Towards a more nuanced understanding of policies that lead to food reformulation for a food system change

The aim of this paper is to review the latest evidence on food reformulation as a public health policy to improve our understanding of how different policy designs can drive reformulation and influence food system change. The focus is on three key nutrients of concern – trans fatty acids, salt and sugar. In recent times, food reformulation has been categorised as either mandatory or voluntary, a distinction that can help assess policy effectiveness. However, this binary classification oversimplifies a far more complex policy landscape. Some policies, whether mandated by government or voluntarily suggested to industry, are explicitly intended to trigger reformulation. In contrast, others, may have never been designed with the intention to encourage reformulation but have nonetheless prompted significant changes in product composition, intake and potential health outcomes. Within what is commonly described as mandatory reformulation, for example, we find a broad mix of policy tools that operate very differently. Some, such as the UK’s Soft Drinks Industry Levy, were deliberately created to incentivise reformulation by applying financial pressure. Others, including front of pack nutrition labelling systems (particularly warning labels) and school food standards have encouraged reformulation only as a positive unintended consequence. These indirect drivers are not always evaluated for their impact on reformulation, which may lead to an incomplete understanding of their contribution to reducing intake of nutrients of concern and improving health outcomes. Nevertheless, emerging evidence suggests no single policy encourages reformulation alone, instead a combination of approaches are likely to drive it and contribute to meaningful and sustained food system change.