Papers in English

The ever-continuing battle between public health and economic interests in nutrition: the case of Nutri-Score

To help consumers making healthier choices at the place of purchase and contribute to the improvement of the diet and to the prevention of nutrition-related chronic diseases, interpretive front-of-pack nutrition labelling have been progressively implemented worldwide1. In Europe, a graded summary and color-coded system, the Nutri-Score was developed and scientifically validated (>45 scientific publications) as one of the best options to improve consumer understanding of the nutritional values of foods and lead to overall healthier purchases2. Evidence on its effectiveness was demonstrated in multiple settings – experimental and large-scale trials in supermarkets, quasi-experimental trials in catering – with consistent results.

For a while, it appeared that the scientific evidence had prevailed: the Nutri-Score was officially adopted in France in 2017, followed in the later years by Belgium, Spain, Luxemburg, Germany, the Netherlands and Switzerland. Initially sceptical, more and more food industry companies joined the scheme, pressured by the demand from consumer groups and the accumulation of scientific proofs supporting the positive effect of Nutri-Score. So far, its implementation remains optional in the current context of regulation at the European level3. However, in the framework of the EC “Farm to Fork” Strategy, the EU commission plans to select a harmonized and mandatory front-of-pack label by 2022. Due to its extensive validation, Nutri-Score appears as a serious contender4.

However, while opposition from some big manufacturers against Nutri-Score appeared early on, new stakeholders have now taken the forefront, which perceive this public health policy as a threat for agricultural products in some sectors that represent a large part of the exports for certain countries (Parmigiano Reggiano and Parma ham in Italy, olive oil and Serrano ham in Spain, Roquefort cheese in France). Given their overall nutritional composition, high in caloric density, saturated fat and salt, these products indeed tend to be classified as of lower nutritional value by the Nutri-Score, as foods which should be consumed in smaller quantities or frequency. Pressure has therefore been mounting over the past months, with strong and vocal opposition to Nutri-Score from a number of agro-industry sectors, supported by some political parties.

Hence, the frame of interpretation of the system has shifted. While Nutri-Score was initially developed as a tool for consumer empowerment and informed decision and transparency on the nutritional composition of products in a public health perspective, these new arguments focus essentially on its potential economic impact on certain sectors, capitalizing on the perception of traditional foods as “good quality” products. Opponents sow confusion over the term, conflating quality of production (through PGI or PDO labels) and nutritional composition to reinforce their position. Political parties (in particular extreme right parties and those with nationalist agendas) use food patriotism as a means to gain traction in the population, portraying the Nutri-Score as a threat from the EU commission against national cultural practices or staging street demonstrations against Nutri-Score in defence of national products seen as under attack.

The adoption of a simplified interpretive front-of-pack nutrition label in the EU, which would follow the best-policies approaches recommended by the WHO5 is therefore under threat. Proposals have emerged either to abandon the scheme entirely for a more analytical approach or diminish its scope substantially to exclude all ‘traditional’ foods (including those with PDO, PGI labels), for which consumers would have to rely on the back-of-pack nutrition declaration to be informed as to their nutritional composition.

Such tactics are typical of political lobbying by the agro-food industries to strike or delay implementation of public health policies. The current environment with strong nationalist progression in several countries shows the potential for the coalition of economic interests with political agendas, and the risk for progressive action for the benefits of consumers and citizens in the EU overall. While more than 400 scientists and public health societies across Europe recently came forward6 to encourage the Commission to select the scientifically validated Nutri-Score as the mandatory front-of-pack label for Europe, the policy decision will necessarily rely on political will. The tug-of-war between economic interests and public health may soon be on full display.

References

1  Kanter R, Vanderlee L, Vandevijvere S. Front-of-package nutrition labelling policy: global progress and future directions. Public Health Nutr 2018; 21: 1399–408.

2  Julia C, Hercberg S. Development of a new front-of-pack nutrition label in France: the five-colour Nutri-Score. Public Health Panor 2017; 3: 712–25.

3  EUR-Lex – 32011R1169 – EN – EUR-Lex. https://eur-lex.europa.eu/legal-content/en/ALL/?uri=CELEX:32011R1169 (accessed June 7, 2018).

4  European Commission. Farm to Fork Strategy. For a fair, healthy and environmentally-friendly food system. Brussels: European Union, 2020 https://ec.europa.eu/food/system/files/2020-05/f2f_action-plan_2020_strategy-info_en.pdf (accessed June 3, 2021).

5 Europe WHO. Manual to develop and implement front‑of‑pack nutrition labelling: guidance for countries on the selection and testing of evidence‑informed front‑of‑pack nutrition labelling systems in the WHO European Region. 2020. https://apps.who.int/iris/handle/10665/336988 (accessed March 11, 2021).

6  EASO. Nutri-Score call: press release and update. 2021; published online March 16. https://easo.org/nutri-score-call-press-release-and-update/ (accessed June 3, 2021).

Chantal Julia1,2, MD, MhD, Mathilde Touvier1, PhD, Emmanuelle Kesse-Guyot1, PhD, Pilar Galan1, MD, PhD, Serge Hercberg1,2, MD, PhD

1 Sorbonne Paris Nord University, INSERM U1153, INRAe INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France

2 Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France

A summary of this text was published in Nature Foods : Julia, C., Touvier, M., Kesse-Guyot, E., Galan P, Hercberg S. “Nutri-Score in tug-of-war between public health and economic interests in the European Union”. Nat Food (2022). https://doi.org/10.1038/s43016-022-00476-0
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