Health Star Rating review – Expert Reaction

The first five year review of the Health Star Rating system has been completed, with a series of recommendations for improvements.

The review concluded that the rating system should continue, but recommended several adjustments to better align with dietary guidelines, including automatically giving fruit and vegetables five stars, more strongly penalising total sugars and rating unsweetened flavoured waters closer to water to distinguish from juice and sugar-sweetened drinks.

The Australia and New Zealand Ministerial Forum on Food Regulation is expected to respond to the report and recommendations by the end of the year.

The SMC gathered expert comments on the review.

Dr Sally McKay, research fellow, University of Auckland, comments:

“The recommendations from the Health Star Rating System Five Year Review will improve the accuracy of the system to represent the relative healthiness of packaged foods and beverages, in particular to lessen anomalies around sugar and salt content, allocate a 5 star rating on all fruit and vegetables (with no added salt, fat or sugar). The allocation of stars for non-alcoholic beverages now reflects the sugar content of beverages, for example flavoured waters with no added sugar will receive a higher Health Star Rating (4.5 stars) than fruit juices.

“As the Health Star Rating is only on 21 per cent of labels of packaged foods, the system should be made mandatory now, though at least there is a time-frame (5 years) for improved uptake by industry before considering mandatory labelling. Having the Health Star Rating on all foods would allow customers to make the healthy choice the easy choice.

“Recommendation eight recognises the need for critical infrastructure to support and evaluate food and nutrition-related public health initiatives. A plan for regular nutrition surveys is essential with the need for a national nutrition survey for children pressing given the previous survey was in 2002.”

No conflict of interest.

Professor Emeritus Elaine Rush, Auckland University of Technology, comments

“The Health Star Rating (HSR) front of pack labelling system focuses on six ‘key’ nutrients and one whole food component to rank packaged foods within a food category and is promoted as a way for ‘consumers’ to make an informed choice. The positive nutrients are protein and fibre and the negative nutrients are sodium, energy, saturated fat and total sugar. The proportion of fruit, vegetable, nut and legume is the only consideration of wholesome ingredients.

“While there has been some success within categories for reformulation and removal of sugar from products by manufacturers, Health Star Rating is focused mainly on processed food and does not deal with the need to provide better access for everyone to a variety of nutritious foods every day including: plenty of vegetables and fruit, grain foods, mostly whole grain and those naturally high in fibre, some milk and milk products, mostly low and reduced fat (Ministry of Health guideline).

“The recently-published food insecurity report from the Ministry of Health clearly shows that poverty is associated with malnutrition: not eating enough fruit and vegetables and the high prevalence of obesity. One in five children lives with severe to moderate food insecurity. This is largely due to a lack of sufficient money to pay for food which is not going to be addressed by changing the labels.

“An informed choice is only for those who have the agency, money, time, education and geographical access to the wholesome foods that are recommended. A variety of wholesome foods, mainly plants and not too much every day.”

No conflict of interest.