How did healthy eating get this complicated?

SECOND OPINION: A new formula for assessing food just doesn’t add up

SECOND OPINION:A new formula for assessing food just doesn't add up

HOW DID food and healthy eating get so complicated? The Draft BAI General and Children’s Commercial Communications Codes 2012 created a furore among farmers and the food and drinks industry. These groups expressed shock and horror because cheese will not be allowed to be advertised on children’s TV programmes. The new codes propose that advertising of all food and drinks classified as high in fat, sugar and salt (HFSS) will be banned during programmes that have audiences of 50 per cent or more children, and will also be restricted to 25 per cent of overall daily advertisement time.

The Nutrient Profiling Model (NPM) developed in the UK will be used to assess whether a food is categorised as HFSS and therefore subject to the new codes. This is where things get very complicated. The formula used to decide whether a food falls into the HFSS category is eye-watering. It took me several hours to figure out how to calculate an overall score for a product, followed by a trip to my local supermarket to put theory into practice.

Here’s how it works. First, you have to calculate total “A” points for a particular food. These points are allocated according to how much energy, saturated fat, sugar and salt in 100g of the product.

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Then you work out total “C” points, based on the amount of fruit, veg, nuts, fibre and protein, in 100g of the food or drink. An overall score is then computed by subtracting C from A.

Food is classified as “less healthy” if it scores four points or more and is subject to the code’s restrictions on advertising. Drinks are categorised as “less healthy” if they score one point or more. For example, cheddar cheese scores 10fat+0sugar+7sodium+4energy minus 0fruit+0fibre+0protein = 21 and is therefore “less healthy”, whereas fish fingers score 0fat+0sugar+2sodium+2energy minus 0fruit+5protein+0fibre = -1 and are therefore “healthy”. Unfortunately, cheese gets no credit for protein content because the A score adds up to more than 11 points. Cheese also gets no score for calcium content, a vital part of a child’s diet.

The NPM has supposedly been validated by a number of research studies but this is not strictly true. The model has been tested in many countries and produced reliable results for classifying food and drinks according to their different component parts. This is not the same as being a valid measure of what is healthy and what is not. Reliability is not the same as validity; a measurement tool can be perfectly reliable and totally invalid. Household statistics gathered by the Central Statistics Office on a regular basis, including numbers of people in each household, sex, age of children, income and educational attainment, are very reliable. While these figures inform us about household composition they tell us very little about the family as a whole: they are just bits of the story.

In the same way, scores allocated to different foods and drinks by the NPM reflect only the components deemed to be healthy or unhealthy by nutritionists. No points are given if food is fresh and locally produced. Portion sizes are not covered by the codes. Parents may not have noticed but yogurt is now often sold in bigger 150ml or 175ml pots instead of the usual 125ml. A single portion of cheese is the size of a small matchbox and will not contribute to obesity. Packets of dried fruits and nuts from thousands of miles away score 1 using the NPM and can therefore be advertised to Irish children, whereas cheese from cows down the road cannot. Even low-fat dairy products will be subject to restrictions on advertising.

We definitely need controls on food advertising, and the new BAI codes will contribute to healthier eating, but they do not go far enough. Advertising of HFSS foods should be banned between 6am and 9pm because children watch TV in the mornings and after 6pm. Portion sizes and calcium need to be included as part of the scoring process. Points should be given for overall healthiness.

I’m no apologist for farmers but I’m with them on this one: cheese and other products from Irish farms are not responsible for Ireland’s fat children. The real problem is the HFSS food and drink eaten before, during, after, and between meals. This is directly related to advertising, which has convinced us that we cannot set foot out the door without carrying a snack – just in case.


Dr JACKY JONESis a former regional manager of health promotion with the HSE