It may seem that your teen can sleep around the clock, especially during school holidays. While that’s not precisely true, teens do need more sleep to help them be their best during busy days. The Journal of Paediatrics & Child Health suggests that teens should aim for 9-10 hours of sleep a day, based on scientific research and study.
According to the Centers for Disease Control and Prevention, adolescents who do not get enough sleep are at risk of health and behavioral challenges. Alarmingly, lack of sleep is common: the CDC analyzed data from the 2015 Youth Risk Behavior Study and determined that 7 out of 10 high schoolers, or 72.7%, did not get enough sleep on school nights.
Added to the regular stresses faced by teens are the additional challenges posed by the pandemic, which has brought about increased sleep difficulties for many. In fact, “coronasomnia,” as researchers dub it, has increased the levels of clinically significant insomnia for all age groups.
How Much Sleep Does A Teenager Need?
Everyone’s need for sleep is unique to them, but teens, in general, need more rest than pre-teens. That is partly due to the changes that they are experiencing in their bodies during puberty. That 9-10 hours of sleep a night allows your teen’s body to refresh and recharge itself while at the same time supporting a level of growth that adults aren’t dealing with.
Not only that, but their brains are developing as well, leading to greater emotional and intellectual maturity and cognitive development, according to researchers at Johns Hopkins Medicine. More sleep helps them negotiate their growing pains and leaves them better able to resist serious health challenges such as depression or drug use.
One primary factor affecting teens’ need for sleep is their circadian rhythm, also known as the internal clock. Circadian rhythm is influenced by the sun and other light sources to tell us when we should be awake and when it’s time to go to bed.
When a teen keeps irregular hours — up till 2 am studying one night, crashing the next at 10 pm — it’s easy for that circadian rhythm to get out of whack. Resetting it can take days and requires your teen to establish a daily routine: to bed at night and up in the morning at roughly the same time each day. Oversleeping one day and pulling an all-nighter the next, in other words, isn’t healthy for teens (or anyone, for that matter) and should be avoided at all costs.
Why Do Teens Need More Sleep?
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Sleep Problems In Teens
Teens as a group are probably more prone to sleep problems than other groups. With their active social lives, schedules that are bursting with activities and the increasing classwork/homework demands as they progress through high school, there are lots of reasons why sleep may be long in coming even when they do get to bed at a reasonable hour.
High school often starts earlier in the mornings than middle or elementary schools, meaning your teens may be getting up before the sun is up. Those early start times can be hard to get used to. Plus, many students have a huge course load, which means they’re up late studying and doing work every night.
As anyone who’s been a teen knows, those are stressful years. But, it’s also a fun time in a child’s life — full of sports games, Friday nights out, shopping trips with friends, and all kinds of exciting things. It can be hard to balance that with school and perhaps a part-time job. Not only does the schedule add to their stress, but if you have a teen who isn’t doing well in school or is getting picked on, they may be carrying burdens that are too much to handle for anyone. Those stressors can easily lead to sleepless nights.
Most likely, your teen has their cell phone in bed with them at night, and if they’re scrolling social media or texting friends, it might be keeping them up later than you realize. All of those bright lights and noises will keep them awake rather than help them sleep. Why? Studies show that the blue light emitted by our devices is detrimental to sleep, disturbing our circadian rhythms more than any other color of light. Experts suggest that you should put away your devices several hours before bed — but that’s a hard thing to ask of a Tik Tok-addicted teen.
During the teen years, when your adolescent children are trying to figure out just who they are in the world, it’s common for them to do a mental compare-and-contrast with their peers. If others are doing it, then they want to do whatever it is as well. And when their friends boast of staying up all night to watch YouTube videos or prepping for an exam, your teen may want to match that endeavor. Sometimes, copying the acts of others is a good thing. And sometimes it’s not. For impressionable teens, staying up till all hours may look like a way to be one of the popular kids, but they pay the price for their loss of sleep in reality.
6 Tips For Sleep-Deprived Teens
There’s no one-size-fits-all solution for handling sleep-deprived teens. It may take time and effort to gradually move your teen in the direction of good sleeping habits, and you may get some pushback when you try. If you are the parent or teacher of a teen, you may have noticed that they like to make their own decisions and often distrust the wisdom of their elders. (You were probably like that yourself, once).
Here are a few ideas, however, that may help you convince your teen that the benefits of a good night’s slumber far outweigh the drawbacks.
- Set rules about screen use. Aim to have teens shut down their smartphones 1-2 hours before bedtime. Have a charging station for family devices that’s in the kitchen or some other public space, rather than your teen’s bedroom.
