Modifying the Health Star Rating nutrient profiling algorithm to account for ultra-processing

Area of Science:

• Nutrition science
• Food policy
• Public health

Background:

• The Australian and New Zealand Health Star Rating system aims to guide consumers towards healthier food choices.
• Ultra-processed foods represent a significant portion of the modern diet and are associated with adverse health outcomes.
• Current food labelling systems may not adequately account for the impact of ultra-processing on food healthiness.

Purpose of the Study:

• To modify the Australian and New Zealand Health Star Rating to incorporate ultra-processing.
• To compare the alignment of modified Health Star Ratings with the NOVA classification system and Australian Dietary Guidelines.
• To assess the impact of ultra-processing on food classification within existing dietary guidance.

Main Methods:

• Cross-sectional analysis of 25,486 food products.
• Four modifications to the Health Star Rating were tested, including adding negative points or capping scores for ultra-processed foods.
• Alignment was assessed based on Health Star Ratings, NOVA groups (1-4), and Australian Dietary Guidelines (core vs. discretionary foods).

Main Results:

• All modified Health Star Ratings showed improved alignment with the NOVA classification of ultra-processed foods (69-88%) compared to the original system (66%).
• No modifications improved overall alignment with Australian Dietary Guidelines (77% original vs. 69-76% modified).
• Alignment with Dietary Guidelines varied significantly across different food categories.

Conclusions:

• Incorporating ultra-processing into the Health Star Rating could enhance its alignment with food processing classifications.
• Coherent dietary messaging requires careful consideration of ultra-processing within broader dietary guidance frameworks.
• Further research is needed to optimize food labelling systems for effective public health communication.