ChrisIn Australia, we have lots of helpful advice from the government, including health advice provided by the Healthy Star Rating process to help us choose healthy food.
The Healthy Star Rating is a national voluntary labelling system that uses stars to show the nutritional profile of packaged foods. Manufacturers can follow guidelines that allow them to put a rating from ½ a star to 5 stars on the front of packaging to rate the overall nutritional profile of packaged food.
Developed by Australian, state, and territory governments, in collaboration with the food industry, public health, and consumer groups, the Healthy Star Rating system provides a quick, easy, and standard way to compare similar packaged foods. The more stars a food has the healthier the choice.
All good.
But then…
Healthy star rating of spreads
But then I saw the image below of the star rating of spreads that go onto toast that appeared on my social media feed posted by Dr David Gillespie.
Butter gets half a star, buttery blend three stars and regular spread four stars.
Can it be that butter is bad for us? Butter is a food that has nourished generations of our forebears, whilst a highly processed alternative, the main ingredient discovered about 30 years ago, gets 4 stars out of a possible 5?
These non-butter ‘butters’ are mostly canola oil extracted from canola seed.
That’s before it’s processed further into a ‘spread’. Part of this process is hydrogenation. This is where oils (liquid) are made solid at room temperature to enhance taste, texture, and shelf life. This process also forms trans fats, which are bad for your health in many ways.
Processed foods
Humans have been processing food since we became humans. We have been making butter for thousands of years. It goes way back to the earliest days of agriculture. Back then, processing was to make food more digestible (eg. cooking) or to last longer (eg. fermentation).
These days food processing has become central to the global food system that has to produce and distribute 22 trillion kilocalories daily to a population of 8 billion people. Foods that leave the farm gate are deconstructed and recombined into products that sell on supermarket shelves. This industrial food production and distribution has become a six-continent, just-in-time supply chain worth trillions of dollars.
This is food processing beyond anything the human body has ever seen.
Next-level processed or ‘ultra-processed’ foods are recognised as bad for our health in several ways, most connected to novelty. Food processing messes with the basic chemistry of food that our bodies have evolved over hundreds of thousands of years to consume. In effect, it makes our diet novel. We eat alien foods compared to our ancestors.
Many people know this is a problem and developed advice like the Healthy Star Rating to keep consumers informed. For example, researchers in Brazil have developed a classification system called NOVA, which provides criteria to divide food into four groups based on their level of processing and provide a processed food definition—you can read our take on NOVA in this post.
NOVA is used by the Food and Agriculture Organisation of the United Nations (FAO) in a publication discussing their place in a healthy diet.
The spreads for your toast are in Group Four that the FAO describes as “…ultra-processed foods are designed to create highly profitable products (low-cost ingredients, long shelf-life, emphatic branding), convenient (ready-to-consume) hyper-palatable products liable to displace freshly prepared dishes and meals made from all other NOVA food groups”.
But, I hear you say, butter contains saturated fat, also bad for our health.
Saturated fat is behind the low star rating for butter in the image. Butter is about 70% saturated fat.
Only humans have been eating saturated fat for a long time. Fat from animals is suggested as the dietary ingredient that led to our large brain. This cerebral advantage was a key factor in our success as a species.
After many years of demonising saturated fat for its perceived role in cardiovascular disease, more recent studies are finding little evidence for this link. The idea that seed oils might be a better alternative is also challenged. Evidence for the link between poor metabolic health and ultra-processed foods piles up.
Minimally processed and eaten for centuries, butter is better for us than these ‘spreads’.
The butter also looks delicious. Photo by Sorin Gheorghita on Unsplash
Should we trust healthy star ratings?
No, we can’t trust the health advice the Healthy Star Rating process provides. That the Healthy Stars labelling is voluntary adds to the potential for it to be used selectively. This means that if the product scores low, the manufacturer gets to omit the star rating from the packaging.
The Healthy Star Rating system not only fails to steer us toward healthy food, it is promoting food that is bad for our health.
Manufacturers of ultra-processed foods, by focussing on particular nutrients (e.g. saturated fats) rather than foods (e.g. butter), can infer a health benefit from their products without explicitly making one. While nutrition science and public health nutritionists have shifted their focus to the foods we eat and the food environments and social pressures that influence diets, food corporations cling to this promotion of particular nutrients.
Clever marketing is conflated with advice for healthy eating.
Healthy star ratings on our food are intended to help us make food choices that support our health. They don’t because they are built with poor logic and without a complete understanding of the evidence.
The temptation is to blame commerce for the misleading advice in the healthy star rating system and disappear down a sinkhole of blame and retribution. We suggest a more positive approach.
We recommend following the NOVA classification of processed food that makes much more sense.
Useful evidence
Astrup, A., Magkos, F., Bier, D. M., Brenna, J. T., de Oliveira Otto, M. C., Hill, J. O., King, J. C., Mente, A., Ordovas, J. M., Volek, J. S., Yusuf, S., & Krauss, R. M. (2020). Saturated Fats and Health: A Reassessment and Proposal for Food-Based Recommendations: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 76(7), 844–857.
Dickie, S., Woods, J. L., Baker, P., Elizabeth, L., & Lawrence, M. A. (2020). Evaluating Nutrient-Based Indices against Food- and Diet-Based Indices to Assess the Health Potential of Foods: How Does the Australian Health Star Rating System Perform after Five Years? Nutrients, 12(5), 1463.
DiNicolantonio, J. J., Lucan, S. C., & O’Keefe, J. H. (2016). The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease. Progress in Cardiovascular Diseases, 58(5), 464–472.
Hamley, S. (2017). The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease: A meta-analysis of randomised controlled trials. Nutrition Journal, 16(1), 30.
Scrinis, G. (2020). Ultra-processed foods and the corporate capture of nutrition—An essay by Gyorgy Scrinis. BMJ, 371, m4601.
Souza, R. J. de, Mente, A., Maroleanu, A., Cozma, A. I., Ha, V., Kishibe, T., Uleryk, E., Budylowski, P., Schünemann, H., Beyene, J., & Anand, S. S. (2015). Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: Systematic review and meta-analysis of observational studies. BMJ, 351, h3978.
Modified from photo by Nathália Rosa on Unsplash
Mark
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