Global Index

India Spotlight Index

Global Index 2018

FAQ Global

Why was the Index established, and by whom?

The rationale for the Index is simple: obesity and undernutrition affect over three billion people and threaten a global health catastrophe. Globally one in three people are now either undernourished, overweight or obese. Over the next ten years malnutrition is set to continue to increase. Over the last 35 years obesity has more than doubled and it has now reached epidemic proportions. Obesity and diet-related diseases affect countries of all income levels. Globally 41 million children under 5 are considered to be overweight, and the bulk (31 m) live in developing countries. By 2030 half of the world population is expected to be overweight or obese. The costs for the obesity epidemic is now approximately 2 trillion USD annually, which is around 3% of global GDP.  At the same time undernutrition affects billions of people globally, increasingly in the form of hidden hunger where people have sufficient food but lack access to adequate micronutrients. Half of the deaths of young children are linked to undernutrition and a substantial amount (12%) is attributed to sub-optimal breastfeeding. Without the support and engagement of the food and beverage industry, it would be impossible to tackle this challenge. The aim of the Index is therefore to promote a more objective public debate around these issues, and encourage companies to do more to address nutritional needs of customers and society at large.

ATNI was conceived by the Global Alliance for Improved Nutrition (GAIN) in 2010. GAIN was then joined by two other leading global not-for-profit bodies concerned about health and nutrition issues: the Bill & Melinda Gates Foundation and the Wellcome Trust. Together they incubated and funded the development of ATNI as a comprehensive and independent assessment of the nutrition policies and practices of the largest companies in the food and beverage industry. From the outset, the three partners determined that ATNI would transition after its initial Index to be an independent body with its own legal structure, governance and funding arrangements. In 2013 the Access to Nutrition Foundation was therefore established in Utrecht, the Netherlands.

For the 2016 Index, the Children’s Investment Fund Foundation (CIFF) joined the Bill & Melinda Gates Foundation and the Wellcome Trust in funding the Index. GAIN is no longer involved in the operations nor the funding of ATNI.

ATNI is now being embraced as an independent benchmarking and accountability tool that works with industry, nutrition experts and civil society to measure companies’ contributions to good nutrition against international norms and standards. Since the first Index, companies have increased their engagement with the research process (17 out of 22 were actively engaged). This shows a positive trend highlighting how the Index can enable the food and beverage industry to shape their policies and practices to help consumers around the globe eat better food. 

Why should companies get involved in trying to improve global nutrition?

Due to the pervasive and increasing role of their products in diets in many countries, global food and beverage manufacturers have the potential to make a powerful contribution to addressing these challenges through their business practices and through their non-commercial and philanthropic giving. This is a social responsibility but it’s also in the companies’ financial and business interests as consumers worldwide are increasingly demanding healthier foods and more ethical practices from companies. 

When will the next Index be published?

The next global ATNI is expected to be published in 2020 or 2021. The frequency of launching the Global Index will be part of the evaluation of the Global Index tool that is going to be conducted in the second half of 2018.

Why does the undernutrition methodology focus only on fortified products?

Not exclusively, though it is designed to a large degree to evaluate the extent to which they are developing fortified products for priority populations in countries with the highest levels of undernutrition. ATNI assesses companies on a broad range of activities that they undertake to improve access to nutritious foods, both with respect to the products they make and how they exercise their influence on consumer choice and behaviour. Companies undertake additional activities that are specific to addressing undernutrition, including their efforts around fortified products or otherwise healthy products that respond to certain nutrient deficiencies among high risk consumers in developing markets. The extent to which they contribute in other ways to programs to address undernutrition (e.g. through philanthropic donations or providing other types of support) is also assessed. This approach was developed with the advice of the ATNI Expert Group and feedback from the stakeholder consultation on the methodology.

Were all companies assessed on all aspects of the methodology?

Only companies with more than five per cent of sales in non-OECD countries are assessed on undernutrition. As a result, Campbell, ConAgra, General Mills, Meiji were not assessed on undernutrition. Ferrero has, furthermore, not been assessed on commercial indicators related to the fortification of their products because their products, mainly chocolate products, cannot be fortified. Also some companies were not assessed on certain aspects that did not relate to their business: e.g. some companies were not assessed on fruits and vegetables targets because their products do not contain these nutrients.

Why are you looking at companies’ efforts to address undernutrition in addition to their general practices on nutrition?

