WHO Regional Office for Europe

NUTRIENT PROFILE MODEL

WHO Regional Office for Europe
nutrient profile model
Abstract
This publication describes a regional nutrient profile model for use and adaptation by Member States
of the WHO European Region when developing policies to restrict food marketing to children.

Keywords

CHRONIC DISEASE
OBESITY
NUTRITION POLICY
DIET
MARKETING
CHILDREN
FOOD

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Contents
Page

Acknowledgements iv
Introduction 1
About the European nutrient profile model 2
How to use this model 3
Definitions of terms used in this model 3
References 4
Annex 1. WHO Regional Office for Europe nutrient profile model 5
Acknowledgements
This publication has been prepared by the WHO Regional
Office for Europe in collaboration with the Department of
Nutrition for Health and Development, at WHO headquarters.

Specific contributions have been made by João Breda, Gauden

Galea, Jo Jewell and Chizuru Nishida.

Further significant contributions, review and comments have

kindly been provided throughout the development of this
publication by Professor Mike Rayner of the University of
Oxford.

Thanks also go to the European Network on Reducing Marketing

Pressure on Children, led by the Norwegian Directorate of
Health and involving 28 Member States, for their support and
participation in the process of developing this model.

iv
Introduction
In July 2013 the ministers of health of the WHO European and involves 28 Member States and is facilitated by the Regional
Member States adopted the Vienna Declaration on Nutrition Office, has conducted some work related to nutrient profiling.
and Noncommunicable Diseases in the Context of Health 2020 Recent meetings of the Network have recognized the value
(1). This Declaration acknowledged the high burden of disease of working towards a common nutrient profile model for use
caused by unhealthy diets in many countries of the Region and or adaptation by Member States in the European context. The
expressed particular concern about the rise of overweight and Regional Office was requested to take action on this issue in
obesity among children. seeking to develop a common approach to nutrient profiling
across the Region. It is recognized that this work has implications
The Vienna Declaration included a commitment to take “decisive for the other regional offices of WHO, and their collaboration has
action to reduce food marketing pressure to children with been sought throughout.
regard to foods high in energy, saturated fats, trans fatty acids,
free sugars or salt” and to develop and implement common In December 2013, an expert meeting was held to agree on
policy approaches that promote, among other things, the use of the principles and necessary steps in developing a common
common nutrient profiling tools. The development of a regional nutrient profile model (6) and to allow participants to draw
nutrient profile model as a common tool for use or adaption by on the lessons learned by those countries that have already
Member States across Europe (on a voluntary basis and taking developed nutrient profile models for the purpose of restricting
into account individual national circumstances) has since been the marketing of foods to children. Following this meeting, the
identified as a key activity in the European Food and Nutrition Regional Office developed a proposal for a model and conducted
Action Plan 2015–2020 (2). a series of consultations on the draft with Member States (at the
technical level), including in-country pilot testing and a face-to-
This nutrient profile model has been developed by the WHO face consultation during a meeting of the European Network on
Regional Office for Europe in response to this mandate and Reducing Marketing Pressure on Children, held in March 2014.
has been specifically designed for the purpose of restricting the The following countries have been actively engaged at various
marketing of foods to children. A 2013 report by the Regional stages of the consultation process: Albania, Austria, Bulgaria, Czech
Office indicated that few countries in the European Region have Republic, Denmark, Estonia, Finland, Hungary, Israel, Norway,
fully implemented restrictions on the marketing of foods to children Poland, Portugal, Serbia, Slovenia, Switzerland and the former
(3). One of the reasons for the less than optimal progress in policy Yugoslav Republic of Macedonia. Other countries have expressed
development may be the difficulty in overcoming the challenge of an active interest.
classifying foods for which marketing should be restricted, which
in turn results from the lack of an appropriate nutrient profile The in-country pilot testing involved countries applying the
model or other means of classifying foods. A handful of countries proposed model to a nationally generated list of between
worldwide have developed, or are developing, nutrient profile 100 and 200 foods that are either: (i) frequently marketed to
models. Of the 53 countries in the Region, only Denmark, Ireland, children, or (ii) commonly consumed (ideally a combination
Norway and the United Kingdom have used a nutrient profile of both). Countries were asked to comment on the food
model in connection with marketing restrictions. categories, the nutrient thresholds, the proposed exclusions and
prohibitions, and to confirm that the model categorized foods
WHO has been working to help Member States develop nutrient in line with national food-based dietary guidelines. Countries
profile models since 2009. A Guiding Principles Framework and responding to the consultation found the food categories and
Manual has been developed and field-tested in six different nutrient thresholds to be largely appropriate and only proposed
countries (4).The first edition is due to be published shortly and a minor modifications. There were some significant differences in
second edition, incorporating feedback from the workshops and the nutritional quality of frequently advertised and commonly
field-testing, is planned. WHO has also developed a catalogue consumed foods that countries reported, indicating that
of nutrient profile models containing details of nutrient profile the marketing environment varies across the Region. Some
models that conform to certain standards (5). countries reported food products being marketed or consumed
with very high levels of nutrients of public health concern. All
The European Network on Reducing Marketing Pressure on countries were, however, supportive and felt that the model was
Children, which is led by the Norwegian Directorate of Health appropriately strict for their national context.

