The Nutri-Score, a Front-of-Pack Nutrition Labelling (FOPNL) system, has emerged as a pivotal tool in the global effort to improve dietary habits and combat Non-Communicable Diseases (NCDs). A recent Swiss study (Lüthi et al., 2024) delves into the scientific evidence supporting the Nutri-Score’s efficacy, and the importance of continued research and dialogue on this system to enhance its implementation in Europe and beyond.
Despite the evidence on the need to prioritise citizens’ health in food and nutrition policies, the new EU’s Vision for Agriculture and Food does not consider neither the epidemics of Non-Communicable Diseases (NCDs) linked to unbalanced diets, nor the European Commission’s duty to harmonise Front-of-Pack Nutrition Labelling (FOPNL) systems in the Single Market. A call for action, to follow.
Nutri-Score: a brief overview
The Nutri-Score system, developed by Santé Publique France on the basis of University of Oxford and FSA (Food Standard Agency) nutrient profiling system, employs a simple, colour-coded scale from A (green) to E (red) to indicate the nutritional quality of food products.
This system aims to guide consumers towards healthier choices within the same product category, by evaluating the content of beneficial nutrients (such as proteins, fruits, vegetables, and fibres) against harmful ones (like sugars, salt, and saturated fats).
Several studies have validated the Nutri-Score’s effectiveness. A landmark study by Deschasaux et al., (2020) involving 500,000 individuals across ten European countries demonstrated a significant correlation between diets with lower Nutri-Scores (closer to red) and higher mortality rates.
The Swiss study
The study by Lüthi, Badran-Amstutz, and Cornuz (2024), published in Médecine de première ligne, examines the Nutri-Score system’s role in public health and its implications for patient-doctor interactions.
Objectives
The primary objective is to equip healthcare professionals with current, evidence-based information on Nutri-Score, enabling them to discuss its benefits and limitations effectively with patients. The study is grounded in a review of existing scientific literature, policy documents, and practical insights from clinical settings, aiming to bridge the gap between scientific research and everyday medical practice.
Methodology
The study employs a comprehensive literature review, analysing over 40 studies on Nutri-Score’s efficacy, alongside policy documents and practical insights from clinical settings. The authors also incorporate feedback from healthcare professionals and patients to provide a holistic view of the system’s impact on public health and medical practice.
Researchers further explore how Nutri-Score has influenced patient-doctor dynamics. With the rise of accessible nutritional information, patients are now more informed and expect healthcare providers to guide them on dietary choices. This shift represents a move away from the traditional top-down flow of information, fostering a more collaborative approach to health management.
Discussion
The Nutri-Score labelling system helps consumers make healthier choices by comparing products within the same category. The authors emphasise the scientific evidence supporting the efficacy of Nutri-Score in improving dietary choices, also by linking diets with lower Nutri-Scores to higher mortality rates, underscoring its potential public health benefits.
However, Nutri-Score does not account for other factors such as the degree of food processing, the presence of additives, or pesticide content, which are increasingly recognised as significant determinants of health outcomes. These factors can’t be calculated within a logo based on nutrition values, it’s worth to add, but may be tackled through complementary information and other measures, such as:
- the ‘ultra-processed’ information that Nutri-Score creator Professor Serge Hercberg proposed in 2021 to add to the NS logo, with a black background surrounding it;
- fiscal incentives to the consumption of organic foods, such as a thorough reduction of VAT and ad hoc ‘food stamps’
Challenges
Regarding industry response, the study notes that while Nutri-Score aims to encourage healthier product formulations, its voluntary nature has led to inconsistent adoption. Some companies have withdrawn the label following algorithm updates that negatively impacted their product scores, rather than embracing the challenge of balancing public health goals with industry interests.
While some industry players are resisting mandatory adoption due to potential impacts on product sales until they will improve their nutritional profiles, it is essential to highlight the long-term benefits of reformulation. Companies that proactively improve their product formulations to achieve better Nutri-Scores can enhance their brand reputation and meet growing consumer demand for healthier options.
Conclusions
The authors advocate for improved communication strategies to increase public awareness of Nutri-Score. They suggest that healthcare providers play a crucial role in educating patients about the system’s benefits and limitations. By integrating Nutri-Score into patient-doctor discussions, healthcare professionals can foster informed decision-making and improve overall health outcomes.
European Commission’s duties
The European Parliament, in its resolution dated 20 October 2021, urged the Commission to adopt nutrition profiles and to introduce a harmonised FOPNL, such as the Nutri-Score. And the European Court of Auditors, in its report on food labelling in the EU (2024), recommended the Commission to close these gaps. Key arguments to present include:
- public health benefits. A mandatory Nutri-Score system would provide clear, consistent information to consumers, helping them make healthier choices and reducing the prevalence of NCDs;
- economic efficiency. Harmonisation would reduce costs for businesses by eliminating the need to comply with multiple national labelling systems, fostering a more efficient Single Market;
- consumer trust. A unified system would enhance consumer trust and confidence in food labelling, promoting transparency and accountability in the food industry and the system.
Future directions
The Nutri-Score represents a significant advancement in nutritional labelling, offering a straightforward tool for consumers to make healthier food choices. As highlighted by Lüthi, Badran-Amstutz, and Cornuz, enhancing communication and understanding of the Nutri-Score among healthcare providers and the public is crucial.b
Future efforts should focus on advocating for its broader, possibly mandatory, adoption to maximise public health benefits.
The mandatory adoption of Nutri-Score as the harmonised FOPNL system in the European Single Market represents a significant opportunity to improve public health, enhance economic efficiency, and foster consumer trust. European policy-makers must prioritise this initiative to create a unified and effective approach to nutrition labelling.
Dario Dongo
References
(1) Lüthi, E., Badran-Amstutz, W., & Cornuz, J. (2024). Nutri-Score : que dire aux patientes et patients sur ce thème scientifique d’actualité ? Médecine de première ligne. DOI: 10.53738/REVMED.2024.20.894.2063.
(2) Deschasaux, M., et al. (2020). Association between nutritional profiles of foods underlying Nutri-Score front-of-pack labels and mortality: EPIC cohort study in 10 European countries. BMJ, 370, m3173. DOI: 10.1136/bmj.m3173.
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.
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