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In this Explainer, find out...
Why is Nutri-Grade labelling required?
How does Nutri-Grade labelling work?
Is Nutri-Grade labelling effective?
Introduction
Have you noticed new labels on your drinks recently? Beverages, both pre-packaged and freshly prepared, must be clearly labelled with Nutri-Grade labels from 30 December 2023. The Nutri-Grade is a grading system that uses a single set of thresholds for sugar and saturated fat content and has four possible grades from ‘A’ to ‘D’.¹
Such labels are not new to Singapore. For example, the Healthier Choice symbol has long been implemented in Singapore. Apart from labels, advertising bans and television campaigns have also been used to nudge consumers to develop healthier consumption behaviours in Singapore. These policies and campaigns are part of a wider preventive healthcare strategy.
Nutri-Grade labels are the latest addition to Singapore’s preventive healthcare strategy. It is targeted at Singaporeans’ excessive consumption of added sugars and saturated fats, which are associated with prevalent chronic diseases such as diabetes and cardiovascular disease.
While this Policy Explainer will not tell you which bubble tea is graded the healthiest, it will delve into the reasons for introducing Nutri-Grade, explore how it works and discuss whether it is an effective policy for reducing the consumption of sugars and saturated fats.
Why Nutri-Grade Labelling?
Lifestyles and Culture
Singapore is (in)famously known for its busy and fast-paced lifestyle, which has created a preference for convenience over health when choosing between food options.² Singaporeans would rather eat outside than to cook. Furthermore, the plethora of food choices gives Singaporeans more choice and they do not need to cook themselves.
Eating outside, however, is not necessarily healthy.³ In Singapore, hawker foods are usually carbohydrate and fat-heavy.⁴ When consumed in excess, these can lead to chronic illnesses such as cardiac disease and diabetes. The consumption of sugar-sweetened beverages has also been found to correlate with a myriad of health complications like weight gain, type 2 diabetes mellitus and cardiovascular disease.⁵
Today, Singaporeans consume an average of 12 teaspoons of sugar, more than the recommended maximum of nine.⁶ Of the 12 teaspoons, about 55% of the sugar intake comes from beverages, 64% of which from pre-packaged drinks and the remaining from freshly prepared ones.⁷
In addition to an unhealthy diet, active lifestyles have gradually evolved into more sedentary ones.⁸ This is a global phenomenon and Singapore is no exception, especially with the rise of white-collar jobs. In 2020, the Ministry of Manpower found that 60% of Singaporeans have Professionals, Managers, Executives and Technicians (PMETs) roles today.⁹ Altogether, poor diets and sedentary lifestyles are an unhealthy combination that makes chronic diseases more likely.
Effects of Chronic Disease on Labour and Well-Being
The prevalence of chronic diseases is undesirable from an economic standpoint. The impact of chronic diseases on labour performance, including absenteeism, lower work productivity and unemployment, is well documented.¹⁰ Thus, the proliferation of chronic diseases in Singapore, such as an increase in the number of people with diabetes from 450,000 to one million by 2050, is a cause for concern.¹¹ With a greater proportion of the population suffering from chronic diseases, Singapore’s workforce will underperform. This will weaken businesses in Singapore and dampen our economic prospects.
Conversely, being free of chronic diseases and in the pink of health is empowering, allowing citizens to maintain their independence and autonomy. This is critical for Singapore’s ageing population, who are more vulnerable to declining health and independence. Empowerment can allow them to lead more fulfilling lives.¹² Societally, good public health can also reduce significant mental health problems and raise social well-being.¹³
Effects of Chronic Diseases on Healthcare
Besides their effects on labour and well-being, chronic diseases can impose a significant healthcare burden on society. In recent years, healthcare costs attributed to chronic disease treatment have increased.¹⁴ It also turns out that the most prevalent triad of chronic diseases in Singapore, which includes hyperlipidaemia, hypertension and type 2 diabetes mellitus, is also the most expensive triad.¹⁵ Thus, a rise in the prevalence of these chronic diseases can increase healthcare costs significantly, both for Singaporeans and for the state.