- Set a bedtime schedule. Your teen may balk at this, but as the parent, you can determine when things should quiet down in the household — which may lead your teen to bed out of boredom if nothing else.
- Keep your teen away from heavy snacks at night. A light snack, like an apple or handful of almonds, is fine. Some foods, in fact, encourage good sleep — like the classic glass of warm milk. Stock your shelves with them, and suggest them to your teen when they’re hungry.
- Get your teen up early on the weekends. Yes, it’s fine to let them sleep till 8 if they’re used to getting up at 6 on school days. But if you can keep them from sleeping until noon, you’ll be doing them a favor by keeping their internal clock running smoothly.
- Invest in good bedding and a comfortable mattress. The key here is to make them want to go to bed because it’s comfortable and welcoming.
- If your teen takes naps, encourage them to keep them short. A 20-minute “power nap” will do more to restore your teen than three hours of afternoon slumber.
Spotlight on Teens With Part-Time Jobs
Managing school and a part-time job can be challenging, but it’s a reality for some teens. That can lead to some harsh decisions — giving up a sport, for example, that takes up considerable time for practices and games. Here are a few tips for teens working to juggle the demands of both their teachers and their boss.
- Schedule, schedule, schedule
Work with your teen to develop a realistic schedule that prioritizes getting enough sleep, as well as leaving time for study. Building and writing down a solid schedule doesn’t come easy to many teens, but developing this habit can yield lifetime benefits.
- Be vigilant
Watch your teen to be sure that they are meeting their commitments, but not at the expense of their health. If you see a study light on in your teen’s room at 2 a.m., for example, you may want to step in to help them over a rough patch by, say, relieving them of a household chore so they can study.
- Give them space
At the same time, it’s important to allow your teen to learn lessons without hovering over them. It’s a fine line to walk — being supportive but not overbearing — and every parent does it differently. That said, remember that sometimes a painful experience (such as getting a poor grade on a test) can lead to growth.
- Make your home sleep friendly
Are you up watching the Late, Late Show in the family room till the wee hours? Do you tend to sleep till noon on the weekends yourself? Consider revamping your whole family’s sleep schedule so that all clearly observe quiet hours.
Here’s The Bottom Line
Our society asks a lot of teens. We expect them to do well in school, excel at extracurricular activities, maintain a social life, and, sometimes, work — either to help support their family or so they can afford new purchases on their own. There’s one common denominator to all that, and it’s getting enough sleep. If your teen is averaging 9-10 hours of sleep a night, they will earn better grades and be able to manage a full schedule much better than if they’re burning the midnight oil regularly. It’s important to support your teen as they negotiate this tricky phase in their life so that they can be the best — and most well-rested — version of themselves every day.
Written by Slumber Yard Team Last Updated: July 12, 2021 Medically reviewed by Lauren Castiello, MS, AGNP-C
- Journal of Paediatrics & Child Health. V.13 (1). Jan. 2008. Accessed at the National Institutes of Health website. Teens and Sleep: Why You Need It and How to Get Enough. Accessed May 21, 2021.
- CDC website. Sleep in Middle and High School Students.Published September 10, 2020. Accessed May 21, 2021.
- Wheaton, Anne G., et al. Short Sleep Duration Among Middle School and High School Students — United States, 2015. Published January 26, 2018. Accessed May 21, 2021.
- UC Davis Health. COVID-19 Is Wrecking Our Sleep With Coronasomnia — Tips to Fight Back. Published September 23, 2020. Accessed May 21, 2021.
- Johns Hopkins Medicine website. Teenagers and Sleep: How Much Sleep is Enough? Published, n.d. Accessed May 21. 2021.
- American Academy of Sleep Medicine website. Poor Sleep Can Negatively Affect a Student’s Grades, Increase the Odds of Emotional and Behavioral Disturbance. Published June 9, 2008. Accessed May 21, 2021.
Besides lack of sleep, teenagers suffer from lack of nutrition due to poor diets. Studies have shown that poor nutrition impacts performance at school and writing exams.
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- A study investigated how the nutritional value of products from the top 10 global food and drink companies changed in response to voluntary reformulation policies in the United Kingdom.
- The results suggest that although these targets did not significantly affect products’ nutritional values, a soft drink industry levy was successful in reducing the sugar content in drinks.
- The researchers say that further policy action is necessary to incentivize companies to change product composition to improve public health.
Poor diets, including those that incorporate foods high in calories, sugar, and salt, are a major risk factor for cardiovascular diseaseTrusted Source, cancerTrusted Source, and general mortalityTrusted Source.
