Nutrient profiling to develop a model

for marketing food and non-alcoholic

beverages to children: Experiences

and lessons learned from Norway

Arnhild Haga Rimestad Norwegian Directorate of Health

IUNS, Granada, 19 September 2013

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Outline

• Background

• Working group

• Challenges

• Process

• Drafts/proposals

• Public consultations

• The result

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Starting points (national)

• Norwegian Action Plan on Nutrition (2007–2011):

• Consider introduction of restrictions on advertising of

unhealthy foods to children and young people

• National Plan For Health and Care Services

(2011-2015):

• Ministries shall consider whether new legal restrictions

on marketing of unhealthy foods to children and young

people are necessary

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Norwegian working group

• Established December 2010 by:

• Ministry of Health and Care Services

• Ministry of Children and Equality

• The working group included the Norwegian:

• Directorate of Health

• Consumer Ombudsman

• Food Safety Authority

• Ministry of Children and Equality

• Ministry of Health and Care Services

• Secretariat: Ministry of Health and Care Services

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Mandate of the working group

• Given by the Norwegian Government March 2011:

• Consider the possible introduction of further restrictions on

marketing of food and beverages to children and young

people in Norway

• Including: Is there a need for new specific legal measures

on this?

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Mandate cont.

• Mandate item 2 (of 9): How to define foods?

- Main responsible: Norwegian Directorate

of Health in cooperation with Norwegian

Food Safety Authority

• Timeline work nutrient profile model: 1 year,

2011-2012

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Background documents

• National documents (regulations, diet and health)

• WHO set of recommendations

• WHO draft framework for implementing the set of recommendation

• WHO draft manual NP models

• European Network on reducing marketing pressure on children (goal, Network Code)

• Documentation on other NP models

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Process: exploring existing models

Selected models:

1. Nordic Keyhole - NK-model

2. FSA/Ofcom model - UK-model

3. US-proposal, draft April 2011

Working process

• How do the models classify foods

- Explored 60 products on the Norwegian market

• Comparisons of results/consequences

• Pros and cons

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Challenges related to the explored models

• Classification of foods:

- Match for typical unhealthy products,

discrepancies for several other food groups

• Some information not easily available or adaptable

- e.g. detailed nutrient contents of foods, amounts

of portions/serving sizes

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Challenges, continued

Some specific challenges:

• US-proposal: nutrient per portion (RACC) or serving

• NK-model: identifies healthier foods products.

• UK-model: uncertain whether all score values could be directly adapted to a Norwegian model

Conclusion:

• US-proposal not applicable

- Nutrient per portion size as reference

• UK- and NK-models

- Comprehensive adaptions would be necessary

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Testing the WHO draft NP manual

• Workshop in Oslo, December 2011

• Process/steps in adaption/developing a model

• Specific results and challenges for Norway

• Pros and cons of different models

• Adaption of existing models

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Steps – developing a new model

Based on WHO draft NP manual

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Process: Developing a new model

• Develop av simplified nutrient profile model

• Specific application: food marketing to children

• Aim of the model: identify unhealthy foods

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Step 1. Purpose

1. Define the purpose of the model

Suggested new model:

• Define unhealthy food and beverages

• Application: restrictions on food marketing to children

• Based on dietary challenges and recommendations

• Define foods with high content and/or are sources of

nutrients connected with health challenges

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Steps 2-3: Foods

2. Decide upon the scope of and exemptions to the model, which products are and are not covered

3. Decide the number of food categories which will be used in the model

Suggested new model:

• Energy dense and nutrient poor foods

• Sources/high content of fat/sugar/salt, foods

considered typical unhealthy; like sweet beverages,

chocolate, sweets, cakes, biscuits, snacks, unhealthy

variants of fast food

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Steps 5-6. Nutrients

5. Decide which nutrients and other food components should be involved

6. Decide the reference amount for the model

Suggested new model:

- Energy

- Fat (total fat, saturated fat, trans fatty acids)

- Sugar (total sugar)

- Salt (sodium)

- Other components (fiber, whole grain, sweeteners)

Reference amount: per 100 g

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Steps 7-8. Nutrient scoring/thresholds

1. Decide whether to use scoring, thresholds or both

2. Decide what numbers should be used to determine thresholds or scores

Suggested new model:

• Definition energy dense foods: 950 kJ-1150 kJ (225-

275 kcal) per 100 g*

• Norwegian food composition database used to test

different threshold values (tested for values in the UK-

model and Keyhole)

*World Cancer Research Fund and American Institute for Cancer Research, 2007

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Final model for public consultation 1

• The new model was presented in April 2012.

• Some adjustments were made.

• A proposal for a nutrient profile model was sent on

public consultation (June 2012)

• This model included 8 different food categories defined by:

• Customs Tariff

• Regulations on Excite Duties

• Content of energy and nutrients (sugar, fat, saturated fat, salt) IUNS 2013

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Proposal on regulation - public

consultation 1 (June-Sept 2012)

• Definitions:

• Children – to 18 years

• Unhealthy foods and beverages –

Norwegian NP model

• Marketing aimed at children – partly

based on the Network Code

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Results public consultation 1

• Two open consultation meetings

• Written comments from 78 different stakeholders:

• 32 were clearly negative (mostly private sector), 34 clearly positive (mostly NGOs, health and consumer organisations)

• Agreement that overweight and obesity is a increasing challenge

• Disagreement about the solutions

• A revised proposal was made based on the comments from the first consultation

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Revised proposal on regulation –

public consultation 2 (May–Aug 2013)

• Definitions of:

• Children – to 16 years

• Unhealthy foods and beverages – revised

Norwegian NP model

• Marketing - revised

• Criteria of when marketing is aimed at children –

revised

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Status today

• The Government has decided to test a strengthened

self-regulation system proposed by industry

• The self-regulation from the industry defines foods

very close to the proposed revised model from the

Government

• The Government will evaluate the self-regulation after

two years. If no effect, an implementation of a statutory

regulation will be considered

• This process has made the topic very high on the

political agenda

• The industry has been made aware of their

responsibilities

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Lessons learned

• Process: systematic and stepwise (WHO NP

manual)

• Knowledge needed in the working group:

• National diet challenges - children

• Food composition/database

• Law: food and marketing

• Marketing

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Lessons learned cont.

• Define the aim of the model

• Learn from other NP models and do comparisons

• Do concrete testing of foods vs model

• Patience

• Public consultation

Aim to define foods in a concrete, clear, simple

and understandable manner

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NP – model Norway - 2013

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8 Food groups

• Chocolate and sugar products, sweet toppings and

desserts

• Snacks

• Beverages

• Fast food

• Edible ice

• Breakfast cereals

• Cakes, biscuits and other sweet baker's wares

• Yoghurt and similar

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THANK YOU !

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