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Seeing red: critics of better food labels fail to understand public health measures

Food labels may help curb the obesity epidemic but opponents willfully misrepresent what we know about them. Marshall Astor

Nutritional labels on food packaging empower consumers to make healthier and more informed food choices. But like other measures taken for public health, food labelling also has its critics.

There’s clear evidence that we have a major problem with obesity in Australia, with two in three adults and one in four children now overweight or obese.

So giving people the chance to make healthy food choices – with clear labelling of menus and food packaging – is more important than ever.

Simplifying the landscape

But Chris Berg from the Institute of Public Affairs recently argued on ABC’s The Drum website that menu labelling doesn’t work.

Berg cites a study of menu labels in New York fast food chains that showed only a minority of customers changed their purchasing to items with fewer calories. Success was restricted to Subway, which already promoted itself as a healthier fast food choice.

He concludes that overall there was no decline in calories purchased. What he fails to mention is that menu labelling was in fact effective for several New York fast food chains, which recorded a significant reduction in calorie intake.

Menu labelling in New York changes the food choices of some consumers. Kevin Krejci

Berg cites other examples where changes in behaviour have been minimal. But the issue is not black and white as he makes out.

Consumption patterns and responses to initiatives such as menu labelling vary according to a range of factors.

Importance of comprehensibility

The success of menu labelling in isolation will be limited particularly if consumers’ understanding of calorie or energy intake is poor.

The current nutrition information panels on the back or side of packaged foods, for instance, are difficult to read and require an understanding of what kilojoule (kJ) per 100 grams means or worse, what kJ per “serve” means when serve is an uncertain quantity.

Consumers may also be fooled by marketing of products highlighted as “low fat”, which are nonetheless high in sugar, or vice versa.

Comprehensible labels are clearly required on the front of food packaging or on menus so consumers can know the total fat, saturated fat, sugar and sodium content of the food.

Obesity is a recent public health problem so the evidence on reversing it is still evolving. The only way to build that evidence base is to continue trialling and evaluating public health measures that show potential for success.

And it is clearly erroneous to argue that just because one type of label may have not had a massive impact in one instance, all labels are bound to fail.

All shapes and sizes

There are many suggestions for types of labels that should be tried. Cancer Council Australia favours a “traffic-light” system where red would signal high, amber moderate, and green low for fat, salt and sugar.

In collaboration with other public health and consumer organisations, the Cancer Council conducted 790 intercept surveys at shopping centres using mock food packages.

Consumers were five times more likely to identify healthier products using the front-of-pack traffic-light system compared with the standard single colour system displaying ingredients as a percentage of daily intake.

This result is supported by research from New Zealand and the United Kingdom.

What’s more, Labelling Logic, the report from the independent Blewett review of food labelling, recommends a traffic-light system.

But the food industry in Australia has instituted front-of-packets labels with single colour boxes showing fat, sugar and sodium as percentage of daily intake. These numbers are difficult to interpret and relate to an “average” adult.

It’s also a system that encompasses a different philosophy to the traffic-light system because it encourages intake – even if limited – while red traffic lights discourage intake of unhealthy foods.

Consumers need an overall assessment of the product’s salt, fat and sugar content. Flickr/digiputz

Percentage of daily intake suggests that any food item with less than the recommended daily intake can still be consumed despite the fact it may have very high levels of fat, sugar, salt or calories and should be avoided.

The food industry is releasing data on the percentage of labelled products but there’s little point in statistics if the labels are not understood by consumers.

Beginnings and endings

We also need to be careful about how we measure success of any food labelling system.

A study from the United Kingdom, for instance, showed traffic-light labelling on ready meals and sandwiches had no impact of the healthiness of products purchased.

But only 4% of the total range of products had been labelled and the assessment was done just four weeks after labelling.

An indication of a true measure of success would require the labels being around for months or years, even in conjunction with an education campaign because changing established behaviours takes a long time.

The first thing to be measured should be whether consumers can understand the labelling system and distinguish healthy and unhealthy foods. Over time, we could measure purchasing patterns to see if there was a move towards healthier foods.

Another powerful measure of success would be to see how many products with red traffic lights are reformulated.

It can be safely assumed that food manufacturers would try to avoid red traffic light labels on their products because they may decrease sales. Any such changes to unhealthy products would bring an additional benefit.

The endgame of food labelling is to curb the rates of obesity and obesity-related chronic diseases in the population.

Surely its a goal worthy enough to accurately test the efficacy of food labels before deciding that labels don’t work based on the misinterpretation of one study.

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