TABLE 5.
Summary characteristics of the 78 included NP models1
| Type of reference amount/unit considered | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Model number | Model name | Type of model2 | Output3 | Category level(s) at which nutrient criteria are applied4 | Number of food categories with nutrient criteria5 | Model including only nutrients/food components to limit (A) or nutrients/food components to limit and to encourage (B)6 | Number/type of nutrients and food components may vary across the model's food categories/types of food product evaluated (Y/N) | Total nutrients/food components to limit7 | Total nutrients/food components to encourage7 | Per 100 g and/or per 100 mL | Per 419 kJ (i.e., 100 kcal) or % of energy | Per serving | Other reference amount or unit8 |
| School food (n = 27) | |||||||||||||
| 93 | National Healthy School Canteens Project | A | A | Major, sub | 6–239 | B | Y | 4 | 1 | Y | — | Y | — |
| 138 | Australia—Fresh Tastes @ School NSW Healthy School Canteens Strategy | A | A | Major, sub | 7310,11 | B | Y | 3 | 1 | Y | — | Y | — |
| 290 | Smart Choices: healthy food and drink supply strategy for Queensland schools—nutrient criteria for the “Occasional” (red) food and drink category | A | A | Sub | 7 | B | Y | 3 | 1 | Y | — | Y | — |
| 293 | South Australia Right Bite for schools and preschools—Nutrient criteria for the “Occasional” (red) category | A | A | Sub | 6 | B | Y | 3 | 1 | Y | — | Y | — |
| 140 | Australia—State Government of Victoria—Go For Your Life healthy canteen kit—nutrient criteria for the “Occasionally” (red) food category | A | A | Sub | 7 | B | Y | 3 | 1 | Y | — | Y | — |
| 393 | Canada—Provincial and Territorial nutrient criteria for foods and beverages in schools (2013) | A | A | Sub | 19 | B | Y | 10 | 3 | — | — | Y | Y |
| 131 | Alberta nutrition guidelines for children and youth | A | A | Sub | 25 | B | Y | 11 | 5 | — | — | Y | Y |
| 144 | Guidelines for food and beverage sales in BC schools | A | A | Sub | 21 | B | Y | 10 | 4 | — | — | Y | Y |
| 193 | Guidelines for foods available in K to 12 schools in Manitoba (criteria for packaged foods) | A | A | Major | 6 | B | Y | 8 | 6 | — | — | Y | Y |
| 241 | New Brunswick healthier foods and nutrition in public schools | A | A | Major, sub | 19 | B | Y | 9 | 8 | — | — | Y | Y |
| 180 | Food and beverage standards for Nova Scotia public schools | A | A | Major | 5 | B | Y | 8 | 2 | — | — | Y | Y |
| 259 | Ontario school food and beverage policy/program memorandum 150 (PPM 150) | A | A | Sub | 33 | B | Y | 9 | 6 | — | — | Y | Y |
| 272 | PEI school nutrition policy | A | A | Major | 5 | B | Y | 7 | 3 | — | — | Y | Y |
| 200 | Healthy eating guidelines for Saskatchewan schools (Nourishing Minds) | A | A | Major | 5 | B | Y | 5 | 9 | — | — | Y | Y |
| 72 | Costa Rica school food regulations | A | A | Sub | 17 | A | Y | 7 | 0 | Y | — | — | Y |
| 167 | Czech Republic draft decree for food sold and advertised in schools | A | A | Major, sub | 16 | B | Y | 8 | 7 | Y | — | — | Y |
| 59 | New School Canteen Standards | A | A | Major, sub | 18 | B | Y | 9 | 0 | Y | — | Y | Y |
| 205 | Hong Kong nutritional criteria for snack classification | A | A | Sub, sub-sub | 12 | B | Y | 9 | 1 | Y | — | Y | Y |
| 211 | FSSAI draft guidelines for making available wholesome, nutritious, safe and hygienic food to schoolchildren in India | A | A | Major | 2 | A | N | 6 | 0 | — | — | Y | — |
| 70 | Food and beverage classification system nutrient criteria (Fuelled4life) | A | A | Sub | 38 | B | Y | 11 | 2 | Y | — | Y | Y |
| 76 | Healthy meals in schools program (Eating Healthily At The School Canteen) | A | A | Major, sub | 2 | B | Y | 12 | 8 | Y | — | Y | Y |
| 60 | Scotland nutritional requirements for food and drink in schools | A | A | Major, sub | 1611 | B | Y | 8 | 1 | Y | — | Y | Y |
| 61 | England requirements for school food regulations | A | A | Major, sub | 1011 | B | Y | 5 | 3 | — | — | — | Y |