Shifting Focus to Preventive Healthcare
Recognising the challenges posed by a rise in chronic diseases, the Ministry of Health has shifted its focus from reactive care, which responds to diseases onlywhen they surface, to preventive healthcare, one that attempts to proactively ensure the well-being of Singaporeans before diseases surface.¹⁶
Since 2023, Singapore’s efforts to strengthen preventive healthcare have coalesced under the Healthier SG initiative. While not part of Healthier SG, Nutri-Grade is part of a broader preventive healthcare strategy, specifically tackling the issue of excessive added sugar and saturated fat intake.
How does Nutri-Grade Work?
The Initial Rollout
Nutri-Grade labels were first introduced on 30 December 2022.¹⁷ These labels (see Figure 1) are mandatory for pre-packaged drinks and drinks sold in automated beverage dispensers.
Nutri-Grade labels have three key features:¹⁸
Grading scales: A grading scale from ‘A’ to ‘D’, where beverages graded ‘A’ are relatively healthier than those graded ‘D’. Their grades depend on the added sugars and saturated fat content.
Colour-coding: A traffic light colour-coding scheme is used for each of the grades. Grades ‘A’ and ‘B’ are coloured green, ‘C’ coloured yellow, and ‘D’ coloured red. This allows information on the amount of added sugar and saturated fat to be more accessible and helps consumers make healthier consumption decisions.
Text bubble: A text bubble highlighting the amount of added sugar content per serving. Lactose and galactose, which are usually found in dairy products, are the only carbohydrates not accounted for by this statistic.
Figure 1: Complete Nutri-Grade Label Examples¹⁹
In addition, advertisements for beverages graded ‘D’ are banned across all media platforms. They can only be advertised at the point of purchase, such as via promotional posters in supermarkets, on the condition that their Nutri-Grade label is clearly displayed. Other drinks are unaffected by this ban.²⁰
Expanding Coverage
Since 30 December 2023, Nutri-Grade labels have been extended to freshly prepared drinks in retail and non-retail settings.²¹ Retail settings include brick-and-mortar stores and digital platforms, while non-retail settings include hotels, workplaces, educational institutions, healthcare institutions and childcare facilities. This offers a more extensive coverage of drinks consumed via other platforms and settings.
A simplified label has also been introduced, including only the specific grade, its associated colour code, and the added sugar statistic (see Figure 2). These statistics are often found on menus for freshly prepared beverages. They are designed to allow consumers to compare options more easily and quickly. Menus printed on smaller interfaces can also display the smaller, simplified labels (see Figure 3).
Figure 2: Simplified Nutri-Grade Labels²²
Figure 3: A Simplified Nutri-Grade Label on a Freshly-Prepared Beverage²³
As for beverage customisations, stores need to declare the amount of sugar added per serving. However, they are not assigned a grade or colour code (see Figure 4).
Figure 4: Example of an Added-Sugar Statistic Label for Beverage Customisations²⁴
Will Nutri-Grade Work?
Nudging towards Healthier Consumption
The Nutri-Grade label is based on a concept in behavioural economics called nudging.²⁵ Unlike legislation, nudges aim to influence behaviour towards an intended outcome. Specifically, it acts on our unconscious thinking that is usually responsible for making instant decisions.²⁶ In the context of childhood obesity, nudging has been used to encourage parents to purchase healthy foods. In the case of Nutri-Grade, the yellow and red colours are aimed at nudging consumers away from beverages with high sugar or saturated fat contents, similar to their function in traffic lights.
There is some evidence that nudges work for foods and beverages. In 2013, the United Kingdom (UK) adopted traffic-light labelling of foods based on calories, sodium and saturated fat content. This traffic-light labelling has seen some success, as more consumers purchased foods in green-coloured, healthier categories.²⁷ It also suggests that Nutri-Grade, which has a similar colour code, could encourage consumers to choose drinks graded ‘A’ or ‘B’.
