Nutri-Score Remains the Front Runner for Europe's Food Label Program

The pop­u­lar­ity of Nutri-Score across the European Union con­tin­ues to rise in the bloc’s bid to har­mo­nize all front-of-pack label­ing (FOPL) sys­tems by 2022.

In Germany, the adop­tion of Nutri-Score con­tin­ues to gain trac­tion, with more major food com­pa­nies opt­ing to label their prod­ucts with the French-born FOPL.

Belgium, the Netherlands and Switzerland are fol­low­ing suit, while Luxembourg and Spain are prepar­ing for their own Nutri-Score national roll-outs as well.

Additionally, the European Consumer Organization, which includes 44 national con­sumer asso­ci­a­tions from 32 dif­fer­ent coun­tries, has already expressed its full sup­port for Nutri-Score.

Despite the oppo­si­tion of some E.U. coun­tries, such as Italy and Czech Republic, Nutri-Score remains the front-run­ner among sev­eral other alter­na­tives to be adopted as an E.U.-wide FOPL

All of this should not come as a sur­prise, accord­ing to Pilar Galan, a senior mem­ber of the nutri­tional epi­demi­ol­ogy research team at the Sorbonne Paris Nord University.

“The imple­men­ta­tion of Nutri-Score on food packs is a ben­e­fit for pub­lic health and for con­sumers,” she told Olive Oil Times. ​“It helps them to make health­ier food choices at the point of pur­chase by deliv­er­ing sim­ple at-a-glance nutri­tional infor­ma­tion, per­mit­ting them to com­pare nutri­tional qual­ity eas­ily across food prod­ucts.”

Comparing prod­ucts within the same cat­e­gory of food is the main point of con­tention for Nutri-Score since it is both a dis­tin­guish­ing fea­ture of the FOPL and the most crit­i­cized for those who oppose the labels.

Nutri-Score assigns a color (from green to red) and a let­ter (from A to E) to clas­sify the prod­uct, which is eval­u­ated for its con­tents per 100 grams or 100 mil­li­liters. The Nutri-Score design also asks the con­sumer to eval­u­ate prod­ucts accord­ing to their spe­cific cat­e­gory.

“Foods belong­ing to the same cat­e­gory or same food item pro­posed by dif­fer­ent brands, or foods belong­ing to dif­fer­ent cat­e­gories only if they are truly rel­e­vant, [so that con­sumers] com­pare foods that are com­pa­ra­ble in their con­di­tions of usage or con­di­tions of pur­chase,” Galan said.

Despite this, many in the olive oil sec­tor believe that the ​“Yellow C” assigned by Nutri-Score to any olive oil does not cor­rectly rep­re­sent the proven health ben­e­fits of extra vir­gin olive oil, which, in their view, means that the label mis­leads the con­sumer.

They believe that extra vir­gin olive oil should be placed in the top healthy food cat­e­gory, the ​“Green A,” as recently stated, by Spanish extra vir­gin olive oil pro­duc­ers and oth­ers.

However, Galan argues that Nutri-Score does not penal­ize olive oil and instead demon­strates to con­sumers that it – along with rape­seed oil and wal­nut oil – is prefer­able to most other veg­etable oils and ani­mal fats.

“Nutri-Score in no way penal­izes olive oil,” Galan said. ​“Olive oil is rated C, which is the best score for added fats, sea­son­ing or cook­ing, and even veg­etable oils. This rank­ing is fully con­sis­tent with pub­lic health rec­om­men­da­tions. In Spain, as else­where, [those rec­om­men­da­tions] do not sug­gest the con­sump­tion of olive oil with­out limit.”

“If con­sumers want to choose a bot­tle of oil, thanks to the Nutri-Score label placed on the super­mar­ket prod­ucts, they will eas­ily see that olive oil is the best rank­ing com­pared to other oils,” she added.

Galan, who is also the co-author of sev­eral stud­ies on Nutri-Score that have been pub­lished by some of the most rel­e­vant sci­en­tific jour­nals, said that the pub­lic health deci­sions that have thus far led to the imple­men­ta­tion of Nutri-Score are mostly based on epi­demi­o­log­i­cal data and not ​“on the speci­fici­ties of the nutri­tional com­po­si­tion of foods and their poten­tial effects on phys­i­o­log­i­cal func­tions.”

“This sup­ports the rec­om­men­da­tions for olive oil, both for pub­lic health rec­om­men­da­tions and for con­sid­er­a­tion in the pos­i­tive ele­ments included in the cal­cu­la­tion of the Nutri-Score,” she said.

