Abstract
In response to the need for better guidance and regulation for commercially produced infant and toddler foods and beverages, the WHO Regional Office for Europe published a Nutrient and Promotion Profile Model (hereafter NPPM) in 2022. This study assessed the nutritional and promotional profile of infant and toddler foods (for ages 6–36 months) sold in Australian supermarkets in 2022 using the NPPM. The main types of claims used for product promotion were also examined and results were presented by category and by packaging type. Nutrient and claims data were extracted for commercially produced infant and toddler products from The George Institute's FoodSwitch database. Products were classified according to NPPM food categories and assessed against relevant nutritional and promotional requirements. Of the 309 products examined, 78% failed to meet the nutritional requirements of the NPPM, and 0% met the promotional requirements. Every product had at least one claim on‐pack that was prohibited under the NPPM, with some products displaying up to 21 different claims on‐pack. Pouches had the highest number of prohibited claims of all packaging types. Findings highlight that urgent work is needed to improve the nutritional quality of commercially produced infant and toddler foods in Australia. The high use of prohibited claims also suggests the need to regulate the type and number of claims that can be made on‐pack, as parents and carers could easily be misled by the deceptive labelling that is currently allowed to be displayed.
Keywords: baby food, claims, infants, marketing, nutrient profiling, promotion, toddlers
Every commercially produced infant and toddler food product available in Australian supermarkets in 2022 failed to meet World Health Organization recommendations for product promotion. Pouches have experienced rapid growth in the infant and toddler food market in Australia and currently represent more than 50% of all products available on supermarket shelves.
Key messages
Every commercially produced infant and toddler food product available in Australian supermarkets in 2022 failed to meet World Health Organization recommendations for product promotion.
A total of 78% of products did not meet the overall nutritional requirements. This was most commonly due to products failing energy and total sugar content requirements.
Up to 21 different claims were found on product packaging, with products on average displaying 6.7 claims.
Pouches, which have experienced rapid growth in the infant and toddler food market in Australia, currently represent more than 50% of all products available on supermarket shelves. This is concerning, given these products had the highest use of prohibited claims.
1. INTRODUCTION
The World Health Organization (WHO) recommends mothers exclusively breastfeed infants from birth to 2 years, with the introduction of solid foods starting around 6 months of age, complementary to breastfeeding (World Health Organization, 2023). However, qualitative research from Australia indicates that the majority of children start consuming commercially produced foods between 4 to 6 months of age (Food Standards Australia New Zealand, 2004). As infants and toddlers have an innate taste preference towards sweet/salty foods, these foods tend to be readily consumed in preference to foods containing less sweet tastes, such as vegetables. This is a concern, given dietary habits are formed as early as 2 years of age (Skinner et al., 2002) and have been shown to persist over time, meaning the healthfulness of early childhood dietary choices may directly impact metabolic health in adulthood (Pearce & Langley‐Evans, 2013).
A wide range of commercially produced infant and toddler foods are available for purchase in Australian supermarkets. Several studies have emerged in recent years showing that commercial infant and toddler foods in Australia are not in line with global standards, with the most recent study showing that 90% of products contained free sugars (defined as any added sugars, plus sugars naturally present in honey, syrups and unsweetened fruit juices), and less than 50% met the draft nutritional criteria established by the WHO (Scully et al., 2023). Other research supports these general findings, showing overall a suboptimal nutritional profile of commercially produced infant and toddler foods in Australia (Dunford et al., 2015). This is despite the Australian Infant Feeding Guidelines stating ‘that consumption of nutrient‐poor foods with high levels of fat/saturated fat, sugar, and/or salt should be avoided or limited’ and no sugars should be added to food for children under 12 months of age (National Health and Medical Research Council, 2013).
Over USD$500 million in retail sales of infant and toddler foods was seen in 2021, with this number expected to increase further in future years (Knowledge Sourcing Intelligence, 2021). Considering that the infant and toddler food market in Australia is projected to grow at a rate of 4.5% per year (Knowledge Sourcing Intelligence, 2021), it is critical to understand the healthfulness of products available for consumers to purchase. Concerningly, trends data has shown a substantial increase in sales of sugar through the infant and toddler foods sector, rising by more than 200 million grams of sugar overall between 2010 and 2021 (Euromonitor Passport, 2022), mirroring global trends of increases in sugar sales through infant and toddler foods (Dunford & Popkin, 2023). Another trend in the market is the move towards convenient packaging in the form of squeeze pouches and single‐serve snack foods (Chung et al., 2023). In particular, the demand for wet infant food packed in pouch‐and‐spout containers has grown exponentially in recent years in Australia (IBIS World, 2023), with previous studies indicating that these products dominate supermarket shelves in the infant and toddler food section, representing in some cases more than 50% of all products available for purchase (Brunacci et al., 2023; Moumin et al., 2020).
A further concern is the use of health and nutrition content claims and wellness messaging. These claims are commonly used on products that contain added nutrients of concern and can contribute to a ‘health halo’ effect, with consumers considering such products to be ‘healthy’ (Kaur et al., 2017). The infant and toddler food sector is no exception. Promotional claims on commercially produced infant and toddler foods can mislead or distract consumers from undesirable qualities, for example, emphasising the use of organic ingredients, convenience, taste or smooth texture to distract from a poor nutrient profile (McCann, Russell & Campbell, & Woods, 2021). These claims and messages influence parental food purchases (Harris et al., 2011), which in turn can influence the eating habits of infants and toddlers.