In 2019, a study found that poor diets account for 18.2% of heart disease, stroke, and type 2 diabetes costs in the United States, which equates to $50.4 billion.
In recent years, Public Health England (PHE) has published a series of voluntary reformulation targets to encourage manufacturers to improve the nutritional values of their food. These included reduction targets for calories, sugar, and salt.
There has been little research on how reformulation targets influence the nutritional values of products by individual companies. Monitoring this could help policymakers develop better ways to improve public health.
Scientists from the University of Oxford in the U.K. recently conducted a study investigating how the nutritional value of products from the top 10 global food and drinks companies changed in response to voluntary reformulation targets in the U.K.
“Our study shows it is possible to monitor the overall healthiness of company product portfolios and chart changes over time,” says Dr. Lauren Bandy of the University of Oxford’s Nuffield Department of Population Health.
“We saw little evidence that the recommended current targets have made a significant difference, and we believe that without more policy action and a transparent monitoring and evaluation system, it is unlikely there will be meaningful change.”
The researchers published their findings in PLOS ONETrusted Source.
The scientists used Euromonitor International to identify the 10 largest food and soft drink manufacturers and examine the sales data for their brands and products between 2015 and 2018.
Altogether, these companies accounted for 24% of the £71.3 billion in sales generated in the U.K. in 2018. They included names such as Coca-Cola, Mondelez International, and Premier Foods.
The researchers also used Edge by Ascential, a private analytics company, to collect nutrition data on all brands that the companies sold between 2015 and 2018.
They then applied a nutrient profile model — which the Food Standards Agency developed for the Office for Communications (Ofcom) — to each product to rate their healthiness.
The team awarded the products points based on their energy, saturated fat, total sugar, sodium level, fiber, and protein, as well as their fruit, nut, and vegetable (FNV) contents.
Between 2015 and 2018, the number of products that the companies manufactured decreased slightly from 3,471 to 3,273.
The researchers also noted a small increase in the proportion of healthy products that the companies offered. In 2015, 46% of products met the criteria for a healthy classification, compared with 48% of products in 2018.
They also found an increase in the proportion of healthy sales from 44% in 2015 to 51% in 2018. However, this change was largely due to an increase in sales of bottled water, low or no-calorie drinks, and fruit juice.
Overall, the researchers found that voluntary reformulation targets led to no significant changes in product nutritional values among the top 10 food and drink companies between 2015 and 2018.
They also found that the average nutritional values of these products collectively fell below the Ofcom threshold for broadcast advertising.
Sugar levy for soft drinks
To explain their results, the researchers say that the introduction of the Soft Drinks Industry Levy (SDIL) in 2018 likely drove the small increase in more healthy soft drink sales.
The SDIL works by charging companies for excess sugarTrusted Source in their drinks. There is a tax of £0.24 per liter on drinks with 8 grams (g) or more of sugar per 100 milliliters (ml), with a lower tax of £0.18 for those with 5–8 g per 100 ml, and no tax for those with less than 5 g per 100 ml.
“When you compare the lack of overall change, we saw in foods with the reductions we saw in the sugar content of soft drinks, it would be easy to draw the line between the voluntary nature of the food reformulation targets and the mandatory and fiscal nature of the soft drinks tax,” Dr. Bandy recently told Medical News Today.
“Other than for acting in a responsible way and to enable consumers to eat more healthily, manufacturers have little incentive to reformulate their products to meet the reformulation targets set out by PHE,” she continued.
The researchers conclude that transparent monitoring and evaluation of food nutritional values could make it easier for policymakers to work with companies to improve public health.
Assessing the healthiness of UK food companies’ product portfolios using food sales and nutrient composition data
Lauren Kate Bandy, Sven Hollowell, Richard Harrington, Peter Scarborough, Susan Jebb, Mike Rayner
Published: August 4, 2021 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254833
The provision and over-consumption of foods high in energy, saturated fat, free sugars or salt are important risk factors for poor diet and ill-health. In the UK, policies seek to drive improvement through voluntary reformulation of single nutrients in key food groups. There has been little consideration of the overall progress by individual companies. This study assesses recent changes in the nutrient profile of brands and products sold by the top 10 food and beverage companies in the UK.
The FSA/Ofcom nutrient profile model was applied to the nutrient composition data for all products manufactured by the top 10 food and beverage companies and weighted by volume sales. The mean nutrient profiling score, on a scale of 1–100 with thresholds for healthy products being 62 for foods and 68 for drinks, was used to rank companies and food categories between 2015 and 2018, and to calculate the proportion of individual products and sales that are considered by the UK Government to be healthy.
