ncorporating Health Star Rating into

NSW nutrition standards

Project’s background and aims
Poor diet is one of the top contributors to obesity and chronic diseases such as diabetes
and heart disease in Australia and globally. There is an urgent need to improve the food
environment to enable consumers to make healthier food choices.

Over the past decade, the state government of New South Wales (NSW) has developed a
series of nutrition standards aimed at increasing healthy product procured by food service
outlets in schools, workplaces, and health facilities (e.g. canteens and cafes). The existing
nutrition standards utilised traffic light-based classification, i.e. red products should be
avoided, amber are foods to enjoy occasionally and green are the ones we should eat more
of. Prior research suggest that food catering staff often have trouble adhering to the traffic-
light based criteria. Recently, the Australian federal government has endorsed the Health
Star Rating scheme – a front of pack labelling system which ranks the healthiness of
packaged foods, which is to be voluntarily introduced by the food industry over the next few
years. Given these recent developments, the George Institute for Global Health was asked
to review how the HSR align with the 2013 Australian Dietary Guidelines, and the existing
traffic-light based nutrition standards, by the NSW Ministry of Health in a bid to consider
how HSR may be incorporated into new nutrition standards in NSW.

Results
Approximately 11,500 products were analysed across 30 food categories (53% core foods
such as breads, milk, and fruits, and 47% discretionary foods such as cakes, snack bars,
and energy drinks). Based on this analysis, the HSR aligned well with the ADG – the mean
HSR were ~3.7 and ~1.9 for core vs. discretionary food, respectively. Two existing traffic
light-based nutrition standards were assessed – the Fresh Taste @ School Healthy School
canteen Strategy, and the Live Life Well @ Health (applies to NSW Health facilities). Our
analysis indicated that products classified as green by the existing traffic light based
standards on average received a HSR ≥ 3.5, whereas amber and red products had
significantly lower average HSR. The result of this investigation suggested that healthy core
foods with a HSR of more than 3.5 stars can be confidently promoted in public settings as
healthier