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Food reformulation and nutritional quality of food consumption: an analysis based on households panel data in France

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Background/objectives: We aimed to quantify the contribution of food reformulation to changes in the nutritional quality of consumers' food purchases, and compare it with the impact of substitutions made by consumers. Subjects/methods: Using a brand-specific data set in France, we considered the changes in the nutrient content of food products in four food sectors over a 3-year period. These data were matched with data on consumers' purchases to estimate the change in the nutritional quality of consumers' purchases. This change was divided into three components: the reformulation of food products, the launching of new products and the consumers' substitutions between products. Key nutrients were selected for each food group: breakfast cereals (sugar, fats, SFA, fiber, and sodium), biscuits and cakes (sugar, fats, SFA, and fiber), potato chips (fats, SFA, and sodium) and soft drinks (sugar). Results: Product reformulation initiatives have improved existing products for most food group-nutrient pairs. In particular, the contribution of food reformulation to the change in nutritional quality of food purchases was strong in potato chips (the sales-weighted mean SFA and sodium contents decreased by 31.4% to 52.1% and 6.7% to 11.1%, respectively), and breakfast cereals (the sales-weighted mean sodium content decreased by 7.3% to 9.7%). Regarding the launching of new products, the results were ambiguous. Consumers' substitutions between food items were not generally associated to an improvement in the nutritional quality of the food purchases. Conclusions: Policies aiming to promote food reformulation may have greater impact than those promoting changes in consumer behavior.
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European Journal of Clinical Nutrition (2018) 72:228235
https://doi.org/10.1038/s41430-017-0044-3
ARTICLE
Food reformulation and nutritional quality of food consumption: an
analysis based on households panel data in France
Marine Spiteri1Louis-Georges Soler2
Received: 10 May 2017 / Revised: 12 September 2017 / Accepted: 8 October 2017 / Published online: 22 December 2017
© The Author(s) 2018. This article is published with open access
Abstract
Background/objectives We aimed to quantify the contribution of food reformulation to changes in the nutritional quality of
consumersfood purchases, and compare it with the impact of substitutions made by consumers.
Subjects/methods Using a brand-specic data set in France, we considered the changes in the nutrient content of food
products in four food sectors over a 3-year period. These data were matched with data on consumerspurchases to estimate
the change in the nutritional quality of consumerspurchases. This change was divided into three components: the refor-
mulation of food products, the launching of new products and the consumerssubstitutions between products. Key nutrients
were selected for each food group: breakfast cereals (sugar, fats, SFA, ber, and sodium), biscuits and cakes (sugar, fats,
SFA, and ber), potato chips (fats, SFA, and sodium) and soft drinks (sugar).
Results Product reformulation initiatives have improved existing products for most food group-nutrient pairs. In particular,
the contribution of food reformulation to the change in nutritional quality of food purchases was strong in potato chips (the
sales-weighted mean SFA and sodium contents decreased by 31.4% to 52.1% and 6.7% to 11.1%, respectively), and
breakfast cereals (the sales-weighted mean sodium content decreased by 7.3% to 9.7%). Regarding the launching of new
products, the results were ambiguous. Consumerssubstitutions between food items were not generally associated to an
improvement in the nutritional quality of the food purchases.
Conclusions Policies aiming to promote food reformulation may have greater impact than those promoting changes in
consumer behavior.
Introduction
To promote healthier diets, two types of interventions are
generally considered. The rst one aims at increasing con-
sumersawareness of the relationship between food and
health, through information and education campaigns. Prior
literature shows that these policies have positive albeit small
effects. The second type of intervention aims at improving
the food environment of consumers [1,2] in order facilitate
healthy choices. The reformulation of food products,
through the decrease in salt, fat or sugar contents, is an
example of this type of intervention made to favor a better
food environment [38]. In many countries, public health
agencies implement partnerships with the food industry and
the retail sector in order to improve the nutritional quality of
foods available on the market [913].
What can we expect from such policies focusing on the
supply side? The potential impact of food reformulation
initiatives on consumersintakes and public health has been
investigated in recent studies. Based on simulations, refor-
mulation scenarios related to salt [1418] or trans fats [19]
contents in foods, or based on the adoption of quality
standards by the food industry [2025], show that the
modication of the nutritional quality of foods may poten-
tially induce signicant health benets.
However, considering the available literature, it is worth-
while to note that most articles address the effects of
‘‘potential’’ changes in food quality and are based on refor-
mulation scenarios and simulations rather than ‘‘real’’ changes
implemented by the food industry. The reason that most
*Louis-Georges Soler
louis-georges.soler@inra.fr
1Toulouse School of Economics, INRA, University of Toulouse
Capitole, Toulouse, France
2INRA-Aliss UR 1303, 65 Boulevard de Brandebourg, 94205
Ivry sur Seine, France
1234567890
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articles address potential reformulation scenarios is linked to
the lack of precise data on quality changes and reformulation
initiatives implemented by the food industry [26,27].
Recently, however, such data sets have been developed in
some countries [2830], enabling researchers to evaluate not
only ‘‘potential’’ scenarios of food reformulation but also real
changes implemented by the food industry.
Based on data collected in France, the aim of this
article is to contribute to estimating the magnitude of refor-
mulation efforts implemented by the food industry and
quantifying their impact on the nutritional quality of con-
sumer purchases.
Methods and data
The changes in consumersnutrient intakes between two
dates may result from changes in consumption patterns
(consumer purchases switch from some products to others)
or changes in the quality of the food products available on
the market. These changes on the supply side can be caused
by the launching of new products and the removal of old
products or the reformulation (i.e., the change in the nutri-
tional composition) of already existing products. In order to
analyze the changes in salt intakes in the U.K., a recent
article [28] proposed a method to quantify these three
effects. Longitudinal data on the contents of the grocery
baskets of a nationally representative sample of households
showed that the average salt content of grocery purchases
fell by 5.1%, from 0.370 g in 2005 to 0.351 g in 2011. This
variation was divided into three components: reformulation
of existing food products by manufacturers, the net effect of
the launching/removal of products, and consumer switching
between products. We applied a similar method in France
by focusing on four specic food groups and considering a
larger set of key nutrients.
