Brian Haddy is Food Program Manager, National Heart Foundation, PO Box 2, Woden ACT 2606
The National Heart Foundation (NHF) is a nongovernment, non-profit community health organisation formed in 1959. For 30 years the Foundation has been encouraging people to stop smoking, exercise regularly, maintain normal weight and eat sensibly. Some of these messages seem to have worked as there has been a steady fall in premature heart disease deaths in Australia since 1967 resulting in a saving of some 103,000 lives in the 20-year period to 1987. However, much remains to be done as cardiovascular disease still accounts for just under 50% of all deaths and Australia still ranks high in international comparisons for coronary heart disease (NHF 1987a).
Until recently probably the most controversial aspect of the Heart Foundation's activities was the anti-smoking area. Many individuals and organisations became more hostile towards the Foundation as its anti-smoking messages, when combined with the efforts of other similar organisations, became more and more successful. This threatened the profitability of the tobacco industry and tobacco retailers, restaurateurs claimed that they would lose revenue if a smoking ban was implemented and sporting groups believed their traditional funding sources were under threat.
The NHF Food Approval Program
Given this background it was expected that when the Foundation undertook an initiative to change behaviour in the dietary area it would meet opposition from various quarters. The initiative is the Food Approval Program which offers food manufacturers and producers the opportunity to use a special National Heart Foundation Approved logo on their products.
When the Foundation launched this Program earlier this year, it generated lively debate within the food industry and amongst health professionals. This review of the Program discusses the various benefits which it can offer the Australian community and offers some responses to several common criticisms of the Program.
First of all the Program has been based, to some extent, on a Heart Food Festival which was conducted by the Foundation in April 1987 and which offered food manufacturers the opportunity to use a special logo on food products (NHF 1987b). Although only a short term campaign, a subsequent evaluation showed that over 40% of the population were aware of the project. Positive feedback was also received from a broad cross-section of the food industry (NHF 1987c). It was realised that an on-going food approval program had a real chance for success in terms of both consumer and industry acceptance. Therefore the Foundation's Diet and Heart Disease Committee commenced work on a set of acceptability criteria for approved foods, a laboratory was appointed to test all foods prior to approval and a licence fee structure was established to provide on-going funds for the promotion of the Program and related education activities. A simple, distinct logo featuring a stylised tick was also devised.
The acceptability criteria for various foods rely heavily on nutrient composition data. The earlier experience with the Heart Food Festival had originally forced the Foundation to look carefully at individual food composition data. For the Food Approval Program the NHF Diet and Heart Disease Committee carefully studied each type of food in turn to arrive at levels it considered appropriate for total fat, saturated fat and sodium, in particular, as well as for dietary fibre, cholesterol and added sugar levels for some food categories. In many cases the acceptability criteria developed have been aligned with definitions in the National Health and Medical Research Council's Food Standards Code (1987) for low or reduced levels of fat and salt. In other cases, usual serving sizes, the broader nutritional value of the food concerned and the availability of lower fat or lower salt substitutes in the marketplace all contributed to the establishment of the criteria (NHF 1989).
The Foundation appointed the South Australian Regional Laboratory of the Australian Government Analytical Laboratories (AGAL) some nine months ago to undertake all its analysis work to test the foods prior to approval. Six different batch samples must be submitted for any food for which a manufacturer is seeking approval and AGAL uses widely-accepted analytical techniques for determining moisture, total fat, fatty acid profiles, sodium, total sugar, sugar profiles, cholesterol and dietary fibre.
The effect of promoting the Food Approval Program acceptability criteria to the food industry has already had a considerable effect in many companies. For the first time, real guidelines are now available for companies wishing to develop and promote low saturated fat and low salt products and the approval logo offers a tangible marketing incentive.
Consumers have also responded very positively to the Program as it provides a quick, easy guide to the type of foods the NHF recommends as part of healthy eating. By influencing some of the food choices people make, the Foundation hopes to improve the national diet and lower the incidence of diet-related health problems.
Food choices are also being affected through the Foundation's input into the advertising of approved products. All companies participating in the Program must sign a legal agreement with the NHF which stipulates prior approval for all advertising copy featuring the approval logo. Through this mechanism, the NHF tries to help ensure food advertising is factually correct and responsible.
A final plus for the Program is that it is generating a significant food analysis data bank which NHF hopes to publish at some future time. Assuming the co-operation of food companies concerned, the NHF expects to be able to publish brand-specific data which would undoubtedly be of great help to many dietitians.
Criticisms of the Program
One of the common criticisms of the Program by some sections of the food industry is that the NHF is artificially dividing foods into “good” and “bad”. In response, the Foundation has never claimed that consumers should only eat NHF Approved foods and has widely acknowledged that many foods not in the Program can be part of a healthy diet. The Program is intended to simply be a general guide to low saturated fat, low salt foods and our accompanying education resources highlight this point.
Some nutritionists have criticised the Program because of its perceived focus on individual foods rather than the total diet. The Foundation is very mindful of this concern and is therefore continuing to put the Program into the context of overall healthy eating. Program posters, literature and publicity reinforce this point further.
The NHF believes the Food Approval Program will become one of the most successful nutrition education initiatives ever undertaken in Australia. However, this success will not occur overnight and requires input form both the food industry and health professionals. This will allow finetuning of the Program to maximise its potential for improving the nation's health status.
National Health & Medical Research Council. 1987. Food Standards Code. Canberra: AGPS.
National Heart Foundation. 1987a. Heart Facts Report 1987. Canberra: NHF.
National Heart Foundation. 1987b. Heart Food Festival 1987. Report No. 1. Canberra: NHF.
National Heart Foundation. 1987c. Heart Food Festival 1987. Report No. 2. Canberra: NHF.
National Heart Foundation. 1989. Guidelines for acceptability. Canberra: NHF.