In response to the need for better guidance and regulation for commercially produced infant and toddler products in Europe, the WHO Regional Office for Europe published 'Nutrient and promotion profile model: supporting appropriate promotion of food products for infants and young children of 6–36 months in the WHO European Region' (hereafter WHO NPPM) in 2022 (World Health Organization, 2022a). The WHO NPPM is designed to support policy changes in the early childhood foods sector to ensure commercial foods for young children aged 6–36 months are of high nutritional quality and are promoted appropriately. Currently, no such nutrition or promotional guidelines exist for Australia and there are no specific compositional regulations for commercially‐produced toddler foods. As such, the primary aim of this study was to assess the nutritional and promotional profile of infant and toddler foods sold in Australian supermarkets in 2022 using the WHO NPPM. The secondary objective was to explore the main types of claims used for product promotion. Given the literature around the changing landscape of the infant and toddler food sector with respect to packaging type, we also examined changes in retail sales of commercially produced infant and toddler foods by packaging type between 2012 and 2022 and the difference in nutrition composition and claims used by packaging type in 2022.
2. METHODS
2.1. Data sources
This study used data from The George Institute's FoodSwitch programme. This programme captures images of packaged foods and beverages using a mobile phone application, allowing for the extraction and collation of key food labelling and food composition data (Dunford et al., 2014). Using this process, the FoodSwitch Monitoring Datasets are generated annually based on data collected from four large Australian supermarkets owned by Aldi, Coles, Independent Grocers of Australia (IGA) and Woolworths in the Sydney metropolitan area. In‐store surveys of all foods and beverages in these stores are conducted by trained data personnel who capture images of key information, including Universal Product Code (UPC), product name, presence of front‐of‐pack nutrition labelling, health and nutrient content claims, ingredients list, manufacturer and brand names and the nutrition label information. The database represents more than 90% of the Australian packaged food market (Dunford et al., 2014). The 2022 FoodSwitch Monitoring Data set was used in this study. The following fields of information were extracted: UPC, brand name, product name, all health and nutrition‐related claims, nutrients per 100 g (energy, protein, total fat, saturated fat, total sugars, added sugars [where available], sodium) and full ingredients list.
Sales data for infant and toddler foods were obtained from Euromonitor Passport (Euromonitor Passport, 2022). Data were obtained for each year between 2012 and 2022.
2.2. Food categorisation
Each product was coded into one of 8 of the WHO's broad food categories (World Health Organization, 2022a): (1) Dry cereals and starches, (2) Dairy foods, (3) Fruit and vegetable purées/smoothies and fruit desserts, (4) Savoury meals/meal components: combinations of starches, vegetables, dairy and/or traditional protein, (5) Snacks and finger foods, (6) Ingredients, (7) Confectionery and (8) Drinks. Within each broad category, products were further classified into sub‐categories according to the WHO NPPM (Supporting Information S1: Table S1). Each product was also assigned to one of four product packaging type categories (pouches, full‐size packages, snack‐size packs and ready‐to‐eat (RTE) jars/tubs).
2.3. Applying the WHO nutrient composition criteria (Part A)
All products were assessed against the relevant NPPM nutrient composition standards for their subcategory. Each subcategory has its distinct nutritional criteria (Supporting Information S1: Table S1), and not all nutrient composition criteria are relevant to each subcategory. To evaluate Australian products against the WHO NPPM, recalculations of some nutritional elements were required:
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Energy: Energy per 100 g was calculated as energy in kilojoules divided by 4.18 to derive kcal/100 g.
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Sodium: Sodium per 100 kcal was derived by dividing sodium content per 100 g by kcal/100 g and multiplying by 100.
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Total sugar: Total sugar (% E) was calculated by dividing total sugar per 100 g by kcal/100 g and multiplying by 100.
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Added sugar or sweeteners: The presence of added sugar or sweeteners was determined by keyword searches in the ingredient lists, as added sugar and sweetener content are not required to be listed on nutrition labels in Australia.
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Protein: Total protein (g/100 kcal) was calculated by dividing total protein per 100 g by kcal/100 g and multiplying by 100. Protein weight was determined at the individual product level using the ingredient list (characterising ingredients in Australia must have their proportions labelled).
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Total fat: Total fat (g/100 kcal) was calculated by dividing total fat per 100 g by kcal/100 g and multiplying by 100.
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Fruit content: The percent weight of fruit content was determined at an individual product level using the proportions stated on ingredient lists.
The WHO NPPM also recommends that the appropriate age range (i.e., 6–12 months for puree products and 6–36 months for all other products) is specified by each product. As such, the age label (in months) was also captured and recorded for each product.
