Is the Health Star Rating future ready?
Since its inception in 2014 the marketing, public health and consumer benefits of the Health Star Rating (HSR) system have been hotly debated. Now in its fifth year, with 31 per cent of eligible products carrying the symbol, the nature of these debates has not subsided.
Common areas vigorously discussed include whether the HSR should be voluntary rather than mandatory, whether the algorithm needs reviewing and whether government promotion has been sufficient enough to position the system adequately within a suite of other healthy eating strategies.
These are just some of the issues addressed in a 123 page draft five year review document due to be discussed at the next Ministerial Forum on Food Regulation. After considering hundreds of submissions and undertaking numerous stakeholder workshops, the overall recommendation is that the system be continued.
However, nutrition research and consumer’s definition of what constitutes healthy food is evolving and changing. Given this, it is timely for food manufacturers, innovators and marketers to reflect on how well the HSR system is positioned as a tool for communicating the health credentials of foods in the future.
My view is that it falls short.
A star rating doesn’t align with consumer’s evolving definition of what constitutes healthy food. Discussions about the validity of the HSR system inevitably turn to the case of yoghurt, breakfast cereals or Milo. One common example is the astonishment expressed that natural, full fat yoghurt which contains only two ingredients get 1.5 stars while a low fat yoghurt with 15 ingredients gets 5 stars. This point of disbelief reflects the difference in outcomes that can occur when the ‘healthiness’ of food is defined primarily on nutrient content and not on the degree of processing or nature of the ingredients.
At the recent Australian Institute of Food Science and Technology Convention held in Sydney, Woolworths presented data showing that Australians consider healthy food as being fresh, natural and minimally processed. Outside of fruit, vegetable, nut and legume content, none of these factors are considered in the way the HSR system works. This point alone creates a gap between consumer perceptions of healthy food, and the ratings given by the HSR, in turn increasing levels of mis-trust in the system, and in the brands that carry the star symbol.
This growing disconnect between how government is defining ‘healthy’ food and how consumers are defining it is a major consideration for food companies. Trust is the greatest currency a brand holds as a means of influencing food purchasing. If consumers do not believe that the way a brand communicates its health credentials is trustworthy, this not only fails to meet the public health objective of the system, it hurts the reputation of the brand. For food businesses looking ahead, and those formulating future ready strategies, this is a key point for reflection and consideration.
Reductionist way is out of touch
Presenting at the International Forum on Food and Nutrition in New York last September, leading nutrition researcher Dr Dariush Mozaffarian from Tufts University highlighted that the reductionist way policy makers are defining foods as healthy has an historical root in the way governments addressed the prevention of scurvy and pellagra in the 1920’s-1940’s.
However this approach, which involves targeting a nutrient or handful of nutrients to fix a problem, is not working well for the reduction of chronic disease. Dr Mozaffarian went as far to suggest that this method, applied most commonly in the form of front of pack interpretative nutrition labels, such as the HSR system, is flawed and potentially misleading.
While reducing added sugar, added salt and added trans fat makes sense, total fat, saturated fat and even kilojoules are misleading metrics to focus on. This evolving point of view is another key consideration for brands looking to remain future relevant, and that are seeking to play an active and more responsible role in guiding consumers toward healthier eating habits.
Behaviour change is the way forward
It’s the variety of foods that are eaten together to create an overall healthy eating pattern that is most important for achieving better health than the ‘healthiness’ of individual foods within the diet. Behaviour change directed at achieving healthy eating patterns is therefore more important for improving public health than evaluating individual foods.
People often argue that any change is good change however attention is a finite resource. When we pay attention to one thing, it’s not just that we focus on advancing that particular thing, it’s that we also give something else up. Something that may have otherwise received our attention does not.
Given that people eat food, not numbers, it could be that directing our attention to behaviour change strategies may be a better and more effective way forward. In fact, we are now starting to see movement in this direction.
Canada’s recently released and revised dietary guidelines include recommendations around enhancing food skills, the importance of promoting cooking and food preparation, celebrating cultural food practises and eating with others.
The Sustainable Food Policy Alliance, an initiative of Unilever, Nestle, Mars and Danone in North America, has put forward recommendations to the Dietary Guidelines Advisory Committee in the USA stating it is their belief that incremental, nutrient-based recommendations have not kept pace with changing dietary patterns and eating styles, nor have they been enough to turn the tide on food- and nutrition-related public health concerns.
This group have recommended that the next iteration of the Dietary Guidelines for Americans consider “Food as Medicine”, link to the UN Sustainable Development Goals and recognize culture as a key driver of the foods and beverages people buy and eat.
Given these changes, it may be that the HSR will struggle to keep up as a future relevant strategy for improving public health. For food businesses seeking to build consumer trust, and to create and implement future ready strategies in this area, assessing how well the HSR fits with these plans will be critical.
Building and maintaining meaningful connections with consumers that not only build brand reputation, but guide consumers toward making better choices for their own health, the health of their families, and the health of the planet requires leading food businesses to think more critically than they have in the past and to develop their own thought leadership in this important and growing area for the future.
Sharon Natoli is a speaker, author, mentor, and director of Food & Nutrition Australia.