The challenge of ensuring nutritional quality in school food environments represents a critical public health priority, particularly in addressing the rising prevalence of childhood obesity and diet-related non-communicable diseases across Europe. School meal programmes serve as pivotal interventions for promoting healthy dietary behaviours amongst adolescents, yet the complexity of food procurement decisions and the broadly formulated nature of existing guidelines present significant implementation challenges.
Amberntsson and colleagues (2025) conducted a groundbreaking evaluation of the Nutri-Score system as a potential tool for guiding and evaluating food procurements in Norwegian high schools, addressing a crucial gap in the literature regarding the practical application of nutrient profiling systems in institutional food service settings.
The Norwegian context presents unique challenges for school food procurement. The Norwegian Directorate of Health has established school meal guidelines to advocate for the availability of healthy food options; however, awareness and adherence amongst school officials and canteen staff remain demonstrably low (Amberntsson et al., 2025).
The broadly formulated nature of these guidelines complicates both the evaluation and selection of appropriate foods, necessitating innovative approaches to support procurement decision-making. The Nutri-Score system, with its intuitive five-colour grading scale from A (highest nutritional quality) to E (lowest nutritional quality), offers a potentially transformative solution for simplifying complex nutritional assessments in real-world procurement scenarios.
Methodology
Study design and data collection
Amberntsson et al. (2025) employed a comprehensive cross-sectional design utilising real-world procurement data from all high school canteens in Viken County, Norway. The study encompassed all food items procured between January 2021 and June 2023, representing approximately 23% of Norway’s total population. This extensive dataset provided robust insights into actual procurement patterns and spending behaviours across diverse institutional settings. The researchers obtained detailed procurement lists from three major suppliers, ensuring comprehensive coverage of products typically purchased in high school food service operations.
The methodological approach incorporated the Nutri-Score 2023 version calculations for all products, representing the most current algorithms for foods and drinks. To establish a reference standard, foods had been previously classified into three distinct categories by nutrition experts based on the Norwegian school meal guidelines:
- foods recommended to be offered (e.g. bread with >50% whole grain)
- foods recommended to be offered in limited amounts (e.g. bread with ≤50% whole grain), and
- foods recommended not to be offered (e.g. white bread).
This tripartite classification system – developed by Matvalget, a government-supported, multi-disciplinary organization that works to stimulate a more sustainable food system in Norway – served as a proxy for the official guidelines (Helsedirektoratet, 2015), providing the necessary granularity for meaningful statistical analysis.
Analytical framework
The research team employed multiple analytical approaches to address the study’s three primary objectives. Agreement and disagreement between Nutri-Score classifications and school meal guideline categories were assessed using boxplots and cross-tabulation analyses. Linear regression models, presented as scatter plots, investigated the relationship between spending on different Nutri-Score categories and adherence to guidelines. The researchers calculated the proportion of total procurement value spent on each Nutri-Score category and guideline classification, providing actionable metrics for policy implementation.
Statistical analyses examined food-group-specific patterns, acknowledging that certain food categories might require differentiated Nutri-Score thresholds. The methodology accounted for the complexity of institutional food procurement, where ingredients for meal preparation must be distinguished from items sold directly to students. This nuanced approach enhanced the practical applicability of findings for food service management.
Results and key findings
Agreement between Nutri-Score and school meal guidelines
The investigation revealed overall good agreement between the Nutri-Score classifications and the Norwegian school meal guidelines. Amberntsson et al. (2025) demonstrated that foods with Nutri-Score A and B largely aligned with products recommended to be offered according to the guidelines. However, the analysis identified important food-group-specific variations requiring tailored recommendations. For bread toppings, particularly fish-based products and cheese, foods with Nutri-Score C and D were also categorised as recommended, reflecting the nutritional complexity of these traditional Norwegian food items.
The study identified specific patterns of disagreement warranting attention. Seventeen beverages (4% of total) classified as recommended but obtaining Nutri-Score D or E were primarily smoothies, whilst twenty-two beverages (5%) recommended not to be offered or in limited amounts received Nutri-Score A or B, including plain milk with 1% fat and flavoured milk with low fat and less than 5% sugars (Amberntsson et al., 2025). These discrepancies highlight the importance of contextual interpretation when applying nutrient profiling systems to diverse food categories.