2.4. Applying the WHO promotion criteria (Part B)
Part B of the WHO NPPM outlines 6 promotional requirements that should be met by each product (Supporting Information S1: Table S2). Each product was individually screened against each of the 6 criteria to determine whether they 'passed' or 'failed' each criterion, as well as Part B overall. To examine the 'compositional, nutritional, health or marketing claims' component of Part B in further detail, a claims coding framework was created, adapted from previous studies examining baby food claims (McCann, Russell, & Woods, 2021; Simmonds et al., 2021), with modifications where required to ensure all claims were captured in the taxonomy (Supporting Information S1: Table S3). In brief, claims were placed into one of 13 high‐level claim categories (allergen‐related claims, cooking method claims, nutrition content claims, ingredient‐based claims, safety claims, country of origin claims, general wellbeing claims, health claims, religion‐based claims, serving‐based claims, texture‐based claims, vegan/vegetarian claims and miscellaneous claims) then into relevant sub‐categories. Claims were also coded as 'allowed' or 'prohibited' under the WHO NPPM. Allowed claims were those related to allergens, religious claims or vegetarian/vegan claims. All remaining claims were considered prohibited.
2.5. Statistical analyses
Statistical analyses were undertaken using Stata V18. The number and proportion of products compliant with each part of the WHO NPPM nutritional and promotional criteria were calculated. In addition, the proportion of products containing each type of claim was examined, as well as the mean and range of number of claims reported on‐pack. Results were examined by WHO NPPM sub‐categories as well as by packaging type. Sales data from Euromonitor International were used to demonstrate changes in the sales of infant and toddler foods by packaging type between 2012 and 2022.
3. RESULTS
Out of 395 products in the infant and toddler food category derived from the 2022 FoodSwitch database, 309 were able to be mapped to a WHO subcategory and were therefore included in the analysis. The remaining 86 products were infant formula and therefore excluded from analysis. The number of products within each WHO subcategory ranged from n = 4 (Fruit snacks) to n = 95 (Fruit‐containing products) (Table 1). Zero products were found for the 'Ingredients' category, and the 'Protein source is the only named food' subcategory. Out of the 309 products examined, 178 (58%) were pouches, and a further 18% (n = 55) were snack‐size packs (Supporting Information S1: Table S4).
Table 1.
Compliance of Australian commercial infant and toddler food products to the WHO NPPM nutritional criteria by food category.
| Food category | Subcategory | Total number and percentage of compliant products (n, %) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Energy density (kcal/100 g) | Sodium (mg/100 kcal) | Total sugar (% energy) | Added free sugar or sweetener | Total protein (g/100 kcal) | Total fat (g/100 kcal) | Fruit content (% weight) | Compliance with all | ||
| Dry cereals and starches | Dry or powdered cereal/starch (n = 13) | 1 (13%) | 13 (100%) | N/A | 8 (62%) | 13 (100%) | 13 (100%) | 11 (85%) | 1 (13%) |
| Dairy | Dairy‐based foods, desserts and cereals (n = 17) | 17 (100%) | 17 (100%) | N/A | 0 (0%) | N/A | 17 (100%) | 17 (100%) | 0 (0%) |
| Fruit & vegetable purées/smoothies and fruit desserts | Fruit‐containing product (n = 95) | 63 (66%) | 94 (99%) | N/A | 85 (89%) | N/A | 93 (98%) | N/A | 34 (36%) |
| Vegetable only product (n = 5) | 3 (60%) | 5 (100%) | N/A | 5 (100%) | N/A | 5 (100%) | 5 (100%) | 3 (60%) | |
| Savoury meals/meal components: combinations of starches, vegetables, dairy and/or traditional protein | Food without protein or cheese named (n = 28) | 11 (39%) | 16 (57%) | 13 (46%) | 21 (75%) | 19 (68%) | 27 (96%) | 28 (100%) | 1 (4%) |
| Food with cheese named but no protein (n = 6) | 6 (100%) | 6 (100%) | 5 (83%) | 5 (83%) | 6 (100%) | 6 (100%) | 6 (100%) | 4 (67%) | |
| Food with protein source not named first (n = 16) | 9 (56%) | 11 (69%) | 11 (69%) | 12 (75%) | 9 (56%) | 15 (94%) | 14 (88%) | 3 (19%) | |
| Food with protein source named first (n = 37) | 24 (65%) | 24 (65%) | 18 (49%) | 31 (84%) | 12 (32%) | 37 (100%) | 36 (97%) | 2 (5%) | |
| Protein source is only named food (n = 0) | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | |
| Snacks and finger foods | Fruit (n = 4) | 4 (100%) | 4 (100%) | N/A | 3 (75%) | N/A | 4 (100%) | 2 (50%) | 2 (50%) |
| Dry or semi‐dry snacks and finger foods (n = 78) | 40 (51%) | 57 (73%) | 55 (71%) | 39 (50%) | 77 (99%) | 73 (94%) | N/A | 19 (24%) | |
| Ingredients | Ingredients (n = 0) | N/A | ‐ | N/A | ‐ | N/A | N/A | N/A | ‐ |
| Confectionery | Confectionery (n = 10) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | ‐ |
| Overall | 178 (60%) | 247 (83%) | 102 (62%) | 209 (70%) | 136 (76%) | 290 (97%) | 119 (94%) | 69 (22%) | |
Abbreviations: NPPM, Nutrient and Promotion Profile Model; WHO, World Health Organisation.