Between 2015 and 2018 there was little change in the sales-weighted nutrient profiling score of the top 10 companies (49 to 51; p = 0.28) or the proportion of products classified as healthy (46% to 48%; p = 0.23). Of the top five brands sold by each of the ten companies, only six brands among ten companies improved their nutrient profiling score by 20% or more. The proportion of total volume sales classified as healthy increased from 44% to 51% (p = 0.07) driven by an increase in the volume sales of bottled water, low/no calorie carbonates and juices, but after removing soft drinks, the proportion of foods classified as healthy decreased from 7% to 6% (p = 33).
The UK voluntary reformulation policies, setting targets for reductions in calories, sugar and salt, do not appear to have led to significant changes in the nutritional quality of foods, though there has been progress in soft drinks where the soft drink industry levy also applies. Further policy action is needed to incentivise companies to make more substantive changes in product composition to support consumers to achieve a healthier diet.
Citation: Bandy LK, Hollowell S, Harrington R, Scarborough P, Jebb S, Rayner M (2021) Assessing the healthiness of UK food companies’ product portfolios using food sales and nutrient composition data. PLoS ONE 16(8): e0254833. https://doi.org/10.1371/journal.pone.0254833
Editor: Jane Anne Scott, Curtin University, AUSTRALIA
Received: January 21, 2021; Accepted: July 4, 2021; Published: August 4, 2021
Copyright: © 2021 Bandy et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: This study used data from two commercial sources. The sales data was accessed under licence from Euromonitor International (https://www.euromonitor.com/packaged-food) via the Bodleian Library, University of Oxford, using Euromonitor’s database portal Passport GMID. The product information dataset, including nutrition composition data, was purchased for the purpose of the lead author’s DPhil research project from Edge by Ascential (https://www.ascentialedge.com/our-solutions). Due to licencing restrictions, the Euromonitor and Edge by Ascential datasets can only be requested under licence for the purpose of verification and replication of study’s findings via the research group’s Data Access Committee (contact: Trisha Gordon foodDBaccess@ndph.ox.ac.uk). Further use of these datasets must be negotiated with the data owners (Euromonitor contact: Ashton Moses – email@example.com, Edge by Ascential contact: David Beech – firstname.lastname@example.org). The authors received no special privileges in accessing the data.
Funding: LB, SH and MR are funded by the Nuffield Department of Population Health, University of Oxford. PS is funded by a British Heart Foundation Intermediate Basic Science Research Fellowship (FS/15/34/31656). All authors are part of the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). SJ is also funded by the NIHR Collaboration for Leadership in Applied Health Research and Care Oxford at Oxford Health NHS Foundation Trust and is an NIHR senior investigator. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
The provision and consumption of foods high in energy, saturated fat, free sugars or salt is an important marker of poor diet and associated with substantial morbidity . To support improvements in public health nutrition, Public Health England (PHE) published a series of voluntary, category-specific reformulation targets for calories, sugar and salt [2–4] to encourage manufacturers to improve the nutritional quality of everyday products. Progress has been monitored by measuring change in the levels of individual nutrients and does not include a more holistic view of how the nutritional quality of products has changed overall.
The food industry in the UK is powerful and consolidated; in 2018, the retail value sales of packaged food and soft drinks products was £71.3 billion, with the 10 largest companies accounting for nearly a quarter (24%) of the total . In order for PHE’s voluntary reformulation targets to be successful in improving quality of the UK population’s diet, food manufacturers–especially the largest companies whose products dominate the market—must make changes across a range of products. So far, PHE has focused on changes in specific food groups and has published only limited company-level analysis, but progress by company is vital to understanding the industry response to the targets.
Nutrient profiling is “the science of classifying and ranking foods according to their nutritional composition for reasons related to preventing disease and promoting health” . Nutrient profiling generally involves the application of a model that classifies or ranks foods based on their overall nutrition composition, rather than looking at individual nutrients in isolation. It has multiple purposes, including supporting health-related labelling schemes and restricting the marketing of foods to children . The UK Government’s current nutrient profile model was developed by the Food Standards Agency (FSA) to provide the Office for Communications (Ofcom) with a tool to differentiate between foods that can and cannot be advertised to children, based on their nutrition composition .
The aim of this study was to assess how the nutritional quality of products offered by the top 10 global food and drink companies has changed over time by applying the FSA/Ofcom nutrient profiling model to a composition database, and weighting it using product sales data.
