School food policies

• Various EU countries' school food policies include voluntary or mandatory standards that limit or forbid provision of foods or beverages high in sugars in school restaurants, canteens. Some school food policies specify upper limits for total daily energy from sugars (commonly ≤10 E%).
• The EU fruit, vegetable and milk scheme, financed through the EU's Common Agricultural Policy provides fruit, vegetables and milk to children in schools to increase their consumption. Among the criteria established for the products to be distributed to schools is that these should have no added sugars. Products containing limited quantities of sugars may be allowed if authorised by the relevant national health/nutrition authorities (DG AGRI).

• The Healthy, Hunger Free Kids Act set standards for the national school lunch and breakfast programmes, which included limits on added sugars in foods and beverages. For example, Smart Snack standards limited sugar content of snacks or of main course meals to maximum of 35% by weight.

Workplace policies

• Vending machines dispensing sugary drinks are prohibited in NHS hospitals in Wales
• Scottish government guidelines for NHS hospital settings include removal of all soft drinks with >0.5g/100 ml of sugar, excluding pure fruit juice, and require that at least 30% of snacks and confectionaries and 70% of refrigerated food, meet nutrition criteria based on, among others, sugar content.

• All food and beverages in vending machines on government premises meet nutrition criteria based on, among others, content of sugar. Criteria not applied to 100% fruit juices.

Social support programmes

• San Bernardino County (CA) Healthy Food Banking Wellness policy has procurement guidelines which include unsweetened dairy products, unsweetened milk or milk substitutes, as well as canned fruits with no added sugars.

Sweet/soft drink tax

• Excise duty of 0.068 €/L for soft drinks, including non-alcoholic beverages & flavoured waters with added sugars

• From 01/01/2018, non-alcoholic beverages e.g. soft drinks, sweetened milks and juices (including 100%) will be taxed on content of sugar and sweeteners. The multi-stage levy will be as follows: products with sugar content of 5-8 g/100 ml - 10 € cents/L, and products exceeding 8 g/100 ml – 30 € cents/L.
• To stimulate reformulation over time, the 30 € cents/L will be gradually applied;  in 2018, only to products with more than 10 g/100 ml of sugar, and then the limit will be reduced to 9 g/100 ml in 2019 and finally to 8 g/100 ml in 2020.
• Sweetened milks and 100% fruit juice drinks could be freed from the tax, since Estonia will ask permission to give them state aid from the European Commission.

• Excise duty of approx. 0.075 €/L for drinks with added sugar and artificial sweeteners, including sodas & fruit drinks.
• Since January 2017, prohibition of unlimited supply, for free or for a fixed price, of drinks with added sugars or synthetic sweeteners in all catering establishments open to the public, including hotels, holiday clubs, reception establishments, establishments training and housing minors (e.g. schools).

• In Norway, a tax of 20.19 Kr (2.10€) /Kg applies to chocolate and sugar products, while sugar is taxed at 7.81 Kr (0.85€) /Kg.

• Excise duties exist since 2011 on sweets, chocolate and non-alcoholic beverages. For sweets and ice cream the tax is 0.95€/Kg. On beverages with more than 0.5% of sugar, the excise tax is 0.22€/L, while for sweetener-based soft drinks and waters it is 0.11€/L on. Producers with an annual production volume of less than 50,000 L are exempt. The tax on sweets was abolished in January 2017, while the beverage tax remains in place.

• Ad valorem tax of 18% on beverages with sugar content > 6.25 g/100 mL. Includes all non-alcoholic drinks, energy drinks and waters. Drinks with sugar content below the threshold value are taxed at 10%

• Excise duty of 0.05 €/L to all beverages with added sugars, excluding milks or yoghurt drinks.

Public health tax

• Tax applying variable rates on salt, sugar, caffeine content of various ready to eat food categories, including soft drinks (with sugar or sweeteners). Tax amounts to 0.02 €/L for products with more than 8 g/100ml of added sugars, exempting drinks with more than 25% fruit or vegetable content or at least 50% of milk. Added sugar in confectionary is taxed at 0.22 €/L for products with sugar content >25%, while for chocolate the threshold is at 40% of total sugars.

Import duties

• Import duties on soft drinks or sugar, ad valorem or per litre of product.