1
About the European nutrient profile model
Nutrient profiling is “the science of classifying or ranking foods not included within the food categories were taken from both
according to their nutritional composition for reasons related to models and supplemented with further examples. The list is not
preventing disease and promoting health” (4). Nutrient profiling exhaustive and may be added to when used nationally.
has been recognized by WHO as a useful tool for a variety
of applications and is considered to be a critical tool for the Further indication of which food products fall within these
implementation of restrictions on the marketing of foods to categories is provided by using international customs tariff codes.
children (1,7). Nutrient profiling provides a means of differentiating This approach was first used by Hungary for the implementation
between foods and non-alcoholic beverages (henceforth “foods”) of its public health tax, and subsequently used in the Norwegian
that are more likely to be part of a healthy diet from those that nutrient profile model. The food tariff codes in the Regional
are less likely (notably those foods that may contribute to excess Office nutrient profile model were taken from The Harmonized
consumption of energy, saturated fats, trans fats, sugar or salt). Commodity Description and Coding System, which is used
Nutrient profiling is a tool to categorize foods, not diets, but can globally including by the European Union. Every food product can
be used through policy to improve the overall nutritional quality be categorized according to a specific tariff code.These codes are
of diets. provided at two levels of detail in this model: four digits, which
is the position number and broadly relates to food product
A number of existing models were considered for use and categories, and (where possible) a six-digit subposition number,
adaptation at a European level. Worldwide, several governments which provides more detail about the specific subcategory of
– including those in the Australia, Ireland, New Zealand, Norway, food products. At the national level, tariff codes can be further
Sweden, the United Kingdom and the United States – have specified to eight digits, or item numbers. When adopting or
developed nutrient profile models, some of which have now been adapting the model for use in national contexts, Member States
incorporated into legislation. Ultimately, however, three European may consider using the eight-digit codes. Food companies should
models were selected for consideration during this process: be familiar with the international tariff code system.
the Danish, Norwegian and United Kingdom models. These are
the only three models that are currently in use in Europe for Nutrient thresholds for the model have largely been taken from
restricting marketing to children and have been either developed the Danish and Norwegian models. The nutrients covered by the
by governments or (in the case of the Danish model) endorsed model are: total fat, saturated fat, total sugars, added sugars and
by government. salt. Energy is included for category 9 (Ready meals, convenience
foods and composite dishes), while non-sugar sweeteners have
After consideration, it was decided to base the European also been included for category 4 (specifically subcategories
nutrient profile model on two existing models: the Norwegian 4b Milk drinks and 4d Other beverages). Thresholds for the
model, developed by the Norwegian government and adapted categories taken from the Norwegian model are largely as
by industry with minor changes for voluntary restrictions in specified in that document, except in cases where the criteria
Norway (8), and the model developed by the Danish Forum of for the same category are stricter or more comprehensive in
Responsible Food Marketing Communication (9), endorsed by the Danish model (categories 6, 7 and 9). For these categories,
the Danish government for voluntary restrictions in Denmark. some of the thresholds are as specified by the Danish model.
While all three models considered were relatively strict and The thresholds for the Danish categories are largely as specified
categorized foods similarly (for example, in the majority of cases in the Danish model. Thresholds for categories 10 and 12 (new
the same foods would/would not be permitted under any model), to this model) have been extrapolated from similar categories in
the rationale for selecting the Danish and Norwegian models was the Danish model (the threshold for category 10 was taken from
that they are based on food categories rather than using a scoring the equivalent threshold for category 8 and the thresholds for
system. Category-specific models are considered easier to adapt category 12 were taken from category 11).Thresholds for salt for
or modify than models based on scoring, which is an important categories 6, 8, 11, 12 and 14 have been taken from the Finnish
consideration for a regional model that countries will be looking Ministry of Trade and Industry Decree on food packing markings
to use nationally. 1084/2004, section 25 (10).1 For these categories, salt criteria
were missing from the Danish and Norwegian models but during
The final model consists of a total of 17 food categories (with consultation and pilot-testing with countries it was considered
some subcategories) (Annex 1). Categories 1–7 and 9 in important to set thresholds. According to the model, marketing
the Regional Office model are broadly the same as the eight for five categories is not permitted, meaning that no nutrient
categories in the Norwegian model. Categories 8, 11 and 13– criteria are required.The same applies to the two food categories
17 are taken from the Danish model. Categories 10 and 12 are
new categories that were added during the consultation process 1
New thresholds will be implemented in Finland as part of this Decree from
with countries. Descriptions of the food products included/ 2016, and the salt thresholds for the relevant categories in this model will then
be updated accordingly.

