Simple, graphical front-of-pack nutrition labels on packaged foods are recommended by the World Health Organization to promote healthier diets (1). Australia and New Zealand’s Health Star Rating label displays the healthiness of foods across ten half-star increments, ranging from 0.5 (less healthy) to 5.0 (more healthy), providing at-a-glance information for consumers to make healthier choices.
As a voluntary scheme, application of stars on pack is optional for the food industry. Since implementation commenced in 2014, uptake has been slow and remains low overall. As of 2023, Health Star Ratings are displayed on only around one third of all products that should be carrying them (2).
Government reporting provides an overall uptake figure, but doesn’t reveal the significant disparity in uptake between the proportion of products with lower Health Stars and those that score highly. Our new work investigates this lacklustre uptake further, by showing how Health Star adoption varies by rating.
In our FoodSwitch sample of 21,197 products in 2023, stars appeared on 37% of products overall. Uptake was unevenly distributed, with the lowest uptake observed in products with a rating of 0.5 (16% of products displaying), while products that rated 5.0 had the highest uptake of 61%.
Lopsided labelling: There remains over 9,000 unhealthy products where low ratings (3 or below) are not displayed on pack.
Only 24% of lower scoring products (HSR≤3) displayed the label, compared to 53% of higher scoring ones (HSR≥3.5, p < 0.001). Ongoing skewed uptake shows clearly that voluntary Health Stars are predominantly and intentionally being used as a marketing tool by the food industry where products score well. By contrast, stars are still omitted from the majority of low-scoring products, creating a lopsided view for consumers.
The picture below provides examples of products available for sale in Australian supermarkets that are still missing stars on pack, along with their estimated (low) ratings. Denying consumers the benefit of this information reduces stars’ potential for warning consumers away from unhealthy products that are major contributors to unhealthy dietary patterns and our burden of chronic disease.
A decade since the introduction of the Health Star Rating system, and in light of overall uptake plateauing, the decision by Australian and New Zealand Food Ministers to start now on preparatory work needed to make the system mandatory is welcome (2,3).
Creating a new law takes time, but starting now will enable the government to swiftly transition to a mandatory Health Star Rating in the (very likely) event that industry fails to meet its final uptake target of 70% at the end of 2025.
These new findings on lopsided uptake add weight to existing assertions that industry will miss the target given that most products that are still without stars are low scoring.
What needs to happen next?
In Australia and New Zealand, our work supports government momentum towards mandating the Health Star Rating system to provide consumers Health Star information on all products.
Internationally, our work provides insights for those countries currently developing or reforming similar front-of-pack nutrition labelling policies. In the European Union, our findings suggest that similar patterns are likely to be found in selective use of systems such as Nutri-Score. They also support continued advocacy for a mandatory harmonised label to overcome this weakness in the operation of otherwise well-designed voluntary schemes.
Beyond their immediate benefits in providing consumers full information on labels, mandatory front-of-pack labels provide a level playing field for industry (rather than imposing extra costs on those companies who choose to adhere voluntarily), and better incentivise industry to improve the formulations of their products to achieve more favourable ratings.
We urge governments worldwide to adopt mandatory front-of-pack nutrition labels to maximise the public health impact of these policies in improving diets.
References
World Health Organization. Tackling NCDs: best buys and other recommended interventions for the prevention and control of noncommunicable diseases, second edition [Internet]. Geneva; 2024. Report No.: CC BY-NC-SA 3.0 IGO. Available from: https://www.who.int/publications/i/item/9789240091078
Laznik N, Dunford E, Jones A, Howes K, Taylor F. FoodSwitch-State of the Food Supply. A Five-Year Review. Australia 2023 [Internet]. The George Institute for Global Health; 2023. Available from: https://www.georgeinstitute.org.au/media-releases/food-industry-failing-to-meet-governments-health-star-rating-targets#:~:text=The%202023%20State%20of%20the%20Food%20Supply%20Report%3A%20A%20Five,2019%20following%20a%20government%20review.
Secretariat FR. Food Ministers’ Meeting communiqué – 25 July 2024 [Internet]. Food Regulation Secretariat; 2024 [cited 2024 Jul 26]. Available from: https://www.foodregulation.gov.au/activities-committees/food-ministers-meeting/communiques/food-ministers-meeting-communique-25-july-2024