An investigation of the change in alignment between the Health Star Rating Scheme and the Nova Food Processing...

Front-of-package labelling informs consumers about the 'healthiness' of foods based on different classification schemes. These schemes reflect competing worldviews for assessing a food's healthiness, represented by nutrient-, food- or diet-based indices. The Health Star Rating scheme (HSR) has been criticised for failing to appropriately score unhealthy products. Updates to the HSR algorithm were implemented over a two-year period from November 2020. This study investigated alignment between a nutrient-based scheme (HSR), food-based scheme (Nova food processing system) and diet-based scheme (Australian Dietary Guidelines (ADG)).

Mintel Global New Products Database.

Retail foods displaying HSR launched or updated onto the Australian market between November 2020 and June 2023.

Products were categorised according to the ADG and Nova, descriptive statistics performed for each category and proportion displaying HSR ≤ 2·0 and ≥ 2·5 calculated for discretionary foods, five food group foods, ultra-processed foods (UPF) and non-UPF. Agreement between categories obtained by Kappa.

Median HSR for UPF and discretionary foods were 3·5 and 2·5, respectively, and 73·7 % of UPF and 58·2 % of discretionary foods displayed HSR ≥ 2·5. Agreement between HSR and Nova was none to slight (k = 0·09, P < 0·001) and HSR and ADG was fair (k = 0·38, P < 0·001). Between 2020-2023, the proportion of UPF displaying HSR ≥ 2·5 increased from 60·2 % to 78·5 % and for discretionary foods 47·0 % to 62·5 %.

The HSR algorithm calculates 'healthy' HSR (≥ 2·5) for a high proportion of UPF and discretionary foods. The HSR's nutrient-based approach to translate food-and diet-based nutrition recommendations into accurate food 'healthiness' assessments is still problematic.