Unprompted, 20% of survey respondents could identify the purpose of the Health Star Rating System
31% of eligible products in Australia displayed the Health Star Rating as of June 2018
There is evidence that manufacturers are reformulating foods in response to the system
History and development of the Health Star Rating System
The Australian Government’s 2011 Labelling Logic Review of Food Labelling Law and Policy identified the need for a front-of-pack food nutrition labelling scheme, within the framework of a comprehensive nutrition policy.1 The Australian and New Zealand Governments agreed to support this recommendation, declaring that a front-of-pack labelling system should provide simple, consistent nutrition information to enable consumers to make healthier food choices.2 The objective was for the system to be readily understandable across socio-economic and culturally and linguistically diverse groups, and for consumers with low literacy and numeracy.
The Australia and New Zealand Ministerial Forum on Food Regulation (the forum) developed the Health Star Rating System for use on packaged foods in conjunction with state and territory governments, industry, and public health and consumer groups. The Health Star Rating System was implemented by the food industry on a voluntary basis from June 2014, with a five-year review delivered in 2019.3 At the time of endorsing the new system in 2013, the forum said it could become mandatory if voluntary uptake was not “widespread and consistent”.4 By 2019, food ministers accepted consultants’ recommendation that the Health Star Rating System remain voluntary and committed to “high interim and final uptake targets”, with details to be finalised as part of an implementation plan.5
How does the Health Star Rating System work?
The Health Star Rating System is a front-of-pack food labelling system which rates the healthiness of packaged food and assigns it a rating from half a star to 5 stars, with a 5-star rated product the healthiest choice.6 The number of stars is determined using a calculator designed to assess positive and risk nutrients in food. The algorithm that drives the calculator was developed in consultation with Food Standards Australia New Zealand and other technical and nutrition experts, and varies by product category.
Health Star Ratings can appear on packaged food in two ways. The first shows just the star rating of the product; the second shows the star rating as well as the amount of various nutrients contained per 100g or 100mL or per pack or serve as specified. Content may be provided for the risk nutrients of energy (kilojoules), saturated fat, sodium (salt) and sugars, and the label may also include one positive nutrient such as protein, dietary fibre, certain vitamins or minerals.
The official Health Star Rating website states that the system is designed to help consumers to “quickly compare the general nutritional profile of foods within the same category of packaged and processed goods”.6 It allows consumers to compare similar foods that are typically displayed together (such as whole grain bread and white bread) but is not designed to compare foods across categories (such as yoghurt and frozen lasagna). Consumers are advised to read Health Star Ratings “together with other important nutrition information on this pack, like serving size and nutrients per serve”.7 Importantly, the website points out that Health Star Ratings are only available on participating packaged foods and: “fresh fruit and vegetables and lean meat are generally healthier choices than processed packaged food products”.6
Monitoring and evaluation of the Health Star Rating System
a. Awareness, understanding and use
A national survey of Australian households has tracked consumer awareness, attitudes and interaction with the Health Star Rating System since September 2015.8 As at August 2018:
- Without prompting, just 20% of respondents could identify the Health Star Rating System as a logo that can help customers choose food in supermarkets. This was less than for the Heart Foundation Tick, identified by 21% of respondents.
- When prompted with a list of 15 logos included on food packaging, 84% of respondents recognised the Health Star Rating System.
Respondents who recognised the Health Star Rating System logo when prompted (n=2053) were asked what they understood the logo to mean:
- Half of respondents said it was a rating or guide to the healthiness of a product (51%).
- Just 3% said the rating was designed to compare options within the same food category.
When prompted with a series of statements, 76% of respondents agreed that Health Stars “make it easier for me to compare products that are in the same category in the supermarket”; but 61% agreed that Health Stars “make it easier for me to compare products that are in different categories in the supermarket”.
- 71% of respondents (n=2053) could recall purchasing a product with a Health Star Rating in the past three months.
- Of this group (n=1454), 61% of respondents said the system had influenced their purchasing decision.
- For those influenced by the system (n=891), 46% said it simply confirmed that they should buy their usual product. Other respondents chose a product with more stars that they don’t often buy (36%); chose a product with more stars they had never tried before (14%); or chose not to buy their usual product (4%).
b. Uptake by industry
Uptake of the Health Star Rating System has been the subject of official government monitoring in Australia and New Zealand, as well as independent cross-sectional examination of the food supply. In Australia, only 5448 products displayed the Health Star Rating as of June 2018, representing 31% of eligible products.9 Health Star Ratings are being applied in some product categories more than others – a 2017 study showed that product categories with the highest uptake of Health Star Ratings included convenience foods, cereals and fruit and vegetable products.10
Even within product categories, food manufacturers are selectively applying Health Star Ratings to their products despite a recommendation that they apply the system consistently across a product range and/or category.11 Manufacturers are choosing to display Health Star Ratings on products that score more highly, with the four-star Health Star Rating the most commonly used.12 Public health advocates argue that selective application of Health Star Ratings within categories limits consumers’ ability to use the system effectively.13
Besides influencing consumer choice, another way that food labelling can improve diets is by prompting food manufacturers to reformulate their products to reduce levels of unhealthy nutrients. A New Zealand study found that implementation of the Health Star Rating system in that country was leading food manufacturers to reformulate some products to make them healthier. The study found that most products displaying Health Star Ratings had been reformulated to some extent, with ratings being mostly displayed on products such as cereals, breakfast drinks, convenience foods and sauces and spreads.14A similar analysis for Australia found that the average energy density of food products carrying Health Star Ratings was lower than before the labelling system was introduced.15