Poor food choices: Clearer labels aim to help South Africans choose healthier options

It is difficult for South Africans to understand which foods are unhealthy when they go shopping. But this will change.

South African supermarkets currently sell large quantities of unhealthy, ultra-processed foods. Packaged foods in particular are high in sugar, salt and saturated fat, all things that are bad for our health.

Research shows that consumption of these foods is associated with increased rates of obesity and related diseases such as diabetes.

Many countries are looking for better labeling systems to help consumers understand if a product is unhealthy. Countries that have adopted simpler labeling systems have seen consumers make healthier food choices.

South Africa’s health minister released draft food labeling regulations in April. This will introduce a new labeling scheme, limit the advertising of unhealthy food and limit the use of misleading health claims.

The draft regulation proposes clearer food labels, which include a new triangle that highlights that the food contains ingredients that are unhealthy. These logos will be placed on the front of the product.

We are part of the working group that advised the Ministry of Health on front of pack nutrition labelling, drawing on our expertise in dietetics, nutrition, public health and law.

We worked with consumers and experts in food labelling, advertising and obesity prevention to create a system designed to work well in South Africa.

But it was a complicated process. This is how we did it.

How do we know which foods are unhealthy?

The first step is to find a way to identify unhealthy foods. There are international guidelines on how much sugar, salt and saturated fat people should eat. These can be used to measure whether a food has too much of these ingredients.

Figuring out whether a food is unhealthy can be difficult, but luckily other countries around the world have already adopted systems like this, known as nutrient profile models, and we could build on what they’ve already done.

We looked at what foods are sold in South African supermarkets. We looked for nutrient profiling models that identify unhealthy foods that work well in other countries and tested them on the South African food supply.

We found that the Chilean model, which focuses only on unhealthy ingredients, sugar, sodium and saturated fat, would work well because it was simple to implement and could very easily and accurately identify unhealthy products.

We then modified the Chilean model to make it work for South Africa.

Choosing the right label

The next thing to decide was what kind of label South Africa should use. There are many different systems, but not all of them work well.

One uses color coding. For example, a low level of salt would get a green marker, while a high level of sugar would get a red one.

There are also descriptive labels that don’t tell consumers whether the amounts are good or bad, only that they are present.

Then there are warning labels, often in the form of road signs, to alert consumers to the high levels of unhealthy ingredients such as saturated fat, sugar and salt.

We looked at how to design a label that would be understandable to the average South African. We consulted South Africans on every element of the label, from text and size to symbols and color.

We developed a black triangle inspired by the hazard warning sign to stand out on colorful food packaging and include images so that anyone, even those who cannot read or speak English, can understand them.

The final part of this work was a nationally representative randomized controlled trial of different labeling systems. Almost 2,000 people of different incomes and education levels participated.

We also found that warning labels caused consumers to change their minds about which foods they would consider buying.

Earlier this year, South Africans had the opportunity to comment on the regulations that will implement this labeling system. It is now up to the department to decide when and how to implement these regulations.

We hope that soon all South Africans will be able to see at a glance which foods are bad for their health.