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KaiApril 29, 2024

Is the health star system past its use-by date?


Plagued by industry lobbying and design flaws, the system may be on the chopping block under National. Is it delivering what it says on the box?

At the supermarket, a woman with a baby strapped to her front pushes a trolley piled high with groceries, and two young children sit amongst the haul. She wants to get the family’s weekly shop done quickly before any of her ticking timebombs has a meltdown. In the breakfast cereal aisle, her toddler demands she buys the boxes decorated with colourful cartoon characters, but she instinctively knows they won’t provide the good stuff her kids need to start the day. 

Without time to synthesise the complex nutritional information on the back of the packets, she is grateful to see most of the cereals have a health rating on the front, so hurriedly grabs one displaying four stars, assuming it to be a solid choice. But what she doesn’t realise is that the food her hungry kids will be shovelling into their mouths at breakfast the next morning contains almost 10 grams of sugar per cup, 80% of a child’s recommended daily intake in a single helping.

Most people who do the shopping for their household will be familiar with the Health Star Rating, the voluntary front-of-pack labelling system designed to help consumers make positive food choices quickly and easily while shopping. While there are benefits to having simplified nutrition information available at a glance, the system in its current form has some shortcomings that concern consumer and health groups alike. In fact, the entire system may be on the chopping block if new health minister Shane Reti follows through on his pre-election promises.

The World Health Organisation recommends front-of-pack nutrition labelling systems to promote healthier eating, and so far, more than 40 countries have adopted some variation of such a tool. Here in Aotearoa, the stars we see on our shelves is a trans-Tasman system that was started in 2014 under National, and since food is freely traded between our two nations, is funded by both the Australian and New Zealand governments. Designed and developed by public health experts, consumer groups and the food industry, it allows consumers to compare the nutritional values of similar packaged foods using a scale of 0.5 to 5 stars: the higher the stars, the healthier the food. Supposedly.

Boyd Swinburn, a professor of population nutrition, says many consumers don’t grasp the complexity of the star system. (Photo supplied)

Boyd Swinburn, professor of population nutrition and global health at the University of Auckland, reports that up to half of New Zealanders’ diets are made up of ultra-processed foods linked to poor health outcomes like cancer, heart disease, obesity and diabetes. “The trouble is that when it comes in a packet, it’s hard to know what the food is actually made of or what it may be doing to those who devour it,” he says. “Interpreting the nutrition information panel on the back kind of takes a nutrition degree.” 

That’s where the friendly arc of stars comes in. It’s calculated based on the positive attributes of food, ie the nutrients we should be eating more of, like protein and fibre, and also negative attributes like sodium, sugar and saturated fat. But because all those things are considered by the calculator’s algorithms before spitting out an assessment of overall nutrition, it’s possible for a sugary breakfast cereal, say, to still be awarded a high rating, as if the good cancels out the bad. 

Kellogg’s Nutri-Grain, for example, markets itself as “fuel for active bodies” and doesn’t target children in its advertising or packaging, but the four-star rating on the box sends mixed messages to would-be customers. The high sugar content – presumably to make it palatable for those with a sweet tooth – is counteracted by added iron, protein, B vitamins and fibre to boost its overall rating. Those nutrients are a positive addition to an individual’s diet, but there are currently no caps on the amount of sugar a highly-rated product can contain, which, given the nutrition community’s ongoing war against the sweet stuff, is potentially misleading for consumers.

Swinburn thinks that while shoppers generally grasp the basics of the hierarchy of stars, they don’t understand the nuances and complexities of the system. Belinda Castles, senior research and test writer at Consumer New Zealand agrees. “I think there has been a lack of education about the health star rating, how it’s calculated and just how consumers should use it in the overall context of choosing a healthy diet,” she says.

One thing that’s not immediately clear to consumers is that the star system compares products within the same category, not across different food types. “When you’re looking at breakfast cereals you can look at the health star ratings,” Castles explains, “but don’t compare, say, breakfast cereals with muesli bars.” So, the system would be helpful if you were deciding between two classic canned staples for lunch: the star on the front of the tins reveals at a glance that Watties Baked Beans is the healthier option (4.5 stars) over its less nutritious sibling Watties Spaghetti (3.5 stars).

What is bewildering, though, is that blue-top milk (4 stars) – which is just milk with no added ingredients – has a lower rating than Strawberry Up & Go (4.5 stars), with its cocktail of confounding ingredients and equivalent of four teaspoons of sugar. Vincent Arbuckle, deputy director-general at New Zealand Food Safety, explains via email that Up & Go is made of trim milk (5 stars) which is lower in saturated fat than blue top, but is penalised slightly (down to 4.5 stars) because of its sugar content.

And what about all the processing required to make the flavoured, pink drink? The star system doesn’t take into account the amount of processing a product has undergone before reaching our shelves. “That’s another thing consumers might not be aware of,” says Castles. “Unfortunately, if you want to dig a bit deeper you really need to look at some of those details on the back of the pack.” Having to do so defeats the purpose of the star system, but a long list of ingredients you wouldn’t cook with at home is a giveaway that the product is heavily processed.

Belinda Castles of Consumer NZ is wary of companies that cherry pick which products will feature the star rating. (Photo supplied)

Another downside identified by consumer advocacy groups and health experts is that the star system is completely voluntary. Over 5,000 packaged food items display the rating, but this is less than a third of total products available. It’s difficult for consumers to make informed choices when not all products supply the same information. While most supermarket home brands are committed to labelling all their products, many of the branded food manufacturers strategically select items to label. Mother Earth, for example, has a four-star rating on the front of their WellBeing Bar, but has chosen to omit the stars altogether on their Baked Oaty Slices. 

