title: A survey of the reformulation of Australian child-oriented food products.
abstract: BACKGROUND
  Childhood obesity is one of the most pressing public health challenges of the 21st century. Reformulating commonly eaten food products is a key emerging strategy to improve the food supply and help address rising rates of obesity and chronic disease. This study aimed to monitor reformulation of Australian child-oriented food products (products marketed specifically to children) from 2009-2011.
  
  
  METHODS
  In 2009, all child-oriented food products in a large supermarket in metropolitan Adelaide were identified. These baseline products were followed up in 2011 to identify products still available for sale. Nutrient content data were collected from Nutrient Information Panels in 2009 and 2011. Absolute and percentage change in nutrient content were calculated for energy, total fat, saturated fat, sugars, sodium and fibre. Data were descriptively analysed to examine reformulation in individual products, in key nutrients, within product categories and across all products. Two methods were used to assess the extent of reformulation; the first involved assessing percentage change in single nutrients over time, while the second involved a set of nutrient criteria to assess changes in overall healthiness of products over time.
  
  
  RESULTS
  Of 120 products, 40 remained unchanged in nutrient composition from 2009-2011 and 80 underwent change. The proportions of positively and negatively reformulated products were similar for most nutrients surveyed, with the exception of sodium. Eighteen products (15%) were simultaneously positively and negatively reformulated for different nutrients. Using percentage change in nutrient content to assess extent of reformulation, nearly half (n = 53) of all products were at least moderately reformulated and just over one third (n = 42) were substantially reformulated. The nutrient criteria method revealed 5 products (6%) that were positively reformulated and none that had undergone negative reformulation.
  
  
  CONCLUSIONS
  Positive and negative reformulation was observed to a similar extent within the sample indicating little overall improvement in healthiness of the child-oriented food supply from 2009-2011. In the absence of agreed reformulation standards, the extent of reformulation was assessed against criteria developed specifically for this project. While arbitrary in nature, these criteria were based on reasonable assessment of the meaningfulness of reformulation and change in nutrient composition. As well as highlighting nutrient composition changes in a number of food products directed to children, this study emphasises the need to develop comprehensive, targeted and standardised reformulation benchmarks to assess the extent of reformulation occurring in the food supply.
authors.affiliation: Nutrition and Dietetics, School of Medicine, Flinders University, Sturt Road, Bedford Park, Adelaide, South Australia, Australia. stephanie.savio@adam.com.au.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Savio
authors.forename: Kaye
authors.initials: K
authors.lastname: Mehta
authors.forename: Tuesday
authors.initials: T
authors.lastname: Udell
authors.forename: John
authors.initials: J
authors.lastname: Coveney
mesh_terms: D000293:Adolescent; D001315:Australia; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004038:Diet, Reducing; D004435:Eating; D005247:Feeding Behavior; D005260:Female; D005502:Food / Q000592:standards*; D018857:Food Packaging / Q000592:standards; D005523:Food Supply; D006801:Humans; D008297:Male; D020380:Needs Assessment; D009751:Nutritional Requirements; D009753:Nutritive Value; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control*; D011634:Public Health
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