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THE vision of the National Heart Foundation of Australia is for Australians to have the best cardiovascular health in the world. The Heart Foundation Tick program is a cost-effective, population-based approach to improving the health of Australians by challenging food manufacturers and food outlets to improve the nutrition of their products.
Doctors can be confident that the Tick signposts healthier food choices that have been independently tested to meet criteria for health maintenance and chronic disease prevention.
The Heart Foundation recommends that products with the Tick be used in the context of a healthy eating pattern; for example, eating Tick approved fish products at least twice a week. Patients with specific dietary needs related to an illness should, as with any condition, seek tailored advice from health professionals.
The Tick has proven to be popular with and trusted by Australians, as it provides one clear, easily identifiable symbol that highlights healthier choices without needing to read and interpret nutrition information panels and ingredient lists when shopping in supermarkets or eating out.
Licensing and costs
The Tick logo is a certification trade mark, which means that the logo is registered to certify that products displaying it have met specified standards of quality and accuracy. The Heart Foundation must be able to demonstrate that these standards are met, and it is responsible for ensuring that the logo is used in accordance with the Tick criteria and regulations that govern its application.
The Tick criteria are lodged with the Australian Competition and Consumer Commission. If food manufacturers fail to operate within the rules, their licence to use the Tick logo can be terminated.
Manufacturers submit independent analyses, from a laboratory accredited by the National Association of Testing Authorities (NATA), to prove compliance with the Tick criteria. This process is mandatory for all food products that carry the Tick except fresh produce.
Licensees sign a legal agreement to abide by the Heart Foundation’s requirements, which include compliance with Food Standards Australia New Zealand codes (Food Standards Code and Code of Practice on Nutrient Claims in Food Labels and in Advertisements), random auditing, nutrient testing, and pre-approval of labels and promotions before going to market.
As the Tick is not funded by governments or public donations, a license fee is incurred for the right to use the Tick logo. The fees are used to pay for developing nutrition criteria, laboratory analysis, and for independent random auditing by SAI Global (an independent auditor) which sends auditors to “mystery shop” at food outlets.
The fees for Tick approved products that are sold in supermarkets are based on a sliding scale of sales volume per annum. For food outlets, fees are based on the number of outlets and degree of auditing required.
The frequency of audits is determined by SAI Global. Supermarket foods are randomly audited throughout the year, with every category audited at least once every 12 months, and all Tick approved products are analysed by the NATA-accredited company DTS Food Laboratories to ensure ongoing compliance with the applicable Tick nutrient standards.
The Heart Foundation Tick program is governed by the Food Information Program Oversight Committee — a group of external honorary volunteers who report to the Heart Foundation National Board. In addition, the Criteria Working Group is responsible for developing the Tick criteria; it comprises experts in food science and technology, public health and nutrition science. No members of the Oversight Committee or Criteria Working Group have any conflicts of interest related to the food industry.
Tick criteria
The category-specific nutrient criteria are developed using a combination of scientific evidence, Heart Foundation position statements, key government policies, and food technology and food law considerations.
The nutritional profile of foods sold in supermarkets is collected independently by Synovate Aztec (an agency that collects supermarket grocery scan data) so criteria can be set in relation to current food-purchasing trends. The criteria are made incrementally tougher. For example, the criteria for sodium levels in bread were reduced significantly for Tick approval, dropping from 450 mg per 100 g to 430 mg per 100 g in 2005, and again in 2006 to 400 mg per 100 g.
Tick criteria have recently been used by the federal government’s Food and Health Dialogue to help set voluntary whole-of-category targets for the food industry to meet within an agreed time frame.
The Tick criteria are based on scientific evidence on chronic disease prevention, and include nutrients and food components deemed by the World Health Organization as important for maintaining good health, such as fruits, vegetables, and high-fibre and wholegrain ingredients. They also specify sodium, saturated fat and trans fat levels, as well as energy limits and portion sizes.
Although out of step with popular opinion, added sugar is not a criterion. This is because existing levels of evidence indicate that there is no direct causal relationship between added sugar and coronary heart disease, diabetes or obesity (with the possible exception of sugar-sweetened beverages). The sugar in Tick products may be from added sugars and/or naturally occurring sugars. The body does not differentiate their similar effects, and laboratory testing cannot accurately distinguish them.
Sugars — like other carbohydrates, fats, proteins and alcohol — contribute to the energy in foods; therefore, the Tick criteria limit these by setting energy limits. There is strong evidence for limiting energy intake to prevent chronic disease.
Conclusion
The Heart Foundation Tick program has resulted in increased awareness of healthier eating and a significant reduction in saturated fats, trans fats and salt in many foods. It is also transforming the practices of food companies to benefit Australians.
* Professor James Tatoulis is chief medical advisor, Dr Lyn Roberts is chief executive officer and Ms Anne-Marie Mackintosh is the nutrient standards and regulatory affairs manager of the National Heart Foundation of Australia.
This Opposing Views article appears as a Rapid Online Publication in the Medical Journal of Australia on the Heart Foundation Tick program. It is reproduced with permission of the MJA. Please click here to read the opposing view by Ms Rosemary Stanton
Posted 1 March 2011