Food activists are pushing for clearer labeling on nutritional risks

Unhealthy food is deadlier than tobacco. That was the stark conclusion of a 2019 study in the medical journal The Lancet, which found that diets high in sodium and low in whole grains and fruit were responsible for one in five deaths in 2017. The figure for smoking-related deaths that year were about one in eight.

Poor diets have also caused rates of obesity, which are linked to strokes, high blood pressure and heart disease, to triple since 1975. A report by campaign organization World Obesity estimates that, by 2035, more than half of the world’s population will be obese.

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As these statistics suggest, there are no easy solutions to a health crisis that stems, at least in part, from people’s choices about what to eat. But one approach many health authorities have tried is the adoption of front-of-pack (FOP) labels. The idea is not simply to alert consumers to the risks of different foods, but also to motivate companies to reformulate products.

One country that takes a hard line and is much studied by policymakers is Chile, which implemented a new FOP scheme in 2016. It takes a three-pronged approach: limit marketing; ban the sale of unhealthy foods at school; and most noticeably by requiring the application of large black warning labels to all products deemed high in calories, high in saturated fat or high in sugar. Similar warning labels have since been adopted in Israel.

It took 10 years to actually bring those labels to market, says Gabriela Fretes, a research associate at the International Food Policy Research Institute. Then, from 2016 to 2019, Fretes evaluated changes to children’s diets after the law was implemented. It appears to be working, she says, and there are no side effects for companies.

Three black octagonal labels on a Chilean product warn of high calories, sodium and saturated fat
Triple threat: Chilean label warns of product high in calories, sodium and saturated fat Jorge Donoso/Alamy

Fretess’ study of 349 children found that, compared to pre-policy levels, the total amount of sugar consumed by children in school decreased by 4.5% in 2018 and nearly 12% in 2019. Her research found also noted a decrease in saturated fat and sodium intake at school over the same period.

In addition, Chile’s food labeling law has prompted companies to reformulate their products. A study, published in the journal Plos Medicine in 2020, found that there was a significant decrease in the amount of sugar and sodium in several groups of packaged foods and beverages after the law was passed.

Similar effects have been observed elsewhere. In the UK, supermarkets and manufacturers, while not mandated by law, such as in Chile, have opted to use an intuitive traffic light system for FOP nutrition labelling. The move followed voluntary guidance issued by the UK government in 2013. Soon after, in 2015, supermarket chain Sainsburys pledged to reduce the number of red lights on its branded products.

Similarly, in the United States, a 2006 regulation requiring manufacturers to label foods containing trans fat, a particularly unhealthy type of fat found in high levels in some processed foods, has prompted a wave of reformulation for remove them.

Another popular method of labeling is the Nutri-Score, a system developed by French researchers (based on a UK nutrient profiling method) and adopted by the French government in 2017. This ranks foods from A to E according to the their nutritional value and has been recommended by the European Commission and the World Health Organization. It has also been approved for use in Belgium, Spain and Portugal.

A Nutri-Score label that gives a product a C rating
Score out of five: The Nutri-Score system, adopted by France, ranks foods from A to E SOPA Images Limited/Alamy

In the United States, however, potential FOP initiatives are complicated by the First Amendment, which protects free speech and prohibits the government from forcing people and, to some extent, companies to say things they don’t want to say. Efforts to require mandatory warning labels may therefore be open to legal challenge, and thus the nutrition labeling enforced by the Food and Drugs Administration (FDA) is minimally limited to serving sizes, servings per container, and nutrient amounts.

However, last year’s launch of the White House’s National Strategy on Nutrition, Hunger and Health could mean that change is afoot. Very important in that strategy was FOP food labeling, which is a really big deal because it’s the first time it’s become a major priority, says Christina Roberto, an associate professor of health policy at the University of Pennsylvania. The FDA, she adds, is currently researching FOP labeling and proposing potential schemes.

Even so, Roberto admits that a truly effective system would risk lawsuits. We know interpretive systems that are very intuitive, people will understand [them], she says. But scholars and legal advocates are trying to figure out what the line is. How good could we get a system that communicates really well to consumers without exposing it to the threat of a lawsuit from industry?

Perhaps the biggest obstacle to food labeling is lobbying by multinational food manufacturers. It’s like tobacco, says Graham MacGregor, professor of cardiovascular medicine at the Wolfson Institute, Queen Mary University of London. We are up against the biggest and most powerful industry in the world… and they will do anything to keep selling these cheap and highly profitable foods.

In 2010, the European Parliament voted on whether the EU should adopt a mandatory traffic light labeling system. This has been rejected in favor of an alternative scheme known as a guideline daily amount (GDA), which lists percentages of recommended daily allowances in each serving.

The guidelines’ daily amount system lists percentages of recommended daily allowances per serving Rosemary Roberts/Alamy

Transparency campaigners and MEPs have accused the food industry of a large-scale lobbying campaign costing up to 1 billion to push the vote in its favour. The CIAA, the European food industry trade body (now called FoodDrinkEurope, FDE), noted that democratically elected MEPs clearly rejected the traffic light proposal, which it declared failed[ed] take into account the place of a food in the context of a balanced diet and a healthy lifestyle.

Efforts to legislate for mandatory EU-wide labeling have since been unsuccessful. However, in 2020, the European Commission released its Farm to Fork Strategy, which committed to proposing harmonized mandatory front-of-pack nutrition labeling by 2022, although this deadline has since been postponed.

Manufacturers continue to have reservations. In a written statement, FDE told the FT that it does not support warning labels, is neutral towards traffic lights and nutrition scores and that a coordinated approach to labeling should not be used as a tool to discriminate against specific food products, categories of foods, nutrients or ingredients as healthy or unhealthy per se. It favors a broader approach, focused on… improving consumer education and encouraging balanced diets and healthy lifestyles.

Roberto acknowledges that no policy is perfect, but he thinks the urgency of the situation justifies schemes like those in Chile and France. We have a really huge public health crisis, where the industry essentially controls our food supply, he says. So, I find it very difficult to argue against the idea of ​​informing the public about what’s in their food.

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