Concordance of Australian state and territory government guidelines for classifying the healthiness of foods in public settings

Abstract Objective: To investigate the concordance between Australian government guidelines for classifying the healthiness of foods across various public settings. Design: Commonly available products in Australian food service settings across 8 food categories were classified according to each of the 17 Australian state and territory food classification guidelines applying to public schools, workplaces, and healthcare settings. Product nutrition information was retrieved from online sources. The level of concordance between each pair of guidelines was determined by the proportion of products rated at the same level of healthiness. Setting: Australia Participants: No human participants. Results: Approximately half (56%) of the 967 food and drink products assessed were classified as the same level of healthiness across all 15 ‘traffic light’-based systems. Within each setting type (e.g., schools), pairwise concordance in product classifications between guidelines ranged from 74% to 100%. ‘Vegetables’ (100%) and ‘sweet snacks and desserts’ (78%) had the highest concordance across guidelines while ‘cold ready-to-eat foods’ (0%) and ‘savoury snacks’ (23%) had the lowest concordance. In addition to differences in classification criteria, discrepancies between guidelines arose from different approaches to grouping of products. The largest proportion of discrepancies (58%) were attributed to whether products were classified as ‘Red’ (least healthy) or ‘Amber’ (moderately healthy). Conclusions: Results indicate only moderate concordance between all guidelines. National coordination to create evidence-based consistency between guidelines would help provide clarity for food businesses, which are often national, on how to better support community health through product development and reformulation.