A focus on four food sectors
Four food groups were considered (breakfast cereals, biscuits
and cakes, potato chips, and soft drinks) for two reasons.
First, these food groups are strong contributors to the intake
of some nutrients that the French public health agency
recommends limiting (See https://www.anses.fr/fr/content/l%
E2%80%99anses-actualise-les-rep%C3%A8res-de-
consommations-alimentaires-pour-la-population-fran%C3%
A7aise). Second, voluntary commitments to food reformu-
lation have been taken by several companies involved in
these sectors (See http://solidarites-sante.gouv.fr/prevention-
en-sante/preserver-sa-sante/le-programme-national-nutrition-
sante/article/les-signataires-des-chartes-d-engagements-de-
progres-nutritionnels and http://agriculture.gouv.fr/alimenta
tion/accords-collectifs-pour-lamelioration-de-loffre-alimenta
ire). Data on the nutritional content of food products were
obtained from the French Food Quality Observatory (See
www.oqali.fr/oqali_eng/) (Oqali). The Oqali database is
brand-specic and is specically designed to follow, over
time, the changes in the nutrient contents of products sold on
the French market. Depending on the food groups, data were
rst collected between 2008 and 2010, and the same protocol
was repeated in 2011 or 2013 so that the observation period
covered two or 3 years. Key nutrients were selected for each
food category: sugar, fats, saturated fats (SFA), ber, and
sodium for breakfast cereals; sugar, fats, saturated fats, and
ber for biscuits and cakes; fats, saturated fats, and sodium
for potato chips; and sugar for soft drinks. Table 1displays
the number of products considered in each food category, the
covered market shares and the initial and second dates of data
collection. Within each food category, the sampled food
products were partitioned into three subgroups: products
removed from the market between t0and t1(Group X), paired
products present on the market at both t0and t1(Group C),
and new products launched before t1(Group N). Food
composition data were matched with purchase data from
Kantar Worldpanel (The Kantar Worldpanel database pro-
vides details on the quantities bought and the corresponding
food expenditures by a representative panel of 20,000
households in France) to compute the market share of each
product at dates t0and t1(The use of nutritional data was
approved by the steering committee of Oqali. We did not
have to ask for an ethical agreement as the food purchase
data were anonymous).
Decomposing the contributions of the food industry
and consumer behavior changes
To measure the evolution of the nutritional quality of food
purchases, we considered the changes in the sales-weighted
average content of key nutrients between dates t0and t1in
each food group. To disentangle the effects of changes on
the supply side from those on the consumer side, we used
the method proposed by Grifth et al. [28]. Let us denote St
as the sales-weighted mean content of a specic key
nutrient for one food group at time t. This value is given at
t0and t1by
St0¼P
i
wit0sit0
St1¼P
i
wit1sit1
where iindexes individual food products, wit0is the market
share of the food product iat t0, and sit0denotes the content
of a given nutrient of the food product iat t0(similar
notation applies for t1). The change in the sales-weighted
mean content of a specic key nutrient between t0and t1is
dened as ΔS¼St1St0. The decomposition into supply
Food reformulation and nutritional quality of food consumption 229
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and demand effects is given by
ΔS¼X
i2C
wit0sit1sit0
ðÞ ð1Þ
þX
i2N
wit1sit1Sto
ðÞ
X
i2X
wit0sit0St0
ðÞ ð2Þ
þX
i2C
sit0St0
ðÞwit1wit0
ðÞþ
X
i2C
sit1sit0
ðÞwit1wit0
ðÞ
ð3Þ
In this expression, the rst term (1) accounts for the
effect of food reformulation carried out on products col-
lected at both t0and t1considering their market share at t0.
Thus, the contribution of a reformulated product to this term
will be greater if its market share at t0is high. The second
term (2) captures the impact of product renewal, more
precisely, the entry of products to the market or their
withdrawal between t0and t1. This term takes into account
the nutrient content of the new products or the removed
products (compared with the overall sales-weighted mean
nutrient content at t0) and their market shares. Thus, for
example, a new product with high sugar content will
increase the sales-weighted mean sugar content of the food
group. This effect will be more important if its market share
is high. The last term (3) reects consumer switching inside
group C (products collected at both t0and t1):
The sub-term P
i2C
sit0St0
ðÞwit1wit0
ðÞrepresents the
contribution of a change in the market share of a
product between t0and t1. For example, if consumers
shift toward products that have high sugar content
(compared with the sales-weighted mean sugar content
of the food group at t0), this step will raise the overall
sales-weighted mean sugar content.
The sub-term P
i2C
sit1sit0
ðÞwit1wit0
ðÞcaptures the
cross effect of changes in the nutrient content
and in the market shares of group C products. For
example, if consumers shift towards products that are
reformulated to have less sugar, this term will be
negative.
Data processing
The algorithm presented above is valid if the total market
shares covered at t0and t1are equal to 100% and the
nutritional composition of the sampled products is known.
This scenario is not exactly the case, as the Oqali samples
do not cover 100% of the sales volume. Two scenarios of
data processing, based on different assumptions, were
considered. A rst computation (scenario 1) was modeled
by assuming that the non-collected references had, on
average, the same characteristics as the whole sample and
followed the same evolution between t0and t1. This data
processing distorts the data less if the market coverage of
the samples studied is high and of the same order of mag-
nitude at t0and t1, and if the samples are representative of
the market at each time of data collection. A second com-
putation (scenario 2) was modeled by assuming that the
products that were not identied in the Oqali data set but
were present in the Kantar Worldpanel data set had, on
average, the same nutritional composition as the whole
sample and were stable over the period of observation.
Finally, missing nutrient composition data were inferred by
assuming that the products had not been reformulated.
Results
Figure 1displays the proportion of the three types of
products (X, C, and N) in each food group by applying
scenario 1. Around a quarter of the market was renewed
during the observation period. Tables 2to 5present the
effects of food reformulation, product renewal and con-
sumer switching. As expected, both scenarios led to similar
results, but the magnitude was lower with scenario 2, which
tends to overestimate the volumes of the group C products
and underestimate the magnitude of reformulation initia-
tives. In the following sections, the estimated effects of food
reformulation, product renewal and change in consumer
choice will be discussed as a range of results, with the low
range corresponding to the results obtained with scenario 2
and the high range corresponding to those obtained with
scenario 1.
