Reducing children's sugar intake through food reformulation: methods for estimating sugar reduction program targets, using New Zealand as a case study.

BACKGROUND: Reducing sugar in packaged foods and beverages could help protect children's future health. Clear methods for the development of feasible yet impactful sugar reduction program targets are needed. OBJECTIVES: To outline methods for the development of program targets that would reduce, by 20%, the total sugar content of packaged foods and beverages commonly consumed by children. New Zealand (NZ) is used as a case study. METHODS: Sugar content and pack size targets were developed using a 6-step process informed by the UK sugar and salt reduction programs. Food groups contributing ≥2% to children's total sugar intake were identified using national dietary survey data. Consumption volume, sugar content, and pack size were obtained from household panel data linked with a packaged food composition database. Category-specific targets were set as 20% reductions in sales-weighted means adjusted for feasibility, i.e., ∼1/3 of products already meeting the target, and alignment with existing, relevant targets. RESULTS: Twenty-two food groups were identified as major contributors to NZ children's total sugar intake. Mean reductions required in sugar content and pack size to meet the targets were 5.2 g  per 100 g/mL (26%) and 61.2 g/mL/pack (23%), respectively. The percentage of products already meeting the sugar targets ranged from 14% for electrolyte drinks and flavored dairy milk to 50% for cereal bars, and for pack size targets compliance ranged from 32% for chocolate confectionary to 62% for fruit juices and drinks. Estimated reductions in annual household sugar purchases if the sugar and pack size targets were met were 1459 g (23%) and 286 g (6%), respectively. CONCLUSIONS: Methods for the development of sugar and pack size reduction targets are presented, providing a robust, step-by-step process for countries to follow. The results of the case study provide a suggested benchmark for a potential national sugar reduction program in NZ.