• Seven companies have strengthened their nutrition strategies and management systems.
• Ten companies demonstrated that they include nutrition considerations in their merger and acquisition (M&A) decisions.
• The companies report to offer higher percentages of ‘healthy’ products (according to their own definitions) as compared to 2016 in their portfolio, with seven companies now reporting that more than half of their products are healthy. This is five more than in 2016. However, most of the companies’ definitions are less strict than those applied by ATNI in the Product Profile assessment.

• Seventeen companies commit to investing in healthy product development and fourteen commit to aligning their research and development (R&D) to important public health frameworks such as national dietary guidelines.
• Four companies have improved their Nutrition Profiling System (NPS) or strengthened the nutritional criteria related to them, and one company is in the process of implementing a new NPS.

• Companies have only set product reformulation targets for half of the product categories assessed and poorly define these targets.
  • The majority of companies (16) define one or more targets to reformulate their products, but six companies – Ajinomoto, Kraft Heinz, BRF, Suntory, Tingyi and Lactalis – do not report any relevant targets
  • Across all companies and categories, in about half of all product categories assessed (61 out of 117), companies did not set targets for relevant nutrients.
  • None of the companies yet has a full set of targets for all relevant nutrients across all product categories.
  • The large majority of companies (19) have not yet set targets to increase positive nutrients (i.e. fruits, vegetables, nuts, legumes and whole grains).
  • Targets that have been set are poorly defined in many cases. For example, they are not applied to all relevant products or, in case of relative reduction targets, baseline values and deadlines are not made clear.
• Only Ajinomoto, Grupo Bimbo and Nestlé have global policies to make healthy food affordable and accessible to all, including to low-income and high-priority populations. Companies should be takings a systematic clear approach in this regard.

• Only six companies cover all types of media in their responsible marketing commitments to children. Only one company – Arla – extends its policy on responsible marketing from children to teenagers aged 13 to 18.
• Although many companies commit to invest in the health of their employees, only eight offer employee health and nutrition programs to all employees, and only five implement independent evaluations. There is a similar trend for programs to encourage consumers to eat healthy diets and lead active lives. These programs are generally poorly designed, with few clear targets, seldom independently evaluated and insufficiently reported on.
• Support to breastfeeding mothers is not yet offered consistently around the world in terms of flexible and supportive working arrangements, and appropriate facilities to express and store breastmilk.
• None of the companies yet commit to full, interpretative labeling on the front of all their products in all markets and ten companies still do not report any relevant commitments or practices related to the responsible use of health and nutrition claims.
• Only three companies – Danone, Nestlé and PepsiCo – commit to lobby in support of measures to prevent and address obesity and diet-related chronic diseases.

• Companies have responded positively to SDG 2 . More companies (11 compared to eight in 2016) now commit to address undernutrition, especially through their core businesses as well as other initiatives.
• Twice as many companies provided evidence of investing in research to develop solutions to undernutrition: The number increased from six to 12 between 2016 and 2018.
• However, most companies’ strategies to address undernutrition are not well-structured or informed by regular, well-organized input from independent experts. Only five companies describe well-structured and strategic commercial approaches to address undernutrition, and six assign top-level oversight to their chief executive officer (CEO) or another senior executive. Similarly, only five companies have a formal expert panel in place.

• Only three out of 14 companies that do not sell breast-milk substitutes focus on women of childbearing age or on children under two in their commercial and/or non-commercial programs, which experts say should be prioritized in order to achieve the best, long-term health impacts.
• Ten companies commit to improve the affordability and accessibility of products formulated to address undernutrition in under-served populations, but few set out measurable objectives and targets. Only six of the companies commit to exclusively fortify products that are healthy and of high underlying quality. Related to this, seven companies commit to using health and nutrition claims on products that have been fortified only when these products are compliant with the internationally-recognized Codex Alimentarius (Codex) fortification guidelines.
• A limited number of companies (five out of 18) demonstrate a commitment to the need to develop and deliver marketing strategies appropriate to reaching undernourished populations.

• Of the total 23,013 products assessed, less than one third are considered healthy in the Product Profile analysis (i.e. with an HSR of 3.5 or higher), and only 14% of the products meet WHO EURO criteria for marketing to children.
• None of the companies’ portfolios comprize more than 50% of products that meet the healthy standard suitable to be marketed to children.
• The ranking of companies on the Product Profile is different to the Corporate Profile, with dairy companies in the lead and companies with diverse portfolios (such as Nestlé, Unilever and PepsiCo) in the middle of the ranking. Companies that predominantly offer confectionery are at the bottom of the ranking, which is expected based on the ingredients of these categories.

• While many companies reported their sales for 2016 generated by ‘healthy’ products, for the most part their definitions of ‘healthy’ appear less strict than that of the independent HSR system used in the Product Profile, which is of considerable concern. Seven companies self-report that more than half of their products meet their own definition of healthy, five more than in 2016.
• Only five companies have a portfolio consisting of more than 50% of healthy products and only two – FrieslandCampina and Lactalis – when these products are sales-weighted.
• The healthiness of all companies’ portfolios taken together vary by country.
  • The U.S. and New Zealand had the highest mean HSR of the nine countries: 2.6 out of 5. Developed countries such as the U.S. (2.6), New Zealand (2.6), Australia (2.4) and the U.K. (2.3) have higher overall HSRs compared to emerging markets such as India (2.1) and China (1.8) which rank last using this metric.

Although these companies state that they support breastfeeding to some degree, a substantial proportion of their revenues and profits depend on ever-increasing sales of their products, which are substitutes for breastfeeding. They therefore have strong incentives to market these products pervasively and persuasively – which the Index shows they continue to do.

Three companies have made significant improvements in aligning their BMS marketing policies and management systems with The Code. Danone improved both its BMS marketing policy and management systems following the publication of the 2016 Index, and now ranks first in the 2018 BMS Marketing sub-ranking, overtaking Nestlé which slipped to second place. Danone extended its policy in relation to infant formula to include low-risk countries and committed to follow its own policy in countries where the regulations are weaker than its policy. Abbott has also made significant improvements to both its policy and management systems, moving up from fifth to third place in this subranking. Since being acquired by RB, MJN shared documents with ATNI for this Index (which it did not do previously), resulting in a better score.

ATNI undertook two in-country assessments for the 2018 Global Index. In Thailand and Nigeria, many marketing practices were found to not comply with the recommendations of The Code and/or local regulations. This illustrates that, in some cases, the management systems of companies are not being applied effectively. Meanwhile, in other cases, corporate policies do not encompass all the recommendations of The Code, nor all of the products within The Code’s scope.

All four companies rated in the BMS Marketing sub-ranking in Thailand were found to have a low level of compliance (where 2,807 incidences of non-compliance were identified in total). Many fewer instances of non-compliance (130) were found in Nigeria, where local regulation at the time of the study was stricter than that in Thailand. In both markets, the two most extensive forms of marketing identified were:

1. Point-of-sale promotions on online retailers’ sites, and;
2. Products with labels that were not compliant with The Code or local requirements.