Breakfast cereals
In the breakfast cereal sector, one can observe strong
changes in the sales-weighted average contents of fats and
saturated fats (+7.5 to 10.1% and +10.2 to 13.6%,
respectively). Evidently, it is consumer choices that mostly
15% of t market 21% of t market 9% of t market 5% of t market
-20%
0%
20%
40%
60%
80%
100%
Breakfast
cereals
Biscuits and
pastries
Potato chips Soft Drinks
New products
(group N)
Paired
products
(group C)
Removed
products
(group X)
74% 79%
64%
74%
26% 21%
36%
26%
Fig. 1 Partitioning of the samples into subgroups (in market shares)
230 M. Spiteri, L-G Soler
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explain the negative change, from a public health point of
view, of the weighted average contents of these nutrients.
One can also observe an interesting decrease in the sales-
weighted average sodium content in breakfast cereals (8.3
to 11.1%). This decrease is clearly the result of refor-
mulations that generated a 7.3 to 9.7% decrease in the
related mean sodium content, and to a lesser degree, con-
sumer switching (generated a 3.6 to 4.9% decrease). Con-
versely, the innovation/withdrawal effect partly offsets
these improvements, leading to a 2.6 to 3.5% increase in the
sales-weighted mean sodium content.
Finally, it appears that the sales-weighted average sugar
content slightly increased in breakfast cereals between t0
and t1(+0.5 to 0.7%). Despite some food reformulations
that led to decreases in the sales-weighted mean sugar
content by 2.3 to 3.0%, consumer switching and product
renewal resulted in an increase in the sales-weighted sugar
content.
Biscuits and cakes
Overall, in the biscuits and cakes sector, the changes in the
nutritional quality of food purchases between t0and t1were
small, except for SFA (the sales-weighted mean SFA con-
tent decreased by 2.4 to 3.7%).
Food reformulation and, to a lesser extent, consumer
switching contributed to decreasing the weighted mean SFA
content (by 1.9 to 2.7% and by 1.2 to 2.0%,
respectively). However, these improvements were partially
offset by product renewal, which led to an increase in the
related mean content of 0.7 to 1.0%.
Potato chips
In the potato chip sector, we observed very strong changes
in the sales-weighted average nutrient content in two cases:
sodium (the related mean content decreased by 10.2 to
12.6%) and SFA (the related mean content decreased by
47.4 to 58.5%). In both cases, these changes were mainly
due to the reformulation effect and, to a lesser degree
(approximately half the size), to the innovation/withdrawal
effect. Conversely, consumer switching weakened these
changes as they slightly increased the sales-weighted mean
contents of SFA (by 1.8 to 16%) and sodium (by 2.7% with
scenario 1). This difference is mainly explained by con-
sumers turning away from products that were reformulated
to have less SFA and sodium. However, according to the
innovation/withdrawal effect, it is worth noting that the
consumers switched toward new products with less sodium
and SFA.
Soft drinks
Finally, in the soft drink sector, it appears that the sales-
weighted average sugar content slightly decreased between
t0and t1. This decrease was clearly the result of the refor-
mulation effect that generated a 1.7 to 2.2% decrease and
the innovation/withdrawal effect that generated a 2.2 to
2.4% decrease in the weighted mean sugar content. Con-
versely, consumer switching offset these effects, leading to
a 3.8 to 4.4% increase in the sales-weighted mean sugar
content.
Discussion
In this study, we aimed to quantify the contribution of food
reformulation to changes in the nutritional quality of con-
sumer food purchases. We compared the contribution of
food reformulation to that of other factors affecting: the
renewal of products on the market and substitutions made
by consumers among existing products.
This study clearly has some limitations. The most
important one is linked to the non exhaustive coverage of
the products available on the market in the Oqali data set.
The algorithm used to decompose the variation of the
nutritional quality of food purchases into the three effects
presented above, imposed to have a full coverage of the
market at t0and t1. As it was not the case in our data set, we
had to make some assumptions about the nutritional content
of non-collected items. Two scenarios were considered.
Even if the magnitude of the effects differs depending on
the scenario, the results seem robust as the general con-
clusions are the same in both cases.
Overall, the results show that, in the four food groups,
product reformulation initiatives implemented by the food
Table 1 Characteristics of the samples of food products
Date t0Date t1
Year Number of products Covered market share (%) Year Number of products Covered market share (%)
Breakfast cereals 2008 254 75.1 2011 362 74.6
Biscuits and cakes 2008 1436 70.4 2011 1824 65.4
Potato chips 2009 135 60.4 2011 217 81
Soft drinks 2010 619 78.1 2013 1208 86.3
Food reformulation and nutritional quality of food consumption 231
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Table 2 Changes in the sales-weighted average content of key nutrients between dates t0and t1in Breakfast cereals
Breakfast cereals Weigthed average at t0Weigthed average at t1Variation of the weighted
average t1/t0
Reformulation New products and
product withdrawals
Consumers switching
(a)(b)(c)(d)(e)(f)
Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2
Sugar 27.7 27.9 27.8 0.7% 0.5% 3.0% 2.3% 1.4% 1.0% 2.4% 1.8%
Total fats 7.4 8.1 7.9 10.1% 7.5% 0.8% 0.6% 1.0% 0.8% 11.9% 9.0%
SFA 3.0 3.4 3.3 13.6% 10.2% 0.6% 0.4% 1.4% 1.0% 12.8% 9.6%
Fiber 5.1 5.1 5.1 1.4% 1.1% 2.9% 2.2% 5.1% 3.8% 0.8% 0.6%
Sodium 0.3 0.3 0.3 11.1% 8.3% 9.7% 7.3% 3.5% 2.6% 4.9% 3.6%
(a) Sales-weighted mean nutrient content at t0(g/100 g)
(b) Sales-weighted mean nutrient content at t1(g/100 g)
(c) Total change in the sales-weighted mean nutrient content between t0and t1(%)
(d) Contribution of reformulation of existing food products to changes in the sales-weighted mean nutrient content (%)