Data types and sources
Volume sales data was sourced from Euromonitor and accessed through the Oxford University Library. The top 10 UK food and soft drink manufacturers and their brands were identified based on global company names using 2018 sales data from Euromonitor . A company is defined by Euromonitor as: “the legal entity that produces or distributes an individual or group of brands in the UK”. All of the brands manufactured by these companies between 2015 and 2018 were identified, including those that dropped in or out of the market. Brands were defined as a set of products that have the same generic name and are manufactured by one company.
The composition data were provided by Edge by Ascential (previously Brand View), a private analytics company that collects product information, including nutrient composition data, by scraping the websites of the UK’s three leading retailers: Asda, Sainsbury’s and Tesco. These data were scraped from these three websites on the same date (13th December) for four consecutive years (2015, 2016, 2017 and 2018). The sales data and nutrition composition data were automatically matched in Python based on three identifier variables that were present in both databases: brand name, category and year. A 10% random sample of brands was checked manually for any errors. Of the 20 brands checked, 4 brands were identified as pairing with the correct brand name but incorrect category. All 4 of these errors were brands that appeared in more than one category (e.g. Cadbury is present in five categories, including baked goods and confectionery). The matching code was adjusted so that it first paired based on matching categories, and then brand names, and no errors were identified after further checks.
Applying the FSA/Ofcom nutrient profile model
The FSA/Ofcom nutrient profile model was applied to the individual product composition data. The appropriate points were awarded based on each product’s energy, saturated fat, total sugar and sodium content (“A-points”) and fibre, protein and fruit, nut and vegetable (FNV) content (“C-points”) per 100g, as set out by FSA/Ofcom’s technical guidance . This system was developed for the purposes of restricting advertising of food to children, but here we have used it to classify products as healthy and unhealthy. A food is classified as ‘less healthy’ if it scores four points or more. A drink is classified as ‘less healthy’ if it scores 1 point or more. For the purpose of comparing companies’ entire product portfolios, we converted the nutrient profile score to a 1–100 scale (-2(original score) +70), so that a higher score indicates healthier products. In order to directly compare drink scores with food scores, we also applied a linear adjustment to the distribution of the soft drinks scores (11x – 704, where x is the score for drinks on the 1–100 scale). The linear adjustment was selected so that the 33rd percentile and 66th percentile of both foods and drinks received the same score (44 and 66, respectively). After the scale conversion and linear adjustment, the thresholds for products to be considered healthy according to the FSA/Ofcom nutrient profile model were 62 or more for foods and 66 or more for drinks.
If the nutrient content for a product was missing, then data was imputed by calculating a brand average for foods in the same category, and if this was not possible, an overall category average. FNV content was estimated based on the ingredients list to categorise ingredients into ‘fruit’, ‘nut’, ‘vegetable’ and ‘other’. The percentage composition of ingredients was identified if this information was provided in the ingredients list. For the products where percentage of ingredients were not given, values were imputed based on a brand and category average, or if this was not possible, a category average.
The total value (£ millions) and volume of food and soft drinks (tonnes) and the sales weighted mean nutrient profiling score (referred to in figure labels as sales-weighted score) were calculated in R for each company and brand, both overall and by category. When one brand had multiple product variants, a simple mean was used. While all brands were included in the analysis, only the top five for each company (n = 50) were presented for the brand-level analyses (Fig 3) for clarity. Bubble and chewing gum and milk formulas for infants, toddlers and children were excluded.
Chi-squared tests were performed in R to test if there were any significant changes in the number of brands and products each company manufactured over time (2015–2018). ANOVA tests were used to test for differences over time in the nutrient profiling scores overall and for each company, category and brand.
In 2018, the top 10 food and soft drink companies had total value sales of £17.1 billion (Table 1). The top 10 companies by value were also the largest 10 in terms of volume sales, although there is variation in the ranking between these two measures. Food company Mondelez is the largest in value terms, while Coca Cola is the largest company in volume terms.
Table 1. Number of products, brands and total volume sales by company, 2018.
In 2018, there were 3273 individual products produced by these companies and included in the dataset under 222 different brands. Premier Foods had the largest product portfolio in 2018, with 613 individual products. Kellogg had the smallest, with 91 individual products. There was a decline in the total number of products that were manufactured by the top 10 companies over the period of analysis, from 3471 in 2015 to 3273 in 2018, a reduction of 6% (p <0.05). Seven out of ten of the companies reduced the number of products they manufacture.
