Data availability
Belgium: the Belgian Nutritrack branded food composition data can be shared by Sciensano upon reasonable request. France: raw data from Oqali is provided at https://www.oqali.fr/en/public-data/data-basis/. Details and how to use the Oqali data are given at https://www.oqali.fr/donnees-publiques/faq/. The Open Food Facts data used in the study are available on their website (https://world.openfoodfacts.org/, accessed on November 2021). OpenFoodFacts is an open collaborative database of food products marketed worldwide, licensed under the Open Database License (ODBL). The Ciqual database is freely available on the Ciqual website (https://ciqual.anses.fr/). Germany: the Global New Product Database (GNPD) by Mintel is a commercially available database; relevant data from the Product Monitoring Database of the Max Rubner-Institut are complemented by purchased data from the consumer research institute GfK. Thus, data from both sources cannot be shared with external persons/institutions. The Netherlands: the Dutch branded food database is not open access, therefore not publicly available.
Code availability
The code used to generate the results is available upon request from the corresponding author exclusively for the purposes of undertaking academic, governmental or non-profit research.
References
Farm to Fork Strategy: For a Fair, Healthy and Environmentally-Friendly Food System (European Commission, 2020); https://ec.europa.eu/food/system/files/2020-05/f2f_action-plan_2020_strategy-info_en.pdf
EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) et al. Scientific advice related to nutrient profiling for the development of harmonised mandatory front-of-pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods. EFSA J. 20, e07259 (2022).
Hercberg, S. Propositions pour un nouvel élan de la politique nutritionnelle française de santé publique dans le cadre de la Stratégie nationale de santé - 1ère partie: mesures concernant la prévention nutritionnelle 128 (2014).
Julia, C. & Hercberg, S. Research and lobbying conflicting on the issue of a front-of-pack nutrition labelling in France. Arch. Public Health 74, 51 (2016).
Tackling NCDs: ‘Best Buys’ and Other Recommended Interventions for the Prevention and Control of Noncommunicable Diseases (World Health Organization, 2017); http://www.who.int/iris/handle/10665/259232
Swiss nutrition policy. FSVO https://www.blv.admin.ch/blv/en/home/das-blv/strategien/schweizer-ernaehrungsstrategie.html (2017).
Programme National Nutrition Santé 2019–2023 (Ministère des solidarités et de la santé, 2019); https://solidarites-sante.gouv.fr/IMG/pdf/pnns4_2019-2023.pdf
Julia, C. et al. Performance of a five category front-of-pack labelling system—the 5-colour nutrition label—to differentiate nutritional quality of breakfast cereals in France. BMC Public Health 15, 179 (2015).
Julia, C. et al. Application of the British Food Standards Agency nutrient profiling system in a French food composition database. Br. J. Nutr. 112, 1699–1705 (2014).
Julia, C. et al. Discriminating nutritional quality of foods using the 5-color nutrition label in the French food market: consistency with nutritional recommendations. Nutr. J. 14, 100 (2015).
Ter Borg, S., Steenbergen, E., Milder, I. E. J. & Temme, E. H. M. Evaluation of Nutri-Score in relation to dietary guidelines and food reformulation in The Netherlands. Nutrients 13, 4536 (2021).
Vlassopoulos, A., Katidi, A., Savvidou, T. & Kapsokefalou, M. Alignment of Nutri-Score with Mediterranean diet pyramid: a food level analysis. Nutrients 14, 5097 (2022).
Julia, C. et al. Development and validation of an individual dietary index based on the British Food Standard Agency nutrient profiling system in a French context. J. Nutr. 144, 2009–2017 (2014).
Julia, C. et al. The 5-CNL front-of-pack nutrition label appears an effective tool to achieve food substitutions towards healthier diets across dietary profiles. PLoS ONE 11, e0157545 (2016).
Julia, C. et al. Validation of the FSA nutrient profiling system dietary index in French adults-findings from SUVIMAX study. Eur. J. Nutr. 55, 1901–1910 (2016).
Barrett, E. M. et al. Criterion validation of nutrient profiling systems: a systematic review and meta-analysis. Am. J. Clin. Nutr. https://doi.org/10.1016/j.ajcnut.2023.10.013 (2023).
Rayner, M., Scarborough, P. & Lobstein, T. The UK Ofcom Nutrient Profiling Model. Defining ‘Healthy’ and ‘Unhealthy’ Foods and Drinks for TV Advertising to Children (2009).
Rayner, M., Scarborough, P., Stockley, L. & Boxer, A. Nutrient Profiles: Further Refinement and Testing of Model SSCg3d Final Report (2005); https://webarchive.nationalarchives.gov.uk/ukgwa/20120404001002/http://www.food.gov.uk/multimedia/pdfs/npreportsept05.pdf
Rayner, M., Scarborough, P. & Stockley, L. Nutrient Profiles: Options for Definitions for Use in Relation to Food Promotion and Children’s Diets Final report (2004).