2
for which marketing is always permitted. In a few instances stricter
nutrient thresholds were introduced following consultation with Definitions of terms
used in this model
countries and to be in line with WHO nutrition guidelines.

Marketing is prohibited if the product contains > 1 g per 100 g

total fat in the form of industrially-produced trans fatty acids,2 or
≥ 0.5% of total energy in the form of alcohol. Total fat refers to the total fat content of the food product, which
may be composed of different levels of fatty acids from the
three broad groupings: saturated fatty acids, monounsaturated
fatty acids and polyunsaturated fatty acids.

How to use this Total sugars refers to the total sugar content of the food product,

model which may be composed of: intrinsic sugars incorporated within

the structure of intact fruit and vegetables; sugars from milk
(lactose and galactose); and all additional monosaccharides
This model is designed for use by governments for the purposes and disaccharides added to foods by the manufacturer, cook
of restricting food marketing to children.3 When determining or consumer, plus sugars naturally present in honey, syrups and
whether a food product may or may not be marketed to children, fruit juices.
a government (or food company) should take the following steps.
Added sugar. For the purpose of this nutrient profile model
1. Identify which food category the product falls under. In some the term “added sugar” is used because available data in
cases this will be clear according to the food category name food composition tables refer to added sugar, defined here
(for example, breakfast cereals; yoghurts). In other cases, it as all monosaccharides and disaccharides added to foods and
may be necessary to reference the “included in category” beverages by the manufacturer, cook or consumer during
or “not included in category” columns, and/or check the processing or preparation. The WHO guidelines on sugars are
customs tariff code number. for free sugars, covering monosaccharides (such as glucose or
fructose) and disaccharides (such as sucrose or table sugar)
2. Once the appropriate food category has been identified, added to foods by the manufacturer, cook or consumers in
the nutritional content of the food product must be cross- addition to sugars naturally present in honey, syrups, fruit
checked against the thresholds. A food product must not juices and fruit concentrates (in this case, intrinsic sugars in, for
exceed on a per 100 g/ml basis any of the relevant thresholds example, fruits and vegetables are not considered free sugars).
for that food product category if marketing is to be permitted.
For example, in the case of breakfast cereals, a product must Non-sugar sweeteners are food additives (other than a mono-
not exceed the criteria for total fat, total sugars or salt. or disaccharide sugar) which impart a sweet taste to a food.
The technological purposes for this functional class include
3. The food products should, where possible, be assessed sweetener, intense sweetener and bulk sweetener. It should
as sold or as reconstituted (if necessary) according to the be noted that products such as sugars, honey and other food
manufacturer’s instructions. ingredients that can be used to sweeten are not associated with
the term “sweetener”.
4. If the marketing is for a restaurant meal, including a quick-
service or take-away meal of two or more menu items, all Energy refers to the total chemical energy available in food and
items must individually meet the relevant nutrient criteria. its macronutrient constituents (carbohydrates, fats, proteins).

