Microplastics found in artery plaque linked with higher risk of heart attack, stroke and death
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Microplastics and nanoplastics are everywhere in our environment – including in our oceans and lakes, farmland, and even Arctic ice algae.
Microplastics have also been found inside of us – with studies detecting them in various tissues including in the lungs, blood, heart and placenta. Understandably, concern is rising about the potential risks of microplastics on our health.
However, while a growing body of research has focused on microplastics and nanoplastics, there’s still a lack of direct evidence that their presence in human tissues is harmful to our health – and it’s uncertain if they are related to particular diseases.
A new study has uncovered a correlation between microplastics and heart health, though. The researchers found that people who had detectable microplastics and nanoplastics in the plaque in their arteries had a higher risk of heart attack, stroke and death.
Heart health
The researchers looked at 257 people altogether. All of the patients were already undergoing preventative surgery to remove plaque from their carotid arteries (the main arteries that supply the brain with blood). This allowed the researchers to collect plaque samples and perform a chemical analysis. They then followed up with participants 34 months later.
Of the 257 participants, 150 were found to have the presence of microplastics and nanoplastics in their arterial plaque – mainly fragments of two of the most commonly used plastics in the world, polyethylene (used in grocery bags, bottles and food packaging) and polyvinyl chloride (used in flooring, cladding and pipes).
A statistical analysis of this data found that patients with microplastics and nanoplastics in their plaque had a higher risk of suffering a heart attack, stroke or death from any cause, compared with those who had no microplastics or nanoplastics in their plaque.
The researchers also analysed the macrophages (a type of immune cell that helps remove pathogens from the body) in the patients’ arteries. They found that participants who’d had microplastics and nanoplastics in their plaque also had evidence of plastic fragments in their macrophages.
They also looked at whether certain genes associated with inflammation (which can be a sign of disease) were switched on in the participants. They found that the participants who’d had microplastics and nanoplastics in their plaque also had signs of inflammation in their genes.
These results may suggest an accumulation of nanoplastics and microplastics in carotid plaque could partly trigger inflammation. This inflammation may subsequently change the way plaque behaves in the body, making it less stable and triggering it to form a blood clot – which can eventually block blood flow, leading to heart attacks and strokes.
Interestingly, the researchers also found the presence of nanoplastics and microplastics was more common in participants who had diabetes and cardiovascular disease. This raises a lot of questions which have yet to be answered – such as why microplastics were more common in these participants, and if there may be a correlation between other diseases and the presence of microplastics in the body.
Other health risks
This study only focused on patients who had carotid artery disease and were already having surgery to remove the build-up of plaque. As such, it’s unclear whether the findings of this study can be applied to a larger population of people.
However, it isn’t the first study to show a link between microplastics and nanoplastics with poor health. Research suggests some of this harm may be due to the way microplastics and nanoplastics interact with proteins in the body.
For example, some human proteins adhere to the surface of polystyrene nanoplastics, forming a layer surrounding the nanoparticle. The formation of this layer may influence the activity and transfer of nanoplastics in human organs.
Another study suggested that nanoplastics can interact with a protein called alpha-synuclein, which in mouse studies has been shown to play a crucial role in facilitating communication between nerve cells. These clumps of nanoplastics and protein may increase the risk of Parkinson’s disease.
My published PhD research in chicken embryos found that nanoplastics may cause congenital malformations due to the way they interact with a protein called cadherin6B. Based on the interactions myself and fellow researchers saw, these malformations may affect the embryo’s eyes and neural tube, as well as the heart’s development and function.
Given the fact that nanoplastics and microplastics are found in carotid plaque, we now need to investigate how these plastics got into such tissues.
In mice, it has been demonstrated that gut macrophages (a type of white blood cell) can absorb microplastics and nanoplastics into their cell membrane. Perhaps a similar mechanism is taking place in the arteries, since nanoplastics have been identified in samples of carotid plaque macrophages.
The findings from this latest study add to a growing body of evidence showing a link between plastic products and our health. It is important now for researchers to investigate the specific mechanisms by which microplastics and nanoplastics cause harm in the body.
