ArticleNutrition & dietetics : the journal of the Dietitians Association of Australia2025
Modifying the Health Star Rating nutrient profiling algorithm to account for ultra-processing.
Article in Nutrition & dietetics : the journal of the Dietitians Association of Australia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review of nutrient profile models for front-of-pack nutrition labelling.Nature food · 2026Pooled it
- Food Processing Knowledge in Relation to Healthiness and Self-Reported Understanding of the Health Star Rating in Australia.Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals · 2026Article
- Generative artificial intelligence creates delicious, sustainable, and nutritious burgers.NPJ science of food · 2026Article
- Quick response codes in the breakfast cereal aisle: prevalence, landing page, and product characteristics.Health promotion international · 2026Article
- Alignment with front-of-package labeling policy and risk of hospitalization: evidence from Canadian National Nutrition Survey linked to routinely collected health administrative databases.The American journal of clinical nutrition · 2026Article
- Application of a Food-Based Nutritional Profiling System to Assess Diet Quality in Diet-Level Data: Evidence on Construct and Convergent Validity from the Hatoyama Cohort Study and Kusatsu Cohort Study.Current developments in nutrition · 2026Article
- Modifying the Health Star Rating nutrient profiling algorithm to account for ultra-processing.Nutrition & dietetics : the journal of the Dietitians Association of Australia · 2025Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
aimTo modify the Australian and New Zealand Health Star Rating to account for ultra-processing and compare the alignment of the modified ratings with NOVA classifications and the current Australian Dietary Guidelines classifications of core (recommended foods) and discretionary (foods to limit).
methodsData was cross-sectionally analysed for 25 486 products. Four approaches were compared to the original Health Star Rating: (1) five 'negative' points added to ultra-processed products (modification 1; inclusion approach); (2) ultra-processed products restricted to a maximum of 3.0 Health Stars (modification 2; capping approach); (3 and 4) same approach used for modifications 1 and 2 but only applied to products that already exceeded 10 'negative' points from existing Health Star Rating attributes (modifications 3 and 4, respectively; hybrid approaches). Alignment occurred when products (i) received <3.5 Health Stars and were NOVA group 4 (for NOVA comparison) or discretionary (for Dietary Guidelines comparison), or (ii) received ≥3.5 Health Stars and were NOVA groups 1-3 or core.
resultsAll Health Star Rating modifications resulted in greater alignment with NOVA (ranging from 69% to 88%) compared to the original Health Star Rating (66%). None of the modifications resulted in greater alignment to the Dietary Guidelines classifications overall (69% to 76%, compared with 77% for the original Health Star Rating), but alignment varied considerably by food category.
conclusionsIf ultra-processing were incorporated into the Australian and New Zealand Health Star Rating, consideration of ultra-processing within the broader dietary guidance framework would be essential to ensure coherent dietary messaging to Australians.
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