Institute of Public Affairs</a> would rather leave obesity to the free market, and the personal responsibility of the people of Australia to fix. Perhaps then, we should contemplate what that strategy might achieve. </p>
<p>We don’t have to wonder for long though, because we are living it. With a market-driven food system based on ever-increasing consumption, our <a href="http://www.diabetesaustralia.com.au/PageFiles/7830/FULLREPORTGrowingCostOfObesity2008.pdf">very costly</a> level of obesity has been a <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960813-1/abstract">predictable outcome</a>. </p>
<p>While we might like to think that the choice of what we put in our mouth is our own and that demand dictates supply, the actual choices we are presented with and the way they are marketed are <a href="http://www.sciencedirect.com/science/article/pii/S0950329312002054">heavily influenced by the food industry</a>. Supermarkets, for example, where many of our food choices are determined, are thought to have been the <a href="http://www.routledge.com/books/details/9780415540292/">single biggest influence</a> on eating habits over recent decades.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=380&fit=crop&dpr=1 600w, https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=380&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=380&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=477&fit=crop&dpr=1 754w, https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=477&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=477&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">It’s in the interests of food companies to frame obesity as an issue of personal responsibility.</span>
<span class="attribution"><a class="source" href="http://www.flickr.com/photos/77967821@N00/5560832028/sizes/l/">Flickr/Attila con la ca mara</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>The food industry commonly argues for <a href="http://www.deloitteaccesseconomics.com.au/uploads/File/DAE-AFGC%20reform%20FINAL%20281013.pdf">reduced regulation</a>. This is clearly driven by a push to maximise their own profits and their obligation to maximise returns to shareholders. </p>
<p>It is understandable for food companies to oppose the provision of readily understandable nutrition information if it has the potential to impact their bottom line. For this reason, it is in the interests of food companies to frame the obesity issue as one of personal responsibility. In this way, they hope to deflect attention from themselves and minimise government intervention. </p>
<h2>Government intervention to reduce obesity</h2>
<p>So, if the market is unlikely to help us here (and all <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2962089-3/abstract">evidence</a> suggests that to be the case), are regulatory interventions likely to be any more successful? </p>
<p>Most of the biggest success stories in Australian public health (immunisation, smoking rates, road safety) that benefit us all have been heavily reliant on government intervention. In the case of seat belts, the laws clearly impact directly on personal choice. But the benefits of having our government “nanny” look after us are <a href="http://www.ors.wa.gov.au/campaigns-programs/seat-belts">very clear</a>.</p>
<p>In the area of obesity, interventions such as restrictions on <a href="http://www.ncbi.nlm.nih.gov/pubmed/19652656">food advertising to children</a>, taxes on <a href="https://theconversation.com/is-a-fat-tax-the-answer-to-australias-obesity-crisis-3712">unhealthy food</a>, and <a href="http://www.ncbi.nlm.nih.gov/pubmed/21079620">improvements to food labelling</a> are likely to be highly effective, while saving the government money.</p>
<p>The responsibility for reducing the national waistline is clearly a joint one between individuals and government. When we hear politicians attempting to frame the issue as a matter solely of personal responsibility, we need to wonder whether they are acting in the public interest or if they’re singing the gold-seeking tune of the private sector.</p><img src="https://counter.theconversation.com/content/23723/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gary Sacks receives funding from the National Health and Medical Research Council (NHMRC).</span></em></p><p class="fine-print"><em><span>Adrian Cameron receives funding from the National Health and Medical Research Council (NHMRC).</span></em></p>Almost two thirds of Australians are now overweight or obese. In fact, obesity and unhealthy diets now contribute to more disease and illness in Australia than smoking. This makes finding solutions to…Gary Sacks, Senior Research Fellow, WHO Collaborating Centre for Obesity Prevention, Deakin UniversityAdrian Cameron, Senior Research Fellow, WHO Collaborating Centre for Obesity Prevention, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/233202014-02-26T03:42:56Z2014-02-26T03:42:56ZFood labels are about informing choice, not some nanny state<figure><img src="https://images.theconversation.com/files/42522/original/d6ssry4t-1393379143.