Meiru Wang, Postdoctoral Researcher, Molecular Biology and Nanotoxicology, Leiden University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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AuDHD means being autistic and having ADHD – and it can look very different to a single diagnosis
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When you finally receive a neurodevelopmental diagnosis that reflects your strengths and the challenges you face, it can be life-changing.
But for people with both autism and attention-deficit hyperactivity disorder (ADHD) – known colloquially as AuDHD – getting the right diagnosis can be difficult.
People with AuDHD (pronounced awe-D-H-D) often find their traits and experiences don’t always neatly fit into either category. Sometimes the two conditions contradict each other and appear to act in opposite ways. Other times they exacerbate or increase a trait or difficulty.
This can delay diagnosis and support.
Halfpoint Images/Getty Images What are these conditions and how common are they?
Autism is a condition that affects social communication. Autistic people often have significant sensory sensitivities and need certainty and repetition. Around 1-2% of children and adults are autistic.
ADHD impacts either the ability to flexibly focus and sustain attention, or results in hyperactivity and impulsivity – or both. Around 5–8% of children and 3% of adults have ADHD.
Around 30% to 50% of autistic people also have ADHD. But despite them commonly occurring together, autism and ADHD have only been able to be diagnosed together since 2013, when the Diagnostic and Statistical Manual of Mental Disorders received its fifth update in the the DSM-5.
What’s usually diagnosed first?
Autism is usually diagnosed at an earlier age than AuDHD and ADHD in childhood.
This may related to autistic traits – social difficulties – often being apparent in preschool, whereas ADHD traits may not become apparent or problematic until school age, when concentration abilities are needed to learn.
But some people can mask their autistic differences through strategies, such as learning explicitly how to socialise, following scripts, copying and mirroring others and hiding autistic traits.
Sometimes, accessing ADHD medication treatment can reveal autistic traits that may not have been obvious and were overshadowed by ADHD. After taking ADHD medications, some people can achieve their preference for being highly structured and organised, when ADHD traits of disorganisation and inconsistency in attention are reduced.
For others, ADHD medication will treat impulsivity that manifests as talkativeness or extroversion, to reveal a deeper introversion and preference for solitary activities.
In recent years, some people who have one existing diagnosis have learned about the other condition on social media and realised they might have AuDHD.
Some difficulties are exacerbated
Maintaining friendships and socialising
For autistic people, maintaining friendships is a core difficulty and can make social interaction draining and overwhelming. Autism makes it difficult to pick up social cues, know what to do or say in social situations, and identify non-verbal signals from others.
ADHD can make it hard to organise social events, stay in touch with friends and respond to texts and calls. When socialising, attention difficulties can make it harder to focus on conversations and remember what was said. Hyperactivity and impulsivity can mean interrupting and talking over others or being overly talkative.
Together, AuDHD can mean a person experiences all these differences in social interactions, resulting in more unintended “social mistakes”.
Stims
Repetitive behaviours in autism (stims) are often ways to regulate or express emotions through repeated movements or vocalisations. They could be repetitive noises such as squeaks or humming, or movements such as rocking back and forth or finger flicking.
ADHD hyperactivity often involves fidgeting and not being able to be still or relax.
Together, movement from stims and fidgets can be more obvious and frequent.
Other traits pull people in different directions
Organisation
Autistic traits include the need for order, systems, categorisation and organisation around the house, at work and with hobbies.
ADHD traits of inattention include significant difficulties with organisation.
The result for people with AuDHD is often internal frustration and discomfort: wanting to be organised but not being able to maintain it.
Special interests
Autistic special interests are usually long-standing (over years) and limited to a few subjects.
ADHD involves seeking novelty and quickly becoming bored and moving on to the next interest once something is no longer stimulating. This might mean buying new things for a hobby but never actually using them.
AuDHD tends to follow the pattern of ADHD. So someone may have intense interests but be exhausted by them sooner than they would with autism alone.
Routine
Autism wants certainty, plans and routine. ADHD wants spontaneity and novelty. Together, autism often seems to win.
People with AuDHD may follow routines due to the anxiety uncertainty causes them, but they may feel bored or dissatisfied as their ADHD needs aren’t met.
Unique strengths
Many late-diagnosed people with AuDHD are highly intelligent and have developed elaborate compensation strategies for their difficulties. Many have found ways to leverage and maximise their strengths.