5. If the product is a food that has a protected designation Saturated fat refers to the major saturated fatty acids in the
of origin or a protected geographical indication or is a diet, namely C14, C16 and C18, except in the case of milk and
guaranteed traditional speciality, marketing may be permitted coconut oil where saturated fatty acids range from C4 to C18.
according to national context.
Industrially produced trans fatty acids refers to the major trans
fatty acids in the diet which are typically isomers of 18:1 trans
2
This is in line with the WHO recommendation on trans fat intake. It is derived from partial hydrogenation of vegetable oils, a technique
recognized that some countries have implemented legislation that bans or
virtually eliminates trans fats from the food supply and these countries may that produces semi-solid fats for use in commercial baking and
choose to adopt a per 100 g figure in line with their statutory limits. frying, margarines and food manufacturing.
3
The definition of marketing to children will need to be established as part of
the policy development process and may vary according to national context.
WHO has defined marketing as “any form of commercial communication or Salt –1 g of sodium is equivalent to about 2.5 g of salt.
message that is designed to, or has the effect of, increasing the recognition, appeal
and/or consumption of particular products and services. It comprises anything
that acts to advertise or otherwise promote a product or service” (11).

3
References
1. Vienna Declaration on Nutrition and Noncommunicable 7. Marketing of foods and non-alcoholic beverages to children
Diseases in the Context of Health 2020. Copenhagen: [website]. Geneva: World Health Organization; 2010
WHO Regional Office for Europe; 2013 (http://www. (http://www.who.int/dietphysicalactivity/marketing-food-to-
euro.who.int/__data/assets/pdf_file/0009/193878/Vienna- children/en/, accessed 2 January 2015).
Declaration.pdf, accessed 2 January 2015).
8. Appendix 1 to Draft Regulations. Foods and
2. European Food and Nutrition Action Plan 2015–2020. beverages that are considered unhealthy under these
Copenhagen: WHO Regional Office for Europe; 2014 Regulations [e-document]. Oslo: Helsedirektoratet;
( h t t p : / / w w w. e u r o. w h o. i n t / __ d a t a / a s s e t s / p d f fi l e 2013 (http://www.eftasurv.int/media/notification-of-dtr/
/0008/253727/64wd14e_FoodNutAP_140426.pdf, accessed Appendix-to-Regulations.-Unhealthy-foods---9005.pdf,
2 January 2015). accessed 2 January 2015).

3. Marketing of foods high in fat, salt and sugar to children: 9. Code of responsible food marketing communication
update 2012–2013. Copenhagen: WHO Regional Office to children. Copenhagen: Forum of Responsible
for Europe; 2013 (http://www.euro.who.int/__data/assets/ Food Marketing Communication; 2015 (http://
pdf_file/0019/191125/e96859.pdf, accessed 2 January k o d e k s f o r f o e d e v a r e r e k l a m e r. d i . d k / S i t e
2015). CollectionDocuments/Code%20with%20guide%
20english%20october%202014%20-%20endelig1.pdf,
4. Guiding principles and framework manual for the accessed 2 January 2015).
development or adaptation of nutrient profile models.
Geneva: World Health Organization (in press). 10. Ministry of Trade and Industry Decree on food packing
markings 1084/2004 [website]. Helsinki: Finlex; 2015
5. Nutrient profiling: catalogue of nutrient profile models. (http://www.finlex.fi/fi/laki/alkup/2004/20041084, accessed
Geneva: World Health Organization (in press). 2 January 2015).