| 325 | USDA smart snacks in school nutrition standards (also known as competitive food standards) | A | A | Major, sub | 10 | B | Y | 10 | 4 | — | — | Y | Y |
| 352 | California's nutrition standards SB12 and SB965 (competitive food and beverage standards for schools) | A | A | Major, sub12 | 5–813 | B | Y | 10 | 14 | — | Y | Y | Y |
| 163 | Connecticut nutrition standards | A | A | Major, sub | 13 | B | Y | 10 | 5 | — | Y | Y | Y |
| 248 | Eat Smart: North Carolina's recommended standards for all foods available in school | A | A | Major, sub | 3–414 | B | Y | 6 | 4 | — | Y | Y | Y |
| Front-of-pack food labeling (n = 12) | |||||||||||||
| 53 | Choices | A | A | Major, sub | 31 | B | Y | 5 | 1 | Y | Y | Y | Y |
| 196 | Health Star Rating System | C | C | Sub | 6 | B | N | 4 | 3 | Y | — | — | — |
| 156 | Chile “Black Octagonal Stop-Sign” warning labels | B | A | Major | 2 | A | N | 4 | 0 | Y | — | — | — |
| 172 | Ecuador traffic light labelling system | B | A | Major | 2 | A | N | 3 | 0 | Y | — | — | — |
| 27 | Heart symbol | A | A | Sub | 75 | B | Y | 10 | 3 | Y | Y | — | Y |
| 178 | Five-Colour Nutrition Label (5-CNL/Nutri-Score) | A | C | Major | 2 | B | N | 4 | 3 | Y | — | — | — |
| 73 | Healthier Choice Symbol program | C | A | Sub, sub-sub | 99 | B | Y | 11 | 8 | Y | — | Y | Y |
| 11 | Keyhole | A | A | Major, sub, sub-sub | 46 | B | Y | 10 | 6 | Y | Y | Y | Y |
| 314 | United Arab Emirates nutrition labeling model (Weqaya logo) | A | A | Major, sub | 20 | B | Y | 12 | 3 | Y | — | Y | Y |
| 41 | Traffic light labelling | B | A | Major | 2 | A | N | 4 | 0 | Y | — | Y | — |
| 1 | Fruits & veggies—More Matters | A | A | Major | 3 | B | Y | 4 | 2 | — | Y | Y | Y |
| 291 | Smart Meal Seal nutrition criteria | A | A | Major | 2 | B | N | 5 | 3 | — | — | Y | Y |
| Restriction of marketing to children (n = 10) | |||||||||||||
| 334 | WHO nutrient profile model for the Western Pacific Regional Office (WHO-WPRO) | A | A | Major, sub | 21 | A | Y | 8 | 0 | Y | — | — | Y |
| 335 | WHO Regional Office for Europe nutrient profile model (WHO-EURO) | A | A | Major, sub | 20 | A | Y | 8 | 0 | Y | — | — | Y |
| 388 | PAHO nutrient profile model (WHO Regional Office for the Americas) | C | A | Major | 1 | A | N | 6 | 0 | — | Y | — | Y |
| 62 | Danish Code of responsible food marketing communication to children | A | A | Major | 10 | A | Y | 2 | 0 | Y | — | — | Y |
| 220 | Ireland—broadcasting authority model for restricting the marketing of food and drink to children | A | C | Major | 2 | B | N | 4 | 3 | Y | — | — | — |
| 44 | South Korea—guideline for energy-dense, nutrition -poor food for children | A | A | Major | 2 | B | Y | 4 | 1 | — | — | Y | Y |
| 392 | Mexico—restriction on the promotion of high-caloric-density foods | A | A | Major, sub | 31 | B | Y | 5 | 1 | Y | — | Y | Y |
| 251 | Norwegian nutrient profile model | A | A | Major | 8 | B | Y | 7 | 1 | Y | — | — | Y |
| 287 | Singapore common nutrition criteria of the guidelines for food advertising to children | A | A | Major, sub, sub-sub | 27 | B | Y | 7 | 8 | Y | — | Y | Y |
| 5 | Ofcom model for regulating the marketing of food to children, final version (WXYfm) | A | C | Major | 2 | B | N | 4 | 3 | Y | — | — | — |
| Regulation of claims (n = 7) | |||||||||||||
| 20 | FSANZ—nutrient profiling scoring criterion | A | C | Major | 3 | B | N | 4 | 3 | Y | — | Y | — |
| 69 | The SAIN, LIM system | A | C | Major | 1 | B | N | 3 | 5 | Y | Y | — | Y |
| 75 | Singapore—nutrient- specific diet-related health claims | A | A | Sub, sub-sub | 99 | B | Y | 11 | 8 | Y | Y | Y | Y |
| 394 | South Africa nutrient profile model (FSANZ validated in South Africa) | A | C | Major | 3 | B | N | 4 | 3 | Y | — | — | — |
| 18 | US—requirements for foods carrying a health claim | A | A | Major | 3 | B | N | 4 | 6 | — | — | Y | Y |