(e) Contribution of product renewal (launching/removal of products) to changes in the sales-weighted mean nutrient content (%)
(f) Contribution of consumers switching between existing products to changes in the sales-weighted mean nutrient content (%)
(c)=(d)+(e)+(f)
Table 3 Changes in the sales-weighted average content of key nutrients between dates t0and t1in Biscuits and Cookies
Cookies and biscuits Weigthed average at t0Weigthed average at t1Variation of the weighted
average t1/t0
Reformulation New products and
product withdrawals
Consumers switching
(a)(b)(c)(d)(e)(f)
Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2
Sugar 32.3 32.8 32.6 1.7% 1.1% 0.1% 0.1% 0.8% 0.5% 0.7% 0.5%
Total fats 18.9 18.8 18.9 0.5% 0.3% 1.2% 0.8% 0.2% 0.2% 0.9% 0.7%
SFA 9.4 9.1 9.2 3.7% 2.4% 2.7% 1.9% 1.0% 0.7% 2.0% 1.2%
Fiber 2.8 2.8 2.8 1.3% 0.9% 0.8% 0.6% 2.2% 1.4% 0.0% 0.0%
(a) Sales-weighted mean nutrient content at t0(g/100 g)
(b) Sales-weighted mean nutrient content at t1(g/100 g)
(c) Total change in the sales-weighted mean nutrient content between t0and t1(%)
(d) Contribution of reformulation of existing food products to changes in the sales-weighted mean nutrient content (%)
(e) Contribution of product renewal (launching/removal of products) to changes in the sales-weighted mean nutrient content (%)
(f) Contribution of consumers switching between existing products to changes in the sales-weighted mean nutrient content (%)
(c)=(d)+(e)+(f)
232 M. Spiteri, L-G Soler
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Table 4 Changes in the sales-weighted average content of key nutrients between dates t0and t1in Potato Chips
Potato chips Weigthed average at t0Weigthed average at t1Variation of the weighted
average t1/t0
Reformulation New products and
product withdrawals
Consumers switching
(a)(b) (c) (d)(e)(f)
Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2
Total fats 34.7 34.5 34.6 0.4% 0.4% 0.2% 0.1% 0.3% 0.4% 0.3% 0.1%
SFA 8.4 3.5 4.4 58.5% 47.4% 52.1% 31.4% 22.4% 17.7% 16.0% 1.8%
Sodium 0.7 0.6 0.6 12.6% 10.2% 11.1% 6.7% 4.2% 3.4% 2.7% 0.1%
(a) Sales-weighted mean nutrient content at t0(g/100 g)
(b) Sales-weighted mean nutrient content at t1(g/100 g)
(c) Total change in the sales-weighted mean nutrient content between t0and t1(%)
(d) Contribution of reformulation of existing food products to changes in the sales-weighted mean nutrient content (%)
(e) Contribution of product renewal (launching/removal of products) to changes in the sales-weighted mean nutrient content (%)
(f) Contribution of consumers switching between existing products to changes in the sales-weighted mean nutrient content (%)
(c)=(d)+(e)+(f)
Table 5 Changes in the sales-weighted average content of key nutrients between dates t0and t1in Soft drinks
Soft drinks Weigthed average at t0Weigthed average at t1Variation of the weighted
average t1/t0
Reformulation New products and product
withdrawals
Consumers switching
(a)(b)(c)(d)(e)(f)
Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2 Scenario 1 Scenario 2
Sugar 6.5 6.5 6.5 0.1% 0.1% 2.2% 1.7% 2.4% 2.2% 4.4% 3.8%
(a) Sales-weighted mean nutrient content at t0(g/100 g)
(b) Sales-weighted mean nutrient content at t1(g/100 g)
(c) Total change in the sales-weighted mean nutrient content between t0and t1(%)
(d) Contribution of reformulation of existing food products to changes in the sales-weighted mean nutrient content (%)
(e) Contribution of product renewal (launching/removal of products) to changes in the sales-weighted mean nutrient content (%)
(f) Contribution of consumers switching between existing products to changes in the sales-weighted mean nutrient content (%)
(c)=(d)+(e)+(f)
Food reformulation and nutritional quality of food consumption 233
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industry have improved existing products (available on the
market at t0and t1) for most targeted food group-nutrient
pairs (except for the sugar content of biscuits and cakes and
the total fat content of chips). It is likely that some of these
changes are linked to individual or collective agreements
implemented by the food industry and the French govern-
ment since 2008. In the breakfast cereal sector, for instance,
several agreements were signed between 2008 and 2011, in
which two large food manufacturers and several retailers
were involved. Another example is given by the potato
chips sector. The saturated fat levels in potato chips sharply
declined between 2009 and 2011, mainly thanks to refor-
mulations (which led to a 2.6 to 4.4 g/100 g decrease in
the sales-weighted average content of saturated fats in this
sector). This decrease was the result of a collective self-
action by the industry to replace the palm oil used for frying
chips with sunower oil, which contains less saturated fat.
In some cases, the magnitudes of the observed changes
seem to be modest, but it is important to keep in mind that
the period of observation was only 3 years.
Considering now the second effect related to the renewal
of the food supply, the results are more ambiguous. Indeed,
the launching of new products and the removal of existing
ones did not necessarily contribute to the improvement in
the nutritional quality of food purchases.
In the soft drink and potato chip sectors, the launching of
new products contributed to reducing the sales-weighted
mean content of ‘‘negative’’ nutrients. This effect con-
tributed to decreasing the sales-weighted mean sugar con-
tent in the soft drink sector by 2% and the sales-weighted
mean SFA content in the potato chips sector by 18 to 22%.
However, in the breakfast cereal and biscuits and cakes
sectors, it turns out that the renewal of the food supply
contributed negatively to achieving public health goals.
Indeed, new products with high market shares belonged to
categories with poorer nutritional quality compared to the
sector average (and vice versa for product withdrawal). The
consequence is that, over the observation period, this effect
contributed, for instance, to increases of approximately 3%
in the sales-weighted mean sodium content in breakfast
cereals and to decreases of approximately 2% in the sales-
weighted mean ber content in biscuits and cakes.