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Food labelling has been a central plank of the food regulatory system since it first emerged in the mid-1800s.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/tranpalitu/2362249322/sizes/o/">Marcos Pozo López/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>Coalition MP Ewen Jones has <a href="http://www.abc.net.au/news/2014-02-26/ewen-jones-says-food-star-ratings-wont-work/5283940">spoken out against</a> reinstating the health star rating website controversially closed down by the assistant health minister. Jones says the government shouldn’t interfere with people’s lives, but food labelling requirements aren’t a manifestation of the nanny state, they’re there to provide accurate, easy-to-understand information. </p>
<p>Indeed, food labelling has been a central plank of the food regulatory system since it first emerged in the mid-1800s. Back then, it was not uncommon for products to be adulterated, or marketed with fraudulent claims.</p>
<p>There were reported cases of people being deceived about the weight of the food or its composition. One practice involved adding white colouring to water to create the appearance of milk. Labels provided an effective tool to help food regulators solve such problems.</p>
<h2>Things stay the same?</h2>
<p>The main issues confronting food regulators have now changed considerably, partly due to the availability of many more products. You might think this increased choice has provided increased opportunity to choose a healthy and varied diet, but that’s not necessarily the case.</p>
<p>Rather, what we have is a proliferation of high-energy, nutrient-poor “discretionary” or junk food constructed from the same basic highly-refined ingredients, such as corn, soy, sugar, fats and salt, typically coloured, flavoured, packaged and marketed in different ways. And the increased amount of information that has accompanied this proliferation often translates into increased confusion.</p>
<p>What’s more, many food products are still marketed with dubious claims. Highly-processed breakfast cereals containing a third of their weight in added sugar, for instance, are marketed as being healthy because they contain a number of added synthetic vitamins and minerals.</p>
<p>Food labels can now be the shopper’s ally by promoting informed choices for a healthy balanced diet, or adversary by promulgating misleading claims that create confusion and uncertainty.</p>
<p>Food regulators are supposed to use labels to help achieve two primary statutory objectives – to protect public health and safety and to provide adequate information relating to food to enable consumers to make informed choices. But there are many reasons why the current approach is inadequate.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=310&fit=crop&dpr=1 600w, https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=310&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=310&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=389&fit=crop&dpr=1 754w, https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=389&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=389&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A screenshot from the health star rating food labelling website shut down by the government.</span>
<span class="attribution"><span class="source">Christina Pollard</span></span>
</figcaption>
</figure>
<h2>Health claims</h2>
<p>Marketing products with health claims, such as “This product helps reduce the risk of heart disease” provides a strong angle for generating increased sales. And the food industry has fought hard for permission to use such claims on food labels.</p>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/18375217">Despite evidence</a> showing these claims have little, if any, benefit for the health of the population, in early 2013, Australian ministers permitted the use of health claims on food labels. </p>
<p>Public health and consumer groups expressed concern that such claims make a nonsense of the fundamental nutrition principle that the balance of the total diet shapes health outcomes, not individual foods. </p>
<p>They also pointed out that junk food manufacturers would take advantage of the marketing potential of such claims. And the <a href="http://www.foodstandards.gov.au/industry/labelling/Pages/Notified-food-health-relationships.aspx">first notification</a> the food regulator received was from the manufacturer of a highly-processed food claiming to have a “calorie burning effect”. </p>
<p>If health claims are to genuinely be about protecting public health and not marketing, food labelling regulations might mandate them and link products’ added sugar with dental cavities, for instance, or their salt content with hypertension.</p>