Strengths in AuDHD can be related to either condition. This can include common autistic strengths such as being highly focused, having meticulous attention to detail and subject matter expertise.
ADHD strengths can include creativity and the ability to develop novel solutions, strategise, quickly research to a deep level, have a high level of focus, and take quick action in highly stressful situations.
Knowing you have AuDHD can result in self-acceptance and understanding, and replace a lifetime of self-criticism. This can lead to developing a life that is right for each individual person with AuDHD rather than trying to fit in with what might be socially and culturally expected.
It also means you can access treatments and supports to support both autism and ADHD needs. This might include ADHD medication, neuro-affirming education and therapy adjusted for autism and ADHD, occupational therapy, ADHD coaching, as well as workplace and academic accommodations.
Tamara May, Psychologist and Research Associate in the Department of Paediatrics, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What should I do if I can’t see a psychiatrist?
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People presenting at emergency with mental health concerns are experiencing the longest wait times in Australia for admission to a ward, according to a new report from the Australasian College of Emergency Medicine.
But with half of New South Wales’ public psychiatrists set to resign next week after ongoing pay disputes – and amid national shortages in the mental health workforce – Australians who rely on psychiatry support may be wondering where else to go.
If you can’t get in to see a psychiatrist and you need help, there are some other options. However in an emergency, you should call 000.
Why do people see a psychiatrist?
Psychiatrists are doctors who specialise in mental health and can prescribe medication.
People seek or require psychiatry support for many reasons. These may include:
- severe depression, including suicidal thoughts or behaviours
- severe anxiety, panic attacks or phobias
- post-traumatic stress disorder (PTSD)
- eating disorders, such as anorexia or bulimia
- attention deficit hyperactivity disorder (ADHD).
Psychiatrists complement other mental health clinicians by prescribing certain medications and making decisions about hospital admission. But when psychiatry support is not available a range of team members can contribute to a person’s mental health care.
Can my GP help?
Depending on your mental health concerns, your GP may be able to offer alternatives while you await formal psychiatry care.
GPs provide support for a range of mental health concerns, regardless of formal diagnosis. They can help address the causes and impact of issues including mental distress, changes in sleep, thinking, mood or behaviour.
The GP Psychiatry Support Line also provides doctors advice on care, prescription medication and how support can work.
It’s a good idea to book a long consult and consider taking a trusted person. Be explicit about how you’ve been feeling and what previous supports or medication you’ve accessed.
What about psychologists, counsellors or community services?
Your GP should also be aware of supports available locally and online.
For example, Head to Health is a government initiative, including information, a nationwide phone line, and in-person clinics in Victoria. It aims to improve mental health advice, assessment and access to treatment.
Medicare Mental Health Centres provide in-person care and are expanding across Australia.
There are also virtual care services in some areas. This includes advice on individualised assessment including whether to go to hospital.
Some community groups are led by peers rather than clinicians, such as Alternatives to Suicide.
How about if I’m rural or regional?
Accessing support in rural or regional areas is particularly tough.
Beyond helplines and formal supports, other options include local Suicide Prevention Networks and community initiatives such as ifarmwell and Men’s sheds.
Should I go to emergency?
As the new report shows, people who present at hospital emergency departments for mental health should expect long wait times before being admitted to a ward.
But going to a hospital emergency department will be essential for some who are experiencing a physical or mental health crisis.
Managing suicide-related distress
With the mass resignation of NSW psychiatrists looming, and amid shortages and blown-out emergency waiting times, people in suicide-related distress must receive the best available care and support.
Roughly nine Australians die by suicide each day. One in six have had thoughts of suicide at some point in their lives.
Suicidal thoughts can pass. There are evidence-based strategies people can immediately turn to when distressed and in need of ongoing care.
Safety planning is a popular suicide prevention strategy to help you stay safe.
What is a safety plan?
This is a personalised, step-by-step plan to remain safe during the onset or worsening of suicidal urges.
You can develop a safety plan collaboratively with a clinician and/or peer worker, or with loved ones. You can also make one on your own – many people like to use the Beyond Now app.
