Policy outcomes of applying different nutrient profiling systems in recreational sports settings: the case for national harmonization in Canada

Objective: To assess agreement among three nutrient profiling systems used to evaluate the healthfulness of vending machine products in recreation and sport settings in three Canadian provinces. We also assessed whether the nutritional profile of vending machine items in recreation and sport facilities that were adhering to nutrition guidelines (implementers) was superior to that of facilities that were not (non- implementers). Design: Trained research assistants audited the contents of vending machines. Three provincial nutrient profiling systems were used to classify items into each province's most, moderately and least healthy categories. Agreement among systems was assessed using weighted kappa statistics. ANOVA assessed whether the average nutritional profile of vending machine items differed according to province and guideline implementation status. Setting: Eighteen recreation and sport facilities in three Canadian provinces. One-half of facilities were implementing nutrition guidelines. Subjects: Snacks (n 531) and beverages (n 618) within thirty- six vending machines were audited. Results: Overall, the systems agreed that the majority of items belonged within their respective least healthy categories (66- 69 %) and that few belonged within their most healthy categories (14- 22 %). Agreement among profiling systems was moderate to good, with kappa(w) values ranging from 0.49 to 0.69. Implementers offered fewer of the least healthy items (P < 0.05) and these items had a better nutritional profile compared with items in non- implementing facilities. Conclusions: The policy outcomes of the three systems are likely to be similar, suggesting there may be scope to harmonize nutrient profiling systems at a national level to avoid unnecessary duplication and support food reformulation by industry.