Development of the Choices 5-Level Criteria to Support Multiple Food System Actions

• Published in: Nutrients 2021-12, Vol.13 (12), p.4509
• Main Authors: Tognon, Gianluca, Beltramo, Belen, Schilpzand, Rutger, Lissner, Lauren, Roodenburg, Annet J C, Don, Rokiah, Nair, Krishnapillai Madhavan, Nnam, Ngozi, Hamaker, Bruce, Smorenburg, Herbert
• Format: Article
• Language: English
• Subjects: Choice Behavior; Compliance; Consumer Behavior; Criteria; Criteria for healthy food products; DIET; DISEASE PREVENTION; Food; Food groups; Food Labeling - standards; Food Preferences - psychology; Food products; Front-of-pack labelling FOPL; Health care; Health policy; Health Promotion - methods; Health Sciences; Humans; Hälsovetenskaper; INDEX; Indicator foods; Logos; Malnutrition; Medborgarcentrerad hälsa (Mech); Non-communicable diseases; Nutrient profiling; NUTRIENT PROFILING SYSTEM; Nutrients; Nutrition; Nutrition Policy; Nutritive Value; Obesity; Public health; QUALITY; Research on Citizen Centered Health, University of Skövde (Reacch US); Thresholds; Undernutrition; VALIDATION
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu13124509

In 2008, the Choices International Foundation developed its logo criteria, identifying best-in-class food products. More advanced, global and graded nutrient profiling systems (NPSs) are needed to substantiate different national nutrition policies. The objective of this work was to extend Choices NPS to identify five levels of the healthiness of food products, so that the Choices NPS can also be used to support other nutrition policies, next to front-of-pack labelling. Based on the same principles as the previous logo criteria, four sets of threshold criteria were determined using a combination of compliance levels, calculated from a large international food group-specific database, the Choices logo criteria, and WHO-NPSs developed to restrict marketing to children. Validation consisted of a comparison with indicator foods from food-based dietary guidelines from various countries. Some thresholds were adjusted after the validation, e.g., because intermediate thresholds were too lenient. This resulted in a new international NPS that can be applied to different contexts and to support a variety of health policies, to prevent both undernutrition and obesity. It can efficiently evaluate mixed food products and represents a flexible tool, applicable in various settings and populations.