Safety plans usually include:
- recognising personal warning signs of a crisis (for example, feeling like a burden)
- identifying and using internal coping strategies (such as distracting yourself by listening to favourite music)
- seeking social supports for distraction (for example, visiting your local library)
- letting trusted family or friends know how you’re feeling – ideally, they should know they’re in your safety plan
- knowing contact details of specific mental health services (your GP, mental health supports, local hospital)
- making the environment safer by removing or limiting access to lethal means
- identifying specific and personalised reasons for living.
Our research shows safety planning is linked to reduced suicidal thoughts and behaviour, as well as feelings of depression and hopelessness, among adults.
Evidence from people with lived experience shows safety planning helps people to understand their warning signs and practice coping strategies.
Sharing your safety plan with loved ones may help understand warning signs of a crisis. Dragana Gordic/Shutterstock Are there helplines I can call?
There are people ready to listen, by phone or online chat, Australia-wide. You can try any of the following (most are available 24 hours a day, seven days a week):
Suicide helplines:
- Lifeline 13 11 14
- Suicide Call Back Service 1300 659 467
There is also specialised support:
- for men: MensLine Australia 1300 78 99 78
- children and young people: Kids’ Helpline 1800 55 1800
- Aboriginal and Torres Strait Islander people: 13YARN 13 92 76
- veterans and their families: Open Arms 1800 011 046
- LGBTQIA+ community: QLife 1300 184 527
- new and expecting parents: PANDA 1300 726 306
- people experiencing eating disorders: Butterfly Foundation 1800 33 4673.
Additionally, each state and territory will have its own list of mental health resources.
With uncertain access to services, it’s helpful to remember that there are people who care. You don’t have to go it alone.
Monika Ferguson, Senior Lecturer in Mental Health, University of South Australia and Nicholas Procter, Professor and Chair: Mental Health Nursing, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Dark Chocolate & Your Age
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It’s well-established that chocolate has some health-giving properties, mostly because of its very impressive polyphenol profile.
See for example:
- Enjoy Bitter Foods For Your Heart & Brain ← this is because foods that are bitter, astringent, and/or pungent, tend to be rich in polyphenols, which as well as their strong antioxidant properties, also exhibit specifically cardioprotective and neuroprotective effects
- Sharp Tastes, Sharp Brain? ← this one’s about how the taste of flavonols (a category under the general umbrella of of flavonoids, which itself is under the general umbrella of polyphenols) itself helps, even before the compound itself is absorbed
- Are You Getting The Right Kinds Of Flavonoids? ← for more about what we just mentioned
So now for some of the latest science…
Come to the dark side; we have chocolate
First of all: why not milk chocolate, doesn’t that have polyphenols too?
And well yes, it does, but in much smaller quantities because the cocoa percentage is much, much lower.
- In the US, 10% cocoa is the norm for milk chocolate
- In Europe, 25% is the threshold that if it’s not met, you can’t legally call it chocolate
- Anywhere, 80–90% is a reasonable range for dark chocolate
So, to get the same polyphenol benefits, you might need to eat 8–9x as much chocolate, and as you can imagine, that might cause different problems.
See also: 10 “Healthy” Foods That Are Often Worse Than You Think ← since milk chocolate often has not just the plummeting cocoa percentage, but also, much more saturated fat and sugar (and that latter’s one to watch out for when choosing dark chocolate, too; some are very different from others!)
Most recently, a team of researchers (Dr. Jordana Bell et al.) did a study with 509 healthy women with an average age of 60, and tested six common cocoa-related chemicals, including caffeine and theobromine, to see whether any were linked to faster or slower biological aging.
A quick note before we continue, about that “biological aging”, we’ve written before about how biological age often gets talked about as a simplified number, but it’s more complex than that, as we can age in different ways at different rates, for example:
- Visual markers of aging (e.g. wrinkles, graying hair)
- Performative markers of aging (e.g. mobility tests)
- Internal functional markers of aging (e.g. tests for cognitive decline, eyesight, hearing, etc)
- Cellular markers of aging (e.g. telomere length)
- …and more, but we only have so much room here
For more on that (including what we can do about each of them to slow or in some cases reverse biological aging), see:
Age & Aging: What Can (And Can’t) We Do About It?
Now, back to the study: what Dr. Bell and her team mainly used as the key epigenetic clock was a DNA methylation model, and what they found was that theobromine stood out—women with higher levels of this chocolate-derived compound had biological-age scores that were about 1.5 years younger.
