The University of Adelaide study was conducted via a survey on the labels of 762 ready-to-drink (RTD) beverages of no more than 600ml in volume, which were non-dairy and non-alcoholic.
Samples were collected from 17 Australian supermarkets in 2016, and the presence of the HSR star rating icon and/or energy-only icon was measured.
Beverages were separated into the sugar-free (less than one gram of sugar per 100ml) or sugar-containing (one gram or more of sugar per 100ml) categories. Sugar-containing beverages were further categorised according to sugar content.
The authors defined the sugar content categories in this study to align with World Health Organisation (WHO) recommendations for free sugar intake.
Drinks with between one and 2.5 grams of sugar per 100ml were ‘low-sugar’, between 2.5 and five grams per 100ml were ‘medium-sugar’, and above five grams per 100ml were ‘high-sugar’.
Free sugar is any sugar added to food or drink, or those already present in honey, syrup or fruit juice. The WHO recommends that free sugar make up less than 10% of daily total energy intake.
It was found that the HSR was used for only 35.3% of all beverages surveyed. Within these, only 6.8% displayed a star rating icon, and these were almost all 5-stars (94.2%) or 4.5-stars (5.8%).
The majority of these drinks were found to be 100% juices (85.7%), despite the fact that had high- or very-high sugar content.
“Fruit juice often contains high amounts of [free sugar]. For example, a typical 500ml bottle of juice can contain almost 12 teaspoons of sugar. For the average person, this can equate to the total daily sugar intake in one drink,” lead study author Aimee Brownbill told FoodNavigator-Asia.
“Under the Australian and New Zealand scheme, fruit juices can also be eligible to receive a 5-star rating, which is a shortcoming of the scheme. It was particularly concerning to find that the 5 star rating is being used on juices high or very high in sugar.”
Within sugar-containing beverages, 29.4% were found to display the energy-only icon, versus just 7.8% displaying the star rating icon. These included energy drinks (69% displayed the energy-only icon), non-carbonated flavoured water (62.5%) and sports drinks (55.2%).
The HSR system is not compulsory in Australia as of yet, and system allows for beverages to display just the energy-only icon, without displaying the star rating icon.
“We found sugary drinks that would score a lower star rating, such as sugar-containing soft drinks, energy drinks and sports drinks, were not displaying the health star icon,” added Brownbill.
“A number of these displayed an energy icon on its own, which does not provide readily understandable information to consumers. This is another shortcoming of the scheme which warrants attention.”
The study found that only drinks that were capable of scoring 4.5 or five stars using the HSR algorithm were using it.
“[The 4.5 and 5 star ratings being displayed are] much higher than the 1.5 average star rating that beverages would receive if the System were universally adopted or compulsory,” said Brownbill.
“We found sugary drinks that would score a lower star rating, such as sugar-containing soft drinks, energy drinks and sports drinks, were not displaying the health star icon.”
“The current scoring which allows juices high in sugar to score 5 stars may work to mislead consumers. The 5 star rating should be reserved only for water.”
“It was interesting to find that other than generic store brands, plain waters were not displaying the star rating despite scoring 5 stars. If manufacturers are not even opting to use the health star rating on water, this indicates it is time to make the system mandatory.”
“Having the scheme remain optional, delays the implementation of what could be a useful measure for consumers.”
Australian Beverages Council response
However, the Australian Beverages Council is standing steadfastly behind the HSR’s current implementation, and does not appear to agree with Brownbill’s findings.
“Data collected from Members of the Australian Beverages Council indicate more than 70 per cent of non-alcoholic drinks carry the HSR by displaying the energy shield, as option five of the display hierarchy of the HSR Style Guide.” said Geoff Parker, Chief Executive Officer, Australian Beverages Council to FoodNavigator-Asia.
“With just under a year before the five year review period comes to an end, this take up rate is particularly strong for a voluntary scheme.”
He added that fruit juice is deserving of the 5-star rating that is granted to it.
“In Australia, the Australian Dietary Guidelines clearly indicate that juice (no added sugar) forms an important part of the Australian diet. The Australian Dietary Guidelines clearly state that 125ml of fruit juice (no added sugar) can occasionally be consumed as one of your two serves of fruit per day.
“On juice (no added sugar), the 5-star rating encourages juice companies to carry the HSR while including more juice combinations that also score well on the HSR,” Parker added.
“The algorithm behind the HSR awards juice (no added sugar) five stars for very good reason – it is the squeezed liquid (juice) and any pulp from the originating piece of fruit, with nothing added.”
As for water, he explained that the reason many plain water products choose not to display the HSR rating die to strict Food Standards Australia New Zealand (FSANZ) definitions.
“[There] are some products in the packaged water category that score poorly because only bottled water as tightly defined by the FSANZ’s Food Standards Code is awarded five stars.”
“There’s a strong argument that too many carbonated and flavoured waters, which contain no sugar at all, are discouraged from using the HSR.”
Parker also staunchly defended the use of energy-only icons without the star ratings, describing these as ‘the most appropriate part of the HSR display graphic to be used on beverages’.
“Energy information […] measures energy as a proxy for sugar in the product, and consumers know these drinks should be enjoyed occasionally as part of a healthy, balanced diet.”
Authors: Brownbill, A.L. et. al.
Health Star Ratings: What's on the labels of Australian beverages?
Health Promotion Journal of Australia