“Scarce and inconsistent”: Experts call for clear nutrition reporting in UK’s out-of-home food sector

14 Aug 2024 --- The British charities Action on Salt and Action on Sugar call for increased nutrition transparency in the UK out-of-home sector after finding that most assessment approaches deem the majority of best-selling menu items in the sector as “less healthy.” The organizations lament that reporting on out-of-home product healthiness “remains scarce and inconsistent.”

The charities note that in contrast to packaged foods, reporting on health and nutrition in the out-of-home sector is scarce and inconsistent. Only three out of 20 leading companies publicly disclose complete nutrition information per 100 g and per serving and ingredient lists. This makes it difficult to set standards for product healthiness in the sector and monitor progress. 

Dr. Kawther Hashem, co-author of the study and head of research and impact at Action on Sugar, stresses: “It is absurd that supermarkets are expected to be as transparent as possible about what they put in their products, from nutrition information to ingredients, allergens and portion size, but when eating out, we are left in the dark.”  

“If companies continue to hide their nutrition information, there is little hope for consumers to choose healthier options. The government needs to act now to resolve this unfair situation and level the playing field,” she argues. 

Research increasingly links unhealthy diets to the prevalence of type 2 diabetes, cardiovascular disease, cancer and other chronic diseases, as well as risk factors like increased weight. For example, diets with limited added sugar have been linked to a lower biological age, and a low-fat vegan diet has led to weight loss and reduced inflammation. 

Nutrient profiling

The researchers assessed the healthiness of the ten best-selling menu items for 19 of the 20 largest UK out-of-home companies, using several assessment approaches in isolation or combined: the UK Nutrient Profile Model, the Multiple Traffic Light Label and a combination of UK voluntary targets or guidelines for sugar, salt and calories. 

The UK Nutrient Profile Model provides a score based on a product’s energy, saturated fat,  total sugars, sodium, protein, share of fruit, vegetable and nut and fiber content in 100 g of a food or drink. If a product scores over a threshold, it is deemed “less healthy.” 

Although the out-of-home sector becomes a larger part of daily diets, nutrition data availability and accessibility is limited.Meanwhile, the Multiple Traffic Light Label is a voluntary front-of-pack label with cut-offs per 100 g/ml of a product and per portion for total fat, saturated fat, total sugars and salt as green (low amount), amber (medium amount) or red (high amount). 

Finally, the researchers looked at voluntary targets for sugar, salt and calories and the sugar cut-off rate in the UK soft drinks industry levy. These set targets for either 100 g/mL or a product serving. 

Tailored healthiness standards

Depending on the method used, the proportion of “healthier items” instead of “less healthy” items ranged from 22% to 54%. 

When using the Nutrient Profile Model in isolation, the researchers found a relatively high rate of “healthier items.” Combining this model with the Traffic light system resulted in the lowest rate of healthy products. When the researchers combined assessments, they only considered a product “healthier” if both assessments did so. 

The report notes: “Using absolute cut-offs for calories or nutrients of concern consistently resulted in more stringent assessments and thus smaller proportions of menu items considered ‘healthier.’”

“Businesses are likely to only improve their products up to the standards we hold them against, so choosing the right standards is crucial,” says Dr. Monique Tan, the study’s lead researcher and lecturer at Queen Mary University of London, UK.

“Given the growing influence of out-of-home foods in our daily diets, the new government must now seize the opportunity to develop tailored healthiness standards for the out-of-home sector. They can do so by giving teeth to the Food Data Transparency Partnership, an initiative instigated under the previous government to improve data provision in the UK food supply chain, which is still under development.”

Incentivize businesses

The charities underscore the “urgent need to incentivize out-of-home companies to offer, and/or shift their sales toward, healthier products.” The report includes recommendations based on stakeholder consultations and the charities’ analyses to guide further work to improve healthiness reporting. 

The charities call on their government to develop tailored healthiness standards for the out-of-home sector.The authors call for improved availability and accessibility of nutrition data, recommend developing a standardized measure of healthiness that considers portion size and urge the government to require mandatory reporting programs. 

Using the UK data set, the researchers derived a set of indicators for a robust approach to assess product healthiness. These include using absolute “per serving” cut-offs for calories and nutrients of concern, such as saturated fat, total fat, total sugars, salt and potentially free sugars. In addition, the research team calls for the provision of “beneficial” elements, like fruits, vegetables and nuts — potentially also fiber and protein content. 

“Restaurant chains, cafes and takeaways significantly impact people’s health. But consumers and investors know far too little about how healthy their meals are,” says Thomas Abrams, co-head of health at ShareAction, an investment NGO that funded the research. Earlier this year, the NGO supported a coalition of Nestlé shareholders in filing a resolution challenging the company to improve the healthiness of its portfolio. 

“This new research shines a spotlight on the opaqueness of the sector and suggests how we can start to measure the healthiness of their meals and sales. As diet-related disease worsens globally, this is the time for companies to adapt. We are excited to use this research to work with investors and drive better industry practice. This will benefit companies, investors and consumers alike.”

By Jolanda van Hal