Healthier food choices

against double burden of

malnutrition

Kigali, 27 August 2019

Rutger Schilpzand

In search for healthy solutions...

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Nutrition transition:

Packaged food intake per capita

3

54

6166

7168

7174 77

0,0

20,0

40,0

60,0

80,0

100,0

120,0

140,0

160,0

180,0

200,0

2005200920132017 2005200920132017 2005200920132017 2005200920132017 2005200920132017 2005200920132017 2005200920132017

North America Latin America Europe Oceania Africa Asia Global

Kg p

er

capita

Source: Global Nutrition Report 2018

Baked goods Dried processed foods Procesed meat & seafood

Sauces, dressings & condiments Edible oils Ice cream and frozen desserts

Savoury snacks Confectionary Sweet biscuits, snack bars & fruit snacks

Ready meals Breakfast cereals

Proportion of healthy packaged foods

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Recent scientific publication BMJ by group of leading UN

nutritionists:

• 71% of deaths in the world is caused by NCDs

• 422M people with diabetes (2014)

• 830M people chronically hungry

• 2.5 Billion people malnourished in any form

• In 2025 this will be half the world population, i.e. 4 Billion

“Poor diet is the leading cause of death”

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Why?

Dietary transition

FROM

Diet

• Varied, nutrient dense diet

Nutrients

• High in fiber, fruits,

vegetables,

Sources of information

• Traditional knowledge

NOW

• Cheap, refined, energy

dense food

• High in fat, sugar, salt,

energy

• Label, marketing

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(still according to the UN experts)

Food system changes are needed

Levers for change a.o.:

• Introduce nutrition standards

• Eliminate trans fatty acids

• Restrict food marketing to children

• Interpretive front-of-pack labelling

• School nutrition programs.

Note: these are among the most cost effective measures

How to find our way back?

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• Global Foundation to foster healthier choices

• Addressing the double burden of malnutrition

• Global criteria on product group level

• Set by independent Scientific Committee

• To be applied in national nutrition policies

• Regional cooperation: East-Asia, Europe, Africa

• Global dialogue with organizations, food companies

Choices International

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• Goal 2.2: End malnutrition

• Goal 3.4: decrease premature deaths from NCDs

• Goal 17: partnerships

• UN Secretary General report 2018: 50% of premature deaths from NCD

in LMICs. Need to accelerate in implementation. More political priority,

funding are needed

Choices commitments to SDGs

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Healthier food options for all consumers

Science based criteria coherent with national nutrition policies

Innovation FOP logo Education

THE POSITIVE LOGO PROGRAMS

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SingaporeThailand Brunei Malaysia China

?Vietnam Indonesia

Czech Rep.CroatiaSlovenia Finland Scandinavia Nigeria

Argentina

Zambia South Africa Zimbabwe

Abu Dhabi

The importance of specific criteria

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• To realize policies on food & health, a differentiation is

needed between more and less healthy

• Dietary guidelines cover daily diet

• Translation is needed to assess products

• Creates a level playing field

• guidance of industry reformulation

• benchmark for industry commitments

• Interpretive labelling

• helps consumer education

• limitation for marketing to children

• taxation

Possible use

of criteria:

Choices criteria to identify healthier products

• To highlight 10-20% healthiest

products in each food group

• Raise nutrition quality, fiber

decrease fat, sugar, salt

• Covers all food and drinks

• Food group specific cut-offs

for key nutrients

• National adaptation to include

national context

• Stepwise tightening every 4 yr

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When relevant

International Scientific Committee

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Prof Madhavan Nair

Nutrition Society, India

Product groups

Based on dietary recommendations in >20 countriesNote: Should be adapted to national circumstances

