Two recent experimental consumer studies conducted in France and Spain – historic protagonists of the Mediterranean diet and good cuisine – confirm once again the effectiveness of the Nutri-Score nutritional labeling system in promoting public health.
1) France, Spain, Italy. The decline of the Mediterranean diet
The population in France, Spain, Italy and all other Mediterranean countries have experienced significant changes in eating habits in recent decades. Average levels of adherence to the Mediterranean diet have declined, often unconsciously, with a serious impact on obesity, including childhood obesity, and related diseases (1,2,3).
The primary cause of the decline of the Mediterranean diet – and of dietary imbalances, in more general terms, even at a global level (4) – is identified in the intense commercial promotion and consequent diffusion of ultra-processed foods, which are often classified as HFSS (High in Fats, Sugar and Sodium).
2) France. Favorable impact of Nutri-Score on the diet of children and adolescents. Study
Nutri-score – the most widespread Front-of-Pack Nutrition Labelling (FOPNL) system in Europe – can play an important role in public health by improving the overall nutritional quality of the diet, which represents a key modifiable risk factor.
A systematic review published in December (Khoury et al., 2024) aims to investigate the ability of the ‘Nutri-Score nutrient profiling model dietary index’ (NS-NPM) to discriminate food consumption and nutrient intake in a population of French children and adolescents. (5)
2.1) Methods
Researchers involved 1279 children and adolescents (50,2% boys and 49,8% girls aged 6 to 17, mean age 11 years), through participation in the ESTEBAN cross-sectional representative survey conducted in continental France.
Food consumption was evaluated with three dietary recalls repeated over 24 hours. Individual dietary indices were calculated by applying the weighted average of the Nutri-Score nutritional profiles of the foods consumed, in relation to energy (kcal).
2.2) Results
Participants with a more favorable dietary index consumed:
– increased amounts of fruits, vegetables, whole grains, milk, poultry, fish products and vegetable oils, as well as
– lower amounts of processed meats and sugary foods.
Dietary indexes are more favorable – and so, diets based on foods with better Nutri-Score scores – also revealed higher intakes of proteins, fibers, vitamins and minerals, as well as lower intakes of fats, saturated and monounsaturated fats, and simple sugars.
The results of the study (Khoury et al., 2024) therefore confirm that the algorithm used to derive nutritional profiles in the Nutri-Score system is a useful tool for characterizing the quality of the diet of children and adolescents, and thus contributes to public health.
3) Spain, the contribution of Nutri-Score to food choices
A recent study conducted in Spain (Samper Márq, 2024) measured the influence of the Nutri-Score logo – on the front of food packaging – on the decision-making process of consumers, in comparison with advertising strategies on food labels. In order to evaluate:
– the degree of influence of advertising messages on consumer decisions
– the ability of the Nutri-Score to counteract external (advertising) influences and help consumers choose the most nutritionally balanced foods
– the possible usefulness of Nutri-Score to improve the healthiness of shopping, selecting the healthiest foods in usual shopping situations, with time limits for the choice. (6)
3.1) Andalusian consumer tests and results
Participants – adult consumers in Andalusia, accustomed to shopping for food – were invited to choose one of three purchasing options, within each product category, with different nutritional characteristics.
The test was conducted in two phases. In the first phase, the products were shown to participants without a nutritional label on the front of the package, while in the second phase, the same products were shown with the addition of the Nutri-Score.
The results show that most participants choose a healthier cart when products have the Nutri-Score logo. This indicates that the inclusion of the Nutri-Score logo can be useful both for consumers interested in healthy eating and for government health policies.
4) Provisional conclusions
Studies under examination further consolidate the already deep-rooted scientific consensus on the value and effectiveness of Nutri-Score to inform consumers on the nutritional profiles of different foods and promote public health, with the specific aim of mitigating the impact of serious and chronic diseases. (7)
Civil society – associations of consumers, patients, doctors and health workers, alongside scientists and research institutes – also calls for the mandatory application of the Nutri-Score, as a nutritional labelling system to be introduced in the EU on all packaged products and ready meals. (8)
The EFSA and ECDC’s One Health report of the European Parliament ‘Current challenges and opportunities for addressing obesity’ has in turn confirmed, in October 2024, that ‘the benefits of introducing the Nutri-Score for public health have been evaluated by several studies‘. (9) When?
Dario Dongo
Footnote
(1) See the paragraph ‘Which Mediterranean Diet?’ in the previous article by Marta Strinati. The benefits of the organic Mediterranean diet. Italian study. FT (Food Times). November 26, 2024
(2) Dario Dongo, Giulia Baldelli. Mediterranean diet and childhood obesity, Europe upside down. GIFT (Great Italian Food Trade).
(3) Sabrina Bergamini, Dario Dongo. Obesity, childhood obesity and marketing. WHO Europe 2022 report. GIFT (Great Italian Food Trade).
(4) Sabrina Bergamini. The obesity ‘pandemic’ affects one in eight individuals. Egalité. 23.3.24
(5) Nadine Khoury, Barthélémy Sarda, Mathilde Touvier, Emmanuelle Kesse-Guyot, Jordi Salas-Salvadó, Nancy Babio, María Ángeles Martínez, Serge Hercberg, Pilar Galan, Pauline Ducrot, Valérie Deschamps, Chantal Julia. Ability of a dietary index based on the updated algorithm underpinning the Nutri-Score to discriminate food consumption and nutrient intake in a French population of children and adolescents. Food Research International, Volume 198, December 2024, 115287 https://doi.org/10.1016/j.foodres.2024.115287
(6) Juan José Samper Márq. Influence of the Nutri-Score logo on the selection of healthy foods. Scientia Omnibus Portus, Volumen 4(8), November 2024. ISSN: 2792-6885 https://tinyurl.com/556s83a5
(7) Dario Dongo. Nutri-Score and prevention of cardiovascular diseases, study in 7 countries. GIFT (Great Italian Food Trade).
(8) Dario Dongo. Health associations’ open letter to EU Commissioners. GIFT (Great Italian Food Trade).
(9) Dario Dongo. Obesity, challenges and opportunities. EU report. GIFT (Great Italian Food Trade).
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.
