Title : Asian Experiences with Positive Front-of-pack Labelling
Organized by : Choices International Foundation
Schedule : Tuesday, August 6 2019. 09.30-11.00
Room : Frangipani
Speaker 1 : Rutger Schilpzand
Profile : As Managing Director of Choices International, Rutger supports national healthy food choice initiatives, based on the Choices program, worldwide. He studied Human Nutrition at Wageningen University and worked as a strategic consultant in nutrition and a campaigner for several NGOs. He is co-founder of the Ghana Schoolfeeding Programme that now serves 1,5 million meals daily to Ghanaian school kids. In 2005, he initiated the Future of Food seminars initiative – international high level seminars about future developments in the global food system.
How to Make The Healthy Choice The Easy Choice?
Background/Aims: Global developments have drastically changed the food environment, which impacts consumer’s food choices in an unprecedented way. It has become more difficult for consumers to choose healthy foods, especially when food marketing drives unhealthy choices. Such consumer choices might result in a detrimental health outcome in the form of non-communicable diseases. The key to prevention of such non-communicable diseases is by following dietary recommendations. But how do pre-packaged and processed food products fit into this picture? Hence, it became imperative to design a set of criteria based on dietary recommendations for the pre-packaged foods available to the consumers. This shaped the starting point for positive labelling programs. A set of criteria has been developed, to identify the healthiest products in each food group. The objectives of these criteria are to guide consumers to healthier products, through the front-of-pack logo program; to develop a reformulation agenda for food companies; to help health authorities to create a high level of coherence in their nutrition policies. This approach has been the starting point for the development of positive labelling programs in a number of East-Asian countries, with support of the Choices International Foundation. Although the logos might look different, yet, they share the same principles of providing a positive message to consumers; the logo should be known, understood, appreciated and used by consumers; a high level of simplicity; product group specific criteria to help companies to benchmark, reformulate and innovate their products; development of the criteria by an independent scientific committee; aligning with the national food culture and endorsed by their respective stakeholders and international collaboration, to facilitate international trade and to exchange information
Speaker 2 : Yang Yuexin
Profile : Prof. Yang is currently serving as the president of CNS, and Professor in the National Institute for Nutrition and Health of the Chinese Center for Disease Control and Prevention. Her research interest is primarily on the study of maternal and child nutrition (1988-1995), food and nutrition (since 1996). She is the coordinator director of FAO—NEASIAFOODS since 2002, vice president of Global Phytonutrients Society, council member of the Federation of Asian Nutrition Societies (2015-2019) and fellow of the International Union of Nutrition Societies. She heads a working group of scientists and health officials in China and has developed a nutrient profiling scheme and implementation plan for a positive front-of-pack logo based on Chinese dietary patterns.
The Promotion of Healthier Choice in China
Backround/Aims: The incidence of obesity and NCDs in China are rising at an alarming rate. Positive front-of-pack（FOP labelling is one of the actions that are implemented to help curb this phenomenon. Since 2008, supported by the national food composition monitoring program, Professor Yang’s team in National Institute for Nutrition and Health of Chinese CDC began to collect the information and set up a database on saturated fat (SFA), trans fat (TFA), sodium and total sugars levels in prepackaged food. Based on the Choices criteria and approach, the positive FOP labels were created to use simple nutritional information to help consumers make healthier food choices. In 2017, CNS released the group standard “labeling specification for healthier choice in prepackaged food” as national healthier choice label. According to the characteristics of Chinese residents’ food consumption, components (the content of total fat, saturated fat, trans fat, total sodium/salt, total sugars or added sugars per 100 g /100 mL of food) in a food product with a negative impact on health were taken as limited indexes. The thresholds of these limited indexes were formulated by a food-category-specific approach, in which 32 subclass of food groups were identified from 10 major ones including processed cereal and grains, processed beans and legumes,dairy products, seeds and nuts, processed meat and meat products, aquatic products, egg products, products of vegetables and fruits, beverages and the others. The “healthier choice” LOGO can be voluntarily labeled for food categories that meet the requirement of the thresholds. The group standard has received high attention from different stakeholders including the scientific community, industry, government and media after it was launched. Meanwhile the Chinese government released the national nutrition plan (2017-2030) in 2017, calling on the food industry to reduce the amount of oil, salt and sugar in prepackaged foods. It also supports the CNS in developing the national standard of ” FOP nutrition labels of prepackaged food” based on the group standard which has being implemented for a year.
Speaker 3 : Annie Ling, PhD
Profile : Annie oversees Policy, Research & Surveillance in the Health Promotion Board, which aims to advance health promotion through integrating research, policy and practice. She is an accomplished public health nutritionist in national food systems working at the interface of public and private sectors, and has spearheaded the set up of locus of expertise in food and nutrition policies. Annie is also Adjunct Associate Professor to the Saw Swee Hock School of Public Health, National University of Singapore.
