Nutri-Grain and Milo Cereal could each lose 2.5 Health Stars under proposed changes to the Health Star Rating system that aim to strengthen the penalty for added sugars.
A medical research unit has come up with a new algorithm that differentiates between the sugar added by manufacturers during processing, and the sugar that naturally occurs in food – such as the sugar in milk and fruit.
We've applied the algorithm to a range of foods to see how it could affect their Health Star Ratings.
Popular products lose health halo under proposed changes
In its submission on the government's proposed changes to Health Star Ratings, The George Institute for Global Health has suggested a change to the HSR algorithm to take the level of added sugars into account. This move is similar to proposals currently on the table in the UK to update their traffic light labelling system.
There are lots of proposed changes that should improve the usability of HSRs, but we wanted to know how this one simple change might affect the HSRs of existing products. We applied the strengthened algorithm to 17 food products, ranging from cereals to natural yoghurt.
Here's what the stronger penalty for added sugar could do to their HSRs.
| Category | Product | Current HSR | Revised HSR* | Difference |
|---|---|---|---|---|
| Cereal | Kellogg's Nutri-Grain cereal | 4 | 1.5 | -2.5 |
| Cereal | Lowan Cocoa Bombs | 3 | 1.5 | -1.5 |
| Cereal | Lowan Original Muesli | 4.5 | 5 | +0.5 |
| Cereal | Nestle Milo cereal | 4 | 1.5 | -2.5 |
| Cereal | Uncle Tobys Plus Protein | 4 | 1.5 | -2.5 |
| Kids snack | Little Bellies Organic Gingerbread Men | 3 | 1.5 | -1.5 |
| Kids snack | Rafferty's Garden Blueberry, Banana & Apple Snack Bar | 2.5 | 1 | -1.5 |
| Meal | On the Menu BBQ Mixed Grill | 3.5 | 3 | -0.5 |
| Meal | Woolworths Delicious Nutritious Butter Chicken with Whole Grain Rice | 4 | 4 | No change |
| Milk drink | Sanitarium Soy Milk Vanilla Bliss | 5 | 4 | -1 |
| Milk drink | Woolworths Full Cream Milk | 4 | 4 | No change |
| Snack | Golden Days Apricot Delight | 2 | 0.5 | -1.5 |
| Snack | Go Natural Berry Frugo's | 0.5 | 0.5 | No change |
| Snack bar | Emma and Tom's Cacao & Orange Life Bar | 2.5 | 3 | +0.5 |
| Snack bar | Go Natural Macadamia Divine | 1.5 | 0.5 | -1 |
| Yoghurt | Gippsland Dairy Natural Yoghurt | 4 | 4.5 | +0.5 |
| Yoghurt | Gippsland Dairy Toffee & Honeycomb Yoghurt | 2 | 1 | -1 |
Table notes: *Revised HSR is where the algorithm refers to added sugar values, rather than total sugar values. As nutrition information panels (NIPs) are required to list only the total amount of sugars, we used products where we could estimate the added sugar values using a combination of NIPs and ingredient lists, or where values were provided by the HSR Technical Advisory Group. If additional changes to the HSR algorithm are adopted, it's likely we'll see further changes to ratings.
What we found
1. Some products gain stars
What's interesting about using the strengthened algorithm is that not only are products with added sugar penalised, but those with only naturally occurring sugars are given a bonus.
Emma and Tom's Cacao & Orange Life Bar receives an extra 0.5 stars as it only contains fruit sugars in the form of dates and raisins, and Gippsland Dairy Natural Yoghurt receives an extra 0.5 stars as its only sugar source is the lactose in the milk.
2. Protein content counts less
Kellogg's Nutri-Grain cereal and Nestle Milo cereal (currently both 4 stars) both lost a whopping 2.5 health stars when the strengthened algorithm was applied, which might make you think twice about putting them in your supermarket basket.
The Nutri-Grain result is especially interesting. The cereal has long been associated with the iron-man image, and claims around protein and calcium content create the impression that it's a healthy breakfast cereal.
But all this distracts consumers from the fact that Nutri-Grain is high in sugar, most of which is added.
Without getting too technical, the primary reason for the huge drop in HSRs in this instance is that under this proposed change these products could lose the ability to receive bonus points for protein content.
Stronger treatment of added sugars would make it harder for cereals – and other products – to claim bonus points for adding protein and other beneficial nutrients to what are otherwise sugary treats.
3. It's easier to spot the healthier option
We also found that the strengthened algorithm helped to further differentiate between foods in the same product category that under the current system have similar HSRs, making it easier to spot the healthier option.
For example, if you were looking to buy some cereal, you might think the 0.5 star difference between Uncle Tobys Plus Protein (4 HSR) and Lowan Muesli Original (4.5 HSR) is not that big a deal.