3.1. Nutrient composition compliance (Part A)
Overall, 22% of products were compliant with all of the relevant Part A subcategory nutrient composition requirements under the WHO NPPM (Table 1). The lowest compliance among all products was seen for 'energy density' (60%) and the highest for 'total fat' (97%). Overall compliance by subcategory ranged from 0% of ‘Dairy’ products to 67% of ‘Food with cheese named but no protein.’ Most products (94%) were compliant with the restrictions imposed on the use of fresh or dried fruit as ingredients. There was a wide range of compliance in relation to energy density, from 13% of ‘Dry or powdered cereals’ to 100% of ‘Fruit’ snacks, ‘Dairy’ products and ‘Food with cheese named but no protein.’ Only 62% of all products were compliant with total sugar requirements. Although 70% of products were compliant with requirements to not include added free sugars or sweeteners, compliance by subcategory ranged from 0% of ‘Dairy’ products to 100% of ‘Vegetable only products.’ Interestingly, the majority of subcategories under the ‘Savoury meals’ category did not meet the NPPM's total protein and protein weight requirements. Only one of the four savoury meal subcategories had 100% compliance, with the remaining three subcategories ranging from 32% to 68%.
3.2. Promotional criteria compliance (Part B)
Overall, 0% of products were compliant with all of the relevant Part B promotional requirements (Table 2). This was due to 0% of products meeting the 'no prohibited claims' requirement. There were also 0% of products meeting the promotion and protection of breastfeeding criteria. The highest compliance was seen with instructions not to consume pouches via the spout (85%). Two‐thirds (68%) of products had a name that accurately reflected the ingredient list, but only 43% met the ingredient list clarity requirements. There was a wide range of compliance with regard to product name clarity, from 3% for ‘Food with protein source named first’ to 100% for 'Dry cereals and starches.’ A similarly broad range of compliance was observed for ingredient list clarity, with low compliance ( < 12%) for all savoury meal subcategories to 100% for ‘Fruit’ snacks. Compliance for most of the Part B requirements was highest overall for both snack subcategories compared to all other categories.
Table 2.
Compliance of Australian commercial infant and toddler food products to the WHO NPPM labelling and promotion criteria by food category.
| Food category | Subcategory | Total number and percentage of compliant products (n, %) | ||||||
|---|---|---|---|---|---|---|---|---|
| Age label (months) | No prohibited claims | Product name clarity | Ingredient list clarity | Instructions not to consume via pack spout | Suitable preparation instructions | Promotion and protection of breastfeeding | ||
| Dry cereals and starches | Dry or powdered cereal/starch (n = 13) | 11 (85%) | 0 (0%) | 13 (100%) | 6 (46%) | N/A | 0 (0%) | 0 (0%) |
| Dairy | Dairy‐based foods, desserts and cereals (n = 17) | 17 (100%) | 0 (0%) | 15 (88%) | 2 (12%) | 15 (100%) | ‐ | 0 (0%) |
| Fruit & vegetable purées/smoothies and fruit desserts | Fruit‐containing product (n = 95) | 59 (62%) | 0 (0%) | 65 (68%) | 53 (56%) | 66 (80%) | ‐ | 0 (0%) |
| Vegetable only product (n = 5) | 5 (100%) | 0 (0%) | 4 (80%) | 2 (40%) | 2 (100%) | ‐ | 0 (0%) | |
| Savoury meals/meal components: combinations of starches, vegetables, dairy and/or traditional protein | Food without protein or cheese named (n = 28) | 27 (96%) | 0 (0%) | 20 (71%) | 3 (11%) | 10 (83%) | ‐ | 0 (0%) |
| Food with cheese named but no protein (n = 6) | 6 (100%) | 0 (0%) | 5 (83%) | 0 (0%) | 0 (0%) | ‐ | 0 (0%) | |
| Food with protein source not named first (n = 16) | 15 (94%) | 0 (0%) | 6 (38%) | 1 (6%) | 4 (80%) | ‐ | 0 (0%) | |
| Food with protein source named first (n = 37) | 37 (100%) | 0 (0%) | 1 (3%) | 4 (11%) | 18 (100%) | ‐ | 0 (0%) | |
| Protein source is only named food (n = 0) | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | |
| Snacks and finger foods | Fruit (n = 4) | 4 (100%) | 0 (0%) | 3 (91%) | 4 (100%) | N/A | ‐ | 0 (0%) |
| Dry or semi‐dry snacks and finger foods (n = 78) | 78 (100%) | 0 (0%) | 71 (91%) | 54 (69%) | N/A | ‐ | 0 (0%) | |
| Ingredients | Ingredients (n = 0) | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ |
| Confectionery | Confectionery (n = 10) | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ |
| Overall | N = 309 | 259 (87%) | 0 (0%) | 203 (68%) | 129 (43%) | 115 (85%) | 0 (0%) | 0 (0%) |
Abbreviations: NPPM, Nutrient and Promotion Profile Model; WHO, World Health Organization.
