Setting reformulation targets per serving: a global system for sodium and sugar reduction and its applicability in the USA
Authors: Vlassopoulos Antonis , Gressier Mathilde , Masset Gabriel 
Published: November 2023

IntroductionProduct reformulation has been a key strategy to address high sodium intakes in many countries, the US FDA has proposed category specific sodium reduction targets per 100g. At the same time the update of Recommended Amounts Customarily Consumed (RACCs) highlights that Americans are now eating larger portions than they used to which in turn impacts their sodium and sugar intakes. Literature to date is inconclusive on whether nutrient reduction targets for reformulation are best set per 100g or per serving (RACCs).ObjectiveTo assess the capacity of reformulation targets per serving to successfully drive sugar and sodium reductions in the US food supply, and the impact of the RACCs update on such capacity.MethodsFoods commonly consumed in the USA were identified using the FNDDS 2011–12 food composition dataset (n=7,618). The Nestlé Nutritional Profiling System (NNPS) was used to classify products as in‐ or out‐of‐scope for reformulation and then split them in 35 products categories each with category specific nutrient targets for energy, total fat, saturated fat, sodium, added sugar, protein, calcium and fiber. The NNPS has a dichotomous Pass/Fail outcome based on whether all nutrient targets are met or not. In a modelling scenario all NNPS Fail products were ‘reformulated’ to meet the NNPS standards. For categories with an updated RACCs the system performance was measured by comparing pass rates with the current versus the updated RACC.ResultsA total of 3,111 products (40.8% of the total) were identified as in scope for reformulation. Sodium carriers such as complete meals, side dishes, meat and fish entrees, sandwiches, hors d'oeuvres, mini mixed dishes and other small meals made up 37.8% of all products in scope, with an additional 15.6% coming from sugar carriers such as beverages, cakes, cookies, desserts and ice creams. Overall, 38% of all products met all nutrient targets (NNPS Pass) with most products failing multiple nutrients rather than just one (55%). 28% and 14% of products failed the sodium and added sugars targets, respectively. If all products were reformulated in order to achieve the NNPS targets there would be on average an 8% reduction in sodium content and a 14% reduction in added sugars.The RACC update impacted 500 products in the database. Overall as shown in Tables 1 & 2, increases in the RACCs were linked with increases in the reformulation intensity both in absolute and relative sodium and sugar reductions and vice versa.DiscussionThe NNPS has good capacity to drive sodium and added sugars reductions by setting targets that are feasible and likely to be within the margin of organoleptic acceptance (~10% reductions). Setting reformulation targets per serving is a relevant public health approach as it allows to address simultaneously issues in the nutrient compositions of foods as well as their consumption pattern. A serving size approach would put priority in the reformulation of products consumed in large servings.Support or Funding InformationThis study was funded by Nestec SA
Proposed RACC updates in the impacted categories and average changes in sodium content and reformulation intensity of the relevant categories

Sodium (mg/serving)
Meeting Sodium targets (%)
Potential Sodium reduction (%)
Potential Sodium reduction (mg/serving)

NEW RACCs categories
OLD RACC
NEW RACC
OLD RACC
NEW RACC
OLD RACC
NEW RACC
OLD RACC
NEW RACC
OLD RACC
NEW RACC

Bagels, toaster pastries, muffins (excluding English muffins) (n=48)
55g
110g
231.6
463.2
71%
60%
20%
56%
49.5
246.6

Carbonated and noncarbonated beverages, wine coolers, water, coffee or tea, flavored and sweetened (n=172)
240 mL
360 mL
41.4
62.1
91%
81%
38%
38%
81.8
102.6

Yogurt (n=21)
225
170
176.9
117.9
86%
100%
30%
0%
100.8
0

Ice cream, ice milk, frozen yoghurt, sherbet: all types, bulk and novelties (n=104)
1/2 cup
160 mL
73.8
98.5
92%
85%
29%
29%
67.8
74.8

Frozen flavored and sweetened ice and pops, frozen fruit juices : all types, bulk and novelties (n=12)
85 mL
17.2
26.9
100%
100%
0%
0%
0
0

Appetizers, hors d'oeuvres, mini mixed dishes, e.g., mini bagel pizzas, breaded mozzarella sticks, egg rolls, dumplings, pot stickers, wontons, mini quesadillas, mini quiches, mini sandwiches, mini pizza rolls, potato skins (n=100)
140g or 55g if sauce added, 1 cup if measurable with cup
85 (or 35 for products with gravy of sauce)
701.7
426.1
53%
86%
27%
16%
310.5
143.5

all other candies [chocolates] (n=39)
40g
30g
56.7
42.6
95%
100%
11%
0%
15.6
0

Proposed RACC updates in the impacted categories and average changes in sugar content and reformulation intensity of the relevant categories

Added sugars (g/serving)
Meeting Sugar targets (%)
Potential Sugar reduction (%)
Potential Sugar reduction (g/serving)

NEW RACCs categories
OLD RACC
NEW RACC
OLD RACC
NEW RACC
OLD RACC
NEW RACC
OLD RACC
NEW RACC
OLD RACC
NEW RACC

Bagels, toaster pastries, muffins (excluding English muffins) (n=48)
55g
110g
5.5
9.3
88%
73%
17%
47%
2.7
12.4

Carbonated and noncarbonated beverages, wine coolers, water, coffee or tea, flavored and sweetened (n=172)
240 mL
360 mL
10.3
15.4
67%
57%
43%
53%
14.3
22.3

Yogurt (n=21)
225
170
13.7
9.2
48%
62%
45%
26%
11.4
4.9

Ice cream, ice milk, frozen yoghurt, sherbet: all types, bulk and novelties (n=104)
1/2 cup
160 mL
73.8
98.5
47%
34%
22%
37%
3.9
8.1

Frozen flavored and sweetened ice and pops, frozen fruit juices : all types, bulk and novelties (n=12)
85 mL
12.9
20.2
50%
17%
24%
41%
5.9
11.6

Appetizers, hors d'oeuvres, mini mixed dishes, e.g., mini bagel pizzas, breaded mozzarella sticks, egg rolls, dumplings, pot stickers, wontons, mini quesadillas, mini quiches, mini sandwiches, mini pizza rolls, potato skins (n=100)
140g or 55g if sauce added, 1 cup if measurable with cup
85 (or 35 for products with gravy of sauce)
1.9
1.2
94%
98%
34%
59%
8.5
10.9

all other candies [chocolates] (n=39)
40g
30g
18.3
13.7
3%
33%
30%
15%
5.9
2.4