On October 31, 2017 an inter-ministerial decree was signed by the Ministers of Health, Agriculture and Economy and Finance recognizing the Nutri-Score as the official nutritional label recommended by the French authorities to be affixed on the front of pre-packed foodstuff (on a voluntary basis due to the European regulation). The Nutri-Score is a graded, colour-coded front-of-pack nutrition label with 5 classes of nutritional quality, ranging from green (associated with the letter A) for the most favorable to dark orange (associated with the letter E) for the less favourable in terms of nutritional value. The signature of the decree formalizing the adoption of the Nutri-Score was the long-awaited epilogue of a battle that lasted nearly 4 years during which powerful lobbies did everything (or almost) to block and/or delay the adoption and implementation of this science-based public health tool[1].
The implementation of the Nutri-Score as a front-of-pack label was (and remains) fully justified by:
– the major public health issues related to nutrition, notably the recognition that nutritional risk factors are some of the main drivers of many chronic diseases with major human, social and economic costs: obesity, cancer, cardiovascular disease, diabetes, high blood pressure, etc.
– the willingness of scientific experts and public health authorities to implement measures to enable consumers to orient their choices towards foods of better nutritional quality, while encouraging manufacturers to improve the nutritional quality of their products through reformulation or innovations.
If the Nutri-Score appears to be a simple idea (but not simplistic as the lobbies that oppose it would want consumers to believe) and is common sense (providing consumers with transparency on the nutritional quality of the foods), its scientific basis is extremely sound and well documented.
A science-based public health tool
The basic idea of the Nutri-Score is simple: to translate the incomprehensible and often unreadable data of the nutrition composition table located on the back of packs (the nutrition declaration made mandatory by a European regulation voted in 2011) to a synthetic label easily visible and interpretable on the front of packs, for all to understand (1). Its purpose is to offer consumers transparency on the overall nutritional quality of prepackaged foods, allowing them, within the few seconds of the purchase act, to recognize and compare the nutritional quality of foods and guide their choices towards better alternatives. In practice, Nutri-Score makes it possible to differentiate the nutritional quality of foods having the same use and often placed in the same supermarket aisles or in very close aisles (for example, within composite dishes, foods consumed for dessert or breakfast, different beverages, etc.); or within the same group, between different foods (for example between different types of breakfast cereals, between different types of vegetable oils, etc.); or between same foods but from different brands (Figure 1).
The interest of the Nutri-Score and its superiority in Europe compared to other nutritional front-of-pack labels, existing or proposed by lobbies, has been widely demonstrated in more than 60 scientific studies published in international scientific journals validating the nutrient profile model underlying the calculation of the Nutri-Score as well as the effectiveness of its graphic format and in particular its superiority compared to other labels to orient consumers’ purchases (2,3).
Various studies (4-6) have thus shown that the score underpinning Nutri-Score allows 1) to classify food groups into 5 categories of nutritional quality that are globally consistent with national and international public health nutritional recommendations and 2) to visualize the high variability in nutritional quality of foods, whether between food categories, within foods of the same category and for the same food between brands.
In addition to its ability to classify food adequately, the public health importance of the algorithm underlying the Nutri-Score is based on its prospective association with the risk of chronic disease. Several studies (7-14) conducted in large cohorts in France (SU.VI.MAX, NutriNet-Santé), Spain (SUN, ERICA) and Europe (EPIC with more than 500,000 participants in 10 European countries), on large populations followed for many years (between 6 and 17 years), have shown that the consumption of foods with less favourable ratings on Nutri-Score scale was associated with an increased risk of developing cancer, cardiovascular disease, metabolic syndrome or excessive weight gain. These studies highlight the public health potential of shifting diets towards more favourable food choices according to the Nutri-Score in terms of chronic diseases prevention.
Regarding the graphic format, numerous studies (15-17) have evaluated the perception and objective understanding of the Nutri-Score, in comparison with other nutritional labels currently used in the world or proposed by different economic actors. The 5-colour front-of-pack label was perceived as the easiest to identify and the most understandable, whatever the socio-economic level of the population considered. It presented the best performances, in particular increasing, in a significant way (in some sub-groups of the population more than twenty times compared to the situation without label), the ability of individuals to correctly classify food products according their nutritional quality.
