What we eat and drink affects our health and well-being in the short and long term. Poor nutrition causes obesity and heart disease at one end of the spectrum, and stunting, wasting and vulnerability to infection at the other. Right now, one in three people globally is either under- or overweight, and this nutrition crisis is placing a huge burden on health services and threatening the achievement of the United Nations’ Sustainable Development Goals.
Many of us have a lot of choice about what we eat, and of course we have to take responsibility for this. In some cases – particularly but not exclusively in the developing world – choice may be constrained by scarcity or limited purchasing power. But there is another strong determinant of global nutrition outcomes, and that’s the growing impact of big food and drink companies.
Since 2013, the Access to Nutrition Foundation has produced a ranking of the largest food and beverage manufacturers, based on the premise that companies can and should increase consumer access to nutritious and affordable food and drink, and responsibly exercise their power. With operations in over 200 countries and approximately $500 billion in sales each year, the world’s 22 biggest food and beverage manufacturers have an enormous influence over consumer choice and behavior. And with this influence comes huge responsibility.
The results of the 2018 Access to Nutrition Index are both heartening and show that progress still needs to be made. On the one hand, we can see evidence of impact: Since the assessment two years ago, many companies have stepped up efforts to encourage better diets, largely through better policies and disclosure of information. For example, seven companies have strengthened their nutrition strategies and management systems. Some have also increased efforts to address undernutrition, either philanthropically or through their core business, for example by fortifying certain foods.
As a result, the average score on the ranking has gone up from 2.5 out of 10 in 2016 to 3.3 in 2018. Nestle tops the ranking this year with a score of 6.8, with Unilever in second place at 6.7 and Danone in third at 6.3. Each of these companies has put policies on nutrition and undernutrition at the heart of their business strategy, and required boards and CEOs to feed in to and sign off on them.
However, the 2018 index shows there is still considerable room for improvement. The new Product Profile, which assesses the healthiness of companies’ ranges in nine countries, reveals that less than a third of the 23,013 products surveyed can be classified as healthy. The Product Profile uses two metrics to determine whether products can be classified as healthy: the Health Star Rating system to assess levels of healthy nutrients like fruit, vegetables and fiber, and unhealthy ones like saturated fats and salt, to give an overall score by product; and the WHO EURO system, which assesses whether products are healthy enough to be marketed to children. Strikingly, our findings contrast markedly with companies’ own assessments of how healthy their products are, suggesting that they are using different criteria and could be more rigorous in holding themselves to account.
For example, Nestle, which tops the 2018 index, says it generated more than 80 percent of its global revenues in 2016 from healthy products. However, index researchers found that only 19 percent of Nestle’s sales in nine countries (which represent 54 percent of its global sales of the categories assessed) were generated by healthy products. Similarly, Unilever, in second place in this Index, reports that 35 percent of its products sold, by volume, reach its own “Highest Nutrition Standards.” Using a slightly different metric, the index found that only 10 percent of Unilever’s sales in the nine countries (which represent 42 percent of its global sales of the categories assessed) were healthy.
Marketing of breast-milk substitutes is another area where many companies need to up their game. Breastfeeding saves lives, especially in developing countries. It helps babies build strong immune systems and lessens their chances of contracting specific diseases or becoming overweight later in life. The International Code of Marketing of Breast-milk Substitutes requires companies to reflect this in their marketing, which they all say they do. But this year’s index found that although Danone, Nestle and Abbott have made significant progress in aligning their marketing policies and management systems with the international code, their activities and those of the other three largest baby food companies assessed in the index continue to contravene its guidance.
Meanwhile, only 14 percent of the products covered by the Product Profile were found to be healthy enough to be marketed to children, and most companies’ responsible marketing policies fall short, for example, by not covering all media channels or not applying to children over 13.
Overall in 2018 there is some cause for optimism, but there is more to do if companies are to fulfill their potential to be a real force for good on global nutrition. The first thing they should do is improve the nutritional composition of their existing products, particularly top-selling items, and publish clear targets so that others can track improvements. Concerted and consistent efforts should be made to increase the affordability and accessibility of healthy products in all markets. And boards must get more involved and take responsibility for spearheading a strategic response to nutrition and undernutrition in their core business.
If companies take these and the other actions recommended in the report, they will be able to move toward being part of the solution – rather than part of the problem – to the urgent global nutrition crisis.
The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Malnutrition Deeply.