Proposed Nutri-Score ranges for food procurement
Based on comprehensive analysis, Amberntsson et al. (2025) developed evidence-based Nutri-Score ranges providing optimal agreement with existing guidelines. The researchers propose that Nutri-Score A and B should generally be recommended, with specific emphasis on selecting whole grain over refined products for flour, rice, and pasta. Nutri-Score C emerges as acceptable for bread toppings and juice in portions not exceeding 250 ml, whilst Nutri-Score D proves acceptable for fish-based bread toppings and ingredients used in small quantities, such as dressings and reduced-fat cream.
The study establishes that Nutri-Score E should generally be avoided, with a single exception for oil-based salad dressings used as ingredients in otherwise healthy meals (Amberntsson et al., 2025). This nuanced approach acknowledges the role of certain higher-fat foods as components of balanced meals while maintaining clear procurement standards. The researchers provide detailed supplementary guidance outlining food-group-specific recommendations, enhancing the practical utility of their findings for procurement professionals.
Quantitative procurement goals
Analysis of actual procurement patterns revealed substantial variation between schools in adherence to guidelines. The proportion of money spent on foods classified as recommended to be offered ranged from 32% to 73% of total procurement value (Amberntsson et al., 2025). This proportion demonstrated strong linear association with spending on products classified as Nutri-Score A or B (β = 0.94, P < 0.001), validating the score’s utility as a procurement evaluation metric.
Based on regression analyses, Amberntsson et al. (2025) propose evidence-based procurement targets: minimum 65% of total value spent on products with Nutri-Score A or B, and maximum 15% on products with Nutri-Score E (including C-E for beverages). These targets align with Viken County’s goals of ≥70% spending on recommended foods and ≤8% on non-recommended items, while acknowledging practical constraints in institutional food service.
Discussion
Implications for school food policy
The findings carry profound implications for school food policy development and implementation. Amberntsson et al. (2025) demonstrate that Nutri-Score offers a valuable complementary tool for guiding and evaluating food procurements in Norwegian high schools, addressing critical gaps in current guidance systems. The study reveals that evaluating individual food items based on current school meal guidelines presents significant challenges, as many foods lack specific recommendations, necessitating extensive nutritional knowledge from procurers.
The research highlights the impact of professional support in procurement decision-making. Schools receiving counselling from Matvalget demonstrated significantly higher proportions of spending on recommended foods, underscoring the value of expert guidance in translating guidelines into practice (Amberntsson et al., 2025). However, the resource-intensive nature of manual classification systems limits scalability, positioning algorithm-based systems like Nutri-Score as more sustainable solutions for national implementation.
Balancing algorithmic guidance with culinary expertise
The researchers thoughtfully address potential unintended consequences of algorithmic procurement guidance. The researchers acknowledge risks of shifting focus toward purchasing ‘correct’ products rather than leveraging culinary expertise to prepare well-balanced meals. From a societal perspective, optimal guidance should emphasise building competence and trust in chefs’ abilities to create healthy meals based on professional assessment, rather than merely understanding acceptable Nutri-Score distributions.
The study recognises that foods with poor nutritional quality can fit within healthy diets when used appropriately as ingredients or to increase consumption of beneficial foods like fish. Effective communication becomes crucial to ensure procurers understand the nuanced role of different Nutri-Score categories within overall meal composition. The proposed 15% maximum for Nutri-Score E products reflects this balance, accommodating necessary ingredients whilst maintaining nutritional standards.
Implementation challenges and opportunities
Current limitations to Nutri-Score implementation in Norway include its status as a non-applied nutrient profiling system, restricting immediate usability as a procurement tool. However, Amberntsson et al. (2025) note that publicly accessible algorithms enable theoretical application provided nutritional content data availability. Integration into web-based procurement systems could enhance accessibility, though practical requirements warrant further investigation.
The contrast with Norway’s existing Keyhole label system presents both challenges and opportunities. Unlike the Keyhole’s binary endorsement approach, Nutri-Score’s graded scale enables evaluation of both recommended and non-recommended foods, providing more comprehensive procurement oversight (Amberntsson et al., 2025). This characteristic proves particularly valuable for monitoring adherence to guidelines restricting less healthy options.
Strengths and limitations
Methodological strengths
The study’s utilisation of comprehensive real-life data covering all purchased items from high schools in Viken County represents a major strength, encompassing 23% of Norway’s population. The inclusion of diverse foods from multiple brands ensures robust representation of typical high school procurement patterns. The quarterly procurement timeframe likely captured most regularly purchased items, enhancing generalisability (Amberntsson et al., 2025).
