Investigating nutrient profiling and Health Star Ratings on core dairy products in Australia

Objective: To determine whether the ratings from the Australian front-of-pack labelling scheme, Health Star Rating (HSR), and the ability to carry health claims using the Nutrient Profiling Scoring Criterion (NPSC) for core dairy products promote foods consistent with the Australian Dietary Guidelines. Design: The Australian nutrient profiling model used for assessing eligibility for health claims was compared with the nutrient profiling model underpinning the HSR system to determine their agreement when assessing dairy products. Agreement between the extent to which products met nutrient profiling criteria and scored three stars or over using the HSR calculator was determined using Cohen's kappa tests. Setting: The four largest supermarket chains in Sydney, Australia. Subjects: All available products in the milk, hard cheese, soft cheese and yoghurt categories (n 1363) were surveyed in March-May 2014. Nutrition composition and ingredients lists were recorded for each product. Results: There was 'good' agreement between NPSC and HSR overall (kappa= 0.78; 95% CI 0.75, 0.81; P< 0.001), for hard cheeses (kappa= 0.72; 95% CI 0.65, 0.79; P< 0.001) and yoghurt (kappa= 0.79; 95% CI 0.73, 0.86; P < 0.001). There was 'fair' agreement for milk (kappa= 0.33; 95% CI 0.20, 0.45; P< 0.001) and 'very good' agreement for soft cheese (kappa= 0.84; 95% CI 0.75, 0.92; P< 0.001). Generally, products tended to have HSR consistent with other products of a similar type within their categories. Conclusions: For dairy products, the HSR scheme largely aligned with the NPSC used for determining eligibility for health claims. Both systems appeared be consistent with the Australian Dietary Guidelines for dairy products, with lower-fat products rating higher.