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I'm seeing Health Stars, what should i do?

Summary

Sometimes food packets have stars and numbers on their front. These are Health Stars. The Health Star Rating (HSR) system gives foods an overall score of between 1 and 5.

This score is worked out by subtracting points for unhealthy nutrients – like lots of sugars – away from all the positive points for healthy nutrients – like protein and fibre. The idea is that healthier foods will end up with more stars. We can use the stars to compare similar foods, like different muesli bars.

People who make foods (manufacturers) can choose whether to put HSRs on their packets. We’re more likely to see them on higher scoring foods like breakfast cereals than on sweets, snacks and drinks. This makes them different from the Nutrition Information Panels (NIPs) which manufacturers must put on their packets so we can always see what’s in it.

What do the stars mean?

The Health Star Rating (HSR) system ranks foods from half a star to five stars. Healthier foods get more stars. It’s a bit like a cross between the per 100 g column of a Nutrition Information Panel (NIP), a nutrition content claim, and a health claim. This overall rating system for packaged foods was introduced in Australia and NZ in 2014. It is voluntary (meaning makers can choose whether to use it or not). By 2016, about 5% of NZ products were using it, and by March 2017 about 2700 products had stars.

What do the labels look like?

Manufacturers (makers) who sign up for the system can put HSR thumbnail labels on the front of their packs. They might look like this.

 The labels can show the star rating plus the levels of energy, saturated fat, sugars, sodium and up to one other featured nutrient per 100 g or 100 mL of the product, in the same order as on a NIP. They can show values for all nutrients, some of them, or just the number of stars for the product. There are also options showing values per pack, and the % DI (Daily intake) for energy. Very small packs just show the energy value only (no stars). The fourth nutrient can be labelled ‘low’ if it meets the conditions under the Foods Standards Code (FSC) or ‘high’ if it meets FSC nutrient claim conditions for being a good or excellent source.

How are they different to NIPs?

They are easier to read than NIPs. While they repeat some of the nutrition content information found in NIPs (like levels of energy, saturated fat, sugars and sodium) they are meant to take the hard work out of weighing up the overall balance between all the healthy and less healthy nutrients in a food. They make quick overall comparisons between similar packaged foods – like between different brands of cereal – easy. They are not meant to be used to compare different types of food (like cheese with cereal).

How are the stars calculated?

The ratings use calculations created by food industry, nutrition and public health experts based on scientific evidence and eating and activity guidelines. They  give points to all the nutrients in a food and then balance the scores of negative nutrients we should eat less of (energy, saturated fat, sugars, sodium) against those of the positive ones we should eat more of (protein, dietary fibre, fruits, vegetables, nuts and legumes). The final score determines the star rating. Negative nutrients have roughly twice the impact on final scores compared with the positive nutrients. Calculations are different for different food classes.

Can all foods have them?

Health stars (HSRs) are only for packaged foods and not for some groups like alcohol, takeaways, and baby formula. You won’t find them on fresh fruit and veg. Sadly, if a food packet doesn’t have stars we can’t tell if that’s because its maker didn’t apply for them or for some other reason. Makers are likelier to put HSRs on products that get high ratings: by 2016 around 84% of products using HSRs had ratings of 3.0 stars or more. And certain food types are likelier to use them: by 2016 they were used by nearly 37% of all breakfast cereals, but only 3.3% chippiess and savoury snacks, 1.6% confectionery (sweets) and 0% fizzy drinks. It’s hard to compare foods in a category if only a few brands have stars.

Can manufacturers change their products to improve their ratings?

By 2016 about 83% of HSR products had been changed (reformulated) to improve their ratings. This included doing healthy things like reducing fats and sugars or increasing protein. The fruit, vegetable, nut and legume content of the total food must be over 40% before it can start counting towards Health Stars or improving ratings.

Is there anything to look out for with these stars?

It’s possible for a food – like a fruit juice or breakfast cereal – to contain lots of sugar but receive 4.5 stars because of its levels of positive nutrients (like fibre or protein). The HSR also lets makers calculate values based on an ‘as prepared’ serve. So remember that the 4.5-star rating for 100 mL Milo is for when it is made using 3 teaspoons powder per 200 mL trim milk: just the powder (which is 46% sugar) rates 1.5 stars; if you made Milo up with whole milk the rating would be 2.5; and it would also rate lower if you made it up with water.

