Original ResearchImprovement of the nutritional quality of foods as a public health tool
Introduction
In confronting the problem of chronic diseases linked to food consumption, improving the nutritional quality of processed foods has become a crucial issue for health policy makers. Indeed, a policy focused on food quality is intended to facilitate healthy choices by consumers, even those who are not fully informed about or conscious of the links between food consumption and health. Decreasing the salt and fat content in foods1, 2, 3, 4, 5, 6 and increasing the wholegrain content7 are good examples of changes being made to food composition to address health-related issues.8
Despite the importance of such a policy orientation, only a small number of articles have analysed ways to improve food quality that are consistent with public health objectives. This issue raises two closely related questions which are addressed in this paper.
Food reformulation can necessitate innovative processing or the use of new ingredients, resulting in higher production costs or additional investments that can limit voluntary changes by firms.9 Taste modifications induced by decreases in sugars, fat or sodium content may also lead to rejection by consumers that can limit a firm’s initiative to make such changes.10 The first question addressed in this study is as follows. If one assumes that individuals continue to consume the same amounts within each food category, but that the nutritional characteristics of each food category have been improved in a realistic way (i.e. acceptable from both a technological and a sensorial point of view), what would be the impact on the nutritional intake of individuals?
To answer this question, detailed data on both the nutritional characteristics of food items and individuals’ consumption patterns are required. Several authors have noted that the availability of such data has become a major issue for policy makers, as the existing publicly available nutrition databases are insufficient to analyse the impact of food supply evolution on public health matters.11, 12, 13 The creation of new information systems is underway in several countries, and such databases are often focused on a specific nutrient, such as salt in the USA,14 the UK15 and Australia.13 In France, in line with these new approaches, the Ministries of Food and Agriculture, Health and Consumption decided to fund the creation of an Observatory of Food Quality (Oqali) in 2008.16 This study used the Oqali database to study several scenarios involving food modification, and to assess their potential impacts on individuals’ consumption in the French population.
Once the potential contribution of food modification to individuals’ nutritional intake has been identified, the second question addressed in this paper is how to encourage such an increase in the nutritional quality within each food category. Food labelling, corporate social responsibility and legal pressure can contribute to food modification.17, 18, 19, 20, 21 However, the modifications implemented may remain limited to expensive lines of products, justifying more direct public interventions to improve the nutritional quality of foods across the industry.22, 23, 24, 25, 26
An interplay between the food industry and the health policy community has been underway in France since 2007 to encourage the voluntary reformulation of foods, especially for products with the lowest nutritional quality in each category of processed foods. In line with this new approach, a goal of Oqali is to establish an independent system of observation to assess the nutritional composition of food items marketed by all brands sold in the French market, and to follow the efforts implemented by the food industry. Oqali was implemented as part of the Second National Nutrition and Health Programme (2006–2010), which also proposed that firms sign ‘charters of commitments to nutritional improvement’ with the Government.27 The final section of this paper discusses the extent to which the methodology, databases and simulation tools presented may support this new approach based on these charters of commitments.28
Section snippets
Food quality database
In the Oqali database, each branded product is described according to several parameters, including nutrient content (energy, protein, fat, saturated fat, carbohydrates, sugars, fibre and sodium), list of ingredients, nutrition and health claims, serving size and nutrition guidelines included on the packaging. Oqali collects nutritional data from several sources, including the product packaging. Manufacturers and retailers may be additional sources of data. Nutrient analyses are performed to
Results
Fig. 1 shows the fat and sugars content scatter plot of the 355 breakfast cereals available on the French market. The variability in food composition is not only due to differences between product categories, but also due to composition variability within the majority of food categories. Thus, Table 1 gives the sugars, fat, fibre and sodium content of the food items within the categories in the breakfast cereal group. Variability within the food categories was assessed by the relative
Discussion
Differences in energy density, nutrient content and costs between food groups have been widely reported.30, 31 More recently, product composition variability within food categories has been investigated. For instance, recent research has shown large variability in sodium content within many food categories.13, 32 In response to these results, several initiatives targeting a reduction in salt consumption have been implemented worldwide.14, 15 Indeed, the focus on salt can be justified because it
Ethical approval
None sought.
Funding
ANR research Project AlimInfo and French Ministries in charge of Food and Health.
Competing interests
None declared.
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