New Labelling System

for Nutrition Values: Rena Agatha

1293876
OVERVIEW
◦ Background
◦ Types of Front-of-pack Nutrition Label
◦ Introduction: Nutri-Score
◦ Foods Labeled with Nutri-score
◦ Nutri-Score in Germany
◦ Perception and Objective Understanding
◦ Use Of FOP Nutrition Labels in Purchasing Situations
◦ FSA Score as an Indicator of The Overall Quality of The Diet at Individual Level
◦ FSA-NPS DI and Health Outcomes
◦ Advantages and Disadvantages
◦ Conclusions
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BACKGROUND
◦ Industrialized countries face a major public health challenge à increasing of chronic diseases
◦ Low-and middle-income countries à a rapid modification of dietary behaviours associated with increased risks of nutrition-
related diseases à rising burden of nutritional diseases worldwide
◦ Solution: government-led strategies and policies à introduced various interventions à improving the diet in the population
◦ Front-Of-Pack (FOP) nutrition labels, especially Nutri-Score, has received growing attention from public authorities and learned
societies
ü Helpful guidance for consumers towards healthier food choices at the point of purchase (at-a-glance nutritional information
à average of 35 seconds to select the food)
ü Motivation for manufacturers to reformulate their products towards healthier compositions
◦ 2001: France has set a public health nutrition policy, the Programme National Nutrition Santé (PNNS, French Nutrition and
Health Program) à laws, regulations and motivations in the nutrition field à improve the population’s health status
◦ 2014: Report commissioned by the Minister of Health from the president of PNNS relayed 15 proposals including the
introduction of FOP nutrition label – the 5-Colour Nutrition label (5-CNL)
◦ 2016: The principle of FOP nutrition label was included in the health law
◦ 2017: The Nutri-Score (5-Colour Nutrition label, 5-CNL) was selected by French health authorities after comparison tests against
several labels proposed by industry or retailers and announced by the Minister of Health as the official FOP nutrition label for
France
◦ EU was notified of the implementation of Nutri-Score in the following month
(Julia and Hercberg, 2017)
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TYPES OF FRONT-OF-PACK (FOP)
NUTRITION LABEL IN USE WORLDWIDE

(Julia and Hercberg, 2017)

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INTRODUCTION: NUTRI-SCORE
◦ Nutri-Score (5-CNL) is a five-color-coded voluntary front-of-pack nutritional label that classifies foods and
beverages according to their nutritional value, developed by the Nutritional Epidemiology Research Team, an
academic public research unit
◦ Classifies foods into 5 nutritional quality levels, ranges from A - dark green (healthier choices) to E - dark orange
(less healthy choices)
◦ Aim: Help consumers to buy healthier and more balanced foods, to achieve better nutrition and prevent chronic
diseases such as diabetes, cardiovascular disease, etc
◦ Calculated using the UK Foods Standards Agency nutrient profiling system (FSA Score), which considers levels of
energy, fat, sugar, salt, fiber, protein, proportion of fruit and vegetables in the entire food
◦ The FSA score refers to nutrient content per 100g food or beverages
◦ Nutri-Score is intended for labeling processed foods and beverages
(Merle et al., 2018; Julia and Hercberg, 2017)

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(Julia and Hercberg, 2017)
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EXAMPLE: NUTRI-SCORE FOR A FICTIONAL
CHOCOLATE COCONUT MUESLI

(https://www.nestle.de)

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 WHICH FOODS ARE ALREADY LABELED
WITH THE NUTRI-SCORE?
◦ Since 2017, the label for processed food has been used in France. Individual
products are already to be found with the labeling in supermarkets in France
◦ The French government recommends food manufacturers to apply the
labeling
◦ Belgium, Germany, Netherlands, Switzerland, Spain, Portugal and Luxembourg
also want to follow
◦ Danone, Iglo, Bofrost, McCain or the bread and bakery maker Mestemacher
have introduced Nutri-Score
◦ Nestle S.A. and Cereal Partners Worldwide (C.P.W.), the international
breakfast venture between Nestle and General Mills, have announced they
will begin using Nutri-Score labeling in Austria, Belgium, France, Germany and
Switzerland starting in the first half of 2020
◦ It is a voluntary system where producers are not forced to display the logo on
their products. However, seven European organisations for consumers' rights
have started an online petition to introduce the system in the entire EU
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(https://www.vzhh.de)
 VOLUNTARY
NUTRITION
LABEL
COMPARISON
IN GERMANY

On 30 September 2019, the Federal Ministry of Food and Agriculture

(BMEL) announced the results of a representative consumer survey on
voluntary nutrition labeling models. The clear winner: the Nutri-Score