In addition, several studies have tested the effect of Nutri-Score compared to other labels and a situation without label on consumers’ choices in terms of impact on nutritional quality of shopping baskets. Several randomized trials tested the impact of different logos on the nutritional quality of the shopping cart, in a framework similar to an online shopping website (18,19). The presence of the Nutri-Score on the front of the packaging was associated with a significant improvement in the nutritional quality of the shopping cart compared to the other front-of-pack labels tested and the reference situation without label. Furthermore, in specific groups of the population (students, low income groups or NCD patients) the exposure to Nutri-Score was accompanied by substitution to raw or minimally processed products (fruits and vegetables, fresh meats). A major point found in all these studies was that Nutri-Score was also the most effective within sub-groups of population based on sex, age, educational level, income, body mass index and level of nutrition knowledge.
A large-scale clustered trial was carried out in real conditions in France in 2016 comparing the impact of Nutri-Score to 3 other logos (and a situation without label) on the nutritional quality of food purchases in 60 supermarkets (10 per logo and 20 controls without logo) over a 10-week period (20,21); 1.7 million cash receipts were analysed. The results of this study showed that the presence of Nutri-Score improved the overall nutritional quality of shopping baskets (around 4 %) and Nutri-Score performed better than all other tested labels. The positive impact of Nutri-Score was particularly significant in disadvantaged populations.
This result was also confirmed by an intervention trial conducted with 809 subjects, testing the Nutri-Score and 4 other front-of-pack labels on food purchases in real life using experimental economics methods (22). Nutri-Score generated an improvement in the average nutritional quality of the participants’ baskets of 9.3%, while the improvements ranged from 2.9% to 6.6% for the other logos. In addition, Nutri-Score was also particularly efficient for populations with the low incomes.
Another study was conducted to evaluate the impact of the Nutri-Score on the choice of portion size by consumers, compared to the front-of-pack label “Evolved Nutrition Label” (ENL) proposed by the Big 6 (a consortium of 6 industrialists: Coca-Cola, PepsiCo, Mars, Mondelez, Nestlé, Unilever) as a variation of the well-known British Multiple Traffic Light system, but calculated on the (arbitrary) basis of portions (23). Nutri-Score appears to be effective in reducing portions sizes selected by consumers for products with a “lower nutritional quality” (sweet spreads, cookies and cheeses) thus helping to limit overconsumption of these products, while ENL appeared to mislead consumers and tended to increase the portion selected for some of the tested foods.
Numerous studies were conducted in 13 European countries and 7 countries outside Europe (24-28) testing the objective understanding of 5 front-of-pack labels. In all these studies, Nutri-Score presented the best efficiency to allow consumers to classify correctly different food products according to their nutritional quality, demonstrating the ability of the Nutri-Score to be applicable in contexts other than France.
In total, all the studies performed on Nutri-Score, conducted in multiple study contexts provide very consistent results highlighting its effectiveness on purchasing behavior and its better performance compared to other types of front-of-pack labels.
Current situation of Nutri-Score in France and Europe
When it was proposed in 2014 in an official report submitted by Serge Hercberg (then president of the PNNS, the French National Nutrition and Health Program) to the then minister of health (Marisol Touraine), no food company was in favour of the Nutri-Score and all opposed it. For four years, almost everything was done by powerful lobbies to prevent the implementation of this public health measure. Finally, only six companies adopted it at the time of the publication of the decree officializing it in France in October 2017. Thanks to consumers pressure (more than 90% of them support it and 87% demand that it becomes mandatory (29)) and the numerous scientific studies demonstrating its usefulness as well as the willingness of public health authorities (Ministry of Health, Santé Publique France), in 2022 more than 870 brands have finally committed to display it on the packaging of their food products (30).
Some firms that were initially very hostile to Nutri-Score, such as Nestlé, which notably participated in 2016 to the Big6 (with Coca-Cola, PepsiCo, Mars, Mondelez, Unilever) initiative to impose an alternative logo on Nutri-Score (the ENL, calculated by serving, which supported, of course, their interests…) changed their stance under consumer pressure. In 2019, three years after its formal adoption in France, Nestlé finally caved in face to scientific works and the strong consumer demand. While some large companies have finally agreed to its adoption, Nutri-Score has been and is still being fought by many large conglomerates such as Coca-Cola, Mars, Mondelez, Unilever, Ferrero, Lactalis, Kraft… and powerful agricultural sectors such as those of the processed meats and cheeses industries. The fact that firms like Carrefour or Nestlé, have given in and finally adopted Nutri-Score that they have fought for years, must be considered as real victories of public health. Now, to force companies that continue to oppose Nutri-Score and refuse to display it on their products, the only solution is to make it mandatory in Europe. Several petitions asking of the European Commission and parliament to make Nutri-Score mandatory have been launched by scientific associations and consumers organisations.
