Reformulation of food products to reduce sugar consumption

Reformulation to reduce sugar

Product reformulation includes efforts to improve the healthiness of foods and beverages at the time of production. Reformulation can reduce the amount of sugar, salt, saturated and trans fats consumed on a population level.¹²

Reformulation to reduce sugar consumption focuses on reducing the amount of free sugars in foods and beverages. Free sugars (referred to as ‘sugars’ on this page) are defined as all monosaccharides and disaccharides added to foods, plus the sugars that are naturally present in honey, syrups and fruit juices used to sweeten foods.¹³ Reformulation to reduce sugar content in foods can be achieved by food manufacturers through reducing sugar without replacement, exploring alternative flavours, using different sugar crystal sizes, and/or partially or fully substituting sugar with other ingredients (such as non-sugar sweeteners).⁴

Reformulation is one of a number of strategies that could contribute to reducing sugar consumption at a population level.⁵⁶ When applied to products that are widely available, the benefits can reach everyone, without relying on substantial behaviour change from individuals.¹ Most studies exploring the impact of food reformulation on food choices, nutrient intakes and health outcomes have focused on sodium and trans fats, with less evidence specific to sugar.⁷⁸ Randomised controlled trials have indicated that the reformulation of food and drink products can reduce sugar intake, energy intake and body weight of individuals.⁹¹⁰

However, these findings derive from studies in controlled environments and the effect of reformulation implemented as a population‐wide intervention may be different.

Considerations for reformulation

Food product reformulation can present challenges for food manufacturers, and may change the cost of production and/or retail prices. Whilst replacement of sugars with non-sugar sweeteners in beverages is often relatively simple, replacing sugars in other foods can be more complicated. For example, it can be difficult to replace sugars without altering the texture of the food or increasing the energy content (e.g., by adding fats).⁵

Reformulation efforts typically focus on packaged, highly-processed products. When considering the potential benefits of reformulation with respect to individual nutrients or ingredients, it is important to also consider the impact on other aspects of product healthiness (e.g., reductions in sugar content being accompanied by increases in sodium or fat content) as well as the impact of diet quality overall.

Reformulation to reduce sugar content is often associated with use of non-sugar sweeteners, defined as low or no calorie alternatives to sugars. Non-sugar sweeteners can be naturally occurring (such as stevia) or synthetic (such as aspartame and saccharine). Low calorie sugars and sugar alcohols (also known as polyols) are sugar or sugar derivatives containing calories, and hence not considered non-sugar sweeteners.¹¹ While reductions in sugar may appear to be beneficial, the increasing use of non-sugar sweeteners in the food supply has raised concerns regarding their possible impact on health. In response to these concerns, in 2023 the World Health Organization released guidelines for the use of non-sugar sweeteners.¹¹ The WHO guidelines recommend against using non-sugar sweeteners to control body weight or reduce the risk of non-communicable disease. The recommendations, which do not apply to those with pre-existing diabetes, are based on a systematic review, which found a lack of evidence that non-sugar sweeteners benefit long-term weight control in adults or children, although weight loss has been seen in some short-term studies.¹¹ The systematic review also found some potential negative effects of long term use in adults, including an increased risk of type 2 diabetes and cardiovascular disease, although the level of evidence supporting these effects were low or very low.¹² There was also limited evidence suggesting a potential increased risk of preterm birth with non-sugar sweetener use in pregnancy.¹² The overall quality of evidence available for the systematic review was considered ‘low certainty’, and therefore the WHO’s recommendation is conditional.

Analysis of the Asia Pacific food supply between 2007 and 2019 found that the use of both sugars and non-sugar sweeteners (the study also included low calorie sugars and sugar alcohols) have increased in packaged foods and drinks, and that the sweetness of the global packaged food supply has increased over time.¹³ These considerations indicate that sugar reduction efforts should be accompanied with ongoing monitoring of the food supply, including sugar content, use of non-sugar sweeteners, levels of product sweetness and overall diet quality.

Lessons learned from government-led reformulation and sugar reduction program

England’s voluntary sugar reduction program (2015-2019)

England’s voluntary sugar reduction program (2015-2019) challenged all sectors of the food industry to reduce sugar by 20% by 2020 for the categories of food that contributed most to the sugar intake in England. Guidelines were published in 2017, outlining a maximum calorie per single serve portion, set for most sugar-rich food categories.¹⁴ Retailers, manufacturers and businesses that provide the food and meals were expected to take action to reduce sugar intake through: 1) reformulation to reduce sugar content per weight or volume; 2) reducing portion sizes; and 3) shifting consumers’ purchasing patterns towards consuming less sugar.