In 2016, Consumer NZ recommended to the Health Star Rating Advisory Committee that the number of stars a high-sugar, high-fat or high-sodium product can get should be limited, and that added sugars should score extra penalty points.

Does anything else looks like the health stars?

The Australian DIG (Daily Intake Guide) system is another voluntary labelling scheme (started in 2006) and it uses front-of-pack icons which look very like HSR icons. DIG icons show the percentage of the adult Daily Intake (%DI) per serve of the food for energy, fat, saturated fat, sugars, sodium and up to two more core nutrients (protein and carbohydrates) – or just for energy on its own. They can also add icons for optional extra nutrients like vitamins and minerals. DIGs never have stars and do not judge the overall balance of nutrients in a food. It is possible to have both DIG and HSR icons on a pack. 

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References

Australian Food and Grocery Council, June 2016. “Best Practice Guide- Daily Intake Guide”. Retrieved from: https://www.afgc.org.au/wp-content/uploads/AFGC-Best-Practice-Guide-DIG-Style-Guide-June-2016-1.pdf 2 August 2017.
Consumer NZ, 8 September 2014. “Health Star Ratings”. Retrieved from: https://www.consumer.org.nz/articles/health-star-ratings 31 July 2017.
Health Promotion Agency, December 2016. “How are Health Star Ratings Calculated?”. Retrieved from: http://www.nutritionandactivity.govt.nz/sites/default/files/2.3%20NPA166%20Behind%20the%20Hype_How%20are%20HSR%20calcuated_Online.pdf 27 July 2017.
Health Star Rating System Style Guide, Version 4, 10 June 2016. Retrieved from: http://healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/651EEFA223A6A659CA257DA500196046/$File/HSR%20Style%20Guide%20v4.pdf 31 July 2017.
Ministry for Primary Industries, November 2015. “Health Star Rating (HSR) Industry Kit”.  Retrieved from: file:///C:/Users/helen.oleary/Downloads/2015-Health-Star-Rating-Industry-Kit%20(1).pdf 27 July 2015.
National Institute for Health Innovation (NIH), November 2016. “Report on the Monitoring of the Implementation of the Health Star Rating System in New Zealand, 2014-206. Retrieved from: https://www.mpi.govt.nz/food-safety/whats-in-our-food/food-labelling/health-star-ratings/monitoring-implementation/ 12 September 2017.
Mhurchu Cliona, Eyles Helen and Choi Yeun-Hyang, 2017. “Effects of a Voluntary Front-of-Pack Nutrition Labelling on Packaged Food Reformulation: The Health Star Rating system in New Zealand”. Nutrients: 9(8): 918. doi :10.3390/nu9080918 . Retrieved from: http://www.mdpi.com/2072-6643/9/8/918/htm 12 September 2017.
Science Media Centre, 30 June 2014. “Health Star Rating Food Labelling – Experts Respond”. Retrieved from: https://www.sciencemediacentre.co.nz/2014/06/30/health-star-rating-food-labelling-experts-respond/ 31 July 2017.
Stuff, 27 April 2017. “Health Star System May ‘Mislead’ Shoppers”: author Susan Edmunds. Retrieved from: http://www.stuff.co.nz/business/91971947/health-star-rating-system-may-mislead-shoppers 31 July 2017.

Useful links

Choice .com., 1 May 2015. “Breakfast Cereal Reviews” and Retrieved from: https://www.choice.com.au/food-and-drink/bread-cereal-and-grains/cereal-and-muesli/articles/breakfast-cereal-review    and https://www.choice.com.au/babies-and-kids/feeding-children/making-healthy-choices/articles/kids-breakfast-cereal-review  29 August 2017.
Ministry for Primary Industries, n.d. “Health Star Ratings”. Retrieved from: https://www.mpi.govt.nz/food-safety/whats-in-our-food/food-labelling/health-star-ratings/ 27 July 2017.

How to Digest Health and Nutrition Claims, and Nutrition Information Panels factsheets from Life Education contain related information.