Here is where I share my thoughts, ideas and opinions about the world of nutrition, food and health. I hope you find good sense, helpful guidance and inspiration to eat great healthy food that makes you feel good.

I write regularly for GI News, an online newsletter for 60,000+ Australasian and International subscribers interested in the glycemic index (GI) and associated health topics such as diabetes, weight loss and a healthy heart. It’s a great read.


23 Feb 2016

Making sense of Health Stars

Posted by Nicole Senior on Tuesday, February 23, 2016

Now that the Health Star Ratings (HSR) have been around for a while, the 'commentariat' has had time and opportunity to weigh in with their opinions. You can read my previous post on the HSR here. While no system can ever be perfect, I think the HSR is a good system but it has copped some unfair criticism, and mostly from a misunderstanding of food and nutrition as well as how the HSR should be used. Here are some of the issues that have been raised.

Fairfax media covered a report NSW Health prepared examining alignment between School Canteen Guidelines and the HSR. While the report concluded a fairly good alignment between canteen recommended foods and foods scoring three stars and above, in sensational fashion only exceptional foods were highlighted- foods that were red and amber rated in canteen guidelines which scored three or more health stars.  The NSW Health report was not proposing the HSR be used in school canteens right away, but simply looking into utilising it in some way in the future. The one glaring difference to be overcome is that canteen guidelines are based on a serve of food while the HSR is based on 100g of a food. (School canteen guidelines are a dogs breakfast in Australia with the states and territories doing their own criteria making it a nightmare for food companies trying to market products to canteens nationally. Moving them toward agreed national guidelines would be a step forward.) 

Some criticise the HSR as giving processed foods a 'health halo'. The fact is, the HSR is meant to be used to identify healthier choices within processed and packaged foods. In my experience this is where people need the most help; when they're staring at a myriad of products with lots of small print on the supermarket shelf and wondering which one is best (this is where the Heart Foundation Tick was excellent - it was easy to spot). It is assumed that people know that fresh whole foods are healthy. It makes intuitive sense that people don't need stars on fresh fruit and vegetables to know they are healthy, but I'd welcome any evidence to the contrary.

A journalist highlighted the example of a flavoured milk scoring 4.5 out of 5 stars and was appalled when she checked the nutrition information panel to find it contained 22g of sugar. She was similarly disappointed at a fruit flavoured yoghurt. What she didn't realise was that milk contains natural sugars which inflates the total sugars listed on the label. And what she failed to appreciate (no small thanks to the quitting sugar bandwagon) was that milk and yoghurt are a nutrient dense core foods and its OK to enjoy a little sugar in these foods- it makes them taste good.These foods score well under the HSR because they contains lots of good stuff that offsets the sugar added. Its the nutrient poor foods like soft drinks and confectionery we need to be wary of. General paranoia in the community about processed foods and the predominance of fad diet culture has created misunderstandings about food and nutrition and increased skepticism about front of pack labelling.

The underlying question that both school canteen guidelines and the HSR aim to answer is: which foods are healthy and which aren't? This is a harder question to answer than you might think. The Dietary Guidelines classifies foods as 'core' and 'discretionary' but by no means provide all the answers when you're faced with a smorgasbord of supermarket products. Its easy at the extreme ends of the spectrum: apples are healthy 'core' foods and apple flavoured cordial is discretionary. But where the lines get fuzzy is with the foods in between that have been changed, combined or added to in some way (which lets face it is a lot of foods we eat). For example, an apple bircher muesli made with apple, muesli, nuts, yoghurt and honey. It has all the goodness of the core foods in the recipe with some added sweetening. And what about an apple cake made with wholemeal flour, walnuts, olive oil, apple and prunes? Its a cake, but its a pretty healthy one. Cake is discretionary but the HSR would offset the beneficial components with the overall kilojoule density. A more traditional cake would not score as well - and isn't that the whole idea? If you want cake, choose the healthier one with more stars. Its hard to define a healthy food versus an unhealthy food (or should we say less healthy?), and perhaps we should not expect any tool to do this perfectly. Food is complicated.

The HSR rating scoring system will be reviewed over time and hopefully this will reduce anomalies but in the meantime lets give the HSR a chance and use it correctly. You can be confident that eating fresh, whole, minimally processed foods is good for you even if they have no stars. And just because a processed food has stars, doesn't mean you should eat more of these and less whole foods. Use the HSR to choose healthier options of processed and packaged foods of the same type, such as soup A vs soup B. Don't use the HSR to choose the healthiest between soup and cheese because they are too different. 

Everyone knows a banana is healthy but the HSR can help you choose a healthier banana cake and help banana cake bakers to change to healthier recipes to earn more stars