“Our issues are the ones that cherry pick the ratings and use it as a bit of a marketing technique,” Castles says. “And that’s where it’s not useful, because you’re not seeing those 0.5 or 1 star products that ideally should be a treat-only food.” 

If the government had looked at the evidence and listened to the experts during the design phase, the Health Star Rating would have been mandatory from the start, Swinburn says. “[It] has been a massive experiment in what happens when you try to do food policy with the food industry,” he says. “You have people in the room who have commercial vested interests designing the system.”

Castles agrees that industry lobbying has muddied the waters. “When you do the public submission process, public health groups and consumer groups are more often than not on the same page and want the same things,” she says. “Industry wants the opposite.”

Five years into the health star system, a review was carried out. Once again, nutrition and community groups advocated for a mandatory system. The government did take on board recommendations to automatically award canned vegetables without additives five stars and to penalise food with higher amounts of salt and sugar, but decided to keep the system voluntary, opting for uptake targets instead.

Expectations were set for 70% of products to display the Health Star Rating by November 2025, but the latest Australian figures have them sitting at around 36%, with New Zealand falling below that. The system has already been in place for almost a decade, Swinburn notes, so companies that wanted to display the stars would have already done so by now. Still, tracking by the Food & Grocery Council shows that industry uptake continues to rise.

Is the star system having an impact on the supply side? Some manufacturers have reformulated their products to earn more stars, and while this could be seen as gaming the system for commercial advantage, research by the University of Melbourne found the star label was associated with a 9% reduction in sodium and a 5% increase of fibre. Kiwi kids have been tucking into a healthier formulation of Weetbix after Sanitarium tweaked their popular breakfast cereal to earn its current five-star rating. Whatever motivated these improvements, the health benefits are being passed onto consumers.

Castle has a word of caution, though. “Food reformulation is usually beneficial to consumers if you’re lowering the salt content or the sugar content of the food, but probably comes down to what’s being added instead.” She points out that companies may add fibre to boost their health star rating, but that not all fibres are created equal. Then there are the chemicals used to replace sugar. “Artificial sweeteners are probably not quite as bad [as sugar], especially when looking at dental health, but it’s the smoking/vaping story all over again,” Swinburn says. “You’re better to avoid both if you can.” To address this loophole, Mexico requires warnings for food items containing artificial sweeteners that they are not recommended for children.

Some 83% of New Zealanders use the Health Star Rating when they are shopping, according to New Zealand Food Safety’s yet-to-be-published 2023 Consumer Food Safety Insights Study, but consumer reports and evidence about the system’s impact are two very different things. A 2022 study published by the University of Melbourne found the system had no direct impact on household purchasing behaviour, ie people bought the same food regardless of the star ratings on the front.

Vincent Arbuckle of New Zealand Food Safety says the system is “robust and fit for purpose”, but critics disagree. (Photo supplied)

This may come down to affordability and education, or the fact that most products displaying the stars are highly rated, but it could also be due to a lack of trust. In the early days of the system, there were teething issues with the algorithms that awarded products with high sugar or salt content high ratings, such as Milo, which boasted 4.5 stars despite being half sugar. While many of those anomalies were ironed out, an aftertaste of consumer scepticism has lingered. Swinburn says that trust in the system sits around 40%, with many consumers viewing the stars as a marketing ploy.

So should the Health Star Rating stay or go? The current system is “robust and fit for purpose”, says Arbuckle of New Zealand Food Safety, whereas Swinburn calls it “an old, outdated, third-rate design”. The government has spent just under $3 million to date on the system, with an ongoing annual expenditure of almost $82,000 to maintain it. Whether that’s money well spent is debatable, but a completely new system will almost certainly come with its own high price tag, and the government is hellbent on trimming fat.

New Zealand and Australia’s food ministers have agreed to jointly fund the system until mid-2026, but noises made by Shane Reti late last year suggest change may come sooner. “I think the star rating system needs to be looked at,” he told NZ Herald. “Australia’s starting to move in other directions, and I think we just need to rethink how we make it easy for [consumers] to make the best choice and the right choice.”

Swinburn is very pleased to hear Reti intends to investigate. “It is great having a minister of health stand up and say, ‘Let’s do something,’” he says. What that something is, though, no-one yet knows, including New Zealand Food Safety, which has briefed the new minister but is unaware of any decisions to scrap the system at this stage. Any changes would need to be tested with consumers to ensure their effectiveness and also be weighed against the cost to industry, NZFS says.

What might a new system look like? Looking overseas for inspiration, Swinburn is most impressed by Latin America, which he says is leading the world. Not only are front-of-pack labelling systems mandatory there, but regulators go further by requiring warning labels (with stop signs or black triangles) to draw attention to high salt or sugar content: think cigarette packets without the grisly blackened lungs. “These are very, very clear signals to the consumer,” Swinburn says, “and they are very clear signals to the industry.” Some countries prohibit food products with warning labels from being marketed or provided in schools, and tax them extra, resulting in a 10-12% positive change in purchasing behaviour.

Whatever Reti decides, any changes to the trans-Tasman system will require agreement between food ministers here and across the ditch, meaning double the bureaucracy and double the lobbying power from food industries. In the meantime, Consumer New Zealand recommends shoppers stick to the edges of the supermarket, where fresh food is located, and reducing highly processed food from the middle aisles. 

As for the packaged items you can’t live without? Until the star system is upgraded to something more substantial and easier to digest, it might be best to take those controversial stars with a grain of salt.

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