<h2>Spreading confusion</h2>
<p>People are frequently confused about the information appearing on food labels. And this confusion isn’t helped by the use of words such as “natural” or “real”, which are undefined in labelling law but imply some kind of benefit.</p>
<p>Some products imply they’re made with fruit when, in fact, they contain little fruit and are very high in sugar. Following a complaint from the Obesity Policy Coalition about the potential misrepresentation of a “65% real fruit” claim on Uncle Tobys Roll-Ups, for instance, the <a href="http://registers.accc.gov.au/content/item.phtml?itemId=762395&nodeId=f4a5abbb563d78fb3dcd2d66b01a2313&fn=d06_62453.pdf">Australian Competition and Consumer Commission</a> took the view that the claim was potentially misleading and deceptive.</p>
<p>Confusion can also be created by what’s implied but not explicitly said. A claim such as “97% fat free”, for instance, might be displayed on products that wouldn’t usually contain fat anyway but have added sugar, such as confectionery.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=445&fit=crop&dpr=1 600w, https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=445&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=445&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=560&fit=crop&dpr=1 754w, https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=560&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=560&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A screenshot from the health star rating food labelling website showing what the system would look like.</span>
<span class="attribution"><span class="source">Christina Pollard</span></span>
</figcaption>
</figure>
<p>Endorsement schemes displayed on food labels are another source of consumer confusion because the criteria used to endorse food products can vary among schemes and with nutrition policy recommendations. Concern has been expressed about the <a href="https://www.mja.com.au/insight/2011/7/rosemary-stanton-tick-program-misguides-consumers?0=ip_login_no_cache%3Da40209ecb0470c4aaba6c2788225e84b">National Heart Foundation’s “Tick” scheme</a>, for instance, because it’s not always consistent with Dietary Guideline recommendations.</p>
<p>The emphasis on most food labels is placed on persuading people to buy the product rather than informing them about it. That’s why the way information is framed on labels imply benefit.</p>
<p>Labels range from “information only” to information with an element of persuasion – “5% fat” is information only whereas “95% fat-free” is information plus persuasion. And people already interested in low-fat products <a href="http://www.ipcommunications.com.au/ipsocm.html">will be persuaded to choose</a> the 95% fat-free product.</p>
<h2>Protecting public health and promoting informed choice</h2>
<p>Clearly, there are problems with the current food labelling regime. But why does something that promotes informed choice have to be so difficult? </p>
<p>Why would Jones and the assistant health minister Fiona Nash want to maintain an information asymmetry in favour of the food industry and at the expense of the people they’re elected to represent? </p>
<p>At least seven years in the making, with the involvement of food ministers, government food regulation advisors, food industry representatives, consumer advocates, public health organisations, and an independent public health nutrition advisor, the Star Rating labelling system was a good start to positive change. </p>
<p>The approach is informative, easy to understand and targeted at helping correct dietary imbalances that are one of the major public health problems confronting food regulators.</p>
<p>But as the debacle with the website showing the system has illustrated, the challenge with developing and implementing informative food labelling is often less about evidence and more about the political will to stand up to the interests of the food industry to whom clear labels may not always be palatable.</p><img src="https://counter.theconversation.com/content/23320/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mark Lawrence is the Principal Investigator for an ARC-linkage funded project modelling policy interventions for food security and sustainability and a Chief Investigator with the NHMRC Centre for Research Excellence in Obesity Policy and Food Systems based at Deakin University. He does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article.</span></em></p><p class="fine-print"><em><span>Christina Pollard is the Principal Investigator on Curtin University’s Healthway funded Food Law, Policy and Communications to Protect Public Health. Curtin University has received 5 years of funding to assist the translation of research into practice through the FLPC project.