3.3. Frequency and types of claims on‐pack
The mean number of claims per product was 6.7, with a range of 1 to 21 (Table 3). The snack subcategories had the highest proportion of claims overall, as well as most types of high‐level claims. ‘Dry or semi‐dry snacks’ had the largest range of prohibited claims per product, ranging from 2 to 12 as well as the highest mean number of allowed claims on‐pack (2.5; range from 0 to 13). Of all 13 high‐level categories of claims examined, the three types that appeared most on infant and toddler food packages were ingredient claims (88%), nutrition content claims (82%) and general health and wellbeing claims (47%); Supporting Information S1: Table S5. 'Free from colours and flavours' was the most common 'free from' claim type (appearing on 85% of products, usually in tandem), and 67% claimed to be 'free from preservatives.' Almost half of all products carried either a 'no added salt' or 'no added sugar claim,' with 34% of products displaying both these claims in tandem.
Table 3.
Number and proportion of allowed and prohibited claims under the WHO NPPM by subcategory.
| Allowed claims | Prohibited claims | All claims | |||||||
|---|---|---|---|---|---|---|---|---|---|
| n (%) displaying | Mean (SD) number of claims | Range | n (%) displaying | Mean (SD) number of claims | Range | n (%) displaying | Mean (SD) number of claims | Range | |
| Dry or powdered cereal/starch | 3 (23%) | 0.2 (0.4) | 0–1 | 13 (100%) | 6.2 (2.7) | 3–11 | 13 (100%) | 6.8 (2.7) | 4–12 |
| Dairy‐based foods, desserts and cereals | 3 (18%) | 0.5 (1.2) | 0–3 | 17 (100%) | 3.8 (1.0) | 3–6 | 17 (100%) | 4.8 (1.9) | 3–9 |
| Fruit‐containing product | 7 (7%) | 0.1 (0.5) | 0–2 | 95 (100%) | 5.6 (2.0) | 2–9 | 95 (100%) | 5.9 (2.1) | 2–10 |
| Vegetable only product | 0 (0%) | 0.0 (0.0) | 0–0 | 5 (100%) | 5.4 (1.3) | 4–7 | 5 (100%) | 5.8 (0.8) | 5–7 |
| Food without protein or cheese named | 3 (11%) | 0.2 (0.8) | 0–4 | 28 (100%) | 5.9 (2.2) | 1–9 | 28 (100%) | 6.3 (2.4) | 1–11 |
| Food with cheese named but no protein | 0 (0%) | 0.0 (0.0) | 0–0 | 6 (100%) | 5.8 (2.2) | 4–10 | 6 (100%) | 6.2 (2.3) | 4–10 |
| Food with protein source not named first | 0 (0%) | 0.0 (0.0) | 0–0 | 16 (100%) | 5.6 (2.4) | 3–11 | 16 (100%) | 5.9 (2.4) | 3–11 |
| Food with protein source named first | 0 (0%) | 0.0 (0.0) | 0‐–0 | 37 (100%) | 5.6 (1.4) | 2–7 | 37 (100%) | 5.7 (1.5) | 2–8 |
| Protein source is only named food | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ |
| Fruit | 4 (100%) | 2.0 (1.4) | 1–4 | 4 (100%) | 7.0 (2.9) | 4–10 | 4 (100%) | 9.5 (1.3) | 8–11 |
| Dry or semi‐dry snacks and finger foods | 43 (55%) | 2.5 (3.5) | 0–13 | 78 (100%) | 5.7 (2.1) | 2–12 | 78 (100%) | 8.6 (4.4) | 3–21 |
| Ingredients | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ |
| Confectionery | 4 (40%) | 1.7 (2.4) | 0–5 | 10 (100%) | 5.3 (0.7) | 4–6 | 10 (100%) | 7.4 (2.9) | 4–12 |
| Overall | 67 (22%) | 0.8 (2.1) | 0–13 | 309 (100%) | 5.6 (2.0) | 1–12 | 309 (100%) | 6.7 (3.1) | 1–21 |
Abbreviations: NPPM, Nutrient and Promotion Profile Model; WHO, World Health Organization.
3.4. Nutrition composition, promotional criteria and claims use by packaging type
Nutrition composition compliance by packaging type varied across most nutritional requirements (Supporting Information S1: Table S4). Overall compliance ranged from 9% for full‐size packages to 29% for snack‐size packages. However, there were no specific trends observed in relation to packaging type and the various nutrient composition requirements. Regarding compliance with promotional criteria, pouches had the lowest compliance for the most part B requirements compared to other packaging types. For example, only 56% of pouches were compliant with product name clarity requirements compared to more than 70% for all other packaging types, and only 33% of pouches were compliant with ingredient list clarity requirements. With respect to claims, pouches had the highest mean number of prohibited claims out of all packaging types (5.8, range = 1 to 11) and RTE jars and tubs the lowest (4.0, range = 2 to 7), while full‐size packs had the highest mean number of all claims (8.2, range = 3 to 21; Figure 1). Of all packaging types, pouches had the highest proportion of ingredient claims (96%) and nutrition content claims (85%), with snack‐size packages having the highest proportion of general health and wellbeing claims (65%; Supporting Information S1: Figure S1). Snack‐size packages and pouches had the highest proportion of products displaying an organic claim (55% and 44%, respectively), with pouches containing the highest proportion of 'no added' claims (74%), 'free from' claims (95%) and 'source of' claims (30%). A dramatic increase in the proportion of sales of pouch products (and a concurrent decrease in RTE tubs/jars) was observed, from 28% in 2012 to 43% in 2022 (Figure 2).
