SHOULD WE THINK OF FOOD REFORMULATION AS CHANGES IN NUTRIENTS AND FOOD ADDITIVES?

Introduction: Food reformulation has been tracked as changes in the content of nutrients of concern to health. Evidence on the adverse health effects of food additives shies light on the need to also track how these have been used in combination or to replace nutrients of concern in foods and beverages. Objective: To assess how food reformulation has combined changes in the content of energy, nutrietns and food additives of 'cosmetic use' (CFA) in foods and beverages sold in Brazil over the last decade. Methods: We used data from the "Global New Products Database (Mintel-GNPD). We created a panel with all processed and ultra-processed foods according to NOVA launched in the Brazilian food supply between 2010 and 2021 with at least one reported change in food composition (nutrients and/or ingredient list) by pairing unique barcodes and product inclusion and reformulation dates (126,441 observations and 6,021 unique products). Outcome variables included energy, saturated fat, sodium, and the presence of total sugars, non-sugar sweeteners (NSS) and CFA. The latter were identified using detailed description of CFA found in ultra-processed foods. We ran year- and product-fixed effect log-linear models. We then explored heterogeneity across food categories. Results: We found significant increases in energy and sodium contents in 2021 as compared with 2010, but not in saturated fat. While we found smaller changes in the prevalence of foods and beverages with total sugars (ranging from 77% to 80%), the presence of NSS grew from 12% to 28%. The number of CFA/products had a 15% upward increase from 2015 to 2021. The number of CFA/product soared in dairy and nondairy sweetened beverages, ready-to-eat meals, and snacks. Finally, CFA changes were followed by greater increases in the energy content of foods in 2019-21 as compared with earlier periods. Conclusions: Foods and beverages have undergone significant reformulation in the 10 years in Brazil, with important heterogeneity across nutrients, total sugars, NSS and other foo additives of 'cosmetic use', and food categories. Monitoring food reformulation will be key to address an unintended worsening of the healthfulness of the food supply. [ABSTRACT FROM AUTHOR]