The ATNI recognizes that food and beverage companies can play a role in addressing both challenges. The global F&B industry is enormous: It grew by 25% between 2011 and 2016, faster than the world population, and generated close to $2.7 trillion in revenue in 2016.39.  In particular, there is significant untapped potential for companies to address undernutrition commercially by developing healthy products that address undernutrition issues, particularly as they expand their presence in markets where undernutrition is still prevalent. In emerging and developing markets sales of packaged foods increased at ten times the rate of high-income countries between 2008 and 2013.

Has the Index methodology changed since the first Index?

New editions of Indexes are always updated in line with newly developed knowledge, guidelines and policies on nutrition. However, the changes for the third Index (2018) were not so extensive as in 2016. As 2013 was the first time that the Index was carried out, there were many learnings from the process and the methodology. The structure of the Corporate Profile methodology for the 2018 Index has not changed since 2016, which means that scores can be compared to the 2016 Index overall. Nonetheless, some indicators were updated in line with changes to international and national guidelines, norms and accepted good practices. The approach to assessing companies’ reformulation targets has also been strengthened considerably by focusing on their major product categories.

A new element to the third edition of the Global Index is a Product Profile that assesses the nutritional quality of the Index constituents’ products. The outcomes of the Product Profile have however not (yet) been incorporated in the Global Index scoring/ranking, but are reported in a separate ranking.

The BMS Marketing Corporate Profile methodology for this Index remains consistent with that of the previous Index (apart from a few small changes) in order to retain comparability. The methodology for the in-country assessments has been updated. It is based on the 2015 edition of the Network for Global Monitoring and Support for Implementation of the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly Resolutions (NetCode).

What value does this Index add beyond information that is already in the public domain?

The Access to Nutrition is currently the only independent means of comparing companies to each other on their global performance on delivering better access to nutrition through all relevant business functions. ATNI’s assessment is based on international guidelines and experts’ guidance. Companies are assessed not only on publicly available information but also on information not in the public domain that was obtained through direct engagement with them.

How can you compare these companies to each other when their product portfolios are so vastly different?

ATNI aims to evaluate the contribution all of the companies are making to improving consumers’ access to nutrition. This is done by evaluating their efforts on improving their product portfolio, how they support consumers in understanding what comprises a healthy diet and a healthy lifestyle, how they label their products, how they present them in marketing materials, whether they offer a wide choice of products in varying sizes, and how they engage with governments and policymakers. Companies can improve their nutrition-related practices in all of these areas regardless of the composition of their product portfolios.

We are confident that the methodology used provides both a common platform through which to evaluate companies as well as being flexible enough to accommodate different business models and product portfolios. 

Has ATNI received financial contributions from industry for the development of the Index?

No. ATNI has a strict policy against accepting any financial contributions from companies or organizations that are part of the food and beverage industry. ATNI’s conflict of interest policy is posted on its website.

Is this an investable index?

While ATNI is not intended to be an investable index, it does have the support of both investment managers and large institutional asset owners from around the world. ATNI has produced an Investor Statement in support of the Index, and its current signatories collectively manage over $3.0 trillion. ATNI is designed to be of value to them by providing insights into companies’ performance on nutrition issues which can be integrated into their financial analyses or used as a basis for engagements with companies on these critical issues.

How does ATNI’s scoring work? Is it absolute or relative?

Companies are scored on an absolute scale from 0 to 10 using a system that rewards good practices rather than penalizing poor ones. A score of 0 indicates that no evidence was found for any nutrition-related commitments or practices. A score of 10 signifies best practice as determined by consensus judgments against established international codes and guidelines and other norms set out in the ATNI assessment methodology. 

Does ATNI address issues such as companies' use of genetically modified organisms, impact on water and the environment, sourcing practices, and labor practices?

  • In this first version of the Index, ATNI confined its scope to those issues that are most important to improving access to nutrition.
  • As such, ATNI does not evaluate companies on other important ways in which they  may have a social and/or environmental impact. Other ratings address some of these issues, such as Oxfam's Behind the Brands Scorecard, which reviews the social and environmental impacts that ten large food and beverage companies are having on the food supply chain.

How is ATNI determining which foods are healthy?

ATNF assesses the healthiness of companies’ portfolios using the Product Profile, a new element of this edition of the Global Index. The nutritional quality of the companies’ products has been analysed by an independent research organization. While there is currently no universally accepted system for determining the nutritional quality of products, and therefore no one international standard for what can be considered a “healthy” product, ATNF has used two well-verified, independently developed nutrient profiling systems - the Health Star Rating System (HSR) and the WHO Euro model. These models were selected after careful consideration and the advice of the Expert Group. The results of the PP as not yet incorporated in the Index score however. See Product Profile section below.

