Do front‐of‐pack nutrition rating systems and symbols (FOPS) direct consumers to the healthiest products in an unregulated environment?

Concern has been raised that unregulated FOPS may mislead consumers into believing that a single food is ‘healthier’ than foods not bearing the FOPS. The nutritional criteria of a non‐profit (Health Check™) and a manufacturer (Sensible Solutions™) FOPS were applied to a national database of packaged food products. The proportion of foods qualifying for a given FOPS was compared to the proportion carrying the FOPS using exact binomial test. 7503 and 3010 of the 10,487 foods in the database could be assigned a Health Check™ or Sensible Solutions™ food category, respectively. 3360 (44.8%) of the foods assigned a Health Check™ category qualified for a Health Check™ symbol and 560 (7.5%) foods carried the symbol. Up to 2380 (79.1%) of the foods assigned a Sensible Solutions™’ category qualified for a Sensible Solutions™ symbol and 122 (4.1%) foods carried the symbol. The discord between products qualifying for and carrying these FOPS persisted at the food category and subcategory level. More than 75% of the products in many of the subcategories of either FOPS qualified for their respective symbols. These results suggest that FOPS are not always a useful guide to identifying the healthiest food products as more products qualify for these systems than are identified by the systems’ symbols. Grant Funding Source : Earle W. Mc Henry Research Chair Award (M.L.), CIHR Frederick Banting and Charles Best Canada Graduate Scholarship, Cancer Care Ontario/CIHR Training Grant in Population Intervention for Chronic Disease Prevention: A Pan‐ Canadian Program (#53893), and CIHR Strategic Training Program in Public Health Policy (T.E.)