FoodMonitoring (Sciensano, 2021); https://foodmonitoring.sciensano.be/
Base de données Oqali (Oqali, 2020); https://www.oqali.fr/donnees-publiques/base-de-donnees-oqali/
Open Food Facts (Open Food Facts, 2021); https://fr.openfoodfacts.org
Gréa, C., Turban, C., Roser, S., genannt Bonsmann, S. S. & Hoffmann, I. Design and methods of the German monitoring of packaged food in the European context. J. Food Compos. Anal. https://doi.org/10.1016/j.jfca.2023.105405 (2023).
Westenbrink, S., van der Vossen-Wijmenga, W., Toxopeus, I., Milder, I. & Ocké, M. LEDA, the branded food database in the Netherlands: data challenges and opportunities. J. Food Compos. Anal. 102, 104044 (2021).
Regulation (EU) No 1169/2011 of the European Parliament and of the Council of 25 October 2011 on the provision of food information to consumers, amending Regulations (EC) No 1924/2006 and (EC) No 1925/2006 of the European Parliament and of the Council, and repealing Commission Directive 87/250/EEC, Council Directive 90/496/EEC, Commission Directive 1999/10/EC, Directive 2000/13/EC of the European Parliament and of the Council, Commission Directives 2002/67/EC and 2008/5/EC and Commission Regulation (EC) No 608/2004 Text with EEA relevance. Official J. EU L 304/18 (2011).
Regulation (EC) No 1924/2006 of the European Parliament and of the Council of 20 December 2006 on nutrition and health claims made on foods. Official J. EU L 404/9 (2006).
Scarborough, P., Arambepola, C., Kaur, A., Bhatnagar, P. & Rayner, M. Should nutrient profile models be ‘category specific’ or ‘across-the-board’? A comparison of the two systems using diets of British adults. Eur. J. Clin. Nutr. 64, 553–560 (2010).
Nutrition criteria. Choicesprogramme https://www.choicesprogramme.org/our-work/nutrition-criteria (2019).
Health Star Rating System. Five Year Review Report (mpconsulting, 2019); http://www.healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/formal-review-of-the-system-after-five-years
EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA)Scientific opinion on the substantiation of health claims related to whole grain (ID 831, 832, 833, 1126, 1268, 1269, 1270, 1271, 1431) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA J. 8, 1766 (2010).
EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) et al. Tolerable upper intake level for dietary sugars. EFSA J. 20, e07074 (2022).
Peters, S. A. E. et al. Incorporating added sugar improves the performance of the Health Star Rating front-of-pack labelling system in Australia. Nutrients 9, 701 (2017).
Mozaffarian, D. et al. Food Compass is a nutrient profiling system using expanded characteristics for assessing healthfulness of foods. Nat. Food 2, 809–818 (2021).
O’Hearn, M. et al. Validation of Food Compass with a healthy diet, cardiometabolic health, and mortality among U.S. adults, 1999–2018. Nat. Commun. 13, 7066 (2022).
Sutherland, L. A., Kaley, L. A. & Fischer, L. Guiding stars: the effect of a nutrition navigation program on consumer purchases at the supermarket. Am. J. Clin. Nutr. 91, 1090S–1094S (2010).
Katz, D. L., Njike, V. Y., Rhee, L. Q., Reingold, A. & Ayoob, K. T. Performance characteristics of NuVal and the Overall Nutritional Quality Index (ONQI). Am. J. Clin. Nutr. 91, 1102S–1108S (2010).
Rios-Leyvras, M. & Montez, J. Health Effects of the Use of Non-sugar Sweeteners: A Systematic Review and Meta-analysis (World Health Organization, 2022); https://www.who.int/publications-detail-redirect/9789240046429
Use of Non-sugar Sweeteners: WHO Guideline (World Health Organization, 2023); https://www.who.int/publications-detail-redirect/9789240073616
Riboli, E. et al. Carcinogenicity of aspartame, methyleugenol, and isoeugenol. Lancet Oncol. 24, 848–850 (2023).
Crosbie, E. et al. A policy study on front-of-pack nutrition labeling in the Americas: emerging developments and outcomes. Lancet Reg. Health Am. 18, 100400 (2023).
Rebolledo, N. et al. Changes in nonnutritive sweetener intake in a cohort of preschoolers after the implementation of Chile’s Law of Food Labelling and Advertising. Pediatr. Obes. 17, e12895 (2022).
Russell, C., Dickie, S., Baker, P. & Lawrence, M. Does the Australian Health Star Rating system encourage added sugar reformulation? Trends in sweetener use in Australia. Nutrients 13, 898 (2021).