The Limits of Nudging
However, it was also found that traffic-light labelling of foods in the UK did not sufficiently discourage consumers from purchasing goods in red-coloured, unhealthier categories.²⁸ Why is this so?
First, consumers may not change their behaviour in response to the nudge since such behavioural changes are strictly voluntary. Thus, a bubble tea lover in Singapore can still choose their favourite bubble tea despite it being graded ‘C’ or ‘D’.
Second, labels may not nudge consumers at all. Some may feel overwhelmed by a large menu, while others may perceive that an active lifestyle can counter the negative consequences of unhealthy beverage consumption. Some menus also feature drinks that are all graded ‘C’ and ‘D’ only, making it impossible for consumers to pick a healthier drink.²⁹
Third, brand loyalty and switching costs also deter consumers from making healthier choices. Unique selling points and consumer preferences give rise to
Figure 6: A Menu for Milk Tea in Singapore³⁰
brand loyalty. This makes drinks less substitutable with one another. Additionally, switching costs are incurred when consumers have to find other brands or compare menus before changing their drink choices. Thus, brand loyalty and switching costs can reduce the impact of nudges on consumer choice.
Misunderstanding Nutri-Grade Labels
Nutri-Grade measures, while well-intentioned, can also be misunderstood when consumers neglect other nutritional indicators. Nutri-Grades are judged only on two nutritional components: added sugar and saturated fat content.
However, this neglects other aspects of a drink’s nutritional value. By referring to the Nutri-Grade, consumers may unknowingly neglect other benefits of a drink (such as full-fat milk, which provides essential protein, or fats, vitamins and calcium for growth and development), or underestimate the unhealthiness of a drink (excessive consumption of Nutri-Grade ‘A’ or ‘B’ drinks can still cause tooth decay).
Hence, Nutri-Grade labels are effective insofar as consumers are aware of the nuances present in nutrition and health. Without effective education and messaging, consumers may not possess sufficiently robust information to effectively use this labelling system.
Feasibility of Rolling Out Nutri-Grade
Apart from being effective, a policy needs to be feasible to implement; a prohibitively expensive policy will incur too many costs that exceed its benefits.
Currently, businesses are expected to calculate and display information on added sugars and saturated fat content themselves. However, as of December 2023, they are not required to submit any test results. Thus, businesses could potentially fudge Nutri-Grade values for private gain, compromising the integrity of the system. Of course, post-market surveillance methods can be used to ensure that Nutri-Grades are truthfully reported.³¹ Yet, ensuring compliance via this method will create a long-term cost.
In addition, not every business can afford to calculate and display Nutri-Grade values. As of December 2023, the Health Promotion Board has excused small food business owners (those earning less than S$1 million in revenue or own less than 10 premises) from labelling freshly prepared beverages.³² Thus, a substantial proportion of drinks still lack Nutri-Grade labels, and consumption of such drinks will not be curbed until further changes are made. Yet, mandating Nutri-Grade labelling across small food owners may contribute to operating costs. This may damage the profitability of small food owners at a time when Singapore’s hawker culture is already under threat.
Conclusion
Nutri-Grade labelling is imperfect. While it is a relatively straightforward label, ex-post studies will be necessary to make it an effective nudge. Equally critical to the success of these labels are the cooperation and support of Singaporean consumers and both local producers and importers. Regardless, by highlighting important nutritional information, labels could better nudge consumers to make healthier choices. It is an important step, together with other policies such as Healthier SG and the Healthier Ingredient Development Scheme, in countering the prevalence of chronic diseases as the country’s population ages and lifestyles remain similarly sedentary, if not more.
This Policy Explainer was written by members of MAJU. MAJU is an independent, youth-led organisation that focuses on engaging Singaporean youths in a long-term research process to guide them in jointly formulating policy ideas of their own.
By sharing our unique youth perspectives, MAJU hopes to contribute to the policymaking discourse and future of Singapore.
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