This association was incredibly statistically significant, p = 3.99e-6, which means the chance of getting these results by chance (i.e. coincidence) is so small that the scientists are putting letters into their numbers to express it. It’s the equivalent of about 1 in 250,627 odds.
You can find the paper in full here: Theobromine is Associated with Slower Epigenetic Ageing ← when you click, on the abstract is visible at first, but if you then click on PDF, you’ll get the rest.
This is a very strong extra benefit, which builds on the previous work we wrote about in Cocoa vs Biological Aging! ← which had to do with inflammatory aging biomarkers
Want to learn more?
You want like to read about…
The “Love Drug” ← this is about phenylethlyamine, a compound found in chocolate that works similarly the amphetamine (but with rather less potential for abuse/harm, for most people).
Enjoy!
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Super-Nutritious Shchi
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Today we have a recipe we’ve mentioned before, but now we have standalone recipe pages for recipes, so here we go. The dish of the day is shchi—which is Russian cabbage soup, which sounds terrible, and looks as bad as it sounds. But it tastes delicious, is an incredible comfort food, and is famous (in Russia, at least) for being something one can eat for many days in a row without getting sick of it.
It’s also got an amazing nutritional profile, with vitamins A, B, C, D, as well as lots of calcium, magnesium, and iron (amongst other minerals), and a healthy blend of carbohydrates, proteins, and fats, plus an array of anti-inflammatory phytochemicals, and of course, water.
You will need
- 1 large white cabbage, shredded
- 1 cup red lentils
- ½ lb tomatoes, cut into eighths (as in: halve them, halve the halves, and halve the quarters)
- ½ lb mushrooms sliced (or halved, if they are baby button mushrooms)
- 1 large onion, chopped finely
- 1 tbsp rosemary, dried
- 1 tbsp thyme, dried
- 1 tbsp black pepper, coarse ground
- 1 tsp cumin, ground
- 1 tsp yeast extract
- 1 tsp MSG, or 2 tsp low-sodium salt
- A little parsley for garnishing
- A little fat for cooking; this one’s a tricky and personal decision. Butter is traditional, but would make this recipe impossible to cook without going over the recommended limit for saturated fat. Avocado oil is healthy, relatively neutral in taste, and has a high smoke point for caramelizing the onions. Extra virgin olive oil is also a healthy choice, but not as neutral in flavor and does have a lower smoke point (but it’s still possible to caramelize onions in olive oil; you just need to do it a touch more slowly). Coconut oil has far too strong a taste and a low smoke point. Seed oils have rather mixed evidence for/against them, healthwise. All in all, avocado oil is a respectable choice from all angles except tradition.
Note: with regard to the seasonings, the above is a basic starting guide; feel free to add more per your preference—however, we do not recommend adding more cumin (it’ll overpower it) or more salt (there’s enough sodium in here already).
Method
(we suggest you read everything at least once before doing anything)
1) Cook the lentils until soft (a rice cooker is great for this, but a saucepan is fine); be generous with the water; we are making a soup, after all. Set them aside without draining.
2) Sauté the cabbage, and put it in a big stock pot or similar large pan (not yet on the heat)
3) Fry the mushrooms, and add them to the big pot (still not yet on the heat)
4) Use a stick blender to blend the lentils in the water you cooked them in, and then add to the big pot too.
5) Turn the heat on low, and if necessary, add more water to make it into a rich soup
6) Add the seasonings (rosemary, thyme, cumin, black pepper, yeast extract, MSG-or-salt) and stir well. Keep the temperature on low; you can just let it simmer now because the next step is going to take a while:
7) Caramelize the onion (keep an eye on the big pot, stirring occasionally) and set it aside
8) Fry the tomatoes quickly (we want them cooked, but just barely) and add them to the big pot
9) Serve! The caramelized onion is a garnish, so put a little on top of each bowl of shchi. Add a little parsley too.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- The Magic Of Mushrooms: “The Longevity Vitamin” (That’s Not A Vitamin)
- Easily Digestible Vegetarian Protein Sources
- The Bare-Bones Truth About Osteoporosis
- Some Surprising Truths About Hunger And Satiety
Take care!
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Policosanol: A Rival To Statins, Without The Side Effects?