| 35 | US—definition of a “healthy” food as an implied nutrient content claim | A | A | Major | 6 | B | Y | 4 | 6 | Y | Y | Y | Y |
| 319 | US—requirements for the “extra lean” and “lean” nutrient content claims | A | A | Major | 4 | A | N | 3 | 0 | Y | — | Y | — |
| Health facilities (n = 5) | |||||||||||||
| 381 | Queensland Health's A better choice – healthy food and drink supply strategy (2007)—nutrient criteria for the red category | A | A | Major, sub, sub-sub | 9 | B | Y | 4 | 1 | Y | — | Y | Y |
| 367 | Healthy food and drink choices for staff and visitors in South Australia health facilities—nutrient criteria for the red category | A | A | Major, sub, sub-sub | 9 | B | Y | 4 | 1 | Y | — | Y | Y |
| 160 | Colchester East Hants Health Authority food and beverage nutrient standards | A | A | Major | 7 | B | Y | 9 | 2 | — | — | Y | Y |
| 285 | Scotland nutritional standards for hospital food: Food in Hospitals | A | A | Major | 3 | B | Y | 3 | 2 | — | — | Y | Y |
| 201 | Healthy food environments pricing incentives nutrition criteria | A | A | Major | 715 | B | Y | 8 | 1 | Y | — | Y | Y |
| Government facilities (n = 4) | |||||||||||||
| 174 | England government buying standards for food and catering services | A | A | Major | 811 | B | Y | 3 | 2 | Y | — | Y | Y |
| 364 | Food service guidelines for federal facilities (formerly Health and sustainability guidelines for federal concessions and vending operations; HHS/GSA guidelines) | A | A | Major, sub16 | 3–617 | B | Y | 8 | 5 | — | — | Y | Y |
| 232 | Massachusetts state agency food standards | A | A | Major, sub, sub-sub | 27 | B | Y | 7 | 3 | — | — | Y | Y |
| 330 | Washington State healthy nutrition guidelines | A | A | Major, sub | 8 | B | Y | 10 | 3 | — | — | Y | Y |
| Vending machines (n = 4) | |||||||||||||
| 146 | Healthier choices in vending machines in BC public buildings policy | A | A | Major | 14 | B | Y | 9 | 5 | — | — | Y | Y |
| 329 | Wales—health promoting vending guidance (hospitals) | A | A | Major, sub | 13 | B | Y | 4 | 1 | Y | — | Y | Y |
| 341 | Nemours Health and Prevention Services (Delaware's public health department) “Go, Slow, and Whoa” model (guide to healthier vending and concessions) | A | A | Major | 11 | B | Y | 11 | 3 | — | — | Y | Y |
| 256 | Nutrition Environment Measurement Survey-Vending (NEMS-V) traffic light system | A | A | Major | 5 | B | Y | 12 | 5 | — | — | Y | Y |
| Recreational facilities (n = 3) | |||||||||||||
| 273 | Queensland—red criteria of the Food for Sport guidelines | A | A | Major, sub, sub-sub | 9 | B | Y | 4 | 1 | Y | — | Y | Y |
| 376 | US National Park Service healthy food choice standards and sustainable food choice guidelines for front country operations | A | A | Major | 2 | B | Y | 4 | 2 | Y | — | Y | Y |
| 169 | Delaware State Parks healthy eating initiative—“Munch Better at Delaware State Parks” | A | A | Major | 2 | B | N | 6 | 1 | — | Y | Y | — |
| Food assistance programs (n = 2) | |||||||||||||
| 81 | Minimum requirements and specifications for food items allowed in the WIC food packages (supplemental foods) | A | A | Major, sub | 2211 | B | Y | 7 | 14 | Y | — | Y | Y |
| 318 | US—Georgia WIC approved food list—criteria to evaluate an eligible food item | A | A | Major | 1518 | B | Y | 12 | 15 | Y | — | Y | Y |
| Food systems/surveillance (n = 2) | |||||||||||||
| 254 | Nutrient value score | C | B | Major | 1 | B | N | 2 | 9 | Y | — | — | — |
| 195 | Health Canada Surveillance Tool tier system | A | A | Major | 4 | A | N | 4 | 0 | — | — | Y | — |
| Consumer education (n = 1) | |||||||||||||
| 351 | Alberta nutrition guidelines for adults | A | A | Sub | 25 | B | Y | 11 | 7 | — | — | Y | Y |
| Taxation (n = 1) | |||||||||||||
| 371 | Hungarian public health tax (tax on food products containing unhealthy levels of sugar, salt, and other ingredients) | A | A | Major, sub | 12 | B | Y | 6 | 1 | Y | — | — | Y |
