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Nutritional quality of packaged foods targeted at children in Brazil: which ones should be eligible to bear nutrient claims?

Abstract

Objectives:

This study aimed to assess the nutritional quality of food products marketed at children, with and without nutrient claims, using two different approaches.

Methods:

Analyses were performed based on a data set with food composition and labelling data from every packaged food marketed at children sold in a major Brazilian supermarket (n=535). Foods were classified as ‘healthier’ and ‘less healthy’ according to the UK/Ofcom nutrient profile model and to the NOVA classification based on the level of food processing. Pearson's χ2 test was used to compare proportions between models. Agreement was assessed using Cohen’s κ-statistic (P<0.05).

Results:

The NOVA model was stricter than the UK/Ofcom model, classifying more products as ‘less healthy’ (91.4%) compared with the nutrient profile-based model (75.0%; P<0.001). Agreement between models was 79.4% (k=0.30), because 72.9% (n=390) of products were categorised as ‘less healthy’ by both models, and 6.5% (n=35) as ‘healthier’. Half of the food products marketed at children from the database (270; 50.5%) bore nutrient claims. From these products with nutrient claims, 95.9% (92.8–98.0) were classified as ‘less healthy’ by the NOVA model, whereas this percentage was 74.1% (68.4–79.2) according to the UK/Ofcom model (P<0.05).

Conclusions:

The high number of foods with low nutritional quality being marketed at children via product packaging and nutrient claims should be of concern to policy makers wanting to improve children’s diets and to tackle childhood obesity. The implementation of nutritional quality criteria to ensure that foods targeted at children should be eligible to bear nutrient claims on their labels could avoid a situation where claims mask the overall nutritional status of a food.

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References

  1. 1

    Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384: 766–781.

    Article  Google Scholar 

  2. 2

    Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013; 380: 2224–2260.

    Article  Google Scholar 

  3. 3

    Brazilian Institute of Geography and Statistics. IBGE. Brazilian Ministry of Health Consumer Expenditure Survey—POF 2008–2009. Anthropometry and Nutritional Status of Children, Teenagers and Adults in Brazil. IBGE: Rio de Janeiro, Brazil, 2010.

  4. 4

    Silveira JAC, Colugnati FAB, Cocetti M, Taddei JAAC . Secular trends and factors associated with overweight among Brazilian preschool children: PNSN-1989, PNDS-1996, and 2006/07. J Pediatr 2014; 90: 258–266.

    Article  Google Scholar 

  5. 5

    Conde WL, Monteiro CA . Nutrition transition and double burden of undernutrition and excess of weight in Brazil. Am J Clin Nutr 2014; 100: 1617–1622.

    Article  Google Scholar 

  6. 6

    Reilly JJ, Kelly J . Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes 2011; 35: 891–898.

    CAS  Article  Google Scholar 

  7. 7

    Hawkes C . Uneven dietary development: linking the policies and processes of globalization with the nutrition transition, obesity and diet-related chronic diseases. Global Health 2006; 2: 4.

    Article  Google Scholar 

  8. 8

    Cairns G, Angus K, Hastings G, Caraher M . Systematic reviews of the evidence on the nature, extent and effects of food marketing to children. A retrospective summary. Appetite 2013; 62: 209–215.

    Article  Google Scholar 

  9. 9

    World Health Organization Nutrient Profiling—Report of a WHO/IASO Technical Meeting, London, United Kingdom, 4–6 October 2010. WHO: Geneva, Switzerland, 2011. Available at: http://www.who.int/nutrition/publications/profiling/WHO_IASO_report2010.pdf accessed on 19 January 2016.

  10. 10

    Rayner M, Scarborough P, Kaur A . Nutrient profiling and the regulation of marketing to children. Possibilities and pitfalls. Appetite 2013; 62: 232–235.

    Article  Google Scholar 

  11. 11

    Rayner M, Scarborough P, Lobstein T The UK Ofcom Nutrient Profiling Model—Defining ‘Healthy’ and ‘Unhealthy’ Food and Drinks for TV Advertising to Children, 2009. Available at: http://www.dph.ox.ac.uk/bhfhprg/publicationsandreports/acadpublications/bhfhprgpublished/nutrientprofilemodel.