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Policosanol (which can be extracted from various sources, but is mostly made from sugar cane extract) is marketed as lipid-lowering agent for improving cholesterol levels, but its research history has not been without controversy:
2001: it works!
After a lot of research in the 1990s, it came out of the gate strong in 2001, with:
❝Policosanol (5 and 10 mg/day) significantly decreased LDL-cholesterol (17.3% and 26.7%, respectively), total cholesterol (12.9% and 19.5%), as well as the ratios of LDL-cholesterol to high-density lipoprotein (HDL)-cholesterol (17.2% and 26.5%) and total cholesterol to HDL-cholesterol (16.3% and 21.0%) compared with baseline and placebo❞
This, by the way, is comparable in efficacy to the most powerful statins, but without the adverse side effects.
Source: Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal women
Furthermore, its effects were not limited to postmenopausal women, and additionally, it was found that 20mg/day was sufficient for optimal effects; 40mg worked exactly the same as 20mg:
2006–2010: we do not trust the Cubans!
After it had been marketed and used in much of the world for some years, extra scrutiny was brought upon it, because the initial studies had been performed by the same lab in Cuba, a commercial lab that had tested them for a private interest (i.e., a company selling the supplement):
Heart Beat: Policosanol: A sweet nothing for high cholesterol
And furthermore, US-based labs were unable to replicate the results:
Policosanols as Nutraceuticals: Fact or Fiction
The Cuban researchers countered that the composition of policosanol as produced in their lab was different than the composition of the policosanol as produced in the US labs, because of the purity of the ingredients used in the Cuban lab.
Which, on the face of it, could be true or could just be the claim of a commercial lab with an association with a company selling a product.
Of course, importing Cuban ingredients to test them in the US was not a reasonably accessible option for the US-based labs, because of the US’s embargo of Cuba. In principle it could be done, but unless there is already a huge clear profit incentive, research scientists are usually on their hands and knees begging for grants already, so getting extra funding for specially-important Cuban ingredients was not going to be likely.
2012: never mind, it does work after all!
An American meta-analysis of 4596 patients from 52 eligible studies (from around the world, so many of them not affected by the US’s embargo; some were from within the US using non-Cuban ingredients, though), found:
❝policosanol is more effective than plant sterols and stanols for LDL level reduction and more favorably alters the lipid profile, approaching antilipemic drug efficacy❞
Those last words there, to be clear, mean “yes, the original claim of being on a par with statins is at least more or less true”.
Source: Meta-Analysis of Natural Therapies for Hyperlipidemia: Plant Sterols and Stanols versus Policosanol
2018: also yes, the Cuban kind does get those extra-effective results, even when tested outside of Cuba
A Korean research team verified this; it’s quite straightforward so for brevity we’ll just drop links:
- Consumption of Cuban Policosanol Improves Blood Pressure and Lipid Profile via Enhancement of HDL Functionality in Healthy Women Subjects: Randomized, Double-Blinded, and Placebo-Controlled Study
- Long-Term Consumption of Cuban Policosanol Lowers Central and Brachial Blood Pressure and Improves Lipid Profile With Enhancement of Lipoprotein Properties in Healthy Korean Participants
Mystery resolved!
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon—it’s not the Cuban kind, because the US’s trade embargo makes it difficult for the US to import even things that are theoretically now exempt from the embargo such as food and medicines. In principle they can now be imported, but in practice, the extra regulations added to Cuban imports make it nearly impossible, especially for small sellers.
Still, it’s 40mg/tablet policosanol from sugar cane extract, and 3rd party lab tested, so it’s the next best thing 😎
Enjoy!
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Parents find Health Star Ratings confusing and unhelpful. We need a better food labelling system
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Food labels are intended to support healthy choices. But not all labelling schemes are equal.
Australia currently uses a voluntary Health Star Rating system. Food manufacturers can choose to add a star label to their packaging to indicate how it compares to other similar products. Or they can choose not to show a star rating on a product at all.
The Australian government is now considering making it mandatory.
But our new research on parenting and food in Australia found the Health Star Ratings are often confusing, misunderstood and have little credibility among shoppers.
If Health Stars are mandated, the system will also need a major overhaul to be trusted and useful for shoppers.
Gustavo Fring/Pexels How do Health Star Ratings work?