She works part-time for the Department of Health in Western Australia as a Nutrition Policy Advisor for the Chronic Disease Prevention Directorate. She has co-written this article as an academic and not as a public servant and not representing the views of the Department.</span></em></p>Coalition MP Ewen Jones has spoken out against reinstating the health star rating website controversially closed down by the assistant health minister. Jones says the government shouldn’t interfere with…Mark Lawrence, Professor of Public Health Nutrition, Deakin UniversityChristina Mary Pollard, Research Fellow, School of Public Health, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/232322014-02-18T19:12:44Z2014-02-18T19:12:44ZBig Food lobbying: tip of the iceberg exposed<figure><img src="https://images.theconversation.com/files/41806/original/528rhrfd-1392711344.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Direct lobbying is one of several tactics food companies use to shape regulation and public perception in their favour.</span> <span class="attribution"><span class="source">Image from shutterstock.com</span></span></figcaption></figure><p>The influence of the food lobby has come into the public spotlight over the past week, with revelations that Assistant Health Minister Fiona Nash’s chief-of-staff, Alastair Furnival, has strong links to the food industry. Furnival <a href="http://www.abc.net.au/news/2014-02-14/staffer-at-centre-of-food-labelling-controversy-resigns/5261052">previously worked</a> as a lobbyist for several food companies and is the <a href="http://www.smh.com.au/federal-politics/political-news/chief-of-staff-for-minister-fiona-nash-forced-to-resign-20140214-32rli.html">co-owner of a firm</a> that has represented the food industry.</p>
<p>The controversy came as Nash <a href="http://www.smh.com.au/federal-politics/political-news/food-rating-fiona-nash-chief-of-staff-intervened-to-have-website-removed-20140211-32g3a.html">personally intervened</a> to have health department staff withdraw a website launching a new government-approved <a href="https://theconversation.com/industry-winning-the-fight-against-better-food-labelling-22472">health star rating</a> food labelling system for Australia. Nash has since been accused of breaching ministerial standards for failing to declare Furnival’s conflict. And Furnival <a href="http://www.smh.com.au/federal-politics/political-news/assistant-health-minister-fiona-nashs-chief-of-staff-alastair-furnival-resigns-20140214-32qol.html">resigned</a> from his chief-of-staff position on Friday.</p>
<p>This incident has exposed one of the many ways in which powerful food companies exert their influence over government policy. From a public health perspective, the major concern is that this is just the tip of the iceberg.</p>
<h2>Big Food tactics</h2>
<p>Big Food lobbying to avoid government regulations for improved food labelling is not new. </p>
<p>In Europe, the food industry reportedly spent a staggering <a href="http://www.corporateeurope.org/red-light-consumer-information">€1 billion</a> successfully lobbying the European parliament to reject a traffic-light food labelling scheme. The scheme, heavily favoured by public health advocates internationally, uses colours to indicate the relative healthiness of foods. The fear for the food industry is that by putting red labels on their products, sales would decline.</p>
<p>Big Food also <a href="http://www.economist.com/news/business/21588088-once-omnipotent-industry-fights-what-may-be-losing-battle-fizzing-rage">lobbied extensively</a> to oppose a proposed tax on soft drinks in Mexico. However, in that case, their lobbying could not prevent the <a href="http://www.theguardian.com/world/2014/jan/16/mexico-soda-tax-sugar-obesity-health">implementation of the tax</a>.</p>
<p>Direct lobbying is just one of <a href="http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001246">several tactics</a> that food companies use to shape the regulatory environment and public perception in their favour.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/41804/original/39ntbd93-1392705284.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/41804/original/39ntbd93-1392705284.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/41804/original/39ntbd93-1392705284.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/41804/original/39ntbd93-1392705284.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/41804/original/39ntbd93-1392705284.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/41804/original/39ntbd93-1392705284.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/41804/original/39ntbd93-1392705284.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Big Food lobbied hard against Mexico’s soda tax but ultimately lost.</span>
<span class="attribution"><a class="source" href="http://www.flickr.com/photos/scelera/2307196659/sizes/l/">Samantha Celera</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
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<p>In the media, food companies typically place the responsibility for obesity on individual choices, rather than <a href="http://www.ncbi.nlm.nih.gov/pubmed/23410611">environmental or corporate influences</a>. They also portray government actions to regulate food environments as interference in personal liberties and free choice.</p>
