Development of the Choices 5-Level Criteria to Support Multiple Food System Actions

Area of Science:

• Nutrition Science
• Public Health Policy
• Food Science

Background:

• The Choices International Foundation established logo criteria in 2008 for identifying healthy food products.
• There is a need for advanced, global, and graded nutrient profiling systems (NPSs) to support diverse national nutrition policies.
• Existing systems primarily focus on front-of-pack labeling and marketing restrictions for children.

Purpose of the Study:

• To extend the existing Choices NPS to include five distinct levels of food product healthiness.
• To develop a versatile NPS applicable to various national nutrition policies beyond front-of-pack labeling.
• To create a system capable of addressing both undernutrition and obesity.

Main Methods:

• Utilized the principles of the previous Choices logo criteria.
• Developed four sets of threshold criteria based on compliance levels from an international food database.
• Incorporated the Choices logo criteria and World Health Organization (WHO)-NPSs for marketing restrictions.
• Validated the system by comparing it with indicator foods from international food-based dietary guidelines.

Main Results:

• An extended international NPS was developed with five healthiness levels.
• Threshold criteria were refined following validation to ensure appropriate grading.
• The system demonstrated effectiveness in evaluating mixed food products.
• The developed NPS is applicable across various contexts and populations.

Conclusions:

• The enhanced Choices NPS provides a flexible and internationally applicable tool for assessing food product healthiness.
• This system can effectively support a range of national nutrition policies aimed at preventing undernutrition and obesity.
• The graded approach allows for nuanced policy implementation and public health interventions.