The National Health and Medical Research Council has funded a research study that reduces high Health Star Rating’s on ‘unhealthy’ foods, by factoring in ultra-processing. Keira Joyce looks at the shortcomings of this approach by failing to reflect the complexities of nutrition and health and their interaction with the human body.
Published in Nutrition and Dietetics last week, the study was led by The George Institute, and tested modifications to the Health Star Rating (HSR) system for ultra-processed foods. It particularly emphasised a greater alignment with the Nova classification system due to the modifications, but also resulted in a lowered alignment with the Australian Dietary Guidelines.
Lead author and Food Policy research fellow at The George Institute, Dr Eden Barrett, said that the modifications to the HSR algorithm penalised the most problematic products by scoring them lower, which may be less confusing for consumers.
“The current HSR system gives a reasonable reflection of the sugar, salt and saturated fat content of our foods and drinks but doesn’t tell us anything about how ultra-processed they are,” said Barrett.
“In the present system, manufacturers can ‘game’ the Health Stars scoring system by adding isolated fibres, proteins and artificial sweeteners that can push their HSR higher, creating a ‘health halo’ effect. As evidence on the long-term harmful effects of ultra-processing continues to emerge, it’s important to address this potentially misleading message on food labels.”
The modifications made in the report also lowered the HSR on foods including packaged whole grain breads, and similar cereal and grain products. While these foods currently meet the ultra-processed definition, research suggests they do not have negative health impacts.
Issues may arise if the processing level of a food, which does not necessarily reflect its nutritional status, is prioritised over the other complex and contextual factors that make up health.
Nova and the case of processing
The Nova food classification system categorises food products into four groups, based on the level of industrial processing they undertake. First proposed in 2009 by researchers at the University of São Paulo, Brazil, it has become a popular tool for communicating health information to the public.
Although it is widely used as a classification system in academic literature, a 2022 study published in the European Journal of Clinical Nutrition concluded that Nova’s categories are inconsistent and its functionality is low for scientific purposes.
As the classification approach is purely based on description, it was interpreted differently by food and nutrition specialists applying it to food products. Without quantitative metrics to assign categories, the system remains rather questionable.
Not to mention the fact that as a classification system, Nova does not represent the nutritional value of food products – only their processing level. It is generally agreed that ultra-processed food products can have negative impacts on health, but without a strict definition of what is considered ultra-processed, this is functionally meaningless.
This topic has been widely debated recently, which makes it all the more interesting why a paper supported by the National Health and Medical Research Council would so strongly emphasise the similarity to the Nova classification system when calculating the alternate Health Star Rating.
For instance, the Australian Food and Grocery Council released a statement in June stating the organisation was concerned that ultra processed food labelling is not based on current nutrition principles and does not consider dietary patterns.
Although the interconnection of heavy industrial processing and negative health impacts should not be disregarded, it should also not be the only focal point in a complex system.
Next steps
The modifications made to HSR in the report resulted in an overall lowered alignment with the Australian Dietary Guidelines classifications, which were last updated in 2013. Although it should be noted that these could be outdated, they are still likely to be a more accurate system for reviewing nutritional value for the Australian population than the Nova system.
The National Health and Medical Research Council was granted $2.5 million by the federal government last year to review and update the current Australian Dietary Guidelines. However, it is concerning to note that the updated guidelines are not expected until 2026, a three year process in a rapidly changing industry environment.
This is an endeavour that will conduct a review of recent scientific literature on health and nutrition and necessitate commentary from all relevant stakeholders, taking into account contextual factors such as resource usage and sustainability.
Consistent and continuous review of nutritional ratings should be undertaken by government and industry to ensure consumer advice remains relevant and prioritised. The Health Star Rating system should be part of this, as the algorithm used to calculate it is over ten years old.
However, prioritising any one aspect, such as processing levels, does not accurately represent the complex interaction of nutrition and health aspects and their interaction with the human body. It will be interesting to see the updated Dietary Guidelines and how they reflect these issues, but we’ll have to wait until 2026.
