Labonté Marie-Ève, Poon Theresa, Mulligan Christine, Bernstein Jodi T, Franco-Arellano Beatriz, L'Abbé Mary R
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Am J Clin Nutr. 2017 Dec;106(6):1471-1481. doi: 10.3945/ajcn.117.161356. Epub 2017 Oct 25.
The Canadian government recently committed to introduce legislation to restrict the commercial marketing of unhealthy foods and beverages to children. We compared the degree of strictness and agreement between nutrient profile (NP) models relevant to marketing restrictions by applying them in the Canadian context. With the use of data from the University of Toronto 2013 Food Label Information Program ( = 15,342 prepackaged foods), 4 NP models were evaluated: the Food Standards Australia New Zealand-Nutrient Profiling Scoring Criterion (FSANZ-NPSC), the WHO Regional Office for Europe (EURO) model, the Pan American Health Organization (PAHO) model, and a modified version of the PAHO model (Modified-PAHO), which did not consider the extent of food processing because the application of this characteristic was prone to ambiguity. The number and proportion of foods that would be eligible for marketing to children was calculated with the use of each model, overall and by food category. The Modified-PAHO and PAHO models would permit only 9.8% (95% CI: 9.4%, 10.3%) and 15.8% (95% CI: 15.3%, 16.4%) of foods, respectively, followed by the EURO model [29.8% (95% CI: 29.0%, 30.5%)]. In contrast, the FSANZ-NPSC would consider almost half of prepackaged foods as eligible for marketing to children [49.0% (95% CI: 48.2%, 49.8%)]. Cross-classification analyses showed that only 8.1% of foods would be eligible based on all models (e.g., most pastas without sauce). Subanalyses showed that each model would be more stringent when evaluating food items that specifically target children on their package ( = 747; from 1.9% of foods eligible under Modified-PAHO to 24.2% under FSANZ-NPSC). The degree of strictness and agreement vary greatly between NP models applicable to marketing restrictions. The discrepancies between models highlight the importance for policy makers to carefully evaluate the characteristics underlying such models when trying to identify a suitable model to underpin regulations restricting the marketing of unhealthy foods to children.
加拿大政府最近承诺引入立法，以限制向儿童进行不健康食品和饮料的商业营销。我们通过在加拿大的背景下应用营养成分模型，比较了与营销限制相关的营养成分（NP）模型之间的严格程度和一致性。利用多伦多大学2013年食品标签信息项目的数据（n = 15342种预包装食品），评估了4种NP模型：澳大利亚和新西兰食品标准局营养成分评分标准（FSANZ-NPSC）、世界卫生组织欧洲区域办事处（EURO）模型、泛美卫生组织（PAHO）模型以及PAHO模型的修改版（Modified-PAHO），后者未考虑食品加工程度，因为这一特征的应用容易产生歧义。使用每种模型计算总体上以及按食品类别划分的适合向儿童营销的食品数量和比例。Modified-PAHO模型和PAHO模型分别仅允许9.8%（95%CI：9.4%，10.3%）和15.8%（95%CI：15.3%，16.4%）的食品符合条件，其次是EURO模型[29.8%（95%CI：29.0%，30.5%）]。相比之下，FSANZ-NPSC模型会将几乎一半的预包装食品视为适合向儿童营销[49.0%（95%CI：48.2%，49.8%）]。交叉分类分析表明，基于所有模型，只有8.1%的食品符合条件（例如，大多数无酱料的意大利面）。子分析表明，在评估包装上专门针对儿童的食品时（n = 747；从Modified-PAHO模型下符合条件的食品的1.9%到FSANZ-NPSC模型下的24.2%），每种模型都会更加严格。适用于营销限制的NP模型之间的严格程度和一致性差异很大。模型之间的差异凸显了政策制定者在试图确定一个合适的模型来支持限制向儿童营销不健康食品的法规时，仔细评估此类模型背后特征的重要性。