(https://www.vzhh.de) 9
NUTRI-SCORE IN GERMANY
◦ In Germany, the companies such as Bofrost (frozen food direct sales company), Danone
(manufacturer of dairy products), Iglo (frozen food manufacturer), McCain (manufacturer of frozen
potato products), Mestemacher (the major bakery) and Nestlé have decided to introduce Nutri-Score
to their products
◦ Nestle: the products should be labeled as quickly as possible. Danone's goal: print the Nutri-score by
the end of 2019 at 90% of all food sold in Germany. Iglo‘s goal: launch the first labeled products in
the second quarter of the year. Bofrost already displays the Nutri-score on its website. McCain
wanted to declare in May. They are waiting for a decision from the political side
◦ The "Protection against nuisance in the economy“ which aims at promoting compliance with
competition law, has stopped this welcome action, these important measures for now
◦ In the legal framework, so far only voluntary scheme is currently possible. Unfortunately, no supplier
is required to mark its products with the Nutri-score

(https://www.vzhh.de)
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EXAMPLE OF CALCULATED NUTRI-SCORE IN
SOME PRODUCTS

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(https://www.vzhh.de)
 PERCEPTION AND OBJECTIVE
UNDERSTANDING
◦ Perception and understanding are the important ascepts for the effectiveness of FOP labels
◦ These prerequisite were evaluated in participants in the NutriNet-Santé cohort study, self-administered
questionnaires. 4 formats were compared, each one corresponding to a specific type of FOP label:
ü Nutrient-specific with numeric information (Guideline Daily Amount, GDA)
ü Nutrient-specific with colour-coded information (Multiple Traffic Light, MTL)
ü Endorsement scheme, which appear only on the more healthy products within a category (Tick)
ü Graded summary systems (5-CNL, the former graphical format for the Nutri-Score)
◦ Several dimensions of perception were explored: liking, attractiveness and perceived cognitive workload
ü The 5-CNL à the easiest to identify, the easiest and most quick to understand
ü GDAs à the least easy label to identify, the heaviest cognitive workload (complexity & processing time)
◦ A second study on the perception of FOP labels: the Nutri-Score had the highest support in the population (preferred
format: 43% of the sample à especially in subjects with low obedience to nutritional recommendations)
◦ Objective understanding à asking participants to rate the nutritional quality of 3 products based on the information
provided by the FOP system
ü Compared to a control situation, all labels significantly increased the probability of correctly ranking the products
ü The 5-CNL à the most effective label (64.6% of correct answers), followed by the MTL (56.4%), GDA (50.2%) and
the Tick (29.4%) labels
ü The probability of correctly ranking products with the 5-CNL à high for subjects of having unhealthy diets: low
educational level and with no perceived nutrition knowledge
(Julia and Hercberg, 2017) 12
 USE OF FOP NUTRITION LABELS IN
PURCHASING SITUATIONS
◦ A randomized study with an experimental online supermarket assessed the impact of 4 types of labels (5-
CNL, MTL, GDAs and Check) in the NutriNet-Santé study
ü 5-CNL à the lowest FSA-NPS scores (the highest nutritional quality of the selected items in the
shopping cart (8.72 ± 2.75) followed by MTL (8.97 ± 2.68) and Tick (8.99 ± 2.71)
ü No effect in the number of purchased items or the price of the shopping cart
◦ An experimental study in a physical experimental supermarket:
ü The 5-CNL with a leaflet explaining the purpose and use of the label à higher nutritional quality of
purchased sweet biscuits
ü No significant effect for breakfast cereals or appetizers
◦ 2 studies using an experimental economy design:
ü The Nutri-Score performed best at improving the nutritional quality of the purchased items (compared
with MTL and Reference Intakes (Ris); Health Star Rating system, MTL, SENS, modified Reference
Intakes (mRIs))
ü The Nutri-Score performed best in households with the lowest income
◦ A large scale trial in 60 supermarkets, 10 each of 4 proposed labels (Nutri-Score, MTL, SENS and the
mRIs) and 20 controls:
ü The Nutri-Score à the largest improvement in the nutritional quality of purchases, followed by MTL and
SENS
ü The Nutri-Score à improvement in all subgroups of the population (subjects buying discount brands),
other formats some subgroups worsen the nutritional quality of their purchases
(Julia and Hercberg, 2017) 13
FSA SCORE AS AN INDICATOR OF
THE OVERALL QUALITY OF THE DIET
AT INDIVIDUAL LEVEL
◦ The FSA score was converted into an individual indicator of the overall nutritional quality of the diet (FSA-NPS
Dietary Index)
◦ As the FSA score of foods, a higher FSA-NPS DI indicates lower nutritional quality of the foods consumed in the
overall diet of the individual
◦ The FSA-NPS DI was validated against food consumption, nutrient intake and biomarkers of nutritional status, in
3 French studies: NutriNet-Santé study, French SU.VI.MAX cohort study and ENNS cross-sectional study
◦ In all 3 studies, higher FSA-NPS DI (reflecting a lower nutritional quality of the diet) was associated with:
ü Higher consumption of sweet, fatty, salty foods and lower consumption of fruits, vegetables, fish and whole
grains
ü Higher intakes of energy, saturated fats, added sugars and lower intakes of polyunsaturated fatty acids,
fibers, vitamins and minerals
ü Lower levels of LDL-cholesterol and antioxidant biomarkers (beta-carotene, vitamin C)
◦ Subjects with higher FSA-NPS dietary index à men, younger, smokers, lower incomes, higher body mass indexes
(Julia and Hercberg, 2017) 14
FSA-NPS DI AND HEALTH
OUTCOMES
◦ Nutri-Score has been shown to be associated with health outcomes in prospective studies
◦ The prospective associations between FSA-NPS DI and health outcomes were investigated in 2 large
French studies: the SU.VI.MAX cohort and the NutriNet-Santé cohort study
◦ The investigated outcomes were cancer (and breast cancer), cardiovascular disease, metabolic syndrome
and weight gain
◦ Less healthy diets (as expressed by the FSA-NPS DI) were associated with a higher risk of developing a
chronic disease
◦ The probability of developing metabolic syndrome were increased by 43%, over-weight and obesity in men
by 61%, cardiovascular diseases by 40-61%, cancer risk by 34% and breast cancer risk by 52%
◦ Nutritional quality of the diet (nutritional quality of the foods consumed using FSA-NPS) is associated with
health outcomes in the long term
◦ Improvements in the nutritional quality of foods consumed à help to prevent chronic diseases

