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Application of the WHO Nutrient Profile Model to products on the German market: Implications for proposed new food marketing legislation in Germany

Holliday, N.; Leibinger, A.; Huizinga, O.; Klinger, C.; Okanmelu, E.; Geffert, K.; Rehfuess, E.; von Philipsborn, P.

2023-04-26 nutrition
10.1101/2023.04.24.23288785 medRxiv
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BackgroundExposure to marketing for foods high in sugar, salt, and fat is considered a key risk factor for childhood obesity. To support efforts to limit such marketing, the World Health Organization Regional Office for Europe has developed a nutrient profile model (WHO NPM). Germanys Federal Ministry of Food and Agriculture plans to use this model in proposed new legislation on food marketing directed towards children, but the model has not yet been tested on products on the German market. Against this backdrop, the present paper aims to assess the feasibility and implications of implementing the WHO NPM in Germany. MethodsWe applied the WHO NPM to a random sample of 660 food and beverage products across 22 product categories on the German market drawn from Open Food Facts, a publicly available product database. We calculated the share of products permitted for marketing to children based on the WHO NPMs nutrient and ingredient criteria, both under current market conditions and for several hypothetical reformulation scenarios. We also assessed effects of adaptations to and practical challenges in applying the WHO NPM. ResultsThe median share of products permitted for marketing to children across the models 22 product categories was 20% (interquartile range (IQR) 3-59%) and increased to 38% (IQR 11-73%) with model adaptations for fruit juice and milk proposed by Germanys Federal Ministry of Food and Agriculture. With targeted reformulation (assuming a 30% reduction in fat, sugar, sodium and/or energy) the share of products permitted for marketing to children increased substantially (defined as a relative increase by at least 50%) in several product categories (including bread, processed meat, yogurt and cream, ready-made and convenience foods, and savoury plant-based foods), but changed less in the remaining categories. Practical challenges in applying the model included the ascertainment of the trans-fatty acid content of products, and the classification of products not required to carry nutrient declarations, such as fresh meats, fish, and similar products. DiscussionThe application of the WHO NPM to a random sample of food and beverage products on the German market was found to be feasible. Its use in the proposed new legislation on food marketing in Germany seems likely to serve its intended public health objective of limiting marketing in a targeted manner specifically for less healthy products. It seems plausible that it may incentivise reformulation in some product categories. Practical challenges in applying the model could be addressed with appropriate adaptations and procedural provisions.

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