Within the Corporate Profile methodology, however, several indicators depend on companies’ own definitions of “healthy” products, which can vary significantly. Having only introduced the PP for the first time, ATNI is not yet in a position to factor the results of the PP into the Corporate Profile methodology. Instead, we evaluate how strong each company’s nutrient profiling system is that it uses to define what are healthy products and use that score to determine a multiplier that is applied wherever the methodology is evaluating companies’ policies, targets or actions relating to ‘healthy’ products.

Ideally, in future, that multiplier will be based on the score achieved in the Product Profile.

How has ATNI assessed the nutritional quality of companies’ products?

Two nutrient profiling systems were selected that met the qualitative criteria developed by ATNF’s Expert Group and based an extensive analysis of a very large number of NPS in existence, by Professor Mike Rayner for the WHO.

The criteria were that the systems must be: developed with appropriate stakeholder consultation; cover the majority of categories of processed food and beverage products; take account of both positive and negative nutrients; not designed solely to address school foods, given requirement to assess foods on the general market; well-validated with results published in the peer-reviewed literature demonstrating that the models produce internally consistent classifications of ‘healthy’ and ‘unhealthy’ foods, consistent with general nutrition principles; enable differentiation of nutritional quality within and between categories; algorithm in the public domain so as to be able to access and apply it.

The Australian Health Star Rating nutrient profiling system was used to determine how healthy each product is. Products are rated between 0.5 stars (least healthy) to 5 stars (most healthy). 

The WHO Regional Office for Europe Nutrient Profile Model (WHO EURO) was used to identify which products are suitable to be marketed to children.

How can some companies with unhealthy product portfolios score so well on ATNI?

ATNF evaluates the contribution all companies are making to improving consumers’ access to nutritious foods around the world. This is determined both by efforts that companies have undertaken to improve the nutritional quality of their product portfolios and the efforts they make in many other aspects of their businesses, such as how they support consumers in understanding what comprises a healthy diet and a healthy lifestyle, how they label their products, how they present their products in marketing materials, offering a wide choice of products in varying sizes, and how they engage with governments and policymakers. Thus if a company with a seemingly less healthy portfolio receives a higher overall score on the ATNI, it is due to strong performance in categories other than Category B (which looks only at their products). We have also introduced to this Index for the first time the Product Profile, undertaken by independent researchers, which assesses how healthy companies’ products actually are. Stakeholders can put the Index scores and ranks side-by-side with the Product Profile results and see more clearly how the companies’ commitments, policies and disclosure compare to the actual nutritional quality of their portfolios.

Could companies elect whether to be included in the Index?

Companies did not have a choice whether to be included in ATNI. Companies also could not pay to be evaluated. However, companies had the option not to take part in the engagement phase of the research. For companies that chose not to participate, their evaluation was based solely on publicly available information.

How is the Access to Nutrition Index used?

The results of ATNI allow for comparison of company performance on delivering better access to nutrition as measured against international guidelines and expert guidance.

  • Companies (including both those ranked and not ranked by ATNI) may use this information to benchmark their performance against peers or to help guide their agenda for nutrition activities.
  • Investors may use this information to guide their engagement with companies and/or investment decisions.
  • Norm-setting bodies may use this information as an input into guideline development, including the identification of areas which currently lack such guidance.
  • Policymakers may use this information to identify areas in need of industry-wide improvement which may be amenable to regulatory intervention.
  • Civil society organizations may use this information to guide their advocacy efforts.
  • Academics may use this information to identify areas in need of further research.
  • Media organizations may use this information to draw attention to priority, or otherwise under-recognized, issues.


Why is this Index important?

This Index underscores the important role of food and beverage manufacturers in addressing obesity and undernutrition, both of which are among the world’s most pressing public health concerns. These public health challenges affect billions of people, and efforts to address them are vital to ensure that people around the world can live healthy and productive lives.

Due to the pervasive and increasing role of their products in diets in many countries, global food and beverage manufacturers have the potential to make a powerful contribution to addressing these challenges through their business practices and through their non-commercial and philanthropic giving.   

The ATNI is the only systematic effort to compare companies’ contribution to addressing global nutrition challenges in a consistent way. It provides all those concerned with addressing obesity and undernutrition with an objective picture of what companies are already doing, where they are doing well and where they can improve. In this way it focuses attention on where corporate practices are weak or inconsistent and where additional intervention is needed, either by companies, through further research or changes to government policy. Because of its rigorous methodology, it helps to move beyond the anecdotal and to present a compreunhegenuine collaborative action.

Improving nutrition for all

The Access to Nutrition Index rates food and beverage manufacturers´ nutrition-related policies, practices and disclosures worldwide on a recurring basis.


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