Background Criteria and revision process

Background

In response to the call of the WHO to contribute to the prevention of non-communicable diseases and obesity in 2004, the Choices criteria were developed as a tool to define healthier food (described by Roodenburg et al. 2001)[1]. These criteria describe the healthiest products per product group by setting maximum values for saturated fat, sugar, sodium, trans fatty acids and energy and minimum values for dietary fiber and are based on the WHO dietary recommendations.

The criteria are evaluated and revised every four years by the International Scientific Committee consisting of leading independent scientists to keep pace with developments in nutrition science, consumer habits and product development. The aim for every periodical revision is to investigate whether the criteria can be tightened relative to the previous criteria version. This stepwise tightening of the criteria pushes food companies to keep improving their products and facilitates consumers to get gradually accustomed to products with less sugar, fat and salt and more fiber. The 2019 version of the Choices International criteria is the result of the third major periodical revision.

The international criteria can be seen as a global benchmark for healthier food, to be used by governments, international health organizations and food companies. They serve as a tool for implementation of health policies, as an agenda for product reformulation and not in the least for front-of-pack labelling in many countries around the world. The criteria can also be used as a starting point for nutrition education to consumers, responsible food marketing or financial incentives.

Major aims for the 2018 revision

The 2018 revision was aimed to create a better balance between the different major food cultures and to review and adapt the criteria in a way that they would become better applicable by different countries. The second aim was to work as transparent as possible. This will be substantiated in a publication about the criteria setting process, that will be submitted to a peer-reviewed scientific journal, expected at the end of 2019.

The Committee

The 2018 criteria revision has been executed by the International Scientific Committee:

• Lauren Lissner, University of Göteborg, Sweden (president)
• Ass Prof. Rokiah Don, International Medical University Malaysia
• Anura Kurpad, St. Johns Medical College, India
• Ngozi Nnam, University of Nigeria, Nsukka
• Yang Yuexin, Chinese Nutrition Society, Beijing
• Ricardo Uauy, University of Chile

The revision process

The International Scientific Committee took the following steps in the determination of the new criteria.

Preparation

1. Stakeholders from science and industry were asked to complete a questionnaire and share their views on the criteria. The outcomes served as input for discussions
2. Dietary recommendations from leading health organizations were analyzed for changes
3. A non-aggregated food product database was obtained from The George Institute (containing 68.000 products from 8 major countries across the world) and additional food data was obtained from the USDA database and NeVo table (Dutch Nutrition database)

Core work: product groups and cut-off values

1. Revision and re-definition of product groups
2. Calculation of compliance of the products in the database to current cut-offs (%)
3. When feasible proposals were made for new product group specific cut-offs (based on 20% compliance for basic product groups and 10% for non-basic product groups)
4. Product groups and cut-offs of other positive logo programs were used as benchmarks
5. Industry members were consulted on the technical feasibility of the proposed new cut-offs
6. The scientific committee made final decisions on product classifications and new cut-offs

Finalization

1. Final version of the revised criteria was presented to the Board of the Choices International Foundation
2. Final version of the criteria was published

[1]AJC Roodenburg et al. (2011). Development of international criteria for a front of package food labelling system: the International Choices Programme. European Journal of Clinical Nutrition, 65: 1190–1200