“It is essen­tially the results of epi­demi­o­log­i­cal stud­ies, in par­tic­u­lar the tri­als of inter­ven­tions, which clearly demon­strate the impact on the health of olive oil and in par­tic­u­lar to the pre­ven­tion of car­dio­vas­cu­lar dis­eases,” Galan added.

However, many in the olive oil sec­tor believe that Nutri-Score does their prod­uct a dis­ser­vice by com­par­ing it to other veg­etable oils – most of which can­not be extracted mechan­i­cally as vir­gin and extra vir­gin olive oils are and instead undergo a chem­i­cal process requir­ing pow­er­ful sol­vents to extract the oils.

Galan coun­ters that the data from her epi­demi­o­log­i­cal work and meta-analy­ses demon­strate that the other veg­etable oils graded with a C by Nutri-Score (namely rape­seed oil) also have health­ful prop­er­ties. She added that while olive oil is typ­i­cal of the Mediterranean coun­tries, any E.U.-wide FOPL has to con­sider other food cul­tures within the bloc too.

On top of all of this, Galan empha­sized that Nutri-Score uses an open-source algo­rithm to cat­e­go­rize the food grades, mak­ing it an objec­tive way to com­pare dif­fer­ent foods of the same cat­e­gory.

“The label is based on an offi­cial algo­rithm that is pub­lic and acces­si­ble to all, pre­cisely described on the web­site of the French pub­lic health agency, Santé Publique France,” she said. ​“The process that allows it to clas­sify foods is totally trans­par­ent and makes it pos­si­ble for food com­pa­nies to use it eas­ily and for every­one to ver­ify the cor­rect attri­bu­tion of the color and let­ter of the Nutri-Score.”

Galan main­tained that Nutri-Score in no way penal­izes the Mediterranean diet, a crit­i­cism fre­quently levied by the staunchest crit­ics of the FOPL.

In Italy, pro­duc­ers and gov­ern­ment offi­cials have voiced con­cerns about the clas­si­fi­ca­tion for spe­cialty foods, includ­ing extra vir­gin olive oil and tra­di­tional items such as Pecorino Romano or Prosciutto San Daniele.

Many believe that lower clas­si­fi­ca­tions for such spe­cial­ties are not con­sis­tent with the healthy sci­en­tif­i­cally-proven pro­file of the Mediterranean diet.

However, Galan points out that the Mediterranean diet closely mir­rors the Piramide Universale, which rec­om­mends a mod­er­ate-level con­sump­tion of dairy prod­ucts and low con­sump­tion of processed meats.

“When com­par­ing the rec­om­men­da­tions of the pyra­mid of the Mediterranean diet and the Nutri-Score, one actu­ally notes the good con­ver­gence,” she added.

As a result, it should not come as a sur­prise if many tra­di­tional cold cuts, cheeses and other cured meats are clas­si­fied by a D or even an E, Galan said, ​“because they con­tain sig­nif­i­cant amounts of sat­u­rated fats and salt and are also high in calo­ries. But like all prod­ucts clas­si­fied D or E under Nutri-Score, cheeses and cured meat can per­fectly be con­sumed as part of a bal­anced diet.”

“Informing con­sumers about the actu­al­ity of the nutri­tional qual­ity of these tra­di­tional food prod­ucts does not pre­vent con­sum­ing them but, of course, in lim­ited quan­ti­ties and fre­quen­cies, which is totally con­sis­tent with the prin­ci­ples of the Mediterranean diet model and with the mean­ing of their clas­si­fi­ca­tion on the Nutri-Score scale,” she added.

According to Galan, Nutri-Score is also a use­ful tool because it can be applied retroac­tively to his­tor­i­cal stud­ies on health and nutri­tion. This helps give researchers a bet­ter idea of how the imple­men­ta­tion of Nutri-Score may impact con­sumer choices and their con­se­quences on health.

“Several cohort stud­ies on a large sam­ple of pop­u­la­tions fol­lowed for many years in France, Spain and at a European level have shown that the con­sump­tion of foods with more favor­able rat­ing in the Nutri-Score scale is asso­ci­ated with a lower risk of devel­op­ing chronic dis­eases, includ­ing can­cers, car­dio­vas­cu­lar dis­eases, weight gain and meta­bolic syn­drome,” Galan said.

She cited the SUN cohort study in Spain as an exam­ple, which fol­lowed 20,000 par­tic­i­pants over a period of 10 years.

“[The results showed that] the con­sump­tion of foods with less favor­able clas­si­fi­ca­tions on the Nutri-Score scale was asso­ci­ated prospec­tively with a higher rate of all-cause mor­tal­ity and can­cer mor­tal­ity, but also that the Nutri-Score cal­cu­la­tion algo­rithm was per­fectly con­sis­tent with the Mediterranean diet model.”