The use of Matvalget’s expert-validated classification as a proxy for school meal guidelines provides necessary specificity for meaningful analysis. The classification’s development by nutrition experts ensures good specificity, whilst systematic exploration of all identified disagreements strengthens the validity of findings regarding Nutri-Score performance.
Acknowledged limitations
Amberntsson et al. (2025) acknowledge several limitations warranting consideration. The use of procurement value as a monitoring metric presents vulnerabilities to price fluctuations potentially impacting effectiveness. The study’s focus on potential rather than actual effects of Nutri-Score implementation limits conclusions about real-world procurement behaviour changes.
Additionally, exclusion of data from some suppliers, though mitigated by comparable product availability from included suppliers, may affect comprehensiveness.
The reliance on Matvalget’s classification as a proxy for official guidelines, whilst necessary and widely utilised across approximately 37% of Norway’s population, introduces potential discrepancies. However, the proxy’s greater detail compared to official guidelines and expert validation support its appropriateness for this evaluative research.
Future research directions
Intervention studies
Future research should prioritise intervention studies examining actual impacts of Nutri-Score implementation on procurement behaviours and student dietary intake. Randomised controlled trials comparing schools using Nutri-Score-guided procurement with control schools could provide causal evidence regarding effectiveness. Longitudinal studies tracking changes in procurement patterns and health outcomes following Nutri-Score adoption would strengthen the evidence base.
Investigation of optimal communication strategies for conveying nuanced Nutri-Score guidance to procurement professionals represents another priority. Research examining how different training approaches influence appropriate interpretation and application of food-group-specific recommendations could enhance implementation effectiveness. Studies exploring integration of Nutri-Score with existing culinary training programmes could address concerns about algorithmic approaches undermining professional expertise.
System integration and scalability
Research addressing technical requirements for integrating Nutri-Score into existing procurement systems warrants attention. Studies examining feasibility, costs, and benefits of incorporating scores into web-based ordering platforms could inform implementation decisions. Investigation of automated scoring systems leveraging existing nutritional databases could enhance scalability.
Comparative effectiveness research examining Nutri-Score alongside alternative nutrient profiling systems in school contexts would inform policy decisions. Studies investigating complementary use of Nutri-Score with existing labelling schemes like the Keyhole could optimise multi-system approaches. Research exploring adaptation requirements for different institutional settings beyond high schools could broaden applicability.
Conclusions
Amberntsson et al. (2025) provide compelling evidence that Nutri-Score represents an effective tool for guiding healthier food procurement and monitoring purchases in alignment with Norwegian school meal guidelines. The system’s ability to complement existing guidelines whilst enhancing recommendation clarity addresses critical implementation gaps in institutional food service. The proposed procurement targets of minimum 65% spending on Nutri-Score A or B products and maximum 15% on Nutri-Score E items offer evidence-based benchmarks for quality improvement.
However, successful implementation requires addressing current limitations, particularly Nutri-Score’s non-applied status in Norway and low awareness of school meal guidelines amongst procurement professionals. The study’s findings support dedicated improvement measures incorporating algorithmic guidance while preserving culinary expertise. As European nations seek harmonised approaches to improving school food environments, this research provides crucial evidence supporting Nutri-Score‘s potential contribution to public health nutrition objectives. Future research examining real-world implementation impacts and optimal integration strategies will further advance this promising approach to enhancing nutritional quality in school food procurement.
Dario Dongo
Cover art copyright © 2025 Dario Dongo (AI-assisted creation)
References
- Amberntsson A., Heide E., Mohn Paulsen M., Løvsjø Solberg S., Løvhaug A. L., Frost Andersen L., & Hope Abel M. (2025). The performance of Nutri-Score as a tool in guiding and evaluating nutritional quality of food procurements for high schools in Norway. Food & Nutrition Research, 69. https://doi.org/10.29219/fnr.v69.11483
- Helsedirektoratet. (2015, September 29). Nasjonal faglig retningslinje for mat og måltider i skolen – Del 3: Videregående skole (IS-2374 BMN). Oslo: Helsedirektoratet. https://www.helsedirektoratet.no/retningslinjer/mat-og-maltider-i-skolen/dokumenter-mat-og-maltider-i-skolen/mat-og-maltider-videregaende-skole-nfr-bokmal.pdf
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.