Figure 1.
Mean number of claim types on Australian infant and toddler foods by packaging type.
Figure 2.
Changes in the proportion of sales of Australian baby foods by packaging type, 2012–2022.
4. DISCUSSION
In this examination of 309 commercially produced infant and toddler foods available in Australian supermarkets, every product failed to meet recommendations set by the World Health Organization. None met the promotional requirements and 78% did not meet overall nutritional requirements specified under the WHO's NPPM. These findings are concerning given the huge growth in infant and toddler foods in Australia, especially in pouches, which were shown in this study to have the highest use of prohibited claims. Results echo the findings of a recent Australian study that found that only one‐third of products met nutritional recommendations set out under the draft WHO NPPM (Scully et al., 2023).
There was substantial variation observed in compliance with the WHO NPPM's criteria. Concerningly, the lowest compliance for the nutritional requirements was for energy density and total sugar content, with over one‐third of products exceeding the total sugar recommendations. Analyses by packaging type showed that pouches, as previous research has demonstrated (Brunacci et al., 2023), dominate the market, representing more than half of all products examined in 2022. Data from Euromonitor Passport also show the fast‐growing rise of pouch‐based packaging in the infant and toddler food market, with this category representing around 28% of the market in 2012, increasing to 43% of the market in 2022. Only 50% of pouches met the total sugar requirement in the WHO NPPM, supporting research from other groups showing that pouch products contain higher amounts of sugar compared to other packaging types in the infant and toddler food sector (Padarath et al., 2020). The high levels of sugar in infant and toddler food products in Australia are of concern, given excess sugar consumption is a primary cause of obesity and related diseases, including diabetes, heart disease and some cancers (World Health Organization, 2022b). In light of these health risks and the knowledge that sales of sugar through the infant and toddler food sector in Australia (and globally) are increasing, these findings support the notion that policymakers should consider setting limits on the use of free sugars in infant and toddler food products.
The driving factor behind zero products in the current analysis meeting the WHO's promotional criteria was that every product displayed at least one prohibited claim on‐pack. Coupled with the fact that infant and toddler food products contain up to 21 different claims on a single package, it is clear that parents are faced with a huge amount of information when deciding which foods to purchase for their young children. Most concerning is that most of these claims are prohibited under the WHO NPPM, with only a much smaller proportion displaying allowed claims (e.g. “Gluten free,” “Vegan”). A recent study examining changes over time in the Australian infant and toddler food sector found that the mean number of total claims per product increased for baby snacks, particularly unregulated claims such as “healthy” (McCann, Russell, & Woods, 2021), echoing the present study's findings. Pouches had the highest mean number of prohibited claims out of all packaging types, which aligns with previous research showing that baby pouch products frequently contain misleading claims on the pack (Brunacci et al., 2023). The high use of claims is worrying, given parents have expressed concerns about unknowingly exposing their infants to sweet tastes and less healthy food options more regularly than intended due to misleading labelling (Garcia et al., 2016). This is because parents may assume that the product is healthier than the nutritional makeup would suggest due to multiple claims on the pack promoting the product's apparent ‘healthiness’. For example, a review by Public Health England showed that parents perceived products as healthy when wordings such as ‘organic’ or ‘free from sugar’ were used on‐pack (Public Health England, 2019).
These findings come at a time when there is fast‐growing development in the literature around the world about the health risks associated with ultra‐processed foods, foods that are industrially processed and contain additives and often less desirable ingredients, including added sugars (Neri et al., 2019). Longitudinal studies have demonstrated a positive association between the consumption of ultra‐processed foods and obesity in young children (De Amicis et al., 2022; Dunford & Popkin, 2023). The presence of industrial additives is one of the many markers of ultra‐processed foods. Although we did not examine additives in the present study, future research would benefit from an in‐depth exploration of ingredients used in these foods, given that recent research out of the United States has shown that baby foods had the largest increase of any food category in terms of the proportion of products containing industrial additives, as well as the largest increase in the proportion of products containing 3+ additives (Dunford et al., 2023). Although some food additives are useful for increasing shelf life and food safety, a link exists between some types of food additives and negative health outcomes in young children (Trasande et al., 2018).
In December 2023, the Australian federal government announced that they are considering options to improve commercially produced infant and toddler foods (Australian Government, 2023). This research outlines some key areas of the market that are currently inadequate and would be important to address as part of future policies, such as the frequent use of claims on product packaging and high levels of total sugar and energy density in these foods. Given the prolific use of pouches, it will be important for packaging type to also be considered in policy‐making decisions. A key limitation of this study was that the WHO NPPM was developed for the European region and, therefore, is not 100% applicable to the Australian market. However, results from this study should be used to either adapt the European model for Australia or to support the development of an appropriate Australian model. The strengths of this analysis include the large database used, with the FoodSwitch database known to cover more than 90% of available products in Australian supermarkets.