<p>Food companies frequently publicise their contributions to worthy causes, such as <a href="http://www.rmhc.org.au/">children’s charities</a>. This seeks to cast members of the food industry as respectable corporate citizens in the eyes of politicians and the public. However, some of these charities have been <a href="http://www.eatdrinkpolitics.com/2013/10/29/clowning-around-with-charity-how-mcdonalds-exploits-philanthropy-and-targets-children/">heavily criticised</a> as being predominantly marketing ploys that distract attention from harmful business practices.</p>
<p>The food industry also funds research that serves to <a href="http://www.foodpolitics.com/2013/11/more-on-food-company-sponsorship-of-nutrition-research-and-practice/">confuse the evidence</a> and keeps the public in doubt. They also set up <a href="http://www.huffingtonpost.com/michele-simon/best-public-relations-mon_b_3273159.html">front groups</a> to lobby on their behalf. And they promise self-regulation in efforts to avoid government regulation, despite the <a href="http://www.opc.org.au/downloads/OPC_Exposing_the_Charade_report_2012.pdf">demonstrated failure of self-regulation</a> for improving food environments.</p>
<p>These Big Food tactics <a href="http://www.ncbi.nlm.nih.gov/pubmed/19298423">closely mirror</a> those used by tobacco companies.</p>
<h2>Flow of unhealthy food</h2>
<p>The corporate sector has been very successful in shaping a regulatory environment that favours market liberalisation and free trade. </p>
<p>For food companies, this enables them to supply and heavily promote a high volume and enormous range of products, many of which are unhealthy. This increased supply of cheap, tasty, energy-dense food has been the <a href="http://www.ncbi.nlm.nih.gov/pubmed/21872749">main driver</a> of population weight gain over the last three decades. </p>
<p>Despite strong evidence that many very affordable and cost-effective government interventions – such as improvements to food labelling, restrictions on the marketing of unhealthy food and drinks to children, and taxes on unhealthy foods (such as soft drinks) – are likely to be <a href="http://www.ncbi.nlm.nih.gov/pubmed/21079620">highly effective</a> in improving population health outcomes, very few of these policies have been implemented globally. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/41797/original/zrwrvztc-1392702475.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/41797/original/zrwrvztc-1392702475.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=336&fit=crop&dpr=1 600w, https://images.theconversation.com/files/41797/original/zrwrvztc-1392702475.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=336&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/41797/original/zrwrvztc-1392702475.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=336&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/41797/original/zrwrvztc-1392702475.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=423&fit=crop&dpr=1 754w, https://images.theconversation.com/files/41797/original/zrwrvztc-1392702475.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=423&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/41797/original/zrwrvztc-1392702475.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=423&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The goal of food labelling is to help consumers make informed decisions.</span>
<span class="attribution"><a class="source" href="http://www.flickr.com/photos/franzj/4733041901/sizes/l/">Franzj/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
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<p>A <a href="http://www.iaso.org/site_media/uploads/bellagio_declaration.pdf">major reason</a> for this lack of action is that governments have faced strong pressure from food companies to maintain the status quo.</p>
<p>Corporate efforts to influence policy are a serious worry for public health. There’s a clear conflict of interest between big food companies seeking to profit from sales of their products (many of which are unhealthy) and public-interest efforts to improve population nutrition. </p>
<p>Indeed, the Director General of the World Health Organisation, Dr Margaret Chan, <a href="http://www.who.int/dg/speeches/2013/health_promotion_20130610/en/">recently referred</a> to the lobby forces of Big Food as one of the biggest challenge that countries face as they try to reduce obesity and diet-related diseases.</p>
<h2>Towards informed choices</h2>
<p>In the case of current efforts to improve food labelling in Australia, the
<a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/frontofpackcommittee">goal</a> of the new labelling scheme is to assist consumers to make informed dietary choices and, in so doing, help improve the health of the population. </p>
<p>The government has engaged heavily with public health experts, consumer groups and the food industry throughout the <a href="https://theconversation.com/industry-winning-the-fight-against-better-food-labelling-22472">policy development process</a>. And Australia’s food and health ministers have <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/ACA58089FC311682CA257BF0001CAB86/%24File/Final%20Forum%20Communique%2013%20December%202013.pdf">all agreed to support</a> the new labelling system.</p>
