Discussion
diabetes, FOP beverage, ’ beverage, sugar reduction
DIABETES
This study assessed the effectiveness of Singapore’s upcoming FOP beverage label, Nutri-Grade (NG), on nutritional quality of products purchased using an experimental online grocery store. For beverages, we found that the weighted (by the number of servings purchased) average NG score (ranging from 1 (D) to 4 (A)) was 7% higher in the NG label condition compared to control, suggesting that the label positively influenced shoppers’ beverage purchasing patterns. This increase appears to be driven entirely due to sugar reduction. The NG label reduced per serving sugar purchased by 1.5 g (equivalent to about 2.9 g of sugar/330 ml can). The sugar reduction is small but could have a meaningful effect over time given that Singaporeans consume an average of 33 g of sugar from beverages daily [The NG label was not effective at reducing saturated fat (g) purchased from beverages, despite it being a target nutrient of the NG algorithm. There are several possible explanations for this result. First, the underlying NG algorithm largely focuses on sugar. Beverages with high sugar content receive NG C or D grades even if they are low in saturated fat. This means that consumers switching out of these beverages toward healthier products could actually When expanded to the entire shopping basket, we found no difference in overall diet quality. This likely results because beverages only accounted for a small proportion of products purchased and we found no evidence that healthier beverage purchases led consumers to substitute toward less healthy foods. Regardless, the fact that the label did not influence overall diet quality reveals the limits of a label focusing on beverages only. Given Singapore’s goal to reduce the incidence of diabetes and other NCDs, these results suggest that additional policies will be needed.Singapore has long applied the Healthier Choice Symbol (HCS) logo on packaged food and beverage products. However, the effectiveness of this and other positive FOP labels have been questioned, largely because they do not help to identify the least healthy products, which are highest in sugar and calories [