Galan added that other stud­ies com­par­ing con­sumer habits had demon­strated that shop­pers with access to the infor­ma­tion pro­vided by Nutri-Score made health­ier choices than those who did not. In the same study, Nutri-Score also out­per­formed other FOPLs.

“According to the stud­ies, the over­all nutri­tional qual­ity of the shop­ping cart improved from 4.5 to 9.4 per­cent by the use of Nutri-Score, and the effect of Nutri-Score was par­tic­u­larly clear in dis­ad­van­taged pop­u­la­tions,” she said.

As a result of these types of stud­ies, Nutri-score’s adop­tion is rec­og­nized as a ​“best prac­tice” in the fight against social inequal­i­ties in can­cer pre­ven­tion by the E.U.-sponsored Innovative Partnership for Action Against Cancer (iPAAC) com­pe­ti­tion.

Away from the data and mod­el­ing stud­ies, Nutri-Score has also proven to be immensely pop­u­lar in France, which was the first coun­try to adopt the sys­tem vol­un­tar­ily.

“Indeed, three years after its adop­tion, Nutri-Score appears as a well-known and sup­ported logo that is increas­ingly impact­ing pur­chas­ing behav­iors of French con­sumers,” Galan said.

According to the researcher, the lat­est data show that 94 per­cent of the French pop­u­la­tion approves the Nutri-Score pres­ence on the pack­ag­ing. In com­par­i­son, 89 per­cent believe that the label should be made manda­tory.

Galan added that con­sumer sup­port had a key role in dri­ving the food com­pa­nies to Nutri-Score.

“When first pro­posed by the sci­en­tists in France, absolutely no com­pany sup­ported Nutri-Score,” she said. ​“Only six com­pa­nies were engaged in October 2017 when Nutri-Score was adopted in France. In May 2018, around 40 com­pa­nies were involved.”

“Due to the pres­sure of con­sumers and sci­en­tific work sup­port­ing the inter­est of Nutri-Score as an impor­tant pub­lic health tool, more com­pa­nies com­mit­ted to Nutri-Score and today 520 com­pa­nies with 690 brands have reg­is­tered in France to dis­play Nutri-Score,” Galan added.

She also noted that a grow­ing num­ber of food pro­duc­ers are refor­mu­lat­ing some of their prod­ucts to improve their nutri­tional pro­file and raise their Nutri-Score grades.

Some E.U. coun­tries such as Austria, Portugal, and Poland are con­sid­er­ing adopt­ing Nutri-Score. Others, includ­ing Sweden or Denmark, intro­duced local food labels decades ago, and author­i­ties do not seem eager to embrace the French FOPL.

Italy, which has voiced its oppo­si­tion to Nutri-Score on mul­ti­ple occa­sions, has also intro­duced its own FOPL – Nutrinform Battery.

“A com­mon food label would be use­ful for European con­sumers, food com­pa­nies, food trade and the mar­ket,” Galan said, in ref­er­ence to an E.U.-wide FOPL. ​“Because of its strong sci­en­tific back­ground, Nutri-Score has been at the core of the E.U. debate on the mat­ter for sev­eral months.”

“However pow­er­ful lob­bies relayed by some mem­ber states, espe­cially Italy, use totally untruth­ful state­ments to dis­credit and block the choice of Nutri-Score at a European level,” she added.

According to Galan, Italy sup­ports ​“a mono­chrome label miss­ing any sci­en­tific sub­strate and whose prin­ci­ple and graphic rep­re­sen­ta­tion are very close to the guide­line daily amounts and ref­er­ence intakes set up by food com­pa­nies in the 2000s, and demon­strated by many stud­ies to be totally inef­fec­tive.”

Regarding the Scandinavian Keyhole FOPL, Galan said that the three-decade-old binary label was no longer con­sid­ered the most effec­tive way to help con­sumers under­stand food qual­ity and nutri­tion.

She added that E.U. should seek to adopt a ​“sin­gle and manda­tory model of nutri­tional label” based on the lat­est sci­en­tific approach to health and nutri­tion.

“Nutri-Score relies on the large range of sci­en­tific val­i­da­tion stud­ies that fol­lowed the method­ol­ogy pro­posed by the World Health Organization Europe,” Galan said. ​“These stud­ies demon­strated the rel­e­vance of the com­pu­ta­tion algo­rithm and the effec­tive­ness of its graphic for­mat.”

“No other labels present such a sci­en­tific back­ground,” she added. ​“All the stud­ies car­ried out with a rig­or­ous method­ol­ogy showed a supe­ri­or­ity and bet­ter per­for­mance of Nutri-Score com­pared to other labels.”