Health Star Rating system changes suggested

Making simple changes to the Health Star Rating (HSR) system to factor in ultra-processing would lower the high scores currently assigned to many unhealthy foods, according to research published in Nutrition and Dietetics.

It would also bring Australia’s main nutritional labelling system more in line with the globally recognised NOVA system, researchers from The George Institute for Global Health found.

The research team modified the algorithm behind the HSR system by deducting or capping points awarded to foods that would be classified as ultra-processed by the NOVA system. They reassessed 25,486 products in the FoodSwitch database, resulting in lower ratings for many less healthy products, such as protein bars and balls, sugary cereals, refined/‘white’ breads and diet soft drinks.

The adjusted models resulted in greater overall alignment of Health Star Ratings with NOVA, improving alignment for up to 22% more products — 88% vs 66% under the current HSR system.

Lead author and dietitian Dr Eden Barrett, a Research Fellow in Food Policy at The George Institute, said: “The current HSR system gives a reasonable reflection of the sugar, salt and saturated fat content of our foods and drinks but doesn’t tell us anything about how ultra-processed they are.

“In the present system, manufacturers can ‘game’ the Health Stars scoring system by adding synthetic fibres, proteins and artificial sweeteners that can push their HSR higher, creating a ‘health halo’ effect. As evidence on the long-term harmful effects of ultra-processing continues to emerge, it’s important to address this potentially misleading message on food labels.

“We found our modifications to the HSR algorithm penalised the most problematic products by scoring them lower, which is less confusing for consumers,” Barrett said.

However, the modifications also lowered the HSR on some other foods like packaged wholegrain breads, and similar cereal and grain products. While these foods currently meet the ultra-processed definition, research shows that they do not seem to be associated with poorer health. Further development of the algorithm may need to factor in ongoing evidence in this area.

Dr Alexandra Jones, Program Lead in Food Policy at The George Institute and a lecturer in public health law at UNSW Sydney, said: “We’re still pushing for Health Star Ratings to be mandatory, otherwise the food industry will continue to display them only on selected foods.

“We also recognise the scoring system must be periodically reviewed to remain aligned with developing nutrition science. The research demonstrates practical ways to factor in ultra-processing as an important element of any future update.”

Consideration of ultra-processing was proposed in the last review of the now 10-year-old Health Star Rating algorithm in 2019 but was limited by a lack of practical proposals for how to achieve this.

Read the full findings here.

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