ArticlePublic health nutrition2026
An investigation of the change in alignment between the Health Star Rating Scheme and the Nova Food Processing Classification System and the Australian Dietary Guidelines.
Article in Public health nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveFront-of-package labelling informs consumers about the 'healthiness' of foods based on different classification schemes. These schemes reflect competing worldviews for assessing a food's healthiness, represented by nutrient-, food- or diet-based indices. The Health Star Rating scheme (HSR) has been criticised for failing to appropriately score unhealthy products. Updates to the HSR algorithm were implemented over a two-year period from November 2020. This study investigated alignment between a nutrient-based scheme (HSR), food-based scheme (Nova food processing system) and diet-based scheme (Australian Dietary Guidelines (ADG)).
settingMintel Global New Products Database.
participantsRetail foods displaying HSR launched or updated onto the Australian market between November 2020 and June 2023.
designProducts were categorised according to the ADG and Nova, descriptive statistics performed for each category and proportion displaying HSR ≤ 2·0 and ≥ 2·5 calculated for discretionary foods, five food group foods, ultra-processed foods (UPF) and non-UPF. Agreement between categories obtained by Kappa.
resultsMedian HSR for UPF and discretionary foods were 3·5 and 2·5, respectively, and 73·7 % of UPF and 58·2 % of discretionary foods displayed HSR ≥ 2·5. Agreement between HSR and Nova was none to slight (k = 0·09, P < 0·001) and HSR and ADG was fair (k = 0·38, P < 0·001). Between 2020-2023, the proportion of UPF displaying HSR ≥ 2·5 increased from 60·2 % to 78·5 % and for discretionary foods 47·0 % to 62·5 %.
conclusionThe HSR algorithm calculates 'healthy' HSR (≥ 2·5) for a high proportion of UPF and discretionary foods. The HSR's nutrient-based approach to translate food-and diet-based nutrition recommendations into accurate food 'healthiness' assessments is still problematic.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.