<p>However, it appears the food industry’s recent efforts to undermine the scheme are having some effect. </p>
<p>Hopefully, the enormous media attention that has accompanied the government’s decision to take down the new food labelling website will enourage the government to follow through on their previous commitments to support the scheme. </p>
<p>But more broadly, we need tighter rules around <a href="http://www.iaso.org/site_media/uploads/bellagio_declaration.pdf">government engagement</a> with the private sector, and <a href="http://onlinelibrary.wiley.com/doi/10.1111/obr.12074/abstract">closer monitoring</a> of the tactics used by Big Food to influence policy. This can generate evidence that can be used to hold food companies and governments to account for their roles in obesity prevention.</p>
<p><strong>Read more about the food labelling scandal:</strong></p>
<ul>
<li><a href="https://theconversation.com/should-the-food-industry-resign-from-the-health-department-too-23292">Should the food industry resign from the health department too?</a></li>
</ul><img src="https://counter.theconversation.com/content/23232/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gary Sacks receives funding from the Australian National Health and Medical Research Council (NHMRC).</span></em></p>The influence of the food lobby has come into the public spotlight over the past week, with revelations that Assistant Health Minister Fiona Nash’s chief-of-staff, Alastair Furnival, has strong links to…Gary Sacks, Senior Research Fellow, WHO Collaborating Centre for Obesity Prevention, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/232922014-02-18T03:33:37Z2014-02-18T03:33:37ZShould the food industry resign from the health department too?<figure><img src="https://images.theconversation.com/files/41767/original/bwd2mq6r-1392693149.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Assistant Minister for Health Fiona Nash's chief of staff has had to resign because of conflicts of interest.</span> <span class="attribution"><span class="source">Alan Porritt/AAP</span></span></figcaption></figure><p><a href="http://www.theguardian.com/world/2014/feb/14/fiona-nash-under-pressure-over-claims-she-misled-senate">Furore over links</a> between Assistant Minister for Health Fiona Nash’s office and industry continues today with <a href="http://www.smh.com.au/federal-politics/political-news/alcohol-lobby-link-to-dumping-health-body-20140217-32wft.html">revelations that her former chief of staff is connected to the alcohol</a>, as well as the food industry. </p>
<p><a href="http://www.smh.com.au/federal-politics/political-news/chief-of-staff-for-minister-fiona-nash-forced-to-resign-20140214-32rli.html">Alastair Furnival resigned last Friday</a> over his role in shutting down a website about the health star rating food labelling system and it’s now been revealed that he played a key role in cancelling the funding of the Alcohol and other Drugs Council of Australia. </p>
<p>Furnival is <a href="http://www.smh.com.au/federal-politics/political-news/chief-of-staff-for-minister-fiona-nash-forced-to-resign-20140214-32rli.html">co-owner of a lobbying firm</a> that has represented major food companies opposed to the new front-of-pack labelling system. According to Fairfax, he and his wife also co-own a company, which, in turn, owns another that lobbied for the alcohol industry in 2012. </p>
<p>Such <a href="http://www.nejm.org/doi/full/10.1056/NEJM199308193290812">conflicts of interest</a> place question marks over an individual’s capacity to judge a situation, perform a duty or make a decision in a fair and impartial manner. But what if a public institution, such as the Department of Health itself, has conflicted interests?</p>
<p>Furnival’s conflict of interest is worrying and should be thoroughly scrutinised. But the influence of the food and alcohol industries at the institutional-level precedes Furnival and will continue despite his resignation.</p>
<h2>A growing closeness</h2>
<p>The <a href="http://www.afgc.org.au/whoweare.html">Australian Food and Grocery Council</a> (AFGC) and the health department have developed close ties in recent years. Senior executives of the Council sat on the <a href="http://www.nhmrc.gov.au/your-health/nutrition/dietary-guidelines-working-committee">Dietary Guidelines Working Committee</a> and the <a>National Preventive Health Taskforce</a>.</p>
<p>It <a href="https://www.health.gov.au/internet/main/publishing.nsf/Content/phd-nutrition-childrens-survey">co-funded a major nutritional health research survey</a> with the health department in 2007, and is a prominent member of the <a href="http://www.foodhealthdialogue.gov.au/internet/foodandhealth/publishing.nsf">Food and Health Dialogue</a>.</p>
<p>At the 2009 AFGC annual dinner, Nicola Roxon, then-minister for health said these relationships weren’t cause for concern. <a href="http://web.archive.org/web/20100305011009/http://www.health.gov.au/internet/ministers/publishing.nsf/Content/sp-yr09-nr-nrsp281009.htm">Roxon</a> welcomed the industry’s partnership with health prevention strategies and research projects, adding that she “saw no reason for people to fear industry engagement – quite the opposite”. </p>
