Last updated: 10/09/2024
Enforce front-of-pack labelling
Enforce the provision of front-of-pack labelling, similar to Nutri-Score, on retail packaging
- High impact on obesity
A percentage estimate of how much the policy would reduce national obesity rates
- Relative reduction in obesity prevalence: 7%
- High evidence quality
A rating of the strength of evidence, accounting for both reliability and validity of the evidence
- Reliability and validity rating: 4/5
- Low cost to governments
Cost to UK and devolved governments over 5 years
- Costs to governments over 5 years: £18m
- Benefit to governments per year: £5bn
What is the policy?
This policy relates to mandating the provision of front-of-pack labelling, similar to Nutri-Score, on the front of retail packing. Front-of-pack nutritional labelling is a policy tool used internationally to promote healthier food consumption. The aim of labelling is to influence consumers at the point of purchase to choose food products with a better nutritional profile, and to incentivise food manufacturers to improve the nutritional quality of products.
Nutritional information can be mandated on packaging in various formats. There are two major types of food labels: interpretive (graphic, easily recognisable simplifications of nutritional information, like traffic lights or star systems) and non-interpretive (numeric summaries that require customers to interpret themselves – usually back-of-package).
Nutri-Score is a simple interpretive nutrition label, based on the UK Food Standards Agency’s nutrient profiling system. It uses five colours to classify food products: from category A indicating higher nutritional quality, to category E indicating lower nutritional quality. A product’s rating is based on the nutrients present in 100g. A high content of fruits and vegetables, fibre, and protein promote a higher score, while high content of energy, sugar, saturated fatty acids, and sodium decrease the score.
Recent context
Whilst it is mandatory for nutritional information to be displayed on the back of all food packaging in the UK, there is not currently any mandatory front-of-pack labelling in the UK, including in Scotland or Wales.
As front-of-pack labelling is voluntary, individual businesses can decide on which foods the information will be most useful to consumers. Across the UK, many businesses who opt to provide front-of-pack labelling use the multiple traffic light labelling system. A four-nation public consultation on front-of-pack labelling took place in 2020, led by the Department of Health. There has not yet been a formal government response to the consultation.
In its strategy Healthy Weight, Healthy Wales, the Welsh Government states that they will: ‘Seek out and harness further opportunities by working across the UK, including enhancing front-of-pack labelling to best support positive food choices’. In Scotland, the Diet and Healthy Weight Delivery Plan outlined intentions to urge the UK Government to push for mandatory front-of-pack labelling, highlighting that it would help consumers easily identify healthier and unhealthier foods.
Case studies
Nutri-Score, France
Nutri-Score was developed upon request from the French Ministry of Health, with French public authorities officially recognising Nutri-Score as the front-of-pack labelling system for food products in October 2017. It was gradually implemented, with 70 food producers voluntarily adopting Nutri-Score by July 2018, rising to 450 producers (representing 50% of the market share) by July 2020.
Santé publique France, the body in charge of Nutri-Score’s implementation, conducts an annual study to track awareness, support and self-declared impact of Nutri-Score on purchasing behaviours across the population. By 2019, 57% of the sample declared they had changed at least one purchasing behaviour due to the measure.
Belgium, Switzerland, Germany, Portugal and Luxembourg have since adopted Nutri-Score, with Spain and the Netherlands intending to follow suit.
Considerations for implementation
Mandating front-of-pack labelling based on Nutri-Score would require legislation to establish new labelling requirements on food businesses (in each of England, Wales and Scotland). It would also need new guidance from government for food businesses on labelling, focused on Nutri-Score.
Regulation commencement timeframes would need to provide sufficient time for businesses to calculate Nutri-Scores for their product portfolio and reprint packaging.
Once in force, the policy would also require monitoring and enforcement by a named agency (for example, the Food Standards Agency).
Estimating the population impact
We estimated that this policy would reduce the prevalence of adult UK obesity rates by approximately 7%
Estimating the per-person impact
We estimated that this policy would reduce average daily calorie intake by approximately 21 kcal per person
We estimated the impact on daily calorie reduction using a meta-analysis conducted by Song et al. (2021). This review reports a meta-analysis of 118 peer-reviewed studies testing the effectiveness of front-of-pack labelling on participants purchasing and consuming behaviour. The traffic light labelling system, Nutri-Score, nutrient warning, and health warning were all able to direct consumers towards more healthful purchasing behaviour. However, colour-coded labels (traffic light labelling system and Nutri-Score) performed better in promoting the purchase of healthier products, while warning labels (nutrient warning and health warning) had the advantage in discouraging unhealthy purchasing behaviour.
