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定义“不健康”:澳大利亚膳食指南与健康星级评分系统一致性的系统分析。

Defining 'Unhealthy': A Systematic Analysis of Alignment between the Australian Dietary Guidelines and the Health Star Rating System.

机构信息

The George Institute for Global Health, Sydney 2042, Australia.

Charles Perkins Centre, University of Sydney, Sydney 2006, Australia.

出版信息

Nutrients. 2018 Apr 18;10(4):501. doi: 10.3390/nu10040501.

Abstract

UNLABELLED

The Australian Dietary Guidelines (ADGs) and Health Star Rating (HSR) front-of-pack labelling system are two national interventions to promote healthier diets. Our aim was to assess the degree of alignment between the two policies.

METHODS

Nutrition information was extracted for 65,660 packaged foods available in The George Institute’s Australian FoodSwitch database. Products were classified ‘core’ or ‘discretionary’ based on the ADGs, and a HSR generated irrespective of whether currently displayed on pack. Apparent outliers were identified as those products classified ‘core’ that received HSR ≤ 2.0; and those classified ‘discretionary’ that received HSR ≥ 3.5. Nutrient cut-offs were applied to determine whether apparent outliers were ‘high in’ salt, total sugar or saturated fat, and outlier status thereby attributed to a failure of the ADGs or HSR algorithm.

RESULTS

47,116 products (23,460 core; 23,656 discretionary) were included. Median (Q1, Q3) HSRs were 4.0 (3.0 to 4.5) for core and 2.0 (1.0 to 3.0) for discretionary products. Overall alignment was good: 86.6% of products received a HSR aligned with their ADG classification. Among 6324 products identified as apparent outliers, 5246 (83.0%) were ultimately determined to be ADG failures, largely caused by challenges in defining foods as ‘core’ or ‘discretionary’. In total, 1078 (17.0%) were determined to be true failures of the HSR algorithm.

CONCLUSION

The scope of genuine misalignment between the ADGs and HSR algorithm is very small. We provide evidence-informed recommendations for strengthening both policies to more effectively guide Australians towards healthier choices.

摘要

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澳大利亚膳食指南 (ADGs) 和健康星级评分 (HSR) 是促进更健康饮食的两项国家干预措施。我们的目的是评估这两项政策之间的一致性程度。

方法

从乔治研究所澳大利亚食品交换数据库中提取了 65660 种包装食品的营养信息。根据 ADGs 将产品分为“核心”或“随意”类,并生成 HSR,无论其是否显示在包装上。将明显的异常值定义为那些被归类为“核心”但 HSR ≤ 2.0 的产品;以及那些被归类为“随意”但 HSR ≥ 3.5 的产品。应用营养物质截止值来确定是否有明显的异常值“高盐”、“总糖”或“饱和脂肪”,并将异常状态归因于 ADGs 或 HSR 算法的失败。

结果

共纳入 47116 种产品(23460 种核心;23656 种随意)。核心产品的中位数(Q1,Q3)HSR 为 4.0(3.0 至 4.5),随意产品为 2.0(1.0 至 3.0)。总体一致性良好:86.6%的产品获得与其 ADG 分类一致的 HSR。在 6324 种被确定为明显异常值的产品中,5246 种(83.0%)最终被确定为 ADG 失败,主要是由于在定义“核心”或“随意”食品方面存在挑战。总共有 1078 种(17.0%)被确定为 HSR 算法的真正失败。

结论

ADGs 和 HSR 算法之间真正的不一致范围很小。我们提供了基于证据的建议,以加强这两项政策,更有效地引导澳大利亚人做出更健康的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64f3/5946286/39a02da4aed4/nutrients-10-00501-g001.jpg

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