Market Impact of Singapore’s Voluntary Nutrition Labelling Programme
Background/Aims: The Healthier Choice Symbol (HCS) aims to assist consumers in identifying healthier food products. The intent is to encourage consumers to switch to healthier alternatives by shifting norms and lightening palates. Therefore, the guidelines have been developed as a moving target to allow consumers to change and adjust their palates over time. At the same time, it incentivises and encourage food manufacturers to continue to reformulate and increase the availability of healthier products in the market. HPB is committed to shift the market toward healthier choices by leveraging on industry partnerships to grow the supply as well as to increase accessibility to healthier products through multi-channel demand generation. As a result of the multi-partnership approach with different stakeholders, there are now about 300 food manufacturers participating in this programme with almost 3500 food products carrying the symbol. Demand for HCS products has been gaining momentum growing at a yearly average of 6% in sales volume, with the market share of HCS products increasing from 15% in 2012 to 25% in 2018. In conclusion, the use of HCS labelling scheme in Singapore has shown to be effective in incentivising food manufacturers to develop healthier food products, and influencing consumers to choose healthier food products.
Speaker 4 : Zalma Abdul Razak
Profile : Zalma is currently serving as Director of Nutrition at Ministry of Health Malaysia. She has been involved in the development and implementation of many nutrition programs, especially on health and nutrition promotion, as well as nutrition rehabilitation programs. She acted as a Chairman for the Technical Working Group for Nutrition Promotion, under the National Plan of Action for Nutrition Malaysia. She also acted as a writer and editor for various nutrition articles published in MyHealth Portal.
The Implementation of Healthier Choice Logo in Malaysia
The implementation of Healthier Choice Logo Malaysia (HCL) was started in 2017 as one of the initiatives to create an environment that support healthy eating practices among Malaysians. The Healthier Choice Logo enables consumers to quickly identify healthier products within the same category of food. It also encourages industries to reformulate their product, to make it healthier. At the moment, there are only 370 products with HCL in Malaysia. Commitment from industries is crucial in ensuring more products with HCL are available to consumers. The consumers also need to be educated on HCL and the importance of choosing healthier products.
Speaker 5 : Dr. Norhayati Kassim MB ChB, MMed PH, MSc HPHE
Profile : Dr Norhayati has been appointed as the Head of Health Promotion Centre since 2008. She has been involved in the development of several strategic national health initiatives such as the Health Promotion Blueprint, National Physical Activity Guidelines and National Multisectoral Action Plan for the Prevention and Control of Non-communicable Diseases. She began her career as a clinical doctor at the Raja Isteri Pengiran Anak Saleha Hospital in Brunei, and later went on to get her qualifications in public health and health promotion respectively. She has served as a Temporary Advisor to WHO; Country Coordinator for ASEAN Health Cluster and secretariat to the Multi-sectoral Task Force for Health. She has also been appointed as Adjunct Senior Assistant Professor at the PAPRSB Institute of Health Sciences
Improving the Food Environment through Brunei’s Healthier Choice Logo
Background/Aims: Front-of-pack labelling such as the Healthier Choice Logo can encourage consumers to make informed healthier food choices and drive positive behavior change. In Brunei Darussalam, the introduction of the Healthier Choice Logo was first mooted in 2014; the Nutritional Labelling Awareness and Uptake of Healthier Food Branding Survey conducted then showed that 85.3% of consumers (n=265) read nutrition labels, of which, 55.3% stated the reason for doing so was ‘to choose healthier items’ and 97.4% supported having a healthier choice logo on packaged food. Brunei’s Healthier Choice Logo is based on a set of locally-adapted nutrient criteria and was officially launched in February 2017 with the aim of creating a local market environment conducive for supporting healthier eating choices. Periodic dialogues and bilateral meetings with local and international food industries have been conducted since then to socialise the Healthier Choice Logo and to encourage the reformulation of related food and beverage products with less salt, less sugar or less fat.
Speaker 6 : Wantanee Kriengsinyos
Profile : Wantanee Kriengsinyos is Associate Professor at the Institute of Nutrition, Mahidol University. Currently, she is the chair of MSc. (Nutrition and Dietetics) program. She gained her doctorate in Nutritional Sciences at the University of Toronto, Canada. She also holds a registered dietitian from the United States. Her current research interests include: 1) Diet and behaviour modification/metabolic study in people with non-communicable diseases (NCDs), 2) Body composition and energy expenditure, 3) Protein quality and amino-acid metabolism, 4) Healthier logo for combating NCDs
Thailand Experiences on Healthier Logo Implementation
Summary-type Front of Pack nutrition labeling has been implemented in Thailand since 2016 on voluntary basis with the supports from Thai Health (NGO for healthy lifestyle promotion) and Thai FDA. The paramount of this program is to reduce the NCD problem in the Thai population by changing their eating habits via nutrition education and increasing food products of healthier nutrient profiles in the market. Initially, there were the nutrient criteria only for 5 industrial food groups, which later expanded to 10 food groups in 2019. At present, the labeling or so called “Healthier Choice” logo has been granted to 1,019 food products from 175 companies. There are 415 food products with the Healthier Choice logo being sold in the market. The budget from Thai Health has been mostly spent on technical activities i.e. criteria development, extension service and post-marketing monitoring. In term of interests from food industries, the program was doing quite well during the past 3 years, which could be observed from increasing numbers of registered and market launched products as well as industrial requests for nutrient criteria of new food groups. The products that are usingthe logo are mostly produced from medium and large-scale industries but not yet from small and cottage industries. The concern for the “Healthier Choice” logo implementation is on the logo visibility and use among consumers. In fact, the main budget expenditure has already been on the logo promotion, which was partly supported from Thai FDA and largely spent product-wise by local and multinational food companies. The recognition on the logo among consumers is still not so well since industrially-produced food productscontribute only 20% of the diets of the Thais. Implementation the logo into foods being sold in franchise coffee shops, convenient stores and restaurants as well as served at the hospitals is therefore the new strategy for increasing the logo visibility.