  12. 12

    Broadcasting Authority of Ireland Revised General and Children’s Commercial Communications Codes. Broadcasting Authority of Ireland: Dublin, Ireland, 2013. Available at http://www.bai.ie/en/codes-standards/#al-block-5 accessed on 15 January 2016.

  13. 13

    Food Standards Australia New Zealand Standard 1.2.7—Nutrition, Health and Related Claims. Australian Federal Register of Legislative Instruments F2014C01191, 2013. Available at: http://www.comlaw.gov.au/Details/F2013L00054 accessed on 19 December 2015.

  14. 14

    Moubarac JC, Parra DC, Cannon G, Monteiro CA . Food classification systems based on food processing: significance and implications for policies and actions: a systematic literature review and assessment. Curr Obes Rep 2014; 3: 256–272.

    Article  Google Scholar 

  15. 15

    Louzada MLC, Martins APB, Canella DS, Baraldi LG, Levy RB, Claro RM et al. Ultra-processed foods and the nutritional dietary profile in Brazil. Rev Saude Publica 2015; 49: 38.

    PubMed Central  Google Scholar 

  16. 16

    Ministry of Health of Brazil Dietary Guidelines for the Brazilian Population. Ministério da Saúde: Brasília, 2014. Available at: http://189.28.128.100/dab/docs/portaldab/publicacoes/guia_alimentar_populacao_ingles.pdf accessed on 12 November 2015.

  17. 17

    Colby SE, Johnson L, Scheett A, Hoverson B . Nutrition marketing on food labels. J Nutr Educ Behav 2010; 42: 92–98.

    Article  Google Scholar 

  18. 18

    Chandon P . How package design and packaged-based marketing claims lead to overeating. Appl Econ Perspect Pol 2013; 35: 7–31.

    Article  Google Scholar 

  19. 19

    Elliott C . Assessing ‘fun foods’: nutritional content and analysis of supermarket foods targeted at children. Obes Rev 2008; 9: 368–377.

    CAS  Article  Google Scholar 

  20. 20

    Schwartz MB, Vartanian LR, Wharton CM, Brownell KD . Examining the nutritional quality of breakfast cereals marketed to children. J Am Diet Assoc 2008; 108: 702–705.

    CAS  Article  Google Scholar 

  21. 21

    Hawkes C . Food packaging: the medium is the message. Public Health Nutr 2010; 13: 297–299.

    Article  Google Scholar 

  22. 22

    Lythgoe A, Roberts C, Madden AM, Rennie KL . Marketing foods to children: a comparison of nutrient content between children’s and non-children’s products. Public Health Nutr 2013; 16: 2221–2230.

    Article  Google Scholar 

  23. 23

    Rodrigues VM, Rayner M, Fernandes AC, Oliveira RC, Proença RPC, Fiates GMF . Comparison of the nutritional content of products, with and without nutrient claims, targeted at children in Brazil. Br J Nutr 2016; 115: 2047–2056.

    CAS  Article  Google Scholar 

  24. 24

    Brazilian Health Surveillance Agency Resolution—RDC No. 54, of November 12, 2012. [Provides the Technical Regulation on Nutrient Claims, 2012]. Federal Employee Gazette of 12 November 2012. Brasília, DF.

  25. 25

    Brazilian Health Surveillance Agency Resolution—RDC No. 360, of December 23, 2003. [Approves the technical rules for packaged food labelling, and become it mandatory]. Federal Employee Gazette of 24 dec 2003. Brasilia, DF.

  26. 26

    Louie CY, Moshtaghian H, Boylan S, Flood VM, Rangan AM, Barclay AW et al. A systematic methodology to estimate added sugar content of foods. Eur J Clin Nutr 2015; 69: 154–161.

    CAS  Article  Google Scholar 

  27. 27

    Scarborough P, Rayner M, Boxer A, Stockley L . Application of the Nutrient Profiling Model: Definition of ‘Fruit, Vegetables and Nuts’ and Guidance on Quantifying the Fruit, Vegetable and Nut Content of a Processed Product 2005. British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford: Oxford, UK.

    Google Scholar 

  28. 28

    Landis J, Koch G . The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159–174.

    CAS  Article  Google Scholar 

  29. 29

    Scarborough P, Rayner M . When nutrient profiling can (and cannot) be useful. Public Health Nutr 2014; 17: 2637–2640.