Between 2015 and 2018 there was little change in the sales-weighted mean nutrient profiling score of all the products manufactured by included companies, moving from 49 to 51 (p = 0.28). The number of individual products that could be classified as healthy also remained relatively unchanged, at 46% in 2015 and 48% in 2018 (p = 0.23) There was an increase from 44% to 51% in the total volume sales classified as healthy (p = 0.07). Once soft drinks were removed, the proportion of volume sales that were classified as healthy decreased from 7% in 2015 to 6% in 2018 (p = 0.33).
The company that saw the largest increase in sales-weighted nutrient profiling score was Coca-Cola (48 to 51), although its score still remained below the FSA/Ofcom threshold (Fig 1). The company with the highest sales-weighted nutrient profiling score was Danone, with a large proportion of sales from dairy and bottled water, followed by Kraft Heinz, which has high volume sales of high-scoring pre-prepared baby foods. Coca-Cola, Mars, Unilever, Nestlé and Mondelez scored poorly, with portfolios dominated by confectionery and snacks.
Fig 1. Total sales-weighted nutrient profiling score by company and year.
Baby food had the healthiest nutrient profiling score in 2018, at 72 (Fig 2) but little change over time. Spreads, confectionery and ice cream and desserts were the categories with the lowest nutrient profiling score. There was weak evidence of increases in score over time of staples, dairy, soft drinks and baked goods.
Fig 2. Total sales-weighted nutrient profiling score by category and year.
There was great heterogeneity between companies within some categories (Fig 3). For example, the company scores within the baked goods category ranged from 22 (Nestlé) to 69 (Premier Foods). In contrast, there was less variation within savoury snacks (39–52) and confectionery (26–42). Coca-Cola was the least diverse company producing only soft drinks, while Mondelez and Nestlé were the most diverse, with their portfolios containing products from six categories.
Fig 3. Sales-weighted nutrient profiling score by company and category, 2018.
Of the five top-selling brands of each company, there were increases in the sales-weighted nutrient profiling score over time for Fanta (Coca-Cola), Volvic (Danone), San Pellegrino (Nestlé), Coco-Pops (Kellogg), Maltesers (Mars) and Angel Delight (Premier Foods) (Fig 4). Only Special K (Kellogg) saw its score cross the Ofcom threshold, up from 58 in 2015 to 62 in 2018 (+7%, p = 0.10). The largest increases were seen in soft drink brands San Pellegrino (+88%, p<0.01), Fanta (+28%, p<0.01) and Volvic (+26%, p<0.01) due to reductions in sugar and energy content. Tropicana (PepsiCo) saw a significant decrease in its score (-14%, p<0.01) due to a reduction in the proportion of sales of reduced sugar products, where the number of different products decreased over time. Coco-Pops (Kellogg) improved its score with an increase of 27% (p<0.01) due to a reduction in sugar, energy and salt. There was no strong evidence for changes in the scores of the top 5 brands for Kraft Heinz, Mondelez, PepsiCo and Unilever.
Fig 4. Sales-weighted nutrient profiling score for top 5 brands by company 2015–2018.
Between 2015 and 2018, there was no evidence of change in the overall mean sales weighted nutrient profiling score of products sold by the top 10 food and drink companies in the UK. This mean score remained well below the Ofcom threshold for broadcast advertising. There was only one company (Kellogg’s) where there was weak evidence for improvement in its overall company score due to reductions in sugar and salt in two of its leading brands (Coco-Pops and Special K). There was a very small increase in the number of products classified as healthy (46% in 2015 to 47% in 2018) but a greater increase in the proportion of sales that were classified as healthy (44% in 2015 to 51% in 2018). This was largely attributable to a reduction in the sugar content of some soft drink products and an increase in the volume sales of healthy beverages (bottled water, low/no calorie drinks and fruit juices), changes likely driven by the introduction of the Soft Drink Industry Levy in 2018 [10,11]. Once soft drinks were removed, the proportion of healthy sales fell to 6% in 2018, down from 7% in 2015. This suggests that despite PHE’s reformulation targets for calories, sugar and salt, there has been no improvement in the nutritional quality of foods that people are buying.
Strengths and limitations
By pairing composition data with sales data and applying a nutrient profile model, both the relative healthiness of individual foods and drinks available, and the relative healthiness of what is sold have been assessed, and how this has changed over time. This gives an idea of how companies are responding to voluntary reformulation targets to improve the nutritional quality of their products overall, rather than in relation to a single nutrient.