Speaker 7 : Yusra Egayanti, S.Si, Apt, MP.
Profile : Yusra Egayanti is the Deputy Director of Subdirectorate of Certain Processed Food Standardization, Indonesia Food and Drug Agency (Indonesia FDA). She is in charge of preparing food standards and regulations, in particular food for special dietary uses, functional ingredients, nutrition labelling, claims, irradiated food, as well as the assessment of genetic modified comodities for food. She is a pharmacist and food technologist who has attended various trainings and workshops in the field of food safety, nutrition, risk analysis, and food standardization.
Regulation on Nutrition Labelling in Indonesia
The prevalence of Non-Communicable Diseases (NCDs) in Indonesia is currently increasing. Based on data from Basic Health Research (2018), the highest prevalence of NCDs were hypertension (34.1%), obesity (21.8%), diabetes mellitus (10.9%), and stroke (10.9%). The main risk factors of NCDs are caused by unhealthy diets and lack of physical activity. An unhealthy diet often associated with excessive consumption of sugar, salt, and fat, Total Diet Survey data (2014), showed those excessive consumption respectively 4.8%; 52.7%; and 26.5%. Labelling is one of the strategies recommended by WHO in NCDs prevention, through labelling consumers would be better informed regarding the benefits and content of the food they consumed. WHO also stated that the trend of health-related claims in the label is increasing, thus providing important consequences for the government to guarantee that the claims are true and not misleading. Indonesia has developed Head of BPOM Regulation No 31 Year 2018 on Processed Food Labelling which stipulated that nutrition information on processed food is mandatory. Furthermore, to ease consumers in interpreting the nutrition content of the product, BPOM also developed the front of pack nutrition labelling, and currently is voluntarily implemented. Thus, BPOM is drafting a technical regulation for the implementation of nutrition information provision. The draft covered mandatory nutrient such as energy, fat, saturated fat, carbohydrate, protein, total sugar and salt (sodium), the exclusion of processed food from mandatory nutrition information, and type of front of pack nutrition labelling which are monochrome format and a healthier choice logo. We expect that those regulations could encourage industries to produce food with better information, and also encourage consumers to make a better choice of foods that may affect their health.
Speaker 8 : Do Thi Phuong Ha, MD, MSc, PhD
Profile : Ha T.P. Do graduated as medical doctor at Hanoi Medical University, got Master of Science degree on Community Nutrition at University of Indonesia – SEAMEO-TROPMED, then received PhD on Nutrition at Wagengen University, the Netherlands. She is the Chair of the Nutrition Department and Food safety at the Viet Nam University of Traditional Medicine and visiting lecturer at Hanoi Medical University. She has been the author and co-authors of a numbers of books, and papers in peer-reviewed journals. She has been a key member in the working groups for developing National Nutrition Strategies on Prevention and Control of Non-communicable diseases and National Plan of Action for Nutrition.
The Double Burden of Nutrition Challenge and Need For Healthy Food Choice Labeling in Viet Nam
Background/Aims: Viet Nam is facing the double burden of nutrition. The prevalence of stunting remained at 23.8% in 2017. Micronutrient deficiencies (iron, zinc, vitamin A, iodine) have been significant public health problems. About one-third of vulnerable groups are anemic and it was not changed in 2000-2015. Particularly, zinc deficiency was affecting 63.3% of women reproductive age, 69.4% under-five children and 80.3% pregnant women in 2015. Besides, noncommunicable chronic diseases have rapidly increased and accounted for 77% of morbidity. National STEPS survey in 2015 showed that 20.3% of the adult were hypertensive, the prevalence of elevated glucose was triple and diabetes increased 63% in 5 years, 30% adult had high blood cholesterol. Adult overweight and obesity was 17.5%, increased more than 5 times after 15 years. Dietary risk has been recognized as the leading risk factor of disease burden in Viet Nam. Salt intake was double recommended level, 57% of adults consumed insufficient fruit and vegetable, consumption of sugar and sugar-sweetened beverage, processed food increased. National Strategy of Prevention and Control of Chronic Disease 2015-2025 identified the objectives of reducing nutrition-related chronic disease’s risk factors such as salt intake, vegetable and fruit consumption, hypertension, high blood cholesterol, and high blood glucose. Increasing awareness, knowledge and practice of general population on healthy food and reformulation of food products to reduce risk factors and/or enhance healthy factors are important matters to be implemented. However, there is no regulation on nutrition labeling in place. In this context, healthy food choice labeling becomes a crucial solution to attain healthy diets.