6. Development of a Regional Nutrient Profile Model for 11. A framework for implementing the set of recommendations
Marketing of Food to Children in Europe – Report of a on the marketing of foods and non-alcoholic beverages
meeting. Copenhagen: WHO Regional Office for Europe to children. Geneva: World Health Organization; 2012
(in press). (http://www.who.int/dietphysicalactivity/Mar keting
Framework2012.pdf, accessed 21 January 2015).

4
Annex 1. WHO Regional Office for Europe nutrient profile model

Marketing not permitted if product exceeds, per 100 g:b

Customs tariff code
Food category Included in category (examples) Not included in category (examples)
(position and/or subposition number)a added non-sugar
total fat (g) sat. fat (g) total sugars (g) salt (g) energy (kcal)
sugars (g) sweeteners (g)
1 Chocolate and sugar confectionery, energy bars, Chocolate and other products containing cocoa; white chocolate; jelly, sweets and boiled sweets; Chocolate flavoured breakfast cereals; cakes 17.04; 18.06; some of 19.05; 20.06; some of 20.08;
and sweet toppings and desserts chewing gum and bubble gum; caramels; liquorice sweets; spreadable chocolate and other sweet and pastries; biscuits and other baked goods some of 21.06 Not permitted
sandwich toppings; nut spreads, including peanut butter; cereal, granola and muesli bars; marzipan covered in chocolate
2 Cakes, sweet biscuits and pastries; other sweet Pastries; croissants; cookies/ biscuits; sponge cakes; wafers; fruit pies; sweet buns; chocolate-covered Bread and bread products 19.01.20; 19.05.20; 19.05.31; 19.05.32
Not permitted
bakery wares, and dry mixes for making such biscuits; cake mixes and batters
3 Savoury snacks Popcorn and maize corn; seeds; nuts and mixed nuts; savoury biscuits and pretzels; other snacks made 08.01; 08.02; 10.05; 19.04.10, 19.04.20;
0 0.1c
from rice, maize, dough or potato some of 19.05; 20.05.20; 20.08.11; 20.08.19; 20.08.99
4 Beverages
a) Juices 100% fruit and vegetable juices; juices reconstituted from concentrate, and smoothies 20.09 Not permittedd

b) Milk drinkse Milks and sweetened milks; almond, soya, rice and oat milks Cream Some of 04.01; some of 04.02; 22.02.90
2.5 0 0

c) Energy drinksf Some of 22.02

Not permitted

d) Other beverages Cola, lemonade, orangeade; other soft drinks, mineral and/or flavoured waters (including aerated) with 100% fruit and vegetable juices; milk drinks 22.01; some of 22.02
0 0
added sugars or sweetener

5 Edible ices Ice cream, frozen yoghurt, iced lollies and sorbets 21.05
Not permitted

6 Breakfast cerealsg Oatmeal; cornflakes; chocolate breakfast cereals; mueslis 19.04.10; 19.04.20
10 15 1.6

7 Yoghurts, sour milk, cream and other similar foods Yoghurt; kephir; buttermilk; flavoured sour, fermented milk and drinking yoghurt; fromage frais; cheese- Milks and sweetened milks; almond, rice and Some of 04.02; 04.03; 04.04; some of 04.06.10;
based and other yoghurt substitutes; yoghurt products containing additional ingredients (such as fruit; oat milks 19.01.10; 19.01.90; some of 21.06 2.5 2.0 10 0.2c
muesli); cream
8 Cheese Medium-hard and hard cheeses; soft cheeses; fresh cheese (such as ricotta, mozzarella); grated or 04.06
20 1.3
powdered cheese; cottage cheese; processed cheese spreads
9 Ready-made and convenience foods and Pizzas; lasagne and other pasta dishes with sauces; quiches; ready meals; ready-made sandwiches; filled Some of 16; some of 19.01.20; 19.02.19; 19.02.20;
10 4 10 1 225
composite dishes pastas; soups and stews (packaged or tinned); mixes and dough some of 19.05; some of 20.05; 21.04
10 Butter and other fats and oils Butter; vegetable oils, margarines and spreads 04.05; 15 20 1.3

11 Bread, bread products and crisp breads g

Ordinary bread (containing cereal, leavens and salt); gluten-free bread; unleavened bread; crisp breads; Sweet biscuits; pastries; cakes 19.05.10; 19.05.40;19.05.90
10 10 1.2
rusks and toasted breads

