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Packaged foods: where healthy is relative


British packaged food and drinks topped the healthy list in a recent survey using an Australian rating system. The US came second and Australia itself third.

What’s worrying, however, is that China and India, where many people are just discovering the joys, or otherwise, of packaged goods, were right at the bottom.

And “healthy” is a relative term. The international survey led by Australia’s George Institute for Global Health highlighted the high levels of sugar, saturated fat, salt and calories per kilojoule in many popular food items.

Lead author Elizabeth Dunford says some countries are doing better than others at addressing the problem. “Unfortunately,” she adds, “it’s the poorer nations that are least able to address the adverse health consequences that have the unhealthiest foods.”

Dunford and colleagues analysed more than 400,000 food and drink products from 12 countries and territories using Australia’s Health Star Rating, which measures levels of energy, salt, sugar, saturated fat, protein, calcium and fibre, then assigns a rating from ½ (worst) to 5.

The UK had the highest average rating of 2.83, followed by the US at 2.82 and Australia at 2.81. India was lowest rating at 2.27 followed by China at 2.43, with Chile coming third from bottom at 2.44.

“India and China are experiencing a ‘nutrition transition’, with national nutrition surveys from the past few decades showing consumption patterns switching from traditional diets based upon fruits, vegetables, unprocessed cereals and legumes to diets that are increasingly dominated by highly processed packaged food and beverage products,” the researchers write in a paper in the journal Obesity Reviews.

“China is now one of the largest consumers of pre‐packaged foods worldwide with sales of pre‐packaged foods increasing by 55% between 2003 and 2009. Increases in the consumption of packaged foods and beverages are driving a double burden of diet‐related disease (i.e. both undernutrition and overnutrition) in many low‐ and middle‐income countries.”

The 12 countries involved in the new study – the others were Canada, Hong Kong, Mexico, New Zealand, Slovenia and South Africa – are the participants in The International Network for Food and Obesity/non‐communicable diseases Research, Monitoring and Action Support (INFORMAS).

China’s products were found to have the most harmful levels of saturated fat, and also scored lowest for average sugar levels at 8.5 grams per 100 grams (more than twice the UK’s average). India was second with 7.3 grams.

India’s products were the most energy dense (kilojoule content 1515 kJ/100 g) and South Africa’s the least (1044kJ/100 g.)

Some other findings of note:

China’s drinks were some of the healthiest in the survey with an average rating of 2.9 but packaged foods were low at just 2.39.

South Africa on the other hand scored low with its drinks at an average 1.92, while its foods came in at 2.87.

Canada topped the list for unhealthy salt levels in foods and drinks with an average of 291mg/100g of sodium, with the US coming second at 279mg/100g.

The UK scored best for sugar at just 3.8 grams per 100 g with Canada second (4.6).

The researchers do acknowledge that many food and drink manufacturers have signed up to the International Food and Beverage Alliance and made pledges to reduce levels of salt, sugar and harmful fat.

And they have some advice.

“The finding that packaged foods and beverages are less healthy in middle‐income countries such as China and India suggests that nutrient profiling is an important tool to enable policymakers and industry actors to reformulate products available in the marketplace to reduce the risk of obesity and NCDs [non-communicable diseases] among populations,” they write.



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