Despite the pressure of lobbies, Nutri-Score has continued its deployment in Europe: after France in 2017, it was officially adopted by Belgium, Spain, Luxembourg, Germany, the Netherlands and Switzerland but still on a voluntary basis due to the European regulation on consumer information voted in 2011 which does not allow member states to adopt any front-of-pack label as a mandatory provision. But in 2022, the European Commission plans to change this regulation as part of its «Farm to fork» strategy. The implementation of a unique and mandatory nutrition front-of-pack label for all European countries by 2023 has suddenly awakened agro-industrial lobbies that were rather satisfied with the optional nature of the Nutri-Score allowing those who did not want to display it not to. Now that a mandatory provision is on the table, a front of opponents to Nutri-Score was thus organized to prevent Nutri-Score from being chosen as the mandatory label for Europe while trying to denature it where it has already been adopted on a voluntary basis. We find there, the ever-opposed agro-food companies like Ferrero, Mars, Mondelez, Coca-Cola, Kraft, Lactalis, General Mills, Unilever… but also agricultural sectors, including cheeses and processed meat sectors, members of the powerful European trade union and professional organization COPA-COGECA; and a country -Italy- transformed into a lobbyist state, because of its government’s proximity to powerful actors in the agri-food industry (notably Ferrero) and certain agricultural sectors (such as Parmesan, Gorgonzola, Prosciutto, Parma ham, San Daniele ham, etc. In France, the Confédération Générale du Roquefort (with behind it Lactalis, the world’s number one dairy product company which sells 70% of Roquefort volumes) and other PDO/PGI cheese and processed meat production sectors have also been particularly active in anti-Nutri-Score lobbying and have mobilized a lot of political figures (especially elected representatives from the production areas) to push for exemption of their products to affix Nutri-Score. Of course, this request is not justified from a scientific or public health viewpoint.
As usually in their mode of action, lobbies use and disseminate many fake news aimed at discrediting Nutri-Score. These fake news are sometimes taken up by good faith people who are not sufficiently familiar with the issue of nutritional labels, but more often they are spread by certain actors defending economic or sometimes ideological interests. That’s why it’s important to demystify them… Several articles of this blog have already been published denouncing multiple fake news used for several years (31,32). But more recently, a new string of fake-news have appeared. Some examples and the scientists’ responses to some of these fake news are presented below.
Among the fake news trying to discredit Nutri-Score
“Nutri-Score penalizes traditional foods”
A typical example of fake news widely disseminated in the media and social networks and often taken up by politicians for most electoral reasons states that Nutri-Score would «penalize» traditional foods. But in fact Nutri-Score only translates the available nutritional composition of foods as it is whether they are traditional, with labels (PDO/PGI, Bio, red label, etc.) or not. This is why some traditional foods with a designation of origin have a rather favorable composition and are classified Nutri-Score A, like lentils of Puy, apples from Limousin, rice from Camargue, mogettes from Vendée or walnuts from Grenoble… According to a recent study performed by the french consumers association UFC Que Choisir, 62% of traditional foods are actually classified as Nutri-Score A, B or C versus 38% classified as D and E (mainly cheeses and processed meats) (33).
If cheeses or processed meat (PDO/PGI or not) are mostly classified as Nutri-Score D or E, this is actually related to their high content of saturated fatty acids and salt and their high calorie density. This does not mean that they should not be consumed. But being classified as Nutri-Score D or E simply reminds consumers that these products should be consumed in moderate quantities and with a limited frequency or should lead to rebalancing in the rest of the meal or the food day/week. This is the meaning of the classification of Nutri-Score D and E. And it is completely consistent with the nutritional recommendations concerning processed meats and cheeses that recommend moderation or even limitation in their consumption.
