Feature articles

Is the Health Star Rating working?

The government’s front-of-pack Health Star Rating (HSR) on packaged foods has been rolling out since mid-2014. Food companies have 5 years to implement the (voluntary) system, and then a formal review will be conducted. We’re now at the half way mark and some evaluation results are available. And, two Australasian studies recently published also shed light on its effectiveness.HSR shopping basket.JPG

Evaluation results: do consumers know about the HSR?
Awareness of the HSR has significantly increased from 42% in September 2015 to 59% in June 2016.

One in four (25%) Australian’s recognise the HSR campaign. Of those who saw the campaign, 77% have carried out at least one behavioural objective of the campaign. The strongest outcomes are for using the HSR in store, and trying to eat healthier.

Awareness tended to be higher in women, people under 35, those with household income over $50,000, and those with a BMI in the healthy range.

Do consumers know how to use the HSR?
There has been a significant increase in the accurate understanding of the HSR, which has increased to 70% in June 2016, up from 64% in September 2015.

Of those aware of the HSR, 33% have bought a new product because it had a higher HSR than their usual product.

1 in 6 people are changing their shopping behaviour based on the HSR system.

Do consumers want to use the HSR? 
The likelihood to use the HSR has also increased from 39% to 50% of the sample stating they would be likely to use the HSR on a regular basis.

65% stated they would like the HSR on more products.

More information regarding the monitoring of the HSR can be found here.

New Zealand Research (1): do interpretive nutrition labels help us buy healthier foods?
This New Zealand research conducted between October 2014 and November 2015 (the first year of HSR implementation) evaluated the effects of two interpretive nutrition labels- Traffic Light Labels (TLL) & Health Star Rating (HSR)- compared with the non-interpretive label Nutrition Information Panel  (NIP, control ) on the healthiness of food purchases over 4 weeks. Thirteen hundred and fifty seven eligible subjects were randomly assigned to each group, and data was collected using smart-phone technology. Healthiness of food purchases was measured by the FSANZ Nutrient Profiling Scoring Criterion (NPSC). The differences in the mean NPSC score between the two different systems and the NIP control did not reach statistical significance. When participants who used the systems more than average were analysed, the people who used the TLL or the HSR had significantly better NPSC scores than those using the NIP.

The HSR had the highest NPSC scores out the two interpretive systems.

Shoppers assigned to the TLL or HSR found these labels significantly more useful and easy to understand than the NIP.

Australian research (2): do health claims and front-of-pack labels increase purchase of unhealthy foods?
One of the possible risks of front-of-pack labels (FoPL) and health claims is that unhealthy foods might be more attractive to consumers, an effect called positivity bias. An Australian research team investigated whether a positivity bias would occur in unhealthy variations of four products (cookies, corn flakes, pizza and yoghurt) under different health claim (no claim, nutrient claim, general level health claim, high level health claim) and FoPL conditions (no FoPL, Daily Intake Guide, Multiple Traffic Lights and the Health Star Rating).  Overall, health claims did not produce a positivity bias, while FoPLs did. The DIG was most likely to elicit this bias.

The HSR most frequently led to lower ratings of unhealthy foods, suggesting it has the lowest risk of inaccurate positivity bias in unhealthy foods.

NOTE: food products carrying health claims of any kind in Australia and New Zealand must meet FSANZ Nutrient Profiling Scoring Criterion (NPSC). This is to ensure healthier products carry claims.                                     

NEXT: Sugar sweetened beverages – what the Australian Health Survey reveals 

1. Ni Mhurchu C, Volkova E, Jiang Y et al. Effects of interpretive nutrition labels on consumer food purchases: the Starlight randomised controlled trial. Am J Clin Nutr 2017. doi: 10.3945/​ajcn.116.144956  
2. Talati Z, Pettigrew S, Dixon H, Neal B et al. Do health claims and front-of-pack labels leads to a positivity bias in unhealthy foods? Nutrients 2016;8:787 

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