Preventing Childhood Obesity : From feeding pratices to dietary recommendations
Nutritional quality and degree of processing of children’s foods assessment on the French market: focus on sweet products and fruit or fruit-based products
In France, 34% of children aged 2 to 7 are overweight or obese according to IOTF definition (League against obesity, 2020). Among the various factors behind overweight, obesity and diet-related diseases, the negative impact of advertising and marketing of foods high in saturated fat, sugars and salt (HFSS) and ultra-processed foods has been shown, particularly in children (Boyland 2016, Sadeghirad 2016, Clark 2020, Elias 2021, WHO 2018).
Marketing contents targeting children (drawings, mascots, etc.) influence children’s food choices, preferences and consumption (Elliott 2008, Boyland 2012) as well as their perception of products (Mzoughi 2017, Enax 2015).
Several studies have assessed the nutritional quality of foods intended for children in different countries, concluding that they are mainly composed of foods HFSS and ultra-processed (Lythgoe 2013, Garcia 2019, Meloncelli 2016).
This study analyses products intended children over 3 years of age (foods and drinks with marketing elements on the packaging) available on the French market, by assessing their nutritional quality using the Nutri-Score as indicator, compliance with the expected nutritional profile for the child according to the criteria of the WHO Europe Nutrient Profile Model, and the level of processing as defined by the NOVA classification. This article will focus on sweet products, looking at whether fruit and fruit-based products are highlighted.
A majority of sugary products found on products targeting children
Almost a quarter of the products in the sample have a sweetener as the first ingredient and a very large majority of products (89.5%) contain free sugars according to the WHO definition (2015). These foods are mainly intended for afternoon snacks and breakfast and can contribute to the excessive intake of total sugars (except lactose and galactose) observed by ANSES from INCA2 . Indeed, 75% of 4–7-year-olds and 60% of 8–12-year-olds exceed the recommended thresholds (ANSES, 2019).
Less than 1/4 of products intended for children bear the Nutri-Score logo
After almost 3 years of implementation, in the sample of products intended for children, only 20.8% of the references identified bear the Nutri-Score logo. Carriers or not, most of children’s products in the sample are Nutri-Score D and E (58.7%) – this figure rises to 62.1% among the sampled foods and beverages containing free and/or added sugars, with a lower proportion of Nutri-Score A -, with a majority proportion of D products (39.3%), even though the National Health Nutrition Program 2019 -2023 recommends using the Nutri-Score indicator to choose foods to encourage, and to reduce the consumption of Nutri-Score D and E products, especially among children (PNNS4, 2019).
Using the NOVA classification, the food offer marketed to children is overwhelmingly ultra-processed with 88.0% of ultra-processed foods (UPFs), especially by the high presence of aromas and ultra-processed sugars (glucose syrup); more than 93% of the products are UPFS regardless of the Nutri-Score class, except for Nutri-Score A products (28.37% UPFs).
No health claims for Nutri-Score 1 products such as fruit and compotes
Four product categories are mainly Nutri-Score A (around 100%): water, plain milk, fresh fruit, and compotes. These four categories only represent 117 products (including 112 compotes) out of 1 155. The correlation with the claims made shows that using nutrition claims has a decreasing gradient of Nutri-Score groups A to E. However, health claims, which are rare in these children’s products, are mainly found on products in Nutri-Score group B, over-represented by dairy desserts: 100% of claims state that « calcium and vitamin D are necessary for normal growth and bone development in children ». And it is regrettable that no health claims are used for Nutri-Score A products despite their nutritional value and the interest of public health authorities in promoting them; only ingredients claims are present in 1/3 of these products.
Finally, among the children’s foods, plain milk, fresh fruit, still water and compotes are the offers that seem to be the most appropriate regarding the 3 indicators chosen, Nutri-Score, WHO Europe Nutrient Profile Model, NOVA.
Based on: Richonnet C, et al. Nutritional Quality and Degree of Processing of Children’s Foods assessment on the French Market. Nutrients, 2022, 14, 171.
– 1155 products were analyzed,
- mainly drawings of a childish nature (97.22% of the products identified),
- mascots (cartoon characters, brand characters, heroes, personification of the food – 77.78%)
- childish name, playful writing font, indication of the child or his attributes (schoolbag, skateboard, hopscotch, etc.) drawn or mentioned in the text, for example “ideal for children’s snacks”, use of the “tu”, game on the packaging or incentive to play online using childish cognitive abilities, primes and license
– systematic pick up of all food and drink packaging, in 20 French supermarkets (hypermarkets and supermarkets, hard-discount retail chains, and organic food stores)
– between October 23, 2020, and January 07, 2021
– products picked up when they included marketing elements intended for children:
– excluding baby food
- Food marketed for children is mostly Nutri-Score D and E, ultra-processed and non-compliant with the WHO European model’s criteria.
- Most of products marketed for children are sweet foods
- Nutri-score A products are under-represented, and the fruit category is mainly represented by compotes