    Article  Google Scholar 

  30. 30

    Harris JL, Thompson JM, Schwartz MB, Brownell KD . Nutrition-related claims on children’s cereals: what do they mean to parents and do they influence willingness to buy? Public Health Nutr 2011; 14: 2207–2212.

    Article  Google Scholar 

  31. 31

    Scarborough P, Payne C, Agu CG, Kaur A, Mizdrak A, Rayner M et al. How important is the choice of the nutrient profile model used to regulate broadcast advertising of foods to children? A comparison using a targeted data set. Eur J Clin Nutr 2013; 67: 815–820.

    CAS  Article  Google Scholar 

  32. 32

    Proença RPC, Silveira BM . Intake recommendations and labeling of trans fat in processed foods in Brazil: analysis of official documents. Rev Saúde Pública 2012; 46: 923–928.

    Article  Google Scholar 

  33. 33

    Silveira BM, Gonzalez-Chica DA, Proença RPC . Reporting of trans-fat on labels of Brazilian food products. Public Health Nutr 2013; 16: 2146–2153.

    Article  Google Scholar 

  34. 34

    Mehta K, Phillips C, Ward P, Coveney J, Handsley E, Carter P . Marketing foods to children through product packaging: prolific, unhealthy and misleading. Public Health Nutr 2012; 15: 1763–1770.

    Article  Google Scholar 

  35. 35

    Devi A, Eyles H, Rayner M, Mhurchu CN, Swinburn B, Lonsdale-Cooper E et al. Nutritional quality, labelling and promotion of breakfast cereals on the New Zealand market. Appetite 2014; 81: 253–260.

    Article  Google Scholar 

  36. 36

    Canella DS, Levy RB, Martins AP, Claro RM, Moubarac J-C, Baraldi LG et al. Ultra-processed food products and obesity in Brazilian households (2008-2009). PLoS One 2014; 9: e92752.

    Article  Google Scholar 

  37. 37

    Rauber F, Campagnolo PD, Hoffman DJ, Vitolo MR . Consumption of ultra-processed food products and its effects on children’s lipid profiles: a longitudinal study. Nutr Metab Cardiovasc Dis 2015; 25: 116–122.

    CAS  Article  Google Scholar 

  38. 38

    Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB . Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011; 364: 2392–2404.

    CAS  Article  Google Scholar 

  39. 39

    Woodward-Lopez G, Kao J, Ritchie L . To what extent have sweetened beverages contributed to the obesity epidemic? Public Health Nutr 2010; 14: 499–509.

    Article  Google Scholar 

  40. 40

    Hu FB, Malik VS . Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence. Physiol Behav 2010; 100: 47–54.

    CAS  Article  Google Scholar 

  41. 41

    Rayner M, Wood A, Lawrence M, Mhurchu CN, Albert J, Barquera S et al. Monitoring the health-related labelling of foods and non-alcoholic beverages in retail settings. Obes rev 2013; 14: S70–S81.

    Article  Google Scholar 

Download references

Acknowledgements

We are grateful to the National Council for Scientific and Technological Development of the Ministry of Science and Technology in Brazil—CNPq for funding the wider project ‘Nutrition labelling in Brazilian foods: thematic analysis of the use by the consumer and influence the choices’ (grant number 440040/2014-0) and for the international scholarships conceded to VMR and GMRF. We also thank the Federal Agency for Support and Evaluation of Graduate Education in Brazil—CAPES for the financial support in the form of scholarships to VMR, ACF and RCO.

Author contributions

VMR was responsible for planning the research, collecting, analysing and interpreting the data, and for drafting the first version of the manuscript. ACF and RCO contributed towards data collection, analysis and interpretation, and revision of the manuscript. RPCP and MR contributed to data analysis, interpretation of results and revision of the manuscript. GMRF had overall responsibility for the study, research coordination, supervision of data collection and analysis and revision of the final manuscript. All of the authors approved this version for publication and accepted the conditions established by International Journal of Obesity.

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Correspondence to G M R Fiates.

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Rodrigues, V., Rayner, M., Fernandes, A. et al. Nutritional quality of packaged foods targeted at children in Brazil: which ones should be eligible to bear nutrient claims?. Int J Obes 41, 71–75 (2017). https://doi.org/10.1038/ijo.2016.167

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