(Julia and Hercberg, 2017)

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ADVANTAGES
◦ Helps consumers to buy healthier and more balanced foods à to achieve better nutritional quality
and prevent chronic diseases such as diabetes, cardiovascular disease, etc
◦ Provides nutritional value information at a glance
◦ Easier (less complex) overview on healthiness of a product for consumers to make a good decision
quickly
◦ Products in a category can be directly compared (easier comparability in terms of health for food
selection between products as the Nutri-score is always calculated based on 100g or 100ml)
◦ Motivates food manufacturers to reformulate their products towards healthier compositions
◦ Unfavorable ingredients are considered
◦ Easy to understand and informative
◦ Its effectiveness has been demonstrated in studies

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DISADVANTAGES
◦ The score does not consider and measure all valuable nutrients or ingredients (vitamins, minerals,
unsaturated fatty acids)
Ø Without simplification, an assessment at a glance can not succeed
◦ Gives neither an information about a balanced compilation of the entire diet (only specific food is
measured), nor the recommended portion size
◦ Does not consider additives (flavor enhancers, sweeteners or flavors). Manufacturers could improve
the rating of their products by using more additives, for example to reduce the fat content
Ø Ingredients list could help
◦ Does not consider sustainability: the regional origin, the ecological cultivation or GMO-free would not
be evaluated, although these aspects are important to many customers
Ø There are additional labels such as "Bio" on the label
◦ Only voluntary: labeling is not mandatory in the EU. Since the Nutri score was previously only
introduced by a few manufacturers, the comparison between different foods is not yet possible
Ø The Nutri-Score should become mandatory for everyone
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CONCLUSIONS
◦ The nutrient profiling system and the actual FOP format of the Nutri-Score were validated in various
complementary studies
◦ The potential of the Nutri-Score as an effective tool to help consumers make healthier food choices
at the point of purchase, specifically in the French context
◦ The Nutri-Score appears to have a positive impact in disadvantaged populations
◦ The adoption of the Nutri-Score in France is voluntary, based on EU regulations
◦ After a notification to the EU Commission, the legal act supporting the Nutri-Score was finally signed
on October 31st, 2017 by the Ministers of Health, Agriculture and Economy and finance
◦ So far, 3 large retailers and 3 manufacturers have agreed in a voluntary commitment treaty to
implement the Nutri-Score. Hopefully, this uptake by large companies will prompt other to follow suit
◦ This uptake by companies needs to be accompanied by large communication campaigns targeting
the population, so that consumers understand and use the system in their food choices
◦ The most important is it needs to be mandatory by law
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REFERENCES
◦ Julia, C. and Hercberg, S., 2017. Development of a new front-of-pack nutrition label in France: the
five-colour Nutri-Score. Public Health Panorama, 3(4), pp. 537-820.
◦ Julia, C. and Hercberg, S., 2017. Nutri-Score: Evidence of the effectiveness of the French front-of-
pack nutrition label. Ernahrungs Umschau, 64(12), p. 181–187.
◦ Merle, A., Werle, C. O. and Yamim, A. P., 2018. HOW TO PREVENT THE HEALTH HALO EFFECT OF
ORGANIC FOODS? THE INFLUENCE OF A NUTRITIONAL-LABELING SYSTEM. 1ère Journée Marketing
et Développement Durable (JMDD), p. 20.
◦ https://www.nestle.de/ernaehrung/nutri-score/
◦ https://www.vzhh.de/themen/lebensmittel-ernaehrung/yeah-nutri-score

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THANK YOU