An assessment of the potential health impacts of food reformulation.

BACKGROUND/OBJECTIVES: Policies focused on food quality are intended to facilitate healthy choices by consumers, even those who are not fully informed about the links between food consumption and health. The goal of this paper is to evaluate the potential impact of such a food reformulation scenario on health outcomes. SUBJECTS/METHODS: We first created reformulation scenarios adapted to the French characteristics of foods. After computing the changes in the nutrient intakes of representative consumers, we determined the health effects of these changes. To do so, we used the DIETRON health assessment model, which calculates the number of deaths avoided by changes in food and nutrient intakes. RESULTS: Depending on the reformulation scenario, the total impact of reformulation varies between 2408 and 3597 avoided deaths per year, which amounts to a 3.7-5.5% reduction in mortality linked to diseases considered in the DIETRON model. The impacts are much higher for men than for women and much higher for low-income categories than for high-income categories. These differences result from the differences in consumption patterns and initial disease prevalence among the various income categories. CONCLUSIONS: Even without any changes in consumers' behaviors, realistic food reformulation may have significant health outcomes.

Improvement of the nutritional quality of foods as a public health tool.

OBJECTIVES: To assess the potential contribution of improving the nutritional quality of processed foods on individuals' nutritional intake and food supply. This paper also discusses the means to encourage firms to implement these reformulations, particularly in public/private partnerships. STUDY DESIGN: The French Observatory of Food Quality was created by the Government for the quantification and follow-up of food reformulation by the food industry. This nutritional composition database on branded products was matched with two consumption databases: TNS Kantar Worldpanel, which provides details on quantities bought and food expenditures; and INCA 2, an individuals' food consumption survey completed by the French Food Safety Agency. Three food groups were considered: breakfast cereals (355 items in 2008), biscuits and pastries (1805 items in 2008), and bread-based products (620 items in 2009). METHODS: First, the variability in nutrient composition within food categories was determined, which made it possible to consider several food composition modification scenarios within each category. The formulation of the food items with the lowest nutritional quality was modified to three different levels to improve the overall level of quality in a given category. Second, the quantities of sugars, fat, fibre and sodium delivered to the French market through breakfast cereals, biscuits, pastries and bread-based products were calculated for each scenario. Finally, the distribution of individuals' nutrient consumption from the three food groups among the French population was assessed. RESULTS: These scenarios generated important improvements of 1-22% (increase in the amount of fibre or decrease in the amounts of sugars, fat and sodium delivered to the market), depending on the scenario, the food group and the nutrient considered. Improvement of the products with the lowest nutritional quality would also lead to significant variation in individuals' nutrient consumption for the average adult and child consumers of the three groups (range 4.2-18.8%, depending on the scenario, the food group and the nutrient considered). CONCLUSION: Encouraging the reformulation of foods, especially for products with the lowest nutritional quality in each category of processed foods, is a worthy target for health policy makers. The methodology presented in this paper provides information for negotiations between policy makers and firms to quantify commitments in terms of their potential impacts on individuals' nutrient intake, and to check that the firms' commitments are actually met.

Nutritional quality and labelling of ready-to-eat breakfast cereals: the contribution of the French observatory of food quality.

BACKGROUND/OBJECTIVES: To assess developments in the nutritional quality of food products in various food groups in France, an Observatory of Food Quality (Oqali) was created in 2008. To achieve its aims, Oqali built up a new database to describe each specific food item at the most detailed level, and also included economic parameters (market share and mean prices). The objective of this paper is to give a detailed analysis of the monitoring of the ready-to-eat breakfast cereals (RTEBCs) sector in order to show the benefits of the Oqali database. SUBJECTS/METHODS: Analysis was limited to products with nutritional information on labels. Packaging was provided by manufacturers or retailers, or obtained by buying products in regular stores. Economic parameters were obtained from surveys on French food consumption and data from consumer purchase panels. The breakfast cereal sector was divided into 10 categories and 5 types of brand. Oqali has developed anonymous indicators to describe product characteristics for each category of RTEBC and each type of brand by cross-referencing nutritional values with economic data. Packaging-related data were also analysed. The major nutritional parameters studied were energy, protein, fat, saturated fat, carbohydrates, sugars, fibre and sodium. Analysis was performed on the basis of descriptive statistics, multivariate statistics and a Kruskal-Wallis test. RESULTS: For the RTEBC, there is large variability in nutrient content throughout the sector, both within and between product categories. There is no systematic relation between brand type and nutritional quality within each product category, and the proportion of brand type within each product category is different. Nutritional labels, claims and pictograms are widespread on packages but vary according to the type of brand. CONCLUSIONS: These findings form the basis for monitoring developments in the nutritional composition and packaging-related data for breakfast cereals in the future. The final objective is to expand the approach illustrated here to all food sectors progressively.