Food reformulation

• The EU Platform on Diet, Physical Activity and Health (EU platform) is a European Commission led and co-ordinated forum for EU stakeholder organisations, ranging from industry to consumer protection and NGOs that are voluntarily committing to tackle current trends in unhealthy diets and lack of physical activity. Various private food sector commitments are aimed to reformulate packaged foods and improve their nutritional profile by reducing, among others, sugars (EC 2015) .
• The 2016 Dutch Presidency Roadmap for Action on Food Product Improvement, endorsed by the majority of EU MS as well as food business operators and some NGOs, aims to facilitate industry reformulation efforts by accelerating coordinated action from national governments, food business operators and NGOs, supported by sound research, independent monitoring and best practice exchange.
• The EU framework for national initiatives on selected nutrients (EU framework) aims to contribute towards achieving population intake levels and dietary patterns recommended by national authorities, EFSA and WHO.  Selected nutrients refer to a complex set of variables that may vary nationally. The framework builds on five key principles of action: Data on intakes, benchmarks & major food categories to focus on, reformulation and changing portion sizes, raising public awareness, as well as monitoring and evaluating. Annex II (EU framework annex) is specifically addressed to added sugars:
  • Annex II is meant as a tool for the benefit and voluntary use of the MS, and can support them in designing, implementing and evaluating reformulation strategies in the context of their public health policies on nutrition-related NCDs.
  • Annex II suggests major food categories where action should be focused (e.g. SSBs, breakfast cereals, confectionary) and calls on MS to define their own priorities based on their respective health needs, traditions and consumption patterns
  • A proposed benchmark is a reduction of a minimum of 10% of added sugars^m in food products by 2020, compared to 2015 levels, or to move towards 'best in class levels', i.e. lowest levels identified in products of the same category in the EU.

• 'ActionSante' program includes voluntary agreement between the food industry and the ministry of health to among others, sugar content in bread and processed foods.

Food marketing restrictions

• Various mandatory (via legislation) or voluntary (via industry self-regulation) policies are in place in the EU to restrict food marketing of foods that are high in sugar, salt and fats to children; a major industry self-regulation effort is the EU Pledge.  See the Food and non-alcoholic Beverage Marketing to children and adolescents in this series.

• In the US, the Children's Food and Beverage advertising initiative is a major industry self-regulatory effort to restrict marketing of foods that are high in sugar, salt and fats to children.  See the Food and non-alcoholic Beverage Marketing to children and adolescents in this series.

Retail initiatives

• In New York, department of health staff collaborate with shop owners in areas with high rates of obesity, to make foods such as, canned products, dried fruits and nuts with no added sugar available in food stores.

Labelling legislation

• EU Regulation 1169/2011 on food information to consumers  requires mandatory nutrition declaration for amounts of sugars, under carbohydrates (stating amount of g per 100 g of product), in prepacked foods
• EU Regulation 1924/2006 includes rules for nutrition claims made on foods. For sugars, nutrition claims comprise of 'sugars-free', 'no added sugars' and 'low sugars'. See 3.4.1

• Health claims not permitted on foods that don't meet a specific nutrient profile criteria system, e.g. foods high in sugar.

• All chain restaurants with 100 or more establishments are required to display nutrient information on menus including, among others, total sugars.

• The 2016 Nutrition Facts Label US regulation revision introduces the requirement for declaration of amount of total sugars; in addition added sugars should also be declared, in grams in a serving of a product, establishing a DRV and requiring the percent of daily value declaration.

Voluntary labelling

• The Keyhole health logo labelling system by the Swedish National Food Agency is used in Scandinavian countries. It is based on a nutrient profile model and aims to identify healthier packaged food choices within a food category, and to stimulate food manufacturers to reformulate and develop healthier products. Sugar content is one of the nutrient criteria, and thresholds depend on the product category.

• 'Healthy Living' is a voluntary labelling scheme with nutrient profiles for different food categories. The scheme is used as a benchmark for public health campaigns but also as a scientific basis for a national initiative on food marketing restraints. Sugar is one of the nutrients to limit in this scheme.

• The Traffic Light front of pack voluntary labelling scheme, proposed by the UK Food Standards Agency, aims to assist consumers in identifying healthier food choices. It uses colour coding related to low, medium or high content of selected nutrients in foods and drinks. For total sugar in foods, the thresholds are (per 100g): green/low: ≤5 g, medium/amber: 5 to ≤22.5 g, high/red: >22.5 g. For total sugar in drinks, the thresholds are (per 100ml): green/low: ≤2.5 g, medium/amber: 2.5 to ≤ 11.25 g, high/red: >11.25g.

• The Health Star Rating (HSR) is a front-of-pack voluntary labelling scheme. The system is based on an algorithm that awards a star rating, based on the quantity of specific food components, such as total sugars.

• Various other voluntary systems include sugars  in their labelling criteria e.g. traffic light/ colour coding systems in Ecuador  and South Korea for total sugars, Heart Check in Nigeria for added sugars.

• The Change4Life campaign aims to improve diets and physical activity in the UK; Smart Swaps and Sugar Smart are major components aimed at reducing sugar consumption and provide examples of how this can be achieved

Recommendation & guidelines

• Nutrition recommendations and food based dietary guidelines in all EU MS states recommend limiting sugar intake. See Paragraph 3.5.