Singapore sees Nutri-Grade label success with lower sugary drink purchases
Key takeaways
- Singapore’s mandatory Nutri-Grade labels reduced household sugar intake from pre-packaged beverages by 18%, while purchases of the least healthy drinks fell.
- Manufacturers reformulated products to cut overall sugar content by 21%, though non-sugar sweetener use rose across all beverages.
- Stronger effects were seen among nutritionally literate and higher-income households, highlighting the need to pair labeling policy with broader nutrition education efforts.
Research has found that mandatory front-of-pack (FOP) labels on sugary drinks have redirected consumers toward healthier drinks and encouraged manufacturers to reformulate products.
The researchers from Duke University and the National University of Singapore (NUS) say their research comes amid the Ministry of Health seeking to extend Nutri-Grade label requirements and ahead of advertising prohibitions on dietary sources of sodium and saturated fat next year.
“This study shows that mandatory labeling can shift the market at scale — changing what people buy and what companies sell,” comments Professor Lok Shee Mei, Duke-NUS’ interim vice-dean for Research.
“The findings also highlight opportunities to strengthen nutrition literacy and for the industry to consider more ways to reformulate. Altogether, this helps Singapore fine-tune Nutri-Grade and provide practical lessons for other countries considering front-of-pack labeling.”
Reformulations and labels spark change
The American Journal of Public Health study found that households purchasing pre-packaged beverages had reduced sugar content by 18% or 3.1 g per day. Purchases of less healthy drinks — graded C or D — also improved, with a 44% reduction.
The researchers analyzed household scanner data from April 2019 to March 2024. They included records of consumer pre-packaged beverage purchases, collected through barcode scans, which revealed changes in sugary beverage purchases and products that were reformulated.
In Singapore, Nutri-Grade labels were implemented in December 2022. The researchers note that the system worked like traffic lights, with red indicating Grade D and green indicating Grade A or B. They add that consumers are empowered to make small daily changes through the Nutri-Grade system.
Reformulation efforts and patterns
The researchers also found that manufacturers reformulated their products to reduce overall sugar content while ensuring beverages were below key sugar thresholds. Products had lower sugar content by 21% overall, while there was a 6% increase in non-sugar sweetener use across all beverages.
The Nutri-Grade system assigns beverages a color-coded grade from A to D based on healthiness criteria of sugar and saturated fat.Additionally, the researchers note that reformulations were also extended to dairy-containing drinks since there was a rise in lactose and a fall in saturated fat levels.
“Nutri-Grade is doing what FOP labels are meant to do: change what people buy and push companies to reduce sugar,” says principal investigator and assistant professor Soye Shin from Duke-NUS’ Health Services Research and Population Health Programme (HSRPH) at the time of the study.
“That’s a meaningful population-level win. However, the market adapts simultaneously, with some products improving their grade by replacing sugar with other sweeteners. This shows why labeling policies may benefit from periodic updates in response to industry practices.”
Nutri-Grade system impacts
The Nutri-Grade system assigns beverages a color-coded grade from A to D based on healthiness criteria of sugar and saturated fat.
C or D graded products are required to display Nutri-Grade labels, while D-graded beverages are banned from advertising. Reformulated products containing non-sugar sweeteners are not graded A even if they contain no sugar.
“We noted that consumers purchased fewer Grade C and D beverages and more Grade A and B beverages,” says study co-author Tan Yan Ning, former research assistant at HSRPH, now a Duke-NUS M.D. student.
“We also saw stronger effects among households with higher nutrition knowledge. This points to a need to strengthen nutrition literacy alongside policy measures such as Nutri-Grade labeling.”
The research team found improvements in sugar reduction were seen across households, especially among higher-income and nutritionally literate households.
According to the researchers, their study is distinct because FOP labels rarely measure consumer and manufacturer response. They suggest future research could extend their research to evaluating out-of-home beverage purchases and how they impact health outcomes.
Reducing global sugar consumption
Action on sugar reduction is gathering pace globally. Researchers recently found that sugar-sweetened beverage tax legislation has risen, with South Asia, followed by Southwest and East Asia, leading in adoption.
In Europe, over 300 German beverage companies are opposing the government’s introduction of a sugar tax or levy on drinks, which is planned for 2028. The Global Health Hub points out that Germany, being the largest sugar consumer in the EU, will be a late adopter since by 2028, nearly half of the EU countries will have implemented a sugar tax.
The WHO has previously pointed out that the taxes on alcoholic and sugar-sweetened beverages are lacking as prices of unhealthy drinks continue to drop in most countries. It urged that combining taxes with subsidies for healthier foods can improve affordability, especially for low-income households, while also generating revenue for public health.