The labels did not show effects in the actual purchase situation, but they did show positive changes when purchasing perception was studied.
This study found Nutri-Score effective in achieving a 6% total energy reduction, compared to no front-of-packaging label, which is equivalent to a 0–54 kcal reduction in energy intake per person per day as per tables published in Hollands et al. (2015). For the modelling, we assume an average reduction of 27 calories per person (adult) per day.
Estimating the population reach
In our analytical model, we applied the effect sizes to people living with overweight or obesity. For adults, that is people aged 18 or above with a BMI of 25+. We are in the process of estimating the impact of this policy on children and will update our findings as soon as possible.
Changes in the prevalence of people living with obesity
Table 1 shows the percentage reduction of adults and children moving from BMI≥30 into a healthier BMI category following the introduction of a mandatory front-of-pack labelling similar to Nutri-Score. We are in the process of modelling the impact for children and will update findings upon completion.
| Adults (England and Wales) | Children (England and Wales) | Adults (Scotland) | Children (Scotland) |
| 7% | In progress | 7% | In progress |
Cost and benefits
Cost over 5 years
We estimated that this policy would cost the governments approximately £18 million over five years
We commissioned HealthLumen to estimate the cost of the policy to both industry and governments over a five-year period.
Table 2 below shows a breakdown of costs. The direct costs to the governments of monitoring and enforcing is estimated at approximately £1.4 million per year and the cost of running a social marketing campaign is estimated at £2.2 million per year (totalling £18 million over five years). The costs to the food industry are estimated at approximately £2 million in the first year for familiarisation and around £4 million per year for three years to change the product labels. This policy would require the implementation of the Food Data Transparency Partnership, the costs of which are not included in this breakdown.
| Group affected | Cost | Horizon | Detail |
| Costs | |||
| Government | £7m | Annual (5 years) | Implementation costs, administering and enforcement of legislation |
| Government | £10.8m | Annual (5 years) | Cost of social marketing campaign |
| Industry | £1.8m | One-off | Familiarisation costs |
| Industry | £11.3m | Annual (3 years) | Implementation costs of changing product labels |
Total annual benefit
We estimated that this policy would have an annual benefit of approximately £5 billion
Using analysis conducted by the Tony Blair Institute and Frontier Economics we estimate this policy would result in benefits of approximately £5 billion per year. Approximately two-thirds of this saving would benefit individuals (via quality-adjusted life years, and informal social care). The remaining third relates to savings that benefit the state via NHS treatment costs, productivity and formal social care. See our Technical Appendix for more information about the cost breakdowns.
Impact on disease incidence
We commissioned HealthLumen to report disease incidence avoided if the policy were implemented. These estimates do not represent the total health benefits. The specific diseases selected are those where there is good evidence that living with obesity is associated with the development of the disease.
Table 3 presents a summary of incidence avoided (rounded to the nearest 100)
| Disease | Incidence avoided |
| Type 2 diabetes | 22,200 |
| Hypertension | 15,000 |
| Coronary heart disease | 6,600 |
| Colorectal cancer | 2,000 |
| Gall bladder disease | 28,800 |
| Ovarian cancer | Not statistically significant |
| Stroke | 3,500 |
| Liver cancer | Not statistically significant |
| Depression | Not statistically significant |
| Musculoskeletal disease | 8,600 |
Behind the averages: impact on inequalities
Recent evidence indicates front-of-pack labelling is an equitable policy approach. Pettigrew et al.’s (2023) study found that across income categories, comparable effects of front-of-pack labelling exposure were observed to improve both understanding of nutritional quality and food choices. This effect was seen across five tests of front-of-pack labelling. However changes in food choice were much smaller across three income groups, reflecting that understanding does not translate into behaviour.
Rating the strength of evidence
We asked experts working in the fields of obesity, food, and health research to rate the strength of the evidence base for each policy, taking into account both reliability (size and consistency) and validity (quality and content) of the evidence. Policies were rated on a Likert scale of 1–5 (none, limited, medium, strong, and very strong evidence base). The Blueprint Expert Advisory Group rated this policy as having a Strong evidence base.
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