5. CONCLUSIONS
This study found that no commercially produced infant and toddler food products in Australia met international standards for nutrition and product promotion. These findings should serve as an alarm bell for policymakers in Australia. Findings highlight that urgent work is needed to improve the nutritional quality of infant and toddler foods, particularly sugar and energy content. The high use of prohibited claims suggests the need to regulate the type and number of claims that can be made on‐pack, as parents and carers could easily be misled by the deceptive labelling that is currently displayed. The study also found that pouches are the fastest growing packaging type in the infant sector, with a 53% increase between 2012 and 22, and that these products contain high levels of sugar and frequent use of claims. Consequently, a reduction in the use of promotional claims, and the sugar content and energy content (particularly for pouches) should form the basis of future policies in the infant and toddler food sector for Australia.
AUTHOR CONTRIBUTIONS
Elizabeth K. Dunford and Daisy Coyle designed this research. Elizabeth K. Dunford conducted the analysis and drafted the paper. Maree Scully and Daisy Coyle reviewed the paper. Elizabeth K. Dunford, Maree Scully and Daisy Coyle all had joint primary responsibility for the final content.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflict of interest.
Supporting information
Supporting information.
ACKNOWLEDGEMENTS
Open access publishing facilitated by University of New South Wales, as part of the Wiley ‐ University of New South Wales agreement via the Council of Australian University Librarians.
Dunford, E. K. , Scully, M. , & Coyle, D. (2024). Commercially‐produced infant and toddler foods—How healthy are they? An evaluation of products sold in Australian supermarkets. Maternal & Child Nutrition, 20, e13709. 10.1111/mcn.13709
DATA AVAILABILITY STATEMENT
Research data are not shared.
REFERENCES
- De Amicis, R. , Mambrini, S. P. , Pellizzari, M. , Foppiani, A. , Bertoli, S. , Battezzati, A. , & Leone, A. (2022). Ultra‐processed foods and obesity and adiposity parameters among children and adolescents: A systematic review. European Journal of Nutrition, 61(5), 2297–2311. 10.1007/s00394-022-02873-4 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Australian Government . (2023). Improve commercial infant and toddler foods. Australian Government. https://www.foodregulation.gov.au/activities-committees/activities/improve-commercial-infant-and-toddler-foods [Google Scholar]
- Brunacci, K. A. , Salmon, L. , McCann, J. , Gribble, K. , & Fleming, C. A. K. (2023). The big squeeze: A product content and labelling analysis of ready‐to‐use complementary infant food pouches in Australia. BMC Public Health, 23(1), 656. 10.1186/s12889-023-15492-3 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chung, A. , Myers, J. , Skouteris, H. , & Backholer, K. (2023). Front‐of‐pack marketing on infant and toddler foods: Targeting children and their caregivers. Australian and New Zealand Journal of Public Health, 47(6):100101. 10.1016/j.anzjph.2023.100101 [DOI] [PubMed] [Google Scholar]
- Dunford, E. , Louie, J. C. Y. , Byrne, R. , Walker, K. Z. , & Flood, V. M. (2015). The nutritional profile of baby and toddler food products sold in Australian supermarkets. Maternal and Child Health Journal, 19(12), 2598–2604. 10.1007/s10995-015-1778-y [DOI] [PubMed] [Google Scholar]
- Dunford, E. , & Popkin, B. (2023). Ultra‐processed food for infants and toddlers; dynamics of supply and demand. Bulletin of the World Health Organization, 101(5), 358–360. 10.2471/blt.22.289448 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dunford, E. , Trevena, H. , Goodsell, C. , Ng, K. H. , Webster, J. , Millis, A. , Goldstein, S. , Hugueniot, O. , & Neal, B. (2014). FoodSwitch: A mobile phone app to enable consumers to make healthier food choices and crowdsourcing of national food composition data. JMIR mHealth and uHealth, 2(3), e37. 10.2196/mhealth.3230 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dunford, E. K. , Miles, D. R. , & Popkin, B. (2023). Food additives in ultra‐processed packaged foods: An examination of US household grocery store purchases. Journal of the Academy of Nutrition and Dietetics, 123(6), 889–901. 10.1016/j.jand.2022.11.007 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Euromonitor Passport . (2022). Online database. Euromonitor Passport. [Google Scholar]
- Food Standards Australia New Zealand . (2004). A qualitative consumer study related to food labelling of infant foods—A TNS Social Research Report. Food Standards Australia New Zealand. https://www.foodstandards.gov.au/sites/default/files/food-standards-code/proposals/Documents/P274_Food_for_Infants_DAR_FINAL.doc [Google Scholar]
- Garcia, A. L. , McLean, K. , & Wright, C. M. (2016). Types of fruits and vegetables used in commercial baby foods and their contribution to sugar content. Maternal & Child Nutrition, 12(4), 838–847. 10.1111/mcn.12208 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harris, J. L. , Thompson, J. M. , Schwartz, M. B. , & Brownell, K. D. (2011). Nutrition‐related claims on children's cereals: What do they mean to parents and do they influence willingness to buy? Public Health Nutrition, 14(12), 2207–2212. 10.1017/s1368980011001741 [DOI] [PubMed] [Google Scholar]