However, when we modelled added sugar changes, the Uncle Tobys cereal could go down to 1.5 stars because, like the Nutri-Grain and Milo cereals, they'd lose their protein bonus points, while the Lowan product could go up by 0.5.
This 3.5 star difference is because the Lowan muesli contains only naturally-occurring sugars, while most of Uncle Toby's Plus Protein's sugars are added.
Even the difference in ratings between natural and sweetened yoghurts gets greater – which again goes to show how scoring added sugars is more useful than scoring total sugars.
Currently, Gippsland Dairy Natural Yoghurt has 4 health stars while its Toffee & Honeycomb version has 2. These ratings indicate that the natural version is better for you, but under the proposed changes the difference in HSRs makes this more obvious.
The natural yoghurt with no added sugar could increase to 4.5 stars, while the toffee yoghurt – with added sugar making up more than half of its total sugar – gets just 1 star.
4. Shoppers would be the winners
The results of our modelling show that incorporating added sugars into the health star rating would benefit Australians, making it easier to identify products higher in added sugar and letting us make informed decisions about what exactly we're eating.
"CHOICE's modelling, carried out in collaboration with The George Institute, shows that penalising added sugar can have a significant impact on the Health Star Ratings of products," says Linda Przhedetsky, CHOICE policy and campaigns adviser.
"Our estimates show that some products could lose as many as 2.5 Health Stars. Including added sugar in the calculation of Health Stars will help people make more informed choices."
Five-year review
The Health Star Rating (HSR) system is a voluntary scheme that was designed to help us make informed, healthy food choices at a glance by ranking food products on a scale from half a star (least healthy) to five stars (most healthy).
It's clearly been of benefit since it was first launched in 2014, with research finding that 60% of Australians who've bought a product with an HSR said the system influenced the product they chose.
While we're supportive of the system, we think it could be strengthened with a number of changes, including incorporating a penalty in the algorithm for added sugar in food and drinks.
Earlier this year, the government provided a draft report on recommended updates as part of a five-year review of the HSR system. Among its findings, the review recommended that:
- HSRs be continued
- further steps be taken to promote the system
- the way the star ratings are calculated should better align with dietary guidelines, including stronger penalties for total sugars, and an automatic rating of 5 given to fresh, frozen or canned fruits and vegies (with no added sugar, salt or fat) .
Once the review is finalised, it will be presented to federal and state governments who will decide on the next steps.
CHOICE wants HSR algorithm strengthened
CHOICE supports many of the government review's key recommendations, but one of the things we're concerned about is that products high in added sugar aren't properly penalised by the current HSR algorithm.
"Sugar has often been added to the food that we buy," says Przhedetsky. "Unlike naturally occurring sugars such as lactose in milk, added sugars are extra sugar that's added during manufacturing.
"Added sugar is hiding in so many different foods, both sweet and savoury – foods like muesli bars, dips, chips or drinks. And it's often listed under multiple names in ingredients lists, meaning that it's hard for people to make an accurate assessment of how healthy products are."
"Manufacturers should clearly label the amount of added sugar that they put in what we eat and drink, and this should be reflected in Health Star Ratings."
Why the system should focus on added sugar instead of total sugar
Not all sugars are created equal.
Intrinsic sugars are naturally-occurring, and are found in nutrient-rich foods such as milk, yoghurt and intact fruits and vegetables. They're part of a healthy, balanced diet.
Added sugars are added to food and drinks during processing or cooking, and they include glucose, honey and fruit juice concentrates. Added sugars provide empty kilojoules – kilojoules with little or no associated beneficial nutrients, yet they're the major source of sugar in the Australian diet and are damaging to our health. (We use the World Health Organization definition of 'free sugars'.)
By focusing on total sugars, the current system treats two products with 30g total sugar the same, even if one product contains 99% added sugar while the other contains mostly intrinsic sugar.
There's also significant public concern about apparent anomalies in the current system, particularly when products with high levels of added sugar, sodium, or saturated fat receive relatively high HSRs. This can have a negative impact on public confidence and trust.
And research shows that people find it's easier to choose healthier foods when added sugars are called out instead of total sugars.
We're calling for the HSR algorithm to penalise added sugars, instead of total sugars, to better reflect Australian dietary guidelines (ADG), to boost consumer confidence in the system and to ensure that HSRs are more useful to consumers.
Correction 1 July 2019: We initially published incorrect current Health Star Ratings (HSRs) for Little Bellies Organic Gingerbread Men, Rafferty's Garden Blueberry, Banana & Apple Snack Bar, Golden Days Apricot Delight, Emma and Tom's Cacao & Orange Life Bar and Go Natural Macadamia Divine, and the incorrect proposed HSR for Emma and Tom's Cacao & Orange Life Bar. These have now been corrected.
Stock images: Getty, unless otherwise stated.