How to explain why supply renewal does not system-
atically improve the nutritional quality of food purchases? If
we assume that consumers do not generally demand pro-
ducts with less salt or less fat and prioritize taste over health
[31], then it is understandable that food reformulation
initiatives are primarily made to improve the nutritional
quality of products already adopted by consumers, provided
that the changes in the nutrient content do not affect the
product taste (and then they remain small), and they are
silently implemented so as not to cause product rejection by
consumers. Rather, commercial and communication
strategies associated with the launching of new products
aim to attract new consumers by promoting taste and
pleasure rather than health. Then, integrating more stringent
nutritional constraints into the design of new products may
be considered ‘‘too risky’’ in some food sectors.
The third effect induced by consumer switching from
some products to others did not generally lead to an
improvement in the nutritional quality of food purchases
during the observation period. In several cases, consumer
switching offset the reformulation effect. For instance, in
the breakfast cereal sector, it was mainly the consumer
switching that explained the negative trend (from a public
health point of view) in the weighted average contents of
total fat and SFA. It is worth noting that our analysis does
not provide any insights to explain consumer changes. They
may have changed because they perceived some alteration
in taste after product reformulation, or they may have
moved for other exogenous reasons (food prices, economic
crisis, advertising, etc.).
Conclusion
Our results converge with other studies [28] that suggest
that policies targeting changes in the food supply may have
greater impact than those promoting changes in consumer
behavior. However, we have shown the complexity of the
food reformulation issue, as food companies may act dif-
ferently depending on the nutrient and food category.
These ndings argue for the development of a proper
strategy for monitoring the nutrient composition of foods at
the brand level in order to evaluate the impact of food
reformulation initiatives more precisely [26,29,30].
Acknowledgements We want to thank the steering committee of Oqali
for providing the data used in the article. They also thank Florence
Stevenin and Oualid Hamza for their contributions to the matching of
the data sets and preliminary treatments. Both authors are responsible
for the design and implementation of the study, as well as the writing
and nal content of the article. This research was funded by the EU
Horizon 2020 Program under Grant Agreement no. 633692
(SUSFANS).
Compliance with ethical standards
Conict of interest The authors declare that they have no competing
interests.
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Food reformulation and nutritional quality of food consumption 235
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... a The % change in sugar density between 2015 and 2019 here are different than the same metric in the third year progress by industry report (7) due to small differences in methodology (such as the classification of foods within the programme categories, or the baseline year for morning goods and cakes). compared with demand-side ones has been found in the other studies using the decomposition approach (20)(21)(22) . A study by Cengiz et al. which evaluated changes in diet quality in the USA found that diet improvements in the USA were driven entirely by supply-side factors, while consumer switches worsened diet quality (23) . ...
... A study by Cengiz et al. which evaluated changes in diet quality in the USA found that diet improvements in the USA were driven entirely by supply-side factors, while consumer switches worsened diet quality (23) . Spiteri and Soler found that the impact of consumer switching was different across categories, while reformulation consistently improved the nutrient density of products (22) . Contrary to the case of soft drink reformulation studied here, other studies using the decomposition approach focused on reformulation in the absence of a tax. ...
Article
Full-text available
The UK government launched a two-component sugar-reduction programme in 2016, one component is the taxation of sugar-sweetened beverages, the Soft Drinks Industry Levy, and the second is a voluntary sugar reduction programme for products contributing most to children’s sugar intakes. These policies provided incentives both for industry to change the products they sell and for people to change their food and beverage choices through a ‘signalling’ effect that has raised awareness of excess sugar intakes in the population. In this study, we aimed to identify the relative contributions of the supply- and demand-side drivers of changes in the sugar density of food and beverages purchased in Great Britain. While we found that both supply- and demand-side drivers contributed to decreasing the sugar density of beverage purchases (reformulation led to a 19 % reduction, product renewal 14 %, and consumer switching between products 8 %), for food products it was mostly supply-side drivers (reformulation and product renewal). Reformulation contributed consistently to a decrease in the sugar density of purchases across households, whereas changes in consumer choices were generally in the opposite direction, offsetting benefits of reformulation. We studied the social gradient of sugar density reduction for breakfast cereals, achieved mostly by reformulation, and found increased reductions in sugar purchased by households of lower socio-economic status. Conversely, there was no social gradient for soft drinks. We conclude that taxes and reformulation incentives are complementary and combining them in a programme to improve the nutritional quality of foods increases the probability of improvements in diet quality.
... Due to the abundance of functional compounds present in the composition of carob pulp flour, this raw material, which is a by-product of the industrial processing of carob fruit, rightly attracts the attention of the scientific community [7]. The presence of crude dietary fiber (up to 47%), the largest part of which are insoluble fibers, as well as minerals and polyphenolic compounds, makes it interesting from the point of view of research and manufacturers, as it provides an opportunity to obtain innovative products, which can largely satisfy new requirements consumers [8]. The beneficial health effects of phenolics are considered in the light of their potent antioxidant, anti-inflammatory, antimicrobial and immunomodulatory properties, and the consequent reduction of the risk of developing mass non-communicable diseases, as well as their potential therapeutic effect [9]. ...
Preprint
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For the development of a high-quality functional bread it is of crucial importance to find a compromise between improving the functional value of the product and impairing its quality. Therefore, the primary aim of this work was to define the effects of carob pulp flour (CF; 10-20% on flour basis) on rheological behavior of dough and quality parameters of bread. Introduction of CF caused a major increase in dough resistance while significantly decreasing dough extensibility, resulting in lower volume with denser crumb structure of obtained bread samples. The negative effects of CF on dough and bread characteristics were partialy compensated by the addition of dry sourdough (DS) as an improver in the amount of 5-10% (flour basis). It was determined that by combining 15% CF and 10% DS bread of very good sensory quality can be produced. The content of total dietary fiber (6.48 g), Mn (0.76 mg) and Cu (0.21 mg) per 100 g of mentioned bread was sufficient for the nutritional claims: "high in fiber", "high in manganese" and "source of copper". Obtained bread had 10 times higher content of total phenols and multiple times higher antioxidant activity compared to the control. Moreover, microbiological tests confirmed the durability of bread with 15% CF and 10% DS up to seven days. Therefore, carob pulp flour can be successfully applied in the production of bread, which characteristics are adapted to modern trends in nutrition.