Basic groups

• Fruits & vegetables

• Water

• Nuts & seeds

• Complex carbohydrates

• Meat, fish, insects

• Dairy

• Oils & fats

• Meals & soups

• Non-basic groups

• Sauces

• Sweet and savory snacks

• Fruit juices

• Milk substitutes

• Other beverages

• All other products

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The Ten Choices Principles

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Negative Positive

Com

ple

x

Sim

ple

Major existing FOP nutrition labels:

from complex to simple and from negative to

positive

Choices Programme: Healthy Choices Made Easy

Modeling studies: calculated

impact on nutrient intake

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A. Roodenburg PLoS One 2011

Choices Programme: Healthy Choices Made Easy

Calculated impact on micro-

nutrient intake in young adults (NL)

Source: Roodenburg cs, PLOS One 8 (2013)

• Validation – criteria use leads to 10-50% lower fat, sugar, salt intake

in calculation studies (Keyhole, Finland, 10 Choices countries)

• Consumer awareness – 80-95% logo recognition (Singapore,

Malaysia, Sweden, Norway, Denmark, Finland, Netherlands)

• Value – Consumers value logo products more, and this increases

over time (Malaysia, Netherlands, Denmark)

• Buying behaviour – Logo leads to healthier food purchases in all

population groups in market study (Netherlands)

• Reformulation – criteria drive product improvement (all countries)

• Sales – turn-over of logo products grows faster in certain categories

than non-logo products (Singapore, Sweden, Netherlands)

• See Choices Scientific Overview 2019 of Positive Labelling

Scientific evidence of impact

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Choices Programme: Healthy Choices Made Easy

Dynamic criteria Singapore:

sugar in soft drinks

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2006

2003

Choices Programme: Healthy Choices Made Easy

POSITIVE LABELS

Nigeria HF Zimbabwe HF S-Africa HSF Zambia SBN

FORTIFICATION LABELS

Ghana South-Africa

Food logos in Africa

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Choices Programme: Healthy Choices Made Easy

the Nigerian Heart Foundation:

Heart Check Food Labelling Programme

➢Partnership between National Agency for Food and Drug Administration and Control

➢Nigerian Heart Foundation

➢Food Industry.

➢Approved food products carry the NHF Heart Mark Label for the consumer to make healthier food choices at the point of purchase.

Choices Programme: Healthy Choices Made Easy

“A mark or seal for eligible products that meet a set of defined

criteria across the various food groups to help consumers

identify nutritious foods in store

The Good Food Logo

Choices Programme: Healthy Choices Made Easy

How are international recommendations to fight the double

burden of malnutrition implemented nationally?

• Focus on Nigeria and Zambia

• Not yet fully implemented

• Due to lack of resoures, expertise, data

• Infrastructure is already available

What is most needed?

• ‘Paradigm shift’ from undernutrition to double burden

• Capacity building, awareness raising among stakeholders

• Adequate funding

• Collaboration with private sector, joint ambitions

• Standards for health, consumer education, labelling

Choices study on Double Burden

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Choices Programme: Healthy Choices Made Easy

• Focus: double burden of malnutrition

• Nutrition goals:

o Sufficient intake of all nutrients

o Reduce overconsumption of SAFA, TFA, sugar, sodium

o Coherence with dietary recommendations

• Balanced stakeholder collaboration

• Implementation on national level

• Regional collaboration

How to foster healthier food choice?

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Choices Programme: Healthy Choices Made Easy

Government

regulation,

education

Science

criteria, studies

NGOseducation

Industry

Implementation

Balanced stakeholder cooperation

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Choices Programme: Healthy Choices Made Easy

National level

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• National criteria to define ‘healthy’

o Determined by leading independent scientists

o Based on national analysis

o International Choices criteria as a starting point

o Integrated with national nutrition policy

• Commitment by national stakeholder platform

o Food industry involvement

• Actions:

o Consumer mobilization and education

o Nutrition panel and front-of-pack labelling

o Product innovation, promotion

o School feeding programs

Choices Programme: Healthy Choices Made Easy

• Training, capacity building, information sharing

• International scientific collaboration:

o data collection

o impact studies

• Support existing programs and new initiatives

• Donor interaction, fund raising

• Foster coherence to facilitate international trade

Founded on an international platform of strong and

committed African organizations and companies

Regional level

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For IRI, 25-9-2017

Thank you for your interest!

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www.choicesprogramme.org