A high proportion of the sampled products in this study displayed nutritional facts. Despite this fact, the Saudi Food and Drug Administration published a report in 2018 showing that 55% of the Saudi population do not read food labels and 56% do not know the correct meaning of a portion size. Apparently, the absence of a standard label format makes it more difficult for consumers to read and compare nutritional facts between products. Therefore, a standard label format will provide a great opportunity to guide the population in choosing healthier products. Language is also a significant barrier for reading nutritional labels, as only half of the information was printed in Arabic (the official and spoken language in the country) and a small fraction of the products had the nutrition label on the front the package. Contrary to this lack of good practice in the Saudi Arabian food industry, almost half of the European products have their nutritional labels on the front of the package [10]. It has been documented in the literature that front-of-package nutrition labeling is more likely to be viewed by consumers, compared with rear nutrition panels [14].
Despite the high percentage of products that displayed nutritional facts, only a small percentage complied with SFDA’s recent regulations. Compared with other countries, compliance with SFDA’s regulation is inferior to what has been reported for other countries’ compliance with their own standards of reporting nutritional facts such as India [15], Serbia [16], and China [17]. Higher compliance with reporting regulation for imported products compared with local products could be because of strict regulations for importing into Saudi Arabia. All products imported into Saudi Arabia should be registered and approved before being allowed to cross the border[15]. Most surveyed products in this study contained more nutrients than are needed by the living human body daily. Excess intake of sugar, fat, and sodium has been linked to an epidemic of diet-related diseases such as obesity, diabetes and hypertension, which have been considered leading causes of morbidity and mortality in Saudi Arabia [16]. Locally, the SFDA launched the strategic plan for healthy food in Saudi Arabia as part of the 2030 vision. It includes reducing sugar, salt, and fat contents in prepackaged foods in addition to advice which includes sugar declaration, nutritional facts, and limiting the use of hydrogenated fat [17].
Similar to a study conducted in Canada [11], the results of this study showed that prepackaged confectionary products are the most sugar-dense food on the Saudi market. High amounts of sugar were also found in bakery and cereal products. It is hard to tell if the sugar content in the sampled products is a natural content of the food product or an added ingredient, since at the time of collection of data for this study, sugar content was not a mandatory declaration for labels on packaged food in the country. The proportion of products with high sugar contents were about 40% of the total products analyzed. There is no available data about the consumption of sugar by the Saudi population. One report by Euromonitor International placed Saudi Arabia as number 9 in the world in the consumption of soft drinks at 89 liters per capita, meaning that Saudis consume at least 26 g of free sugar daily from soft drinks only [18]. Excess intake of sugar is associated with an increased rate of obesity, non-communicable disease risk, and dental caries. The intake of free sugars is supposed to be less than 10% of total energy intake based on WHO recommendations [19]. On the other hand, the Saudi government started enforcing taxes on soft drinks and energy drinks in April 2017, which will have a long-term effect on lowering consumption of sweetened beverages [20].
The average sodium level in prepackaged foods varied widely with remarkable differences in the mean level between food categories. More than half of the total products analyzed have high or medium sodium contents that exceeded the daily intake limits. The sodium content was the highest in snacks and sauces and spreads. Within each food category, our results were similar to those of other countries. Similar to products in the United States market [23], sauces and spreads displayed the highest sodium content. Excess sodium intake is the second dietary factor for numerous diseases worldwide [5]. In this study, surveyed bakery products showed a low mean sodium content, thus complying with the recommendation of the SFDA for less than 1 gram for each 100 grams for any type of bread [21].
Sodium reduction regulations have been effective in controlling the normal salt consumption of populations and are considerably more powerful than only instructing people about the need to reduce salt intake [22]. In Canada, a targeted 16.2% significant reduction in sodium levels with a 25% decrease in products with high sodium levels was achieved after a national sodium reduction strategy [23]. New Zealand and the UK also have similar successful strategies to decrease salt in prepackaged food [24, 25].
The 2015–2020 Dietary Guidelines for Americans recommended consuming less than 2,300 mg of sodium each day. In Saudi Arabia, one study measured the adult intake of salt as 3220 mg per day, which exceeded the recommended daily intake [26].
Our survey demonstrates that industrial use of hydrogenated fat is common in the Saudi market, particularly in some food categories. These results are concerning since trans-fats are harmful to the body, particularly regarding the advancement of dyslipidemia and CVD. [15] A systematic review of 32 articles indicated that trans-fat bans would reduce heart disease risk. [27]
Recognizing the trans-fats in any products could be difficult for consumers since the names vary and, accordingly, prevent them from eliminating this sort of fat from their diet. In addition, manufacturers are permitted to label products containing between 0 and 0.5 g of trans-fats per serving as “0 grams” in Saudi Arabia, the United States, and Codex [28]. Decreased use of trans-fats in the Saudi market is conceivable yet banning these fats has not been accomplished; nearly two out of 10 prepackaged food products contain hydrogenated fat.
A main limitation of this study is that the accuracy of the nutritional facts displayed on food labels was not validated by laboratory analyses of content. Similar studies conducted in other countries have shown good correlation between data on the label and the results of chemical analyses [29, 30].