Only 10 companies, based on global company name, were included in the analysis, which represented 24% of total value sales in the UK in 2018 . These companies were selected based on their value sales, although they are also the top 10 companies in terms of volume sales. By selecting companies based on their global, rather than national, names, UK retailers were excluded from the analysis. This is a major limitation given that own-label brands from the top 3 UK retailers (Tesco, Sainsbury’s and Asda) represented a total market share of 21% in 2018 . While this study sets out a useful and important method for ranking companies in terms of healthiness of product portfolios, future studies should include retailers and a wider range of companies. This would give a more comprehensive picture of how food and drink companies and retailers in the UK are changing their products to meet public health targets. There are a number of data-driven limitations. The first is in relation to missing and imputed data. The values for seven nutrients (energy, saturated fat, total sugars, sodium, fibre, protein and FNV content) are needed to calculate the FSA/Ofcom nutrient profile score of a product. 32% of the 13,371 products included in this study had missing values for fibre, and 67% products had insufficient ingredients information and composition detail to be able to calculate %FNV accurately. There was no difference in the proportion of missing values over time. Missing values were imputed with either a category and/or brand average. The high proportion of missing/imputed fibre and FNV was to be expected as the labelling of fibre on foods is not mandatory (unlike other macronutrients)  and the percentages for individual ingredients (i.e. FNV ingredients) only have to be stated when the product title includes an ingredient name, or when a claim about the amount of an ingredient has been made on the label .
To test what impact the imputed fibre data had on the results, a sensitivity analysis was conducted. 31% (n = 4186) of all products in the original dataset had imputed fibre values, and these were evenly distributed across the four years. For our sensitivity analysis, we adjusted the fibre content for these products to 0.0g/100g, with the FSA/Ofcom points awarded for fibre also then given 0, the lowest score possible. The number of products that were classified as healthy fell from 47% to 46% in 2018, and there were negligible changes in the total sales-weighted nutrient profiling score for 2018, which fell from 51 to 50.
For fruit, nut and vegetable (FNV) content, 8896 (67%) of included products had imputed values, although three-quarters of these (n = 6624) fell into categories that you would not expect to contain enough FNV to score one point: baked goods, confectionery, dairy, ice cream, savoury snacks, soft drinks, spreads and staples. To test what impact the imputed FNV data may have had on the results, the remaining 2272 products (baby food, breakfast cereals, ready meals, and sauces, dressings and condiments) had their %FNV adjusted to 0%. After this adjustment, 25% (n = 564) of the 2272 products saw a change in their final Ofcom score. The overall proportion of products classified as healthy in 2018 fell from 47% to 46%. The results were the same as those found with the fibre sensitivity analysis, with a similar group of products being affected by the lack of fibre and FNV values. These results suggest that while the missing fibre and FNV values is a weakness in the dataset, the interpretation of the data was unchanged, and it has not affected the overall results.
Data restrictions meant that time period covered changes between 2015 and 2018. Previous reformulation efforts made before 2015, for example as part of the salt reduction programme that began in 2006, will have been excluded. Using a wider historic time period may show that some companies who started reformulation efforts promptly have made more signficant changes than recorded here. Applying this method to datasets in multiple countries may offer insight into how companies are responding in countries with varying public health nutrition policies, for example voluntary reformulation targets in the UK compared to taxes on energy dense foods in Mexico  and mandatory warning labels in Chile .
The FSA/Ofcom nutrient profile model was used because it is designed for and used in the UK market and has been widely validated in terms of how its use may impact on dietary choices . However, its original purpose was for the assessment of whether or not a product should be advertised to children, rather than to assess the nutritonal quality of a company’s product portfolio and classifying products as healthy and unhealthy, as it was used here. It would be possible to conduct similar analyses using other nutrient profiling models such as Health Star Rating  and Nutri Score , though since all rely on changes in the underlying nutrient composition differences between scoring systems are likley to be modest.
We combined the distributions of food and drink products by using a linear transformation that matched the distributions at two points–the 33rd and 66th percentile. The selection of the two matching points was arbitrary. Matching at different points (e.g. the 25th and 75th percentiles) would have produced a different linear transformation and hence different scores for drinks. This is an inevitable limitation associated with combining scores for companies with both food and drink profiles.
Comparisons with other studies.