... The manufacturer's point of view related to the HSR label, its purpose of implementation, expected outcomes, and social benefits are important aspects of this systematic review. The reviewed studies have revealed that food businesses adopt unique approaches to modify the nutritional structure of their manufactured goods dependent on the nutrient and food category (Spiteri & Soler, 2018). The manufacturers were reluctant to use the HSR label, and limits of commercial goodwill were observed in applying HSR voluntarily (Shahid et al., 2020). ...
... For a 30 g portion, this represents an intake of no more than 10% of the fibre recommendations for children, and even 7.5% for children aged 11 and over. Manufacturers' efforts to reformulate should be encouraged in order to improve the wholegrain and fibre composition of cereals intended for children [25]. To optimise children's fibre intake, the recommendation could be to opt for breakfast cereals that are less processed and richer in fibre, such as mueslis with oats and plain cereal oats (8.4 g per 100 g), by choosing wholegrain products with the highest proportion of cereals in the list of ingredients. ...
Article
Full-text available
Objective: Analyse the breakfast cereal market to help to help healthcare professionals to guide parents in choosing healthy products for their children. Study design: Observational study of the breakfast cereals available in the biggest supermarkets, discount stores and organic chains in France, Belgium and Luxembourg. Methods: An analysis of nutritional qualities using three indicators: Nutri-Score (initial and modified version), WHO Europe nutrient profile model, and Nova. Results: 645 products were listed; 559 excluding duplicates. A total of 28.8% are marketed to children and make up the group of “children’s” cereals, 62.1% of cereals are Muesli, Oats and other cereal flakes (MOCF), and 54.9% are “organic”. The study shows that “children’s” cereals have a poorer nutritional profile: a higher proportion of Nutri-Score D, higher sugar content, lower fibre content, less conformity with the WHO Europe nutrient profile model and a higher proportion ofultra-processed. On the other hand, MOCF and “organic” products generally have a better nutritional profile: less sugar, more fibre, more Nutri-Score A, less Nutri-Score D and fewer ultra-processed products. Conclusions: Parents should therefore opt for cereals that do not bear any reference to children on the packaging.
Article
In the context of the rising prevalence childhood obesity, this study investigated children's preferences for chocolate chip cookies, a high impact food category. The objective was to explore drivers of preferences and to identify potential pathways for reformulation. A home use test was conducted in four cities in France with 151 school‐aged children on eight commercial chocolate chips cookies. An external preference mapping analysis was performed using descriptive analysis data from a trained sensory panel and analyses of cookies' composition and physicochemical properties. Texture emerged as a critical driver of preference, with a majority of children favoring softer textures. Preferences were not particularly driven by sweetness, challenging the assumption that children always prefer the sweetest products. Cluster analysis revealed distinct preference patterns that were linked to children's BMI and demographic factors. Notably, children with higher BMIs showed preferences for sweeter cookies and higher sugar content.
Article
Full-text available
Background/Objectives: Low quality diets are a risk factor for non-communicable diseases; therefore, improving diet quality is a public health and policy priority in the UK and elsewhere. Reformulating food/beverage products to make them healthier may be an effective approach. Evidence suggests that fiscal interventions, notably taxes/levies on soft drinks, can lead to reformulation but the evidence for voluntary or mandated non-fiscal interventions is less clear. We aimed to review and synthesise contemporary evidence to determine whether non-fiscal policies/interventions result in the reformulation of food/beverage products Methods: In April 2023, we systematically searched ten international academic and nine grey literature databases. We included real-world study designs, all nutrients, in- and out-of-home sectors, and studies published from 2013, to ensure policy relevancy. We excluded modelling studies. Using the Synthesis Without Meta-Analysis method we conducted vote counting of studies based on the direction of effect and narrative synthesis by intervention type. Risk of bias was assessed using a tool developed by the EPPI-Centre and quality was assessed using GRADE. Results: We included 77 real-world studies from 19 countries, reporting 100 non-fiscal policies/interventions. Most commonly, these were reduction targets (n = 44), front-of-pack labels (n = 23), and advertising standards (n = 9). Most interventions were voluntary (n = 67), compared to mandatory (n = 33), and focused on the in-home sector (n = 63). The vote counting results showed non-fiscal policies/interventions overall led to improvements in reformulation in 60/63 studies with a valid direction of effect (95%, 95% CI 0.869, 0.984, p < 0.001). Mandatory implementations were more successful than voluntary implementations with 15/15 showing an improvement (100%, 95% CI 0.796, 1], p < 0.001), compared 40/43 showing an improvement (93%, 95% CI 0.814, 0.976, p < 0.001). Most of the studies were of low quality, due to the observational nature of the studies. Sodium was the most commonly targeted nutrient (n = 56) and was found to be reformulated in most studies. Causation is difficult to establish from real-world studies, but evidence suggests that regulatory and multi-component strategies may be effective at driving reformulation. Conclusions: Non-fiscal policies/interventions can play an important role in driving reformulation, alongside fiscal measures. This work was funded by the National Institute for Health and Care Research PRP-PRU-02-15-Healthy Weight and registered on Open Science Framework.
Article
Full-text available
Objectives Various studies have highlighted how consuming adequate dietary fibre (DF) foods could confer multiple potential health benefits to humans, though data suggested that the average intake of the population is below the recommendations. The aim of this study, which involved probabilistic, mathematical and statistical modelling, was to understand, for the first time, how fibre fortification in a broad array of food categories could impact the diet and health status of Chinese consumers. Design A simulation-based approach was used to examine the potential impact of fibre fortification. The China Health and Nutrition Survey dataset was used to evaluate intakes of DF together with a dietary intake mathematical model. Commercially manufactured foods and beverages eligible for fibre fortification were identified and a total of 296 food and beverages were selected for fibre fortification calculation. Foods and beverages eligible for fibre fortification and the concentration of fibre used at intervention were identified based on Chinese legislations and regulations of nutrition label claims. Populations who meet the dietary reference values of fibre fortification have their health outcomes such as weight, cardiovascular disease (CVD) and type 2 diabetes risk quantified prefibre and postfibre reformulation as per published studies. Results The simulated fibre fortification intervention model has shown that the mean DF intake increased by 13.28%, from 12.8 g/day of baseline to 14.5 g/day, leading to an increase of 48% (from 6.85% to 10.13%) and 54% (from 14.22% to 21.84%) of the adult and children population, respectively, achieving the recommended fibre guidelines. Additionally, 234 diabetes cases per day (85 340 cases per year) as well as 73 065 deaths secondary to CVD could also potentially be averted or delayed with the increase of DF intake via fibre fortification. Conclusions This study provides a practical application implicating the potential public health benefits that could be achieved with food product reformulation.
