Table 1

A framework for analysing and improving the performance of FOP nutrition labelling regulation

ComponentRecommendationApplication to FOP nutrition labelling
Domain One: Regulatory form
Regulatory frameworkThe regulatory framework is appropriate to the jurisdiction’s legal context.27Governments should consider mandatory legal frameworks to overcome suboptimal voluntary uptake.16 17 Existing laws (eg, constitutions) may determine whether mandatory implementation is legally possible.16
FOP nutrition label format selectionThe FOP nutrition label format selected supports the regulatory objective(s), that is, can be understood and used by consumers to inform healthier choices.The FOP nutrition label format should be interpretive, that is, use words, colours and/or symbols to make judgments11 16 17 and be understandable to all population subgroups.11 16 29 Formats indicating unhealthfulness appear more effective in guiding consumers to nutritionally favourable products.17
Domain Two: Regulatory substance
Regulatory Objective(s)Clear, measurable objectives by which success of regulation can be assessed.27The aim of FOP nutrition labelling is to inform and guide consumers towards healthier food choices; a secondary aim is to stimulate healthier formulation by the food industry.11 16 17
Operative terms and conditionsKey terms and conditions are clearly defined; regulatory rules are sufficiently expansive to achieve the regulatory objectives.27Operative terms include: display specifications that promote visibility and salience; nutrients and food components included that link to health evidence; valid scoring criteria and reference amount; justified scope (products included and excluded).11 16 17
Policy coherenceRegulation is framed within comprehensive policies to promote healthier diets.4–7FOP nutrition labelling should be aligned with and enhance operation of other national public health and nutrition policies, food regulations and relevant WHO and Codex guidance.11
Domain Three: Regulatory governance
Drafting regulatory rules and scheme designTransparency and accountability mechanisms are incorporated into regulatory regimes from their inception, including when developing substantive regulatory rules.27Government retains ultimate responsibility and authority for setting regulatory objectives and scope; developing and validating scoring criteria with independent expert input; setting a review framework; leading a stakeholder engagement process for development of a trusted system, including use of multistakeholder committees or public consultation to develop label format, content and supporting documents (eg, style guides). Information should be transparent and easily accessible (eg, submissions to public consultation released, public meetings and minutes of committees).11 There should be appropriate safeguards for managing conflicts of interest.16
AdministrationAdministration by a government or independent body which monitors and enforces compliance, publicly disseminates information on performance to facilitate external scrutiny.27Administration granted to an independent statutory authority (eg, food standards agency), government body (eg, ministry of health) or multistakeholder group with appropriate safeguards for managing conflicts of interest. The administrative body must be provided with requisite authority and resource to conduct monitoring and enforcement activities and to publicise performance outcomes.11 27
MonitoringMonitoring informs continuous improvement through collection of baseline data, setting of process and outcome indicators and timeframes for achievement, ongoing data collection.27Baseline and follow-up data collected on: uptake and label compliance by industry (eg, using a database with photographs of labels and/or licensing scheme), consumer understanding and use, product purchases, population dietary intakes, nutrient composition of foods and reformulation.11 16
EvaluationStructured, regular review ensures regulation meeting its objectives. A review framework set during development includes baseline data and, performance indicators and timeframes to evaluate effectiveness.27Government-led and/or carried out by independent body or research group (eg, auditor, consultant) with authority to assess achievement of the regulatory objectives using a transparent framework and sufficient data to assess whether performance indicators met in the specified timeframes.11 16 17
EnforcementA wide range of enforcement options are available, including incentives to encourage and reward high levels of compliance, ‘soft’ enforcement measures such as persuasion and more punitive measures for instances of serious or persistent non-compliance. Publication of decisions enhances transparency, allows development of ‘precedent’ for users.27Enforcement may be supported by premarket approval, for example, licensing; or auditing of products in the market. The administrative body possesses range of sanctions, including positive and negative publicity, written requests for action, withdrawal of right to use (positive) labels, fines or legal action under new or existing law. A complaints handling mechanism may allow all stakeholders to raise issues with regulation or instances of non-compliance.27
  • FOP, front-of-pack.