<p>Perhaps. But when the <a href="http://www.afgc.org.au/whatwedo.html">aim of the food and grocery council</a> is to “influence federal and state policies to ensure our members’ views are represented at the highest level”, legitimate questions arise about whether these partnerships conflict with the work of the health department. </p>
<p>Lawrence Lessig, professor of law and director of the <a href="http://www.ethics.harvard.edu/lab/about-us">Edmond J. Safra Center for Ethics</a> at Harvard University, warns that such partnerships can <a href="http://www.ethics.harvard.edu/lab/about-us">corrupt an institution</a> by creating:</p>
<blockquote>
<p>an economy of influence that illegitimately weakens the effectiveness of an institution especially by weakening the public trust of the institution. </p>
</blockquote>
<p>So does the health department’s relationship with the food and grocery council weaken its effectiveness and public trust of the institution? For many, the answer is yes.</p>
<h2>Keeping everyone happy?</h2>
<p>In 2011, the health department responded to the <a href="http://www.foodlabellingreview.gov.au/internet/foodlabelling/publishing.nsf/content/home">Blewett Review</a> of food labelling law and policy by rejecting the major recommendation of a traffic-light front-of-pack labelling system. <a href="http://www.smh.com.au/national/health/fat-chance-of-breaking-junk-food-grip-20111230-1pfgd.html">Journalists</a>, <a href="http://www.phaa.net.au/documents/111209%20Food%20Ministers%20too%20close%20to%20industry.pdf">public health researchers</a> and <a href="http://www.abc.net.au/lateline/content/2011/s3251022.htm">consumer groups</a> all believed the decision was due to the food and grocery council’s influence. </p>
<p>Catherine King, then-parliamentary secretary for health, defended the decision in an <a href="http://www.abc.net.au/radionational/programs/nationalinterest/stop2c-look2c-buy3a-traffic-lights-on-food/3710042#transcript">interview</a> with the ABC. King explained the traffic-light scheme would “be a fairly big change for industry” and decided that “we need to get public health and industry together to try and…look at another system”.</p>
<p>This led to the <a href="https://www.health.gov.au/internet/main/publishing.nsf/Content/frontofpackobjectives">Forum on Food Regulation</a>, a collaborative process involving the AFGC, public health researchers and health department officials. The Forum’s objective was to develop a front-of-pack food labelling system that “must strike a balance between seeking to ensure good public health outcomes and ensuring a strong and profitable food industry”.</p>
<p>But are these objectives compatible? If a profitable industry undermines public health, is a balance feasible? And does the attempt to reach a balance weaken the effectiveness of the health department, the institution that arbitrates this relationship?</p>
<p>A profitable food industry is certainly in the nation’s economic interest. But the idea that it should be a primary concern for the health department rubs against its more obvious objective of ensuring public health.</p>
<p>Individual conflicts of interest can cause <a href="http://en.wikipedia.org/wiki/Kids_for_cash_scandal">significant damage</a> – Furnival and those responsible for his appointment need to be fully investigated. But whether the increasing acceptance of <a href="http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2268079">public-private partnerships</a> is the best way to ensure public goods needs critical attention. These partnerships have the potential to undermine public trust and weaken the effectiveness of vital public institutions. </p>
<p>The public needs to be confident that public officials and public institutions are acting in their interest. Recent events at the individual and institutional level imply that such confidence is misplaced.</p>
<p><em>CORRECTION:</em> This article has been amended to reflect that the name of the health department recently changed from Department of Health and Ageing to Department of Health. The error was introduced during the editing process.</p><img src="https://counter.theconversation.com/content/23292/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The author would like to thank Associate Professor Jonathan H. Marks and Emeritus Professor Donald B. Thompson. This analysis partly draws on research undertaken as Postdoctoral Fellow on their collaborative project (<a href="http://rockethics.psu.edu/bioethics/food-ethics/research">http://rockethics.psu.edu/bioethics/food-ethics/research</a>) jointly funded by the Rock Ethics Institute at the Pennsylvania State University and the Edmond J. Safra Center for Ethics at Harvard University.</span></em></p>Furore over links between Assistant Minister for Health Fiona Nash’s office and industry continues today with revelations that her former chief of staff is connected to the alcohol, as well as the food…Christopher Mayes, Post-Doctoral Fellow in Bioethics, University of SydneyLicensed as Creative Commons – attribution, no derivatives.