Nutrient profiling to develop a model for marketing food and non-alcoholic beverages to children: Experiences and lessons learned from Norway

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1 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

2 Outline Background Working group Challenges Process Drafts/proposals Public consultations The result

3 Starting points (national) Norwegian Action Plan on Nutrition ( ): Consider introduction of restrictions on advertising of unhealthy foods to children and young people National Plan For Health and Care Services ( ): Ministries shall consider whether new legal restrictions on marketing of unhealthy foods to children and young people are necessary

4 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

5 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?

6 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,

7 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

8 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

9 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

10 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

11 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

12 Steps developing a new model Based on WHO draft NP manual

13 Process: Developing a new model Develop av simplified nutrient profile model Specific application: food marketing to children Aim of the model: identify unhealthy foods

14 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

15 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

16 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

17 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 ( kcal) per 100 g* Norwegian food composition database used to test different threshold values (tested for values in the UKmodel and Keyhole) *World Cancer Research Fund and American Institute for Cancer Research, 2007

18 Final model for public consultation 1 The new model was presented in April 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)

19 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

20 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

21 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

22 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

23 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

24 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

25 NP model Norway

26 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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30 THANK YOU!

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