Evaluation of the Nutri-Score Algorithm Advisory Report (Health Council of the Netherlands, 2022); https://www.healthcouncil.nl/documents/advisory-reports/2022/11/29/evaluation-of-the-nutri-score-algorithm
Update of the Nutri-Score Algorithm—Update Report from the Scientific Committee of the Nutri-Score 2022 (Scientific Committee of the Nutri-Score, 2022); https://www.santepubliquefrance.fr/determinants-de-sante/nutrition-et-activite-physique/articles/nutri-score/documents/rapport-2022-sur-les-modifications-de-l-algorithme-de-calcul-pour-les-aliments-solides-proposees-par-le-comite-scientifique-du-nutri-score
Update of the Nutri-Score Algorithm for Beverages. Second Update Report from the Scientific Committee of the Nutri-Score V2-2023 (Scientific Committee of the Nutri-Score, 2023); https://www.santepubliquefrance.fr/determinants-de-sante/nutrition-et-activite-physique/documents/rapport-synthese/update-of-the-nutri-score-algorithm-for-beverages.-second-update-report-from-the-scientific-committee-of-the-nutri-score-v2-2023
Acknowledgements
We thank M. Egnell (French Directorate of Health) for acting as Secretariat for the Scientific Committee of Nutri-Score, efficiently organizing the workflow of the group (meeting agenda and minutes, logistical help in setting in-person and remote meetings); J. de Goede (Health Council of the Netherlands) for her contribution in the review of the evidence for the group; V. Bullón-Vela, C. Sayón-Orea, M. Bes-Rastrollo and M. A. Martínez-González (University of Navarra) for their contribution in the review of the evidence regarding olive oil; the Department of Nutritional Behaviour at the Max Rubner-Institut for providing us with the required packaged food data of the national product monitoring as an essential part of the performed analyses; and the Oqali team for providing us with reliable curated data for the French food market. We also thank J. Lauvai, Department of Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut for carefully editing the document for English language. The scientific committee members did not receive funding for the work. B.S. was supported by a Doctoral Fellowship from Université Sorbonne Paris Nord to Galilée Doctoral School.
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Author notes
These authors contributed equally: Benedikt Merz, Elisabeth Temme.
Authors and Affiliations
Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
Benedikt Merz,Hanna Haidar&Charlotte Kühnelt
National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
Elisabeth Temme&Elly Steenbergen
Haute Ecole Leonard de Vinci, Health Sector, Dietetics Department, Brussels, Belgium
Hélène Alexiou
Department of Epidemiology and Data Science, Amsterdam UMC, location Vrije Universiteit, Amsterdam, the Netherlands
Joline Wilhelma Johanna Beulens
Amsterdam Public Health, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
Joline Wilhelma Johanna Beulens
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
Joline Wilhelma Johanna Beulens
Paderborn University, Institute of Nutrition, Consumption and Health, Faculty of Natural Science, Paderborn, Germany
Anette Elisabeth Buyken
Nutrition and Health Research Group, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
Torsten Bohn
Santé publique France, French National Public Health Agency, Saint-Maurice, France
Pauline Ducrot
Department of Agricultural, Forest and Food Sciences, Bern University of Applied Sciences, Zollikofen, Switzerland
Marie-Noëlle Falquet
Observatory of Nutrition and Study of Obesity in Spanish Agency for Food Safety and Nutrition, Madrid, Spain
Marta García Solano
Externas GmbH, Bern, Switzerland
Esther Infanger
Department of Epidemiology and Health Monitoring, Robert Koch-Institut, Berlin, Germany
Charlotte Kühnelt
Universidad Autónoma de Madrid, CIBER of Epidemiology and Public Health, and IMDEA-Food (CEI UAM+CSIC), Madrid, Spain
Fernando Rodríguez-Artalejo
Nutritional Epidemiology Research Team - Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
Barthélémy Sarda&Chantal Julia
Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
Stefanie Vandevijvere
Public Health Department, Paris-Seine-Saint-Denis University Hospitals (AP-HP), Bobigny, France
Chantal Julia
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Contributions
B.M. and E.T. contributed equally to this study and share first co-authorship. C.J. coordinated the study, acted as Chairperson for the Scientific Committee of Nutri-Score and drafted the original paper. She is the guarantor. C.J. and B.S.; B.M., C.K. and H.H.; E.T. and E.S.; S.V. collected and analysed data from databases in France, Germany, the Netherlands and Belgium, respectively, for the study. All authors participated in the review of the literature and participated equally in the interpretation of results, decision-making process for the scientific committee and critically revised the paper for important intellectual content. All authors have read and agreed to the published version of the paper.
Corresponding author
Correspondence to Chantal Julia.
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B.M., E.T., H.A., J.W.J.B., A.E.B., T.B., P.D., M.-N.F., M.G.S., E.I., F.R.-A., S.V. and C.J. are members of the Scientific Committee of the Nutri-Score.
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Nature Food thanks Eden Barrett, Alison Tedstone and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.
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Merz, B., Temme, E., Alexiou, H. et al. Nutri-Score 2023 update. Nat Food 5, 102–110 (2024). https://doi.org/10.1038/s43016-024-00920-3
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DOI: https://doi.org/10.1038/s43016-024-00920-3
