The Role of Law in Reducing Kidney Disease, Diabetes and other Obesity-Related Diseases: An Introduction to Traffic Light Labelling

On 20 March 2011, it was revealed that the number of chronic kidney patients has tripled from the year 2000 to 2009. Since the main cause of renal failure is diabetes mellitus, it appears that something is not right with health policy on diabetes up to now, particularly in relation to the provision of understandable and accessible nutritional information.

I’ve been a big fan of traffic light labelling for a while now, and particularly so because it has been scientifically established that in general, consumers have difficulty interpreting nutrient claims as contained on food packaging.[1] The fact is, even I would not know whether 4.9 grams of fat per serving and 11.4 grams of sugars is alright for me to consume in a day. What more someone who is not exposed to health data regularly?

Traffic light labelling is labelling that uses colour codes to inform consumers of high fat, sodium and sugar content in foods. For example, an application of traffic light labelling to help reduce diabetes would mean that foods high in sugar would have a red dot or marking on the packaging, foods with moderate sugar levels would have a orange dot, and foods low in sugars would have a green dot. Such a system has been used in the United Kingdom (front-of-pack traffic light system)[2] and in schools across the Waitemata District in New Zealand (traffic light system to reduce consumption of high-sugar drinks).[3]

Such labelling can be easily understood by persons of all ages and literacy levels, is accessible due to its positioning on all food labels and packaging, and can be easily introduced to the public via various media channels. Yet, no one has discussed the possibility of introducing this policy at all.

Tortolero et al in their 2009 article propose mandating calorie labelling on school menus and in school cafeterias and also providing this information to parents and parent-teacher associations.[4] Although calorie labelling is better than no calorie labelling, I still think that traffic light labelling will be better understood.

Since diabetes is an obesity-related disease, it is interesting to know that steps have in the past been taken to introduce the provision of nutritional information in restaurant menus in the United States given that in restaurant foods, sodium levels, among others, are ‘vastly underestimated’ by consumers.[5] This may be especially relevant to Malaysia where a large proportion of us eat out/buy food from restaurants at least twice a week. Burton et al illustrate: ‘Increased prevalence of obesity-related diseases has been blamed, in part, on the increased consumption of foods prepared outside the home.’[6]

The provision of nutritional information in menus could also been done with traffic light labelling alongside numerical nutritional information. Why is this a legal issue? Well, in my view, the inclusion of compulsory traffic light labelling legislation in a stand-alone public health statute, among other innovative legal measures, can act as a catalyst to change social norms and attitudes to health.

---

[1] Cliona Ni Mhurchu and Delvina Gorton, ‘Nutrition Labels and Claims in New Zealand and Australia: A Review of Use and Understanding’ (2007) 31(2) Australian and New Zealand Journal of Public Health 105 at 109

[2] Id at 110

[3] Ibid

[4] Susan R Tortolero, Karyn Popham and Peter D Jacobson, ‘Improving Information on Public Health Law Best Practices for Obesity Prevention and Control’ (2009) 37 Journal of Law, Medicine and Ethics 99 at 103

[5] Scot Burton, Elizabeth H Creyer, Jeremy Kees and Kyle Huggins, ‘Attacking the Obesity Epidemic: The Potential Health Benefits of Providing Nutrition Information in Restaurants’ (2006) 96(9) American Journal of Public Health 1669 at 1674

[6] Id at 1669