- IBIS World . (2023). Baby Food Manufacturing in Australia—Market Size, Industry Analysis, Trends and Forecasts (2024‐2029). IBIS World. https://www.ibisworld.com/au/industry/baby-food-manufacturing/5058/#IndustryStatisticsAndTrends [Google Scholar]
- Kaur, A. , Scarborough, P. , & Rayner, M. (2017). A systematic review, and meta‐analyses, of the impact of health‐related claims on dietary choices. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 93. 10.1186/s12966-017-0548-1 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Knowledge Sourcing Intelligence . (2021). Australia baby food market size, share, opportunities, COVID‐19 impact, and trends by product type (organic baby food, non‐organic baby food), by distribution channel (online, offline), and by food category (dried baby food, milk formula, prepared baby food, others)—Forecasts from 2023 to 2028. Knowledge Sourcing Intelligence. https://www.knowledge-sourcing.com/report/australia-baby-food-market [Google Scholar]
- McCann, J. R. , Russell, C. G. , & Woods, J. L. (2021). The nutritional profile and on‐pack marketing of toddler‐specific food products launched in Australia between 1996 and 2020. Nutrients, 14(1):163. 10.3390/nu14010163 [DOI] [PMC free article] [PubMed] [Google Scholar]
- McCann, J. R. , Russell, G. C. , Campbell, K. J. , & Woods, J. L. (2021). Nutrition and packaging characteristics of toddler foods and milks in Australia. Public Health Nutrition, 24(5), 1153–1165. 10.1017/s1368980020004590 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Moumin, N. A. , Green, T. J. , Golley, R. K. , & Netting, M. J. (2020). Are the nutrient and textural properties of Australian commercial infant and toddler foods consistent with infant feeding advice? British Journal of Nutrition, 124(7), 754–760. 10.1017/s0007114520001695 [DOI] [PubMed] [Google Scholar]
- National Health and Medical Research Council . (2013). Infant feeding guidelines. National Health and Medical Research Council. https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n56b_infant_feeding_summary_130808.pdf [Google Scholar]
- Neri, D. , Martinez‐Steele, E. , Monteiro, C. A. , & Levy, R. B. (2019). Consumption of ultra‐processed foods and its association with added sugar content in the diets of US children, NHANES 2009–2014. Pediatric Obesity, 14(12):e12563. 10.1111/ijpo.12563 [DOI] [PubMed] [Google Scholar]
- Padarath, S. , Gerritsen, S. , & Mackay, S. (2020). Nutritional aspects of commercially available complementary foods in New Zealand supermarkets. Nutrients, 12(10), 2980. 10.3390/nu12102980 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pearce, J. , & Langley‐Evans, S. C. (2013). The types of food introduced during complementary feeding and risk of childhood obesity: A systematic review. International Journal of Obesity, 37(4), 477–485. 10.1038/ijo.2013.8 [DOI] [PubMed] [Google Scholar]
- Public Health England . (2019). Foods and drinks aimed at infants and young children: Evidence and opportunities for action. Public Health England. https://assets.publishing.service.gov.uk/media/5d135aeeed915d3189039b4c/Foods_and_drinks_aimed_at_infants_and_young_children_June_2019.pdf [Google Scholar]
- Scully, M. , Schmidtke, A. , Conquest, L. , Martin, J. , & McAleese, A. (2023). Commercially available foods for young children (<36 months) in Australia: An assessment of how they compare to a proposed nutrient profile model. Health Promotion Journal of Australia: Official Journal of Australian Association of Health Promotion Professionals, 34(4), 750–758. 10.1002/hpja.705 [DOI] [PubMed] [Google Scholar]
- Simmonds, L. , Brownbill, A. L. , Zee, A. , & Netting, M. J. (2021). Health‐related marketing messages on product labels of commercial infant and toddler food packaging in Australia: A cross‐sectional audit. BMJ Paediatrics Open, 5(1):e001241. 10.1136/bmjpo-2021-001241 [DOI] [Google Scholar]
- Skinner, J. D. , Carruth, B. R. , Bounds, W. , & Ziegler, P. J. (2002). Children's food preferences. Journal of the American Dietetic Association, 102(11), 1638–1647. 10.1016/s0002-8223(02)90349-4 [DOI] [PubMed] [Google Scholar]
- Trasande, L. , Shaffer, R. M. , Sathyanarayana, S. , & Council on Environmental Health (2018). Food additives and child health. Pediatrics, 142(2):e20181408. [DOI] [PMC free article] [PubMed] [Google Scholar]
- World Health Organization . (2022a). Nutrient and promotion profile model: Supporting appropriate promotion of food products for infants and young children 6–36 months in the WHO European Region. World Health Organization. https://iris.who.int/bitstream/handle/10665/364678/WHO-EURO-2022-6681-46447-67287-eng.pdf?sequence=1 [Google Scholar]
- World Health Organization . (2022b). Sugars factsheet. World Health Organization. https://cdn.who.int/media/docs/librariesprovider2/euro-health-topics/obesity/sugars-factsheet.pdf?sfvrsn=d5b89d5f_3&download=true [Google Scholar]
- World Health Organization . (2023). Infant and young child feeding. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Supporting information.
Data Availability Statement
Research data are not shared.