Nutritional quality and reformulation of a selection of children's packaged foods available in Australian supermarkets: Has the Health Star Rating had an impact?

Aim To examine whether the nutritional quality of children's packaged food products available in Australian supermarkets improved between 2013 and 2016, and whether any change could be detected in product reformulation since the introduction of the Health Star Rating (HSR) labelling scheme. Methods Packaged food products marketed towards children were purchased from three Australian supermarkets in July 2013 (for a previous study) and July 2016. Nutritional quality was assessed using the Food Standards Australian New Zealand Nutrient Profiling Scoring Criterion. Comparisons were made between the nutrient composition and formulation of products (a) available in 2013 and 2016; and (b) with and without HSR graphics. Results Of the 252 children's packaged products analysed, 53.6% were classified as 'less healthy'. HSR-labelled products had a significantly higher proportion classified as 'healthy' than those without the HSR (chi(2) = 26.5; P < 0.0001; 73.8% and 59.0%, respectively). Overall, 28.5% displayed the HSR; the majority (81.5%) having a rating of >= 3.0 stars. Cereal-based products had the greatest uptake of the scheme, with HSR-labelled products having significantly lower mean energy and saturated fat content (P < 0.01) and higher mean protein and fibre content (P < 0.001) than non-HSR products. Reformulation of products that were available in 2013 had occurred in 100% of HSR-labelled products in comparison to 61.3% of non-HSR labelled products. Conclusions Despite the introduction of the HSR, more than half of children's packaged foods sampled are 'less healthy'. However, early indications suggest that the HSR may stimulate healthier product reformulation.