Article
Encouraging the food industry to reformulate their products is a possible public intervention to improve diet quality. In this paper, we assess the impact of food reformulation on per capita salt and saturated fatty acids (SFAs) intake, in France, for four product categories, namely, potato chips, fresh pizzas, frozen pizzas, and frozen meals, taking into account the changes in products' nutritional quality and consumer choices. Nutrient intake is calculated by matching data on food purchases and nutritional data, collected at the same date. An algorithm is run to disentangle the specific effect of food reformulation. We find that food reformulation, which is based on voluntary individual firm choices or voluntary industry‐wide agreement in our case studies, contributes to decrease SFAs and salt intake in seven out of eight cases. However, the magnitude of the impact is moderate, except in the case of potato chips for which a much stronger impact is observed. Product renewal has an ambiguous effect, depending on the nutrient considered. By contrast, changes in consumer behavior increase the intake of SFAs and salt in all cases. Finally, food reformulation generally benefits all consumers equally, regardless of income or age. For food categories with consumption disparities, product reformulation can reduce heterogeneity in nutrient intake across socioeconomic groups, provided that recipes are greatly and widely improved [EconLit Citations: D12, D22, I1].
Article
Reductions in sugar intake are at the center of policy discussions to improve health. In this article, we use barcode‐level nutrition and sales data on the near‐universe of all packaged food products in the United States over 2007–2015 to investigate whether food manufacturers have reduced added sugar in their product offerings and whether these reformulations have played a role on consumers' sugar intake. We find that reformulation efforts would have reduced sugar intake by 52.8% between 2007 and 2015 had households' shopping baskets in 2015 remained the same as in 2007. However, consumers' purchases have gravitated toward more sugary products over time, thereby negating more than twothirds of the reduction in sugar intake that reformulation could have brought about. As a result, sugar intake has only decreased by 15.6%. Evidence shows that the largest reformulation effects come from product groups that have received the greatest scrutiny. Sweetened beverages, desserts, and sweets together represent 89% of pure reformulation, where sweetened beverages alone represent 43%. We also analyze the change in added sugar intake across income and find larger reductions in higher‐income households; this finding suggests that existing disparities in diet quality have become more pronounced over time [EconLit Citations: D22, I12, I18, L66].
Article
Full-text available
Background and objective: Approximately 20% of US children and adolescents consume pizza on any given day; and pizza intake is associated with higher intakes of energy, sodium, and saturated fat. The reformulation of pizza products has yet to be evaluated as a viable option to improve diets of the US youth. This study modeled the effect on nutrient intakes of two potential pizza reformulation strategies based on the standards established by the Nestlé Nutritional Profiling System (NNPS). Methods: Dietary intakes were retrieved from the first 24hr-recall of the National Health and Nutrition Examination Survey (NHANES) 2011-12, for 2655 participants aged 4-19 years. The composition of pizzas in the NHANES food database (n = 69) were compared against the NNPS standards for energy, total fat, saturated fat, sodium, added sugars, and protein. In a reformulation scenario, the nutrient content of pizzas was adjusted to the NNPS standards if these were not met. In a substitution scenario, pizzas that did not meet the standards were replaced by the closest pizza, based on nutrient content, that met all of the NNPS standards. Results: Pizzas consistent with all the NNPS standards (29% of all pizzas) were significantly lower in energy, saturated fat and sodium than pizzas that were not. Among pizza consumers, modeled intakes in the reformulation and substitution scenarios were lower in energy (-14 and -45kcal, respectively), saturated fat (-1.2 and -2.7g), and sodium (-143 and -153mg) compared to baseline. Conclusions: Potential industry wide reformulation of a single food category or intra-category food substitutions may positively impact dietary intakes of US children and adolescents. Further promotion and support of these complimentary strategies may facilitate the adoption and implementation of reformulation standards.
Article
Full-text available
Purpose To describe the Nestlé Nutritional Profiling System (NNPS) developed to guide the reformulation of Nestlé products, and the results of its application in the USA and France. Design The NNPS is a category-specific system that calculates nutrient targets per serving as consumed, based on age-adjusted dietary guidelines. Products are aggregated into 32 food categories. The NNPS ensures that excessive amounts of nutrients to limit cannot be compensated for by adding nutrients to encourage. A study was conducted to measure changes in nutrient profiles of the most widely purchased Nestlé products from eight food categories (n = 99) in the USA and France. A comparison was made between the 2009–2010 and 2014–2015 products. Results The application of the NNPS between 2009–2010 and 2014–2015 was associated with an overall downwards trend for all nutrients to limit. Sodium and total sugars contents were reduced by up to 22 and 31 %, respectively. Saturated Fatty Acids and total fat reductions were less homogeneous across categories, with children products having larger reductions. Energy per serving was reduced by <10 % in most categories, while serving sizes remained unchanged. Conclusions The NNPS sets feasible and yet challenging targets for public health-oriented reformulation of a varied product portfolio; its application was associated with improved nutrient density in eight major food categories in the USA and France. Confirmatory analyses are needed in other countries and food categories; the impact of such a large-scale reformulation on dietary intake and health remains to be investigated.