12 Fresh or dried pasta, rice and grains Filled pasta and pasta in sauce 10; some of 11; 19.02 excluding 19.02.20
10 10 1.2

13 Fresh and frozen meat, poultry, fish and similar Eggs 02 excluding 02.10; some of 03 excluding 03.05
Permitted

14 Processed meat, poultry, fish and similar Sausage, ham, bacon; chicken nuggets; smoked and pickled fish; tinned fish in brine or oils; fish fingers Pepperoni pizza 02.10; some of 03; some of 16
20 1.7
and breaded/battered fish

15 Fresh and frozen fruit, vegetables and legumes Fruit and vegetables; legumes; starchy vegetables, roots and tubers Tinned fruits, vegetables and legumes; fruit in 07 excluding 07.10, 07.11, 07.12, 07.13; some of 08
Permitted
syrup; dried fruit; frozen fruit with added sugar excluding 08.01; 08.02; 08.11; 08.12; 08.13; 08.14
16 Processed fruit, vegetables and legumes Tinned fruit, vegetables and legumes; dried fruit,h dried vegetables and legumes; marmalade; jams; pickled Fruit juice 07.10; 07.11; 07.12; 07.13; some of 08.03; some
vegetables and fruit; stewed fruits; fruit peel; frozen French fries; frozen fruit with added sugar of 08.05; some of 08.06; 08.11, 08.12, 08.13 and
08.14; 20.01; 20.02; 20.03; 20.04; 20.05; 20.06; 20.07; 5 10 0 1
20.08.20, 20.08.30, 20.08.40, 20.08.50, 20.08.60,
20.08.70, 20.08.80; 20.08.93; 20.08.97; 20.08.99
17 Sauces, dips and dressings Salad dressings; tomato ketchup; mayonnaise; ready-to-use dips; soya sauce; mustard and mustard flour 21.03
10 0 1

Sat. fat = saturated fat. d

This is in line with the WHO Guidelines on Sugars Intake for Children and milks (so called "follow-up milks") is not necessary. Further, any food or drink g
For this category, countries may choose to include a threshold for minimum
Adults (in press), as fruit juices are a significant source of free sugars for children. given before complementary feeding is nutritionally required may interfere with dietary fibre content, for example >6g dietary fibre.
a
Where appropriate, a four-digit position number has been given. Where “some However, it is recognized that countries, according to national context and the initiation or maintenance of breastfeeding and should, therefore, be neither
of ” is indicated, this means that most (but not all) food products in this position national food-based dietary guidelines, may take the decision to permit the promoted nor encouraged for use by infants during this period.
h
This is in line with the WHO Guidelines on Sugars Intake for Children and
number are covered. In some instances a six-digit subposition is provided so as marketing of 100% fruit juices in small portions. Adults (in press), as dried fruits are a significant source of concentrated sugars
to pinpoint specific products more easily. f
There is no agreement on a definition of energy drinks. However, such a for children. However, it is recognized that countries, according to national
e
This nutrient profile model applies to products for children above 36 months. category of drinks includes a variety of non-alcoholic beverages. While caffeine context and national food-based dietary guidelines, may take the decision to
b
The food products should, where possible, be assessed as sold or as Follow-up formulas and growing-up milks are not covered by this model. It is considered the main ingredient, a number of other substances are often permit the marketing of dried fruits in small portions.
reconstituted (if necessary) according to the manufacturer’s instructions. should be noted that World Health Assembly Resolution WHA39.28, adopted present. The most common of these include guarana, taurine, glucuronolactone
in 1986, states that the practice of providing infants with specially formulated and vitamins. A common feature is that these beverages are marketed for their
c
Salt equivalent. actual or perceived effects as stimulants, energizers and performance enhancers.

5 6
The WHO Regional Office for Europe

The World Health Organization (WHO)

is a specialized agency of the United Nations
created in 1948 with the primary responsibility
for international health matters and public
health. The WHO Regional Office for Europe
is one of six regional offices throughout the
world, each with its own programme geared
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countries it serves.

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Original: English