However, opponents to Nutri-Score try to take advantage of the positive image that traditional foods have, often perceived by consumers as «good quality» products, to try to discredit Nutri-Score. Arguing the fact that some of these products benefit from an PDO or PGI labels, they maintain a confusion around the term of “quality”. In fact, being awarded with official quality signs for a food product reflect, of course, positive elements, such as a virtuous modes of production, the link to a specific territory, manufacturing according to a sometimes ancestral know-how and precise specifications; but as important as these characteristics are, they have nothing to do with the nutritional composition of these products. Being part of the culinary heritage, having an PDO or PGI designation of origin are certainly very respectable elements that deserve to be valued. However, the PDO/PGI labels do not include in their definition, and therefore in their attribution, the notion of «nutritional value» (this is not their role). It is therefore incorrect to suggest that these labels of origin would give these food products a nutritional value that they do not have. Even with a PDO or PGI label, a red label, or being organic, processed meats or cheeses rich in fatty acids and salt and calories remain rich in fatty acids and salt and calories. Being part of the regional gastronomic heritage is certainly quite respectable, but it has nothing to do with having a nutritional quality favourable to health.
Thus, for these foods, as for all others, nutritional transparency is necessary. The request for exemption of traditional foods, relayed by different organisations of producers and politicians is therefore not acceptable. The display of the Nutri-Score is complementary to the labels reflecting other qualities of the products. On the other hand, the display of Nutri-Score on these products is fully in line with the concept of “consuming less but better”… For the same budget devoted to cheese or processed meats, whose consumption must be limited as indicated by Nutri-Score (in terms of frequency and quantity), the other signs of quality make it possible, within these categories, to direct the choices of consumers towards these products. Of course, communication could encourage the consumption of PDO or PGI products over those that are not when possible on a budget, but not by hiding the reality of their nutritional composition. The message could be: “consume less but better”.
But in reality, who hides behind the positive and friendly image of these products perceived as traditional? If we look specifically at the production of Roquefort (and this is true for many PDO/PGI cheeses), we find, in fact, powerful multinationals such as Lactalis (world n°1 of dairy products food companies) and Savencia (5th world group). Lactalis alone holds 70% of the production of Roquefort and many other cheeses, controls half of the French PDOs but also sells other products such as dessert creams, butter, fresh cream, all products classified rather D and E by the Nutri-Score. Savencia, alongside its wide range of cheeses including several PDO (Maroilles, Roquefort, Epoisses), also produces processed meat and chocolate (also D and E). So, behind the image of small local producers and sheep breeders highlighted in the anti-Nutri-Score campaigns, are hidden large agri-food conglomerates that defend their own financial interests. So by attacking Nutri-Score to supposedly defend PDO cheeses, it is in fact a Trojan horse that Lactalis and other industrialists advance to try to block the implementation of Nutri-Score or distort it. Moreover, at the same time, Lactalis is conducting another destabilization operation against Nutri-Score by proposing for its other non-PDO products, its own in-house label «It’s the plate that counts», obviously favorable to its products.
Various political parties in Europe (especially extreme right, nationalists and populists parties) do not hesitate to exploit arguments related to food and culinary patriotism as a means of trying to strengthen their attractiveness in the population, portraying the Nutri-Score as a threat (sometimes as coming from the European Commission) by opposing national or regional cultural practices. In Italy, extreme-right parties even organized street demonstrations to show their opposition to Nutri-Score in the name of the so-called defense of national or regional products presented as unfairly attacked… This has nothing to do with science and public health!
“Nutri-Score does not take into account ultra-processing, additives, etc.”
Among the other campaigns led by opponents to Nutri-Score, we can often hear the argument that Nutri-Score does not include the degree of processing (and the presence of additives associated) in its calculation. In fact, ultra-processing and nutritional composition are two different dimensions of food, likely to affect, each and independently, the risk of chronic diseases through different specific and complementary mechanisms. As with all other nutritional labels, Nutri-Score only provides information on the composition/nutritional quality of food, and does not include in its computation the other health dimensions of food: ultra-processing, presence of additives, neo-formed compounds or pesticide residues. As important as they are, these dimensions are not integrated in any front-of-pack nutrition label implemented in the world, because they cannot be integrated in the calculation of a single indicator and therefore aggregated into a single logo. It is therefore (alas) impossible to ask a synthetic label to combine these different dimensions on its own.
Of course, summarize the overall health dimensions of food through a single and reliable indicator, which would be able to predict global health risk would be, obviously, the dream of any public health nutrition actor in the interest of consumers. But it is not by chance and certainly not by incompetence, if no international research team or public health structure in the world, or any committee of independent national or international experts, nor has the WHO, been able to develop such a synthetic indicator.