The government set up the front-of-pack Health Star Rating system in 2014 in collaboration with the food industry, public health and consumer groups.
Product ratings range from (bad) ½ to (good) 5 stars.
Calories, saturated fat, sugars and sodium decrease the rating. Fibre, protein, and the content of fruit, vegetables, nuts and legumes increase it.
The good and bad offset each other. This means companies can strategically formulate products to boost the rating and mask unhealthy ingredients.
Processing and additives – such as sweeteners, colouring, emulsifiers, preservatives and artificial flavourings – are not part of the calculation.
Previous research has found the ratings can incentivise ultra-processed foods over minimally and unprocessed foods, and misrepresent healthfulness. Some researchers have also suggested practical ways to modify the rating algorithm to account for processing.
The Health Star Rating’s own consumer research found 74% of consumers do not understand that the rating cannot be used to compare dissimilar products.
What parents told us
In our interviews with 34 parents in Australia, participants often described the Health Star Ratings as “misleading”, “not helpful” and “on the wrong product”. One participant called it the “fake health star rating”.
They gave many examples:
Like you might buy 100% orange juice or fruit juice and it might have only half a star health star rating, but then you can buy like a box of processed muesli bars and it will have five stars. – Mother of three high school aged children, urban WA
Coco Pops or Nutrigrain have three and a half star rating, and what exactly does that mean? – Mother of one primary school aged child, urban WA
Participants wondered if the Health Stars were something companies paid for, a “marketing thing”.
Positivity bias
Part of the problem with the Health Stars is the positivity bias of the symbol. As one participant put it, “All stars are good. Right?”
Another noted their children comment on the stars, saying “but look Mum, it’s five stars.”
However, parents were not convinced:
A lot of packaged stuff is rated as five stars. I’m like yeah, well, don’t know about that. It’s still packaged. – Mother of two primary school aged children, urban NSW
Participants thought discretionary foods should not have any stars. As one participant said:
The other day, we saw a mud cake and it has a two out of five star health rating. How can that be a two out of five star?… Like there should not even be a star available for this. – Mother of pre-school aged child, urban NSW
Burden on parents
Parents often disregarded the rating. For example:
This particular thing, you know, had all sorts of additives, had actually had a much higher rating than something that actually didn’t have any additives… what I ended up buying was rated slightly lower. – Mother of two primary school aged children, rural Victoria
Instead participants used ingredients lists, apps such as Yuka, and “hours of internet research” to guide healthier choices.
But there was a sense of frustration that the burden was on them. Participants said:
I feel like food labels are extremely deceptive and by producers, purposely confusing. – Mother of one primary school aged child, urban SA
It has to be government driven because companies won’t change unless they’re forced to by the government. – Father of two primary school aged children, urban Tasmania
We need a food labelling system that works
Still, the parents we spoke to think a front-of-pack system is valuable. As one participant explained:
I do think if I had a better system for that, that would get a lot of use. – Mother of two primary school aged children, urban NSW
Parents repeatedly stated a desire for transparency over food, for information they can trust and food policies that prioritise consumer health.
As one mother put it, the “multi-billion dollar” food industry will not do this on their own, and “that’s where the government needs to step in.”
If Health Stars are mandatory, how could labelling be overhauled?
Chile, Mexico, Brazil and other countries, including Canada from 2026, are now using “stop-sign” warnings to steer consumers away from the least healthy products. Large Black Octagons alert consumers to high sugar, sodium and saturated fats, and ultra-processing.
Starting in 2026, a new front-of-package symbol will be required on many Canadian foods and drinks that are high in saturated fat, sugars or salt. Canada.ca/en/health Evidence shows these warning labels have improved nutrition and public health in other countries and could be an option for Australia.
We need to mandate a fit-for-purpose food labelling system that supports healthy eating. Governments should centre the voices of consumers in these and other national food policies to ensure they work as intended.
Juliet Bennett, Postdoctoral Research Fellow, University of Sydney; Alex Broom, Professor of Sociology & Director, Sydney Centre for Healthy Societies, University of Sydney, and David Raubenheimer, Leonard P. Ullman Chair in Nutritional Ecology, Nutrition Theme Leader Charles Perkins Centre, Chair Sydney Food and Nutrition Network, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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