Front and Centre: Labelling Works
By Mhairi Brown, Policy and Public Affairs Manager for Action on Sugar and Action on Salt
At Action on Salt and Sugar, our key aim is reducing population salt, sugar and excess calorie intake to improve health. We know the most impactful and cost-effective method to do this is reformulation: improving food and drinks by taking out salt, sugar and saturated fat, while ideally increasing levels of fibre, fruit and vegetables. So much of the salt and sugar we eat has already been added to food and drinks available in supermarkets, corner shops, cafes, restaurants, fast food outlets… by simply getting the food industry to play their part and make this food healthier, we can have a huge impact on health.
But while reformulation may be our modus operandi, we also support other policies that can help improve the nutritional quality of food and drinks. Advertising and price promotion restrictions for less healthy products, for example, will help us see more of the products that nourish us. And thanks to the structure of the policy, if companies reformulate their products to meet certain criteria, then their products can still be advertised and promoted.
Another key policy is front of pack nutrition labels.
UK’s Front of Pack Labels
Recommended by the World Health Organization as a key tool to help consumers make healthier choices1, front of pack labels help us to see at a glance what is in our food and drinks. In the UK, front of pack labelling has been in place for many years but in 2013, the Government released voluntary guidance to help standardise the format2. That format now combines a ‘traffic light’ label to highlight high (red), moderate (amber) or low (green) levels of total fat, saturated fat, sugars and salt per 100g or 100ml of food or drink products, alongside percentage reference intakes for each of the nutrients plus calories.
Front of pack labels have an additional function to highlighting the healthier choice though. Evidence shows that traffic light labels increase the demand for healthier foods, which in turn stimulates food companies to reformulate their products to meet that demand3. Indeed, since 2015, Sainsbury’s have committed to reducing the number of ‘red lights’ displayed on their own-brand products, with an ambition to reach just one in five (21%) products displaying any red label by 20204. The Co-operative and Tesco also use traffic light labels to define which of their products are ‘healthy’.
As part of their commitment to preventing obesity, the Government wants to make sure that front of pack labels are as clear and useful as possible5. In 2020, they released a consultation6 which invited views from the general public on the current traffic light system alongside views of the Nutri-Score label, which is predominately used in France, and nutrient warning labels, which are used in many countries across Latin America.
Our new research
In light of the government’s consultation, we investigated which type of labelling would have the most impact in the UK. Together with colleagues from Resolve to Save Lives in the USA, The George Institute for Global Health in Australia, the University of Calgary in Canada and the University of Auckland in New Zealand, we carried out a systematic review and network meta-analysis of the current available 134 peer-reviewed studies, published over 30 years, on traffic light labels, Nutri-Score and warning labels7.
We found that all three label types are able to direct consumers to choosing and purchasing healthier products, meaning that they all helped to reduce the energy, salt, fat or saturated fat content of processed foods and drinks chosen or purchased. Interestingly, colour-coded labels (traffic light labels and Nutri-Score) perform better in highlighting positive aspects and encourage consumers to purchase healthier products. In contrast, warning labels highlight the negative aspects which discourages the purchase of less healthy products.
Our research also found that much of the existing research on nutrition labels focuses on short term computer simulations, not real-world evidence.
The future of front of pack labelling
So what does this mean for the UK? Ultimately, labelling works: all interpretive front of pack nutrition labels have an impact. The UK’s exit from the EU will allow the Government to introduce mandatory requirements for food labelling and given that so many companies currently display them, its time to create a level playing field to bring the remaining companies in line.
The Government’s response to the National Food Strategy would be the perfect opportunity to create this level playing field. In 2019, the Department for Environment, Food and Rural Affairs (DEFRA) commissioned Henry Dimbleby to conduct an independent review to help the Government create its first National Food Strategy for 75 years. This review was released in July 20218, highlighting the historic reform needed to protect the NHS, improve the health of the nation and save the environment. The Government has committed to responding with a White Paper within six months which will set out the legislation they will put in place. We strongly recommend that a legislative proposal for mandatory front of pack nutrition labelling be included in this White Paper.
Crucially, once in place the scheme should be evaluated to assess how effective it is and how useful consumers find it. That evaluation should capture the impact on the nutrition content of food and drinks - caused by making all companies put nutrition information front and centre on their products - and the benefits to population health.
This will give us the real-world evidence we need to inform a decision on how to make the UK’s nutrition labels as clear and as useful to consumers as possible.
- World Health Organization (2019). Guiding principles and framework manual for front-of-pack labelling for promoting healthy diet. https://www.who.int/nutrition/publications/policies/guidingprinciples-labelling-promoting-healthydiet.pdf?ua=1
- Department of Health (2013). Guide to creating a front of pack (FOP) nutrition label for pre-packed products sold through retail outlets https://www.food.gov.uk/sites/default/files/media/document/fop-guidance_0.pdf
- House of Lords Science and Technology Committee (2011) Behaviour Changehttps://publications.parliament.uk/pa/ld201012/ldselect/ldsctech/179/179.pdf
- Sainsbury’s, 2019. Our ongoing commitment to providing clear nutritional labelling for our customers https://www.about.sainsburys.co.uk/making-a-difference/our-values/ourstories/2019/25072019-our-ongoing-commitment-to-providing-clear-nutritional-labellingfor-our-customers
- Cabinet Office and Department of Health and Social Care (2019). Advancing our health: prevention in the 2020s https://www.gov.uk/government/consultations/advancing-our-health-prevention-in-the-2020s/advancing-our-health-prevention-in-the-2020s-consultation-document
- Front-of-pack nutrition labelling in the UK: building on success. 2020. Department of Health and Social Care, Department of Health (Northern Ireland), The Scottish Government and Welsh Government
- Song J, Brown MK, Tan M, MacGregor GA, Webster J, Campbell NRC, et al. (2021) Impact of color-coded and warning nutrition labelling schemes: A systematic review and network meta-analysis. PLoS Med 18(9): e1003765. https://doi.org/10.1371/journal.pmed.1003765
- National Food Strategy (2021). The Plan https://www.nationalfoodstrategy.org/