Front-of-pack labelling policies and the need for guidance
Authors: Francisco Goiana-da-Silva, David Cruz-e-Silva, Marisa Miraldo, Conceição Calhau, Alexandra Bento, Diogo Cruz, Fernando Almeida, Ara Darzi, Fernando Araújo
Journal: The Lancet Public Health (2019)

Food labels are a challenge for most consumers, and the development of easily understandable labelling is essential when it comes to empowering consumers in making healthier food choices.1WHOPolicy brief: producing and promoting more food products consistent with a healthy diet.http://www.who.int/nmh/ncd-coordination-mechanism/Policybrief32.pdfDate: 2014Date accessed: December 5, 2018Google Scholar Countries across Europe (such as France and the UK) have adopted approaches to convey additional nutritional information in an easy-to-understand way. Evidence suggests2Cecchini M Warin L Impact of food labelling systems on food choices and eating behaviours: a sytematic review and meta-analysis of randomized studies.Obes Rev. 2016; 17: 201-210Crossref PubMed Scopus (255) Google Scholar, 3Emrich TE Qi Y Lou WY Abbe MR Traffic-light labels could reduce population intakes of calories, total fat, saturated fat, and sodium.PLoS One. 2017; Crossref PubMed Scopus (42) Google Scholar that the uniform colour-coded interpretative labelling, which has been implemented in the UK and France, can improve people's ability to understand nutritional information and make healthier food choices. Additionally, signposting foods that might be considered less healthy enable more nutritionally-balanced food baskets. The French Ministry of Health (MOH) developed the Nutri-Score model and defined it as the national reference model for food labelling. To date, more than 90 food manufacturers and retailers have committed to use the Nutri-Score labels on their products. The Belgian and Spanish MOH have also announced their endorsement of this model. However, in other countries little progress to standardise food labelling has been made. This inertia is because policy and regulatory levers lie outside the health sector, with scarce collaboration between different areas of government, and a strong opposition to some labelling schemes from the food manufacturing and retail sectors. In these countries, the absence of national and uniform food labelling schemes and the presence of several non-coherent interpretative food labelling models hinders the efforts towards improved understanding and use of food labels. For example, Portugal has a diversity of interpretative food labelling models on the market. It is therefore urgent to clarify the scientific evidence behind each model and to clearly identify the best approach towards an evidence-based national labelling strategy. Countries, including Portugal, have asked for stewardship and technical support from WHO Regional Office for Europe regarding the development of an evidence base framework for front-of-pack labelling.4WHOEuropean food and nutrition action plan 2015–2020. 2014.http://www.euro.who.int/__data/assets/pdf_file/0008/253727/64wd14e_FoodNutAP_140426.pdfDate accessed: December 5, 2018Google Scholar The recent WHO report5Kelly B Jewell J What is the evidence on the policy specifications, development processes and effectiveness of existing front-of-pack food labelling policies in the WHO European Region?.http://www.euro.who.int/__data/assets/pdf_file/0007/384460/Web-WHO-HEN-Report-61-on-FOPL.pdf?ua=1Date: 2018Date accessed: December 5, 2018Google Scholar on labelling schemes is very timely and represents an opportunity for governments to act. With an improved evidence base on the effectiveness of food labelling models, it should become easier for countries to define their national policies and regulations, including a single coherent nutritional information model. Until now, most governments argued that the scarcity of robust evidence would deeply hamper objective policies regarding food labelling systems, and several countries postponed decision making and put the onus of responsibility on an absence of guidance from the European Commission. The first EU joint meeting on front-of-pack nutritional labelling only took place mid-2018. Economic and political interests are delaying action. The absence of leadership allows retailers and manufacturers to use and develop their own front-of-pack labelling systems, probably without health outcomes considerations. The WHO report5Kelly B Jewell J What is the evidence on the policy specifications, development processes and effectiveness of existing front-of-pack food labelling policies in the WHO European Region?.http://www.euro.who.int/__data/assets/pdf_file/0007/384460/Web-WHO-HEN-Report-61-on-FOPL.pdf?ua=1Date: 2018Date accessed: December 5, 2018Google Scholar puts an end to the pre-existing evidence gap and provides governments and the European Commission the knowledge to produce a single front-of-pack labelling system that best promotes public health with no further unnecessary delays. FAr was Portugal's Secretary of State for Health (2015-18). We declare no competing interests.