Prevalence of Front-of-Pack Warning Signs among Commercial Complementary Foods in Seven High and Upper Middle-Income Countries

Abstract

Front-of-pack nutrition labelling (FOPNL) can provide a mechanism for communicating the nutritional quality of commercially produced complementary foods (CPCF) to caregivers. To better understand the role FOPNL may provide for CPCF, this study aimed to evaluate CPCFs against national and global FOPNL systems to determine the proportion that would warrant warning or traffic light signs for high levels of concerning nutrients. A cross-sectional assessment was conducted to evaluate the levels of selected nutrients in CPCF available in Australia (n = 266), Brazil (n = 41), Chile (n = 73), Mexico (n = 164), the United States (n = 562), the United Arab Emirates (n = 135), and the United Kingdom (n = 643). The analysis was based on national FOPNL systems and the WHO Regional Office for Europe CPCF nutrient profiling model’s ‘high sugar’ FOPNL warning. A substantial proportion of CPCFs contained excessive levels of total sugar, total fat or saturated fat that would warrant a red/amber traffic light or warning sign on product labels. Additionally, the high prevalence of added sugars and sweeteners identified in CPCFs was concerning. Based on these findings, the use of FOPNL among CPCFs could be beneficial to communicate the nutritional quality of these products to caregivers and trigger the reformulation of CPCFs with inappropriate nutrient profiles.