There are a number of studies that have examined the nutrient content of foods sold in the UK over time. Previous studies have shown that voluntary salt reduction targets in the UK led to gradual and important changes in the salt content of foods between 2008–2011 [19,20], although a more recent report from Public Health England (PHE) suggests that only 28 of 52 of the 2017 salt reduction targets had been met in 2018 . Two studies have shown that there were significant changes in the sugar content of soft drinks in the UK in context of the introduction of the Soft Drink Industry Levy [10,11]. The changes in the sugar content of soft drinks presented in these studies is in line with the results presented here, where the majority of the change in the volume sales of foods classified as healthy was driven by changes in the sugar content of soft drinks. Another study has also looked at the sugar content of foods between 2015 and 2018 and also presented findings by category and company .This study showed that 24 out of the top 50 companies (including retailers) in the UK had met Public Health England’s 5% sugar reduction targets, and that companies have made limited progress towards meeting this voluntary policy. Public Health England have themselves published a series of reports that monitor progress being made towards their 20% sugar reduction targets using both sales and composition data . For example, they have shown that there was a -2.9% reduction in the sugar content of foods between 2015 and 2018 . A strength of our study is that it applies a nutrient profiling model, whereas these analyses are based on single nutrients and are therefore not directly comparable. However, they generally show that there has been mixed progress by the food industry towards public health goals.
INFORMAS (International Network on Food and Obesity/NCD Research, Monitoring and Action Support) have produced a series of company scorecards that rank the world’s top 25 food companies, including supermarkets and quick-service restaurants, in a number of different areas, including product formulation . While the scores are not based on quantitative analysis of the nutritional quality of companies’ products, they are based on business practices and companies’ commitments to nutrition-related policies, which is also important for monitoring food industry progress towards public health goals.
In 2019, the Access to Nutrition Initiative (ATNI) published its UK Product Profile . It analysed the nutritional quality of 3069 products from the top five food categories of the world’s top 18 manufacturers in 2016. The ATNI study also applied the HSR nutrient profiling model. Nine companies (excluding Premier Foods, a UK-only company) included here were also included in the ATNI index. ATNI found that 31% of products were classified as healthy enough to advertise to children, compared to 45% in 2016 here. 22% of sales were classified as healthy, as opposed to 55% in this study. These differences are likely to be accounted for by the fact that ATNI had a lower coverage (this study included 3438 products for 10 companies in 2016, compared to 3069 products for 18 companies for ATNI). The main advantage of this study over ATNI’s UK Product Profile is that it includes four years’ worth of data and therefore examines trends over time, whereas ATNI’s study is a snapshot of a single year. The two studies are not directly comparable as the ATNI companies were defined at the global level, rather than UK level, and therefore the brands included under each company vary. However, the general ranking of the companies were similar between the two studies; Kraft Heinz and Danone were the two top scoring companies, and Nestlé, Mars and Mondelez were ranked at the bottom.
Another study similar to this one, conducted in India by Jones et al. 2017, used Euromonitor sales data and nutrition composition data for 943 products, collected from either the packet or company websites . It applied the Health Star Rating (HSR) to analyse the nutritional quality of the top 11 packaged food manufacturers in India. The study found that the overall healthiness of products was low and that only 17% of products were considered healthy . This is lower than the 45% of products classified as healthy in this study in 2016. These differences are to be expected as the Indian study excluded products like staples (bread, pasta, rice), and used a different nutrient profiling model (HSR). Despite covering a very different market, it demonstrates that a high proportion of products sold by leading companies in other countries are also unhealthy, and that this problem is not isolated to the UK.
Implications of research
This study shines a spotlight on the very small changes over time in the nutritional quality of food and drink products from the UKs largest food and beverage companies. While the proportion of volume sales increased from 44% to 53% over time, this change was entirely down to increased volume sales of bottled water, low/no calorie drinks and high-scoring fruit juices. The brands that saw the biggest changes to their scores over time were soft drinks. Once soft drinks were removed, the total volume sales of foods classified as healthy dropped to just 6% in 2018, down from 7% in 2015. This strongly suggests that PHE’s reformulation targets for sugar, salt and calories have not had a substantive impact on the nutritional quality of foods.
This method of ranking food and drink companies based on the nutritional quality of their product portfolios could be used to benchmark companies as a tool for ‘healthier’ impact investment. There is an increasing interest by investment banks and other financial organisations to assess what impact food companies are having on public health and how responsible their business practices are (known as impact investment) . This has already been done in part by ATNI in collaboration with Shared Action  and INFORMAS .
Transparent monitoring of this kind also allows for greater consumer understanding of the work that is, or is not, being undertaken by companies. There is some evidence that pressure from the social environment is a factor influencing corporate behaviour , and public benchmarking exercises may increase pressure on companies to make meaningful change.
This study has demonstrated that it is feasible to monitor overall healthiness of company product portfolios over time. It shows that companies have made little change to the nutritional quality of their product portfolios, despite a few individual brand success stories, a factor which needs to be considered by policy makers when reviewing the current focus on single-nutrient reformulation programmes. Implementing a transparent monitoring and evaluation system such as this, would allow for targeted work with the companies to drive improvements in public health nutrition.
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