Public Health England assessed the program by separately monitoring food to be eaten in the home (retailers and manufacturers branded products) and out of home (including takeaway and delivered). Results showed that the voluntary industry program did not achieve widespread and consistent reductions in sugar, and did not substantially change the sugar intake of people in England.¹⁵¹⁶¹⁷ For food eaten in the home, there was an overall decrease of 3.5% in sales-weighted average sugar content, compared to the target 20%. Some product categories, such as breakfast cereals, saw a higher reduction (average 13.3%), whilst others, such as puddings, saw an increase in sugar content. The overall energy content for these food products hardly changed since 2015. Despite the small overall reduction in sugars, there was an increase in the tonnes of sugar-rich products sold and a change towards consumption of high sugar products that had no reduction in sugar content. For takeaway and delivered foods, the evaluation found little change in the sugar content per weight, but some reduction in average energy per portion. This may be reflective of an industry shift towards smaller portion sizes, without reformulation of products.

The poor outcomes from this voluntary sugar reduction program can be contrasted with the success seen by the UK’s salt intake reduction program over a similar time period. The salt reduction program resulted in a 15% reduction in the average salt intake of the population over 7 years, and considerable reductions in the sodium content of many processed foods, in particular ready-made meals, soups and breads.¹⁸ As part of the initiative, voluntary sodium reduction targets for processed food categories were published. Although the targets were voluntary, potential factors leading to the success of the sodium reduction included clear time frames for industry to achieve targets with the potential threat of regulation, strong ministerial support, and sustained media pressure (including ‘naming and shaming’ of companies who did not take action).¹⁸

The impact of the UK’s voluntary sugar reduction program also contrasts starkly with the impact of the UK’s Soft Drink Industry Levy (SIDL).¹⁹ Introduced in 2018 to encourage soft drink manufacturers to lower the sugar content of soft drinks, the mandatory levy led to a significant reduction in the household purchasing of sugar in drinks (34% from 2015 to 2020).¹⁷ Evaluations indicate that the SDIL prompted extensive reformulation and sugar reduction in beverages, resulting in a 46% decrease in sales-weighted average sugar content of drinks from 2015 to 2020.¹⁷ This is a significantly greater decrease in sugar content than those seen for the food categories included in the voluntary sugar reduction program (whereby only a 3.5% reduction in sales-weighted average sugar levels was achieved, for foods eaten at home), although it is noted that sugar reduction in beverages may be more straightforward than in other food categories.¹⁵

The findings of the Public Health England sugar reduction program are consistent with other voluntary industry programs that have seen minimal benefits.¹⁶²⁰ Together, these findings clearly signal the need for government regulation to improve product reformulation.

Reformulation in Australia: The Healthy Food Partnership

The Healthy Food Partnership (HFP) is a collaboration between the Australian Government, public health groups and food industry bodies. It includes a voluntary Reformulation Program, which runs from 2020 to 2026, and sets voluntary reformulation targets for 36 subcategories of foods and drinks.²¹ The targets cover popular processed foods such as bread, cheese, pizza, savoury snacks, sausages and bacon. Companies are encouraged to participate and asked to submit regular progress reports.

To date, industry uptake of the program has been low, with few food and beverage manufacturers in Australia signed up to the Reformulation Program. As a result, products in-scope of reformulation targets from participating companies make up only a small proportion of products in the overall packaged food supply. For example, the Government evaluation of the HFP Reformulation Program conducted in May 2024 (2 years into the program) found that participating products (for which sugar data was provided by manufacturers, total 199 products) accounted for only 11% of sugar from products within categories in-scope of sugar targets (such as flavoured milk, ready-to-eat cereals, fruit drinks, muesli bars, and soft and energy drinks).²² The evaluation indicated that of the 199 participating products in scope of the sugar targets, one third showed a lower sugar content in 2023 compared to 2021. Importantly, this reduction in sugar content from the participating products was equivalent to less than 0.1 gram per person per day. The proportion of participating products that had a sugar content below the relevant maximum target increased from 70% in June 2021 to 78% in June 2023.²²

Several independent evaluations of the HFP Reformulation Program targets estimate that, even if widely adopted by the food industry, the initiative is only likely to achieve minor reductions in population sugar consumption.²³²⁴ This is largely due to targets that are considered not sufficiently stringent. In addition, the HFP sugar targets do not cover popular high sugar food categories, such as ice cream, lollies, chocolate and confectionery. The current categories only cover an estimated 22.3% of packaged foods purchased by Australian households in 2018, and categories with sugar targets cover less than 10% of products purchased by Australian households.²⁵

Accordingly, public health researchers have called for stricter targets, and for targets to be expanded to cover more packaged food categories.²³²⁴²⁵ Critics of the HFP reformulation program have also noted that there are not enough incentives in place for companies to voluntarily participate in the program, and recommend routine public reporting of progress by all food companies, including benchmarking of companies against targets.²⁶ Other research suggests mandatory implementation of targets should be considered, if voluntary industry efforts continue to be insufficient.²⁷²⁸

Content for this page was reviewed and updated by Jasmine Chan and Gary Sacks at the Global Centre for Preventive Health and Nutrition at Deakin University. For more information about the approach to content on the site please see About | Obesity Evidence Hub.