Send to

Choose Destination
Obes Rev. 2019 Jul 22. doi: 10.1111/obr.12879. [Epub ahead of print]

A comparison of the healthiness of packaged foods and beverages from 12 countries using the Health Star Rating nutrient profiling system, 2013-2018.

Author information

Food Policy Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia.
National Institute for Health Innovation, University of Auckland, New Zealand.
School of Public Health, The University of Sydney, Sydney, Australia.
School of Population Health, University of Auckland, Auckland, New Zealand.
Global Obesity Centre, Deakin University, Victoria, Australia.
Nutrition and Public Health research group, Nutrition Institute, Ljubljana, Slovenia.
Nutrition and Health Research Center (CINyS), National Institute of Public Health of Mexico, Cuernavaca, Mexico.
Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.
University of Toronto, Toronto, Canada.


We compared the healthiness of packaged foods and beverages between selected countries using the Health Star Rating (HSR) nutrient profiling system. Packaged food and beverage data collected 2013-2018 were obtained for Australia, Canada, Chile, China, India, Hong Kong, Mexico, New Zealand, Slovenia, South Africa, the UK, and USA. Each product was assigned to a food or beverage category and mean HSR was calculated overall by category and by country. Median energy density (kJ/100 g), saturated fat (g/100 g), total sugars (g/100 g) and sodium (mg/100 g) contents were calculated. Countries were ranked by mean HSR and median nutrient levels. Mean HSR for all products (n = 394,815) was 2.73 (SD 1.38) out of 5.0 (healthiest profile). The UK, USA, Australia and Canada ranked highest for overall nutrient profile (HSR 2.74-2.83) and India, Hong Kong, China and Chile ranked lowest (HSR 2.27-2.44). Countries with higher overall HSR generally ranked better with respect to nutrient levels. India ranked consistently in the least healthy third for all measures. There is considerable variability in the healthiness of packaged foods and beverages in different countries. The finding that packaged foods and beverages are less healthy in middle-income countries such as China and India suggests that nutrient profiling is an important tool to enable policymakers and industry actors to reformulate products available in the marketplace to reduce the risk of obesity and NCDs among populations.


food labelling; health star rating; nutrient profiling; packaged food


Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center