Epidemiological studies, especially prospective cohort studies, confirm the importance of each of these food dimensions in the development of chronic diseases independently of each other. Although Nutri-Score only focuses on the nutritional information of consumers, this already represents a lot in terms of public health, as demonstrated by the prospective cohort studies (some involving more than 500,000 people followed for more than 15 years), which show at the individual level that the consumption of foods that are well classified by Nutri-score is associated with lower mortality and a lower risk of developing chronic diseases: cancer, cardiovascular disease, obesity,etc. In several studies, it has been shown that the deleterious effect of ultra-processed foods remains significant, even after adjustment for the nutritional quality of the diet. But on the other hand, the effect of the nutritional components is also independent of the level of processing/ultra-processing: in the NutriNet-Santé cohort, the associations between the nutritional score that underpins the Nutri-Score and cancer risk still remain significant after adjusting for the proportion of ultra-processed foods in the diet. Similarly, studies on the role of pesticides take into account the nutritional quality of the diet and associations persist.
Thus, in the context of current knowledge, if it is not possible to combine all health dimensions of foods into the same algorithm to obtain a single synthetic label, at least they can be associated graphically. Even if some practical issues need to be resolved, it seems feasible to add a dark border to the Nutri-Score, for example, to characterize ultra-processed foods and displaying beside, for organic foods, the corresponding official label.
Of course to suggest that Nutri-Score favours ultra-processed foods and ultimately harms health is totally disinformation!
“Nutri-Score does not include all the nutrients of interest present in foods: vitamins, minerals, polyphenols, free sugars, types of fatty acids…”
By choice, the Nutri-Score does not take into account vitamins, minerals or other compounds within the foods. That is because the Nutri-Score is a tool for transparency on the nutritional composition of foods, and data on the composition of foods in vitamins, minerals, polyphenols, free sugars, type of acids,… are not available in the nutrition declaration because they are not mandatory in the European regulations (regulation INCO, No°1169/2011).
The inability to access these nutritional data prevents the ability to integrate them into the development of a tool for transparency, as it would necessitate to rely exclusively on proprietary data from the industry. But should the information be available at some point in time on a mandatory basis (on added or free sugars in particular), and the computation of the Nutri-Score algorithm may integrate them…
But an additional interest of the Nutri-Score (as HSR in Australia), is that it takes into account in the calculation of its algorithm, unlike other existing nutritional front-of-pack nutritional label, not only ‘unfavourable’ elements as calories, sugar, saturated fat and salt; it incorporates also other ‘favourable’ elements such as the percentage of fruits and vegetables contained in the food. However, fruits and vegetables are an excellent “proxy” for certain vitamins (such as vitamin C and beta-carotene); and proteins are an excellent proxy for certain minerals (such as calcium and iron). A very rigorous scientific process incorporating numerous studies conducted by the Oxford team (34,35) that developed the initial FSA score, have been used to justify the nutrients or elements retained in the algorithm (given their potential impact on health) and to limit, through sensitivity studies, their number and to avoid redundancies between elements. Thus through its substitutes (its «proxies»), the algorithm underlying Nutri-Score takes into account many more elements than the only list displayed for its calculation.
