Table 1 Description of health-related claim (HRC) data

Impact of HRCs on dietary choices [11]

A systematic review of the effect of HRCs on pre-packaged foods, on dietary choices, including a meta-analyses of choice experiments which measured the likelihood of choosing a product when a HRC was present relative to when it was not.

Meta-analyses of 17 studies found that products carrying HRCs were 75% (OR 1.75, 95% CI 1.60, 1.91) more likely to be chosen than identical products without HRCs. Analyses by food group found that odds ratios differed by food group.

Prevalence of HRCs (the proportion of foods that carry at least one HRC) [10]

A randomly sampled selection of pre-packaged foods available to purchase in the UK, Germany, the Netherlands, Slovenia, and Spain. Approximately 400 products were sampled from each country. The nutritional information and HRC information was recorded from the food label.

Overall, 26% (95% CI 24, 28%) of foods carried a HRC, and the prevalence differed significantly between food groups.

Nutritional quality of foods carrying HRCs [18]

Using the same sample of foods described above [10], this study compared the mean levels, per 100 g of nutrients for foods carrying HRCs against foods that do not.

Compared to foods that did not carry any HRCs, foods with claims had, on average, significantly (p < 0.001) lower levels of; energy (− 43.7 kcal/100 g), protein (− 1.0 g/100 g), total sugars (− 3.2 g/100 g), saturated fat (− 2.9 g/100 g), and higher levels of fibre (+ 0.7 g/100 g p < 0.001), and lower levels of sodium (− 354 mg/100 g, p < 0.006)

The impact of using nutrient profile models to regulate the use of HRCs [18]

Using the same data above [10, 18] this study assessed the impact of restricting health claims with a nutrient profile model. This was assessed as difference in the mean level of nutrients of foods that carry health claims and pass the FSANZ NPSC and foods that do not.

For our study we looked at the mean level of nutrients for foods that carry HRCs and pass the FSANZ NPSC, and the EU model, and foods that do not.

Foods that carry health claims had, on average per 100 g, significantly (p < 0.01), fewer calories (− 29 g), less protein (− 1 g), total sugars (− 3 g), significantly (p < 0.001), less saturated fat (− 2 g) and sodium (− 842 mg) and more fibre (+ 0.8 g).

Using the FSANZ NPSC to restrict health claims resulted in greater differences but this varied by nutrient. Foods that carried health claims and passed FSANZ NPSC had significantly (p < 0.001) fewer calories (56 kcal), less protein (− 1.6 g), total sugars (− 7.3 g), saturated fat (− 2.9 g), sodium (− 977.6 mg), and more fibre (+ 1 g), relative to foods without claims.