Prepackaged foods healthiness ranking index: developing front-of-pack labeling to facilitate the assessment and validation of healthiness rankings of prepackaged foods in China

• Published in: BMC medicine 2024-09, Vol.22 (1), p.402-13, Article 402
• Main Authors: Wu, Feiyan, Qin, Yulong, Hou, Dan, Xie, Sasa, Zhang, Guanchao, Zhang, Dexing, Yang, Min
• Format: Article
• Language: English
• Subjects: Artificial sweeteners; China; Chronic illnesses; Consumption; Convenience foods; Datasets; Delphi method; Delphi Technique; Descriptive labeling; Dietary guidelines; Evaluation; Exposure drafts; Food; Food labeling; Food Labeling - methods; Food Labeling - standards; Food Packaging - standards; Food quality; FOPL; Health aspects; Health policy; Health rank; Humans; Labeling; Literature reviews; Methods; Nutrients; Nutrition; Nutritive Value; PHRI; Prepackaged food; Ranking; Rankings; Salt; Sodium; Surveys
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-024-03600-y

The Medium and Long-Term Plan for the Prevention and Treatment of Chronic Diseases (2017-2025) in China has highlighted the importance of reducing fat, sodium, and sugar in foods. However, front-of-pack labeling, which enables consumers to assess the health levels of prepackaged foods, is lacking in China. In response to the Zhejiang Provincial Health Commission's request, we sought to develop a method for efficiently evaluating the health level of prepackaged foods. Through a comprehensive literature review, we established a systematic framework: the Prepackaged Foods Healthiness Ranking Index (PHRI). We determined specific threshold values and grading criteria and conducted two rounds of Delphi survey to refine the index. Using a measurement dataset, we aimed to determine the optimal limit values for assessing the health level of prepackaged foods in real-world settings. After two rounds of Delphi surveys, the PHRI underwent multiple revisions until consensus among experts was reached. The final decision regarding the upper limit values set 30% Nutrient Reference Values as the limit for solid foods and 15% Nutrient Reference Values for liquid foods. The calculation of PHRI values was successfully implemented with the dataset, in accord with current nutrition awareness and real-world conditions. The PHRI provides a valuable tool for assessing the healthiness of prepackaged foods. This front-of-pack labeling system provides a convenient method for evaluating the nutritional quality of prepackaged foods. Ultimately, the PHRI has the potential to contribute to advancements in health policy, practice, and education in China.