“Nutri-Score is calculated per 100g, not per serving…”
Another argument put forward to discredit Nutri-Score and often found in the discourse of the lobbies is the fact that it is calculated for 100g while “we do not eat 100g of cheese, 100g sausage, 100g mayonnaise or 100g chocolate spread…” But this choice is explained by the fact that the elements of the nutritional composition (calories, sugars, fats, saturated fatty acids, salt, proteins, etc.) that are currently accessible on food packaging (the mandatory “nutrition declaration” voted in Europe in 2011) and therefore usable to build a nutritional label (whatever it may be) are expressed per 100g or 100ml (Annex XV to the INCO Regulation, 2011). If they are not expressed per serving, it is because setting portion serving/portions sizes for foods are very difficult to define because they vary widely according to individual energy requirements. To be relevant, they should be therefore defined specifically for men, women, adolescents, young children, active or sedentary subjects… So, it makes it difficult to calculate a universal FOP nutrition label based on the different portion sizes and displayed on the packaging. As serving sizes cannot be standardized on a scientific basis and defined according to different relevant consumer groups (with specific nutritional needs), when they are proposed on packs of some foods, it is currently in the form of a single quantity fixed by the manufacturer itself. This allows potential manipulation of the information: manufacturers have just to define smaller portion sizes on their packs to artificially reduce the amounts of fat, sugar or salt in the serving of their products indicated to consumers. And, if this serving size is used for the computation of FOP nutritional labels (as requested by some food companies and agricultural sectors), it would allow them to “white-wash” the colors of the label at their advantage. Similarly breakfast cereal manufacturers suggest serving of 30g servings, while it is known that the majority of teens consume 60 or 80 g per serving. For cheeses, the few manufacturers that display a serving on their packs, usually consider 30g, while in reality, especially among the great cheese lovers, the amount consumed are much larger. Finally, companies selling chocolate bars sold in packets of two usually use only one of those as a serving size…
To compare products, it is necessary to use a reference value. For example, when comparing the prices of food products, we systematically refer to the price per kilo, precisely to avoid the hazards related to the weight of the product. Even though we do not systematically consume 1kg of food products… With regard to nutritional quality, taking into account a standard amount, such as 100g, is the best choice allowing a valid comparison between foods without inducing an estimation error. This common denominator makes it possible to compare 100 ml of olive oil to 100 ml of another oil; 100g of breakfast cereals to 100g of other cereals; 100g of a pizza to 100g of another pizza; 100 g of Emmenthal, 100g of Maroilles, Roquefort or Mozzarella…
Illegitimate comparisons of foods such as “olive oil is less classified than breakfast cereals, yet olive oil is healthy and breakfast cereals are unhealthy” or “fries vs smoked salmon !”
Another fake-new widely relayed. But in fact, it’s important to keep in mind that Nutri-Score is not a binary front-of-pack nutritional label characterizing the overall health value of foods in an absolute way (good vs bad). It does not classify foods as “healthy” or “unhealthy”. Such a purpose for a nutritional logo would remain totally questionable because this property is related to the quantity consumed of the food and the frequency of its consumption, but also to the overall dietary balance of individuals (nutritional balance is not based on the consumption of a single food, or even on a meal or a day…). These complex notions cannot, of course, be summarized by a nutritional logo attributed to a specific product of a given brand…
The objective of the Nutri-Score is to help consumers to compare, in a relative way, the nutritional quality of foods allowing them, at a glance, to compare the nutritional quality of food, which is already very important to guide their choices at the time of purchase. But this comparison is only of interest if it concerns foods that are relevant to be compared by consumers in terms of consumption, use or purchasing conditions. The consumers are not confronted to choose between breakfast cereals and olive oil. It is highly unlikely that they would consider consuming olive oil for breakfast, or seasoning their salad with breakfast cereals… In reality, the consumers needs to be able to compare the nutritional quality of foods that are relevant to substitute in their consumption (and are often in the same supermarket aisles or in nearby aisles). As seen above, if he wants to choose the foods for his breakfast, it is important, as explained in Figure 1, that he can compare foods of different categories but consumed on this occasion, for example bread, pastries, breakfast cereals or cookies. And of course to have access to transparency on nutritional quality within the major categories or according to brands, to be able to compare different breakfast cereals between them, or the different industrial pastries or packed breads depending on the brands…
Concerning breakfast cereals there is a very great variability of nutritional quality as showns with Nutri-Score ranging from A to E depending on the type of cereal (the same is true for the same type of breakfast cereals but of different brands). And if the consumer wants to choose an added fat he will compare within the different oils (or possibly with the butter). He will see that olive and rapeseed oils are in the best possible class of Nutri-Score (C) for added fats and that there is no alternative A or B (even olive and rapeseed oil are 100% fat). (Figure2).
Another element of deception with this type of illegitimate comparisons is that they play on stereotypes in terms of belief or perception of foods. For instance, the image of French fries is rather perceived as nutritionally unfavorable in the popular belief (often linked to fast foods), while the image of «traditional» foods such as Roquefort, Serrano ham, sardines or smoked salmon hase a rather favorable perception. However it is important to take into consideration the reality of the nutritional composition of these products. Roquefort or Serrano ham are classified Nutri-Score E,due to their high content in saturated fats and salt. Smoked salmon is classified D -widely quoted as a criticism of the Nutri-Score- due to its richness in salt (2.5 to 3.5 g of salt per 100g), unlike fresh salmon which is classified A, what is never mentioned in the comments questioning the classification of salmon by Nutri-Score. French fries classified as A are usually only pre-cut potatoes…and those classified B have a very limited amount of fats and added salt.