Article
Full-text available
Hypertension is a major modifiable risk factor for cardiovascular disease and mortality, which could be lowered by reducing dietary sodium. The potential health impact of a product reformulation in the Netherlands was modelled, selecting packaged soups containing on average 25% less sodium as an example of an achievable product reformulation when implemented gradually. First, the blood pressure lowering resulting from sodium intake reduction was modelled. Second, the predicted blood pressure lowering was translated into potentially preventable incidence and mortality cases from stroke, acute myocardial infarction (AMI), angina pectoris, and heart failure (HF) implementing one year salt reduction. Finally, the potentially preventable subsequent lifetime Disability-Adjusted Life Years (DALYs) were calculated. The sodium reduction in soups might potentially reduce the incidence and mortality of stroke by approximately 0.5%, AMI and angina by 0.3%, and HF by 0.2%. The related burden of disease could be reduced by approximately 800 lifetime DALYs. This modelling approach can be used to provide insight into the potential public health impact of sodium reduction in specific food products. The data demonstrate that an achievable food product reformulation to reduce sodium can potentially benefit public health, albeit modest. When implemented across multiple product categories and countries, a significant health impact could be achieved.
Article
Full-text available
Public health action to reduce dietary salt intake has driven substantial reductions in coronary heart disease (CHD) over the past decade, but avoidable socio-economic differentials remain. We therefore forecast how further intervention to reduce dietary salt intake might affect the overall level and inequality of CHD mortality. We considered English adults, with socio-economic circumstances (SEC) stratified by quintiles of the Index of Multiple Deprivation. We used IMPACTSEC, a validated CHD policy model, to link policy implementation to salt intake, systolic blood pressure and CHD mortality. We forecast the effects of mandatory and voluntary product reformulation, nutrition labelling and social marketing (e.g., health promotion, education). To inform our forecasts, we elicited experts' predictions on further policy implementation up to 2020. We then modelled the effects on CHD mortality up to 2025 and simultaneously assessed the socio-economic differentials of effect. Mandatory reformulation might prevent or postpone 4,500 (2,900-6,100) CHD deaths in total, with the effect greater by 500 (300-700) deaths or 85% in the most deprived than in the most affluent. Further voluntary reformulation was predicted to be less effective and inequality-reducing, preventing or postponing 1,500 (200-5,000) CHD deaths in total, with the effect greater by 100 (-100-600) deaths or 49% in the most deprived than in the most affluent. Further social marketing and improvements to labelling might each prevent or postpone 400-500 CHD deaths, but minimally affect inequality. Mandatory engagement with industry to limit salt in processed-foods appears a promising and inequality-reducing option. For other policy options, our expert-driven forecast warns that future policy implementation might reach more deprived individuals less well, limiting inequality reduction. We therefore encourage planners to prioritise equity.
Article
Background The Dutch ‘Task Force for the Improvement of the Fatty Acid Composition’ initiated fatty acid reformulations in branches using vegetable oils and fats to reduce the trans(TFA) and saturated fatty acid (SFA) content of foods. Objective This study estimates the impact of recent reformulations in the task force food groups by estimating changes in median intake of TFA and SFA in Dutch young adults. Methods This is a modelling study with food consumption data of young adults. Intakes were estimated before reformulation using food composition data of 2001 as a reference and while including most recent fatty acid composition of foods for task force food groups. Food composition of other foods and food consumption was assumed unchanged. Results Average TFA intake signifi cantly decreased from 1.0 E% in the reference to 0.8 E% in the reformulation scenario. Pastry, cakes and biscuits, and snacks contributed most to the decrease of TFA. Estimated SFA intake did not change. When solid baking and spreading fats were additionally replaced with fl uid ones, SFA intake decreases from 12.9 E% to 12.1 E%. Conclusion Fatty acid reformulation in the task force food groups contributed to reductions in TFA intake. For further reductions in SFA intake a different food choice is primordial.
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Improving diet quality has been a target of public health policy. Governments have encouraged consumers to make healthier food choices and firms to reformulate food products. Evaluation of such policies has focused on the impact on consumer behaviour; firm behaviour has been less well studied. We show that the recent decline in dietary salt intake in the UK was entirely attributable to product reformulation; consumer switching between products worked in the opposite direction and led to a slight increase in grocery salt intensity. These findings point to the important role that firms can play in achieving public policy goals.
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Globally, excess salt intake is a significant cause of preventable heart disease and stroke, given the established links between high salt intake, high blood pressure, and cardiovascular disease. This paper describes and evaluates the voluntary approaches to salt reduction that operate in the United Kingdom and the United States, and proposes a new strategy for improving their performance. Drawing on developments in the theory and practice of public health governance, as well as theoretical ideas from the field of regulatory studies, this paper proposes a responsive regulatory model for managing food reformulation initiatives, including salt reduction programs. This model provides a transparent framework for guiding industry behavior, making full use of industry's willingness to participate in efforts to create healthier products, but using 'legislative scaffolding' to escalate from self-regulation towards co-regulation if industry fails to play its part in achieving national goals and targets. (C) 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-SA license (http://creativecommons.org/licenses/by-nc-sa/4.0/).
Article
Background/objectives: Policies focused on food quality are intended to facilitate healthy choices by consumers, even those who are not fully informed about the links between food consumption and health. The goal of this paper is to evaluate the potential impact of such a food reformulation scenario on health outcomes. Subjects/methods: We first created reformulation scenarios adapted to the French characteristics of foods. After computing the changes in the nutrient intakes of representative consumers, we determined the health effects of these changes. To do so, we used the DIETRON health assessment model, which calculates the number of deaths avoided by changes in food and nutrient intakes. Results: Depending on the reformulation scenario, the total impact of reformulation varies between 2408 and 3597 avoided deaths per year, which amounts to a 3.7-5.5% reduction in mortality linked to diseases considered in the DIETRON model. The impacts are much higher for men than for women and much higher for low-income categories than for high-income categories. These differences result from the differences in consumption patterns and initial disease prevalence among the various income categories. Conclusions: Even without any changes in consumers' behaviors, realistic food reformulation may have significant health outcomes.European Journal of Clinical Nutrition advance online publication, 16 December 2015; doi:10.1038/ejcn.2015.201.
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Up to now, most nutritional policies have been set up to inform consumers about the health benefits induced by more balanced diets. Reviews of the impacts of these policies show that the effects are often modest. This has led governments to implement, in more recent times, policies focused on the market environment, especially on the characteristics of the food supply. The goal of this paper is to review theoretical and empirical studies focusing on changes in the food supply induced by alternative policies, and to attempt to draw from them policy guidelines and conjectures to test in future research.