1BC, British Columbia; FSANZ, Food Standards Australia New Zealand; FSSAI, Food Safety and Standards Authority of India; GSA, General Services Administration; HHS, Health and Human Services; LIM, limited nutrients; major, major category; N, no; NP; nutrient profile; NSW, New South Wales; Ofcom, Office of Communications; PAHO, Pan American Health Organization; PEI, Prince Edward Island; Sub/sub, subcategory; sub-sub, sub-subcategory; SAIN, Nutrient Adequacy Score for Individual foods; WHO-EURO, WHO-Europe; WHO-WPRO, WHO Western Pacific Region; WIC, Women, Infants and Children; Y, yes.
2A, summary indicator system; B, nutrient-specific system; C, combination of both.
3A, classification; B, score; C, combination of both.
4Major, sub-, or sub-subcategory level. Major food categories represented the first and sometimes only level of categories described in a model. In some models, ≥1 major category was subdivided into subcategories. In a few cases, ≥1 subcategory was further subdivided into sub-subcategories (e.g., Nordic Keyhole model, no. 11, in which the major category of meat and meat products includes 2 subcategories, and 1 of these also includes 3 sub-subcategories). It should be noted that certain models included “exempted” and/or “excluded” foods within the list of food categories, whereas other models did not and therefore presented “exempted” and/or “excluded” foods separately.
5It should be noted that certain models established nutrient criteria at the major, subcategory, and/or sub-subcategory levels. As such, the number of food categories at any level may not correspond to the number of food categories with nutrient criteria. Although the term “nutrient” criteria is used, the data presented here may include nutrient-based and/or food-based criteria because certain models provided a combination of nutrient-based and/or food-based criteria for all or a selection of the food categories.
6None of the included models considered only nutrients and food components to encourage.
7Total excludes optional nutrients and food components that can be considered as part of some models but that are not mandatory. Details on the specific nutrients and food components considered in each model are provided in Supplemental Table 4.
8Details on the other possible reference amounts/units for each model are provided in Supplemental Table 5. These may include, e.g., the evaluation of some nutrients or food components in terms of other prespecified amounts (in g or mL; e.g., per 250 mL), % of total fat, % daily value or reference daily intake, % weight/quantity of a component in a product (e.g., % fruit content), the presence (or absence) of a nutrient or food component in a product (e.g., no added sweeteners) or its position in the ingredient list (e.g., the first ingredient must be a whole grain).
9For the nutrient-based criteria presented in the boxes from pages 17–34 of the National Healthy School Canteens Guidelines (15): 23 food categories with nutrient criteria. For the “nutrient criteria for foods categorized as amber”: 7 food categories with nutrient criteria. For the “nutrient criteria to help make ‘healthier choices’ within some food subcategories”: 6 food categories with nutrient criteria.
10Across all green, amber, and red foods.
11Primarily food-based criteria.
12For elementary schools: major, sub. For middle/high schools: sub.
13For elementary schools: 5 food categories with nutrient criteria. For middle/high schools: 8 food categories with nutrient criteria.
14For grades pre-K–5 and 6–8: 4 food categories with nutrient criteria. For grades 9–12: 3 food categories with nutrient criteria.
15Not including optional meal category.
16For concessions: major. For vending: major, sub.
17For concessions: 6 food categories with nutrient criteria. For vending: 3 food categories with nutrient criteria.
18Two of the food categories are under consideration.