What's law got to do with it Part 2: Legal strategies for healthier nutrition and obesity prevention

This article is the second in a two-part review of law's possible role in a regulatory approach to healthier nutrition and obesity prevention in Australia. As discussed in Part 1, law can intervene in support of obesity prevention at a variety of levels: by engaging with the health care system, by targeting individual behaviours, and by seeking to influence the broader, socio-economic and environmental factors that influence patterns of behaviour across the population. Part 1 argued that the most important opportunities for law lie in seeking to enhance the effectiveness of a population health approach

Formulated meal replacements: a comparison of the nutritional adequacy of available products

Objective: To assess the nutritional compliance of formulated meal replacements available in Australian pharmacies with the Food Standards Australia and New Zealand guidelines; and to assess the nutritional adequacy of formulated meal replacements recommended diets based on meal replacement or total diet replacement (very low energy diets). Design: Products available at major pharmacies as of November 2007 were identified and nutritional information and instructions for use were obtained from the product packaging and/or the manufacturing company. Main Outcome Measures: Individual serves, prepared as directed, were compared to Standards Australia and New Zealand standard 2.9.3 of the food standards code. Nutritional adequacy was assessed by comparing the nutritional composition to the Nutrient Reference Values for average obese adult males and females, using Foodworks 2007. Results: Results demonstrated that while most products were compliant with the Standards Australia and New Zealand standard for formulated meal replacements composition the majority of the products and/or programs were deficient in one or more nutrients. Of the 17 products from 11 brands, no very low energy diets programs (of seven) were found to be nutritionally complete. Only two meal replacement programs (of 16) were nutritionally complete in comparison to the recommended dietary intakes and AIs for both a representative obese man and woman. Conclusion: The results highlight the important role of clinicians in ensuring programs followed by patients are nutritionally adequate and implemented and supervised as intended, in order to minimise side-effects and risks. There is a need for Standards Australia and New Zealand regulations governing very low energy diets, where formulated meal replacements are recommended for total diet replacement