Background and aims: The World Health Organization recommends front-of-pack nutrition labelling (FOPNL) to promote healthier diets. Governments determine whether FOPNL is voluntary or mandatory. Mandatory labels can provide consumers with wider access to information but are typically opposed by industry. Our aim was to exploit a natural experiment of changes to Australian food labels by comparing uptake of a voluntary Health Star Rating (HSR) FOPNL against uptake of a mostly mandatory Country of Origin Label (CoOL) over a similar period.
Methods: Numbers and proportions of products carrying the HSR and CoOL were recorded each year between 2015 and 2023 as part of annual surveys of four large Australian food retailers.
Results: Voluntary HSR uptake increased steadily between 2014 and 2018, reaching around 40% by 2023. CoOL uptake rose rapidly from 2016 to 2019, reaching over 90% by 2023. In categories where CoOL was voluntary, uptake by 2023 was around 50%. In our 2023 sample of >20,000 products, around 50% of products displayed CoOL only, around 35% carried both HSR and CoOL, around 5% carried HSR only, and the remaining 10% carried neither label.
Significance: The CoOL experience shows that widespread and rapid food labelling change can be achieved where it is mandated. The Australian government should mandate the HSR FOPNL system without further delay to maximise uptake and associated public health benefits. Australia’s experience strengthens the case for other jurisdictions to develop and implement mandatory FOPNL.