The statements made in the fake news about French fries imply both irrational perception of this type of food (negative image linked to fast-food) and ,once again, a lack of understanding of how a nutritional label is established and what its role can be. Indeed, by definition, the Nutri-Score (like all other FOP nutrition labels) is, in fact, only a translation of the declared nutritional values present on the back of the package, which refers to foods as it is sold. The manufacturer is required to be transparent about the nutritional composition of foods which are placed on the market, but he cannot consider and/or anticipate the variability of the methods of preparation, use or consumption for its product.
However, for frozen French fries several cooking methods are possible. Baking pre-cooked frozen fries (usually classified B by Nutri-Score) has no impact on the nutritional composition, so the Nutri-Score is not modified in this case after cooking (it remains B). On the other hand, for frozen French fries (not pre-cooked) usually classified A by Nutri-Score (they are simply peeled and cut potatoes), the information on the cooking method given on the packaging recommends using a deep fryer. Under these conditions, the Nutri-Score will change, depending on the cooking oils (more or less rich in saturated fatty acids) from A to B or maximum to C. The subsequent addition of salt may also affect the score, but cannot reasonably be anticipated upon purchase of the product.
However, it appears necessary in the case of foods that cannot be consumed as purchased (such as frozen, uncooked fries), and only for those whose specific and detailed cooking method is indicated on the packaging that could impact the Nutri-Score, that the manufacturer alerts consumers to the change induced on the Nutri-Score by giving 1) the Nutri-Score of the product as sold (classical use of Nutri-Score using the elements that are on the nutritional declaration) and 2) a statement on the potential Nutri-Score obtained by the product after cooking according to the recommended mode indicated on the package (for French fries the modification leads to a higher class of Nutri-Score after passing in deep fryer).
There are, in fact, many other fake news disseminated by lobbies. Some of are incredibly fanciful or even conspiracy: Nutri-Score would oppose the Mediterranean diet, would have been created to penalize «made in Italy» products, would be the control of Europe on the content of our plates, was created by the big industrialists to promote junk food, … Despite the absurdity of these arguments, they are sometimes the subject of political instrumentalization. We have already provided a number of elements of response to these fake news and debunking their mechanisms in several articles published on this blog (31,32).
However, it is clear that Nutri-Score is not an universal panacea. And we cannot expect for Nutri-Score or any other nutritional label to solve all the nutritional problems we face today, in France and all around the world. Nutri-Score must be integrated into an ambitious public health nutrition policy. Like all nutritional labels, it has its limitations (described above). Even as a nutritional logo it is not 100% perfect. And even if it already works well as demonstrated by the numerous scientific studies that have validated it, it needs, as it was intended at the time of its implementation, to be regularly improved in line with the progress of scientific knowledge and the experience of its deployment. The Nutri-Score is a public health tool that must evolve over time. Its next update by a European Scientific Committee composed of independent researchers is expected in summer 2022. The work undertaken and the improvements proposed in the interim report of the European Scientific Committee in charge of updating the Nutri-Score (36) are very promising. Thus the Nutri-Score, which already works well, will be even more effective! Of course the modifications developed on purely scientific bases will not satisfy those who criticize certain food rankings by Nutri-Score by projecting their own beliefs or ideology on how foods should be classified. Nor will those who ask more of Nutri-Score than can provide a nutritional logo. Similarly, those who are waiting for modifications to the algorithm to meet only their economic interests will also be disappointed. But once again Nutri-Score was built on a scientific basis. It was scientifically validated. And it is still science that must lead to propose and build its update!
Conclusion
The fear of a new regulation aiming to display Nutri-Score on all foods in Europe has brought out a new discourse of opponents. This discourse is based on various fake-news surfing on established popular beliefs that they hijack (“traditional foods must be good”, “you don’t eat 100g of different foods”, “fries are very fatty”, “smoked salmon is very healthy”, etc.). But above all what is striking today is that, in addition to the fake news disseminated, and the lack of consideration of the support of consumer associations (in particular the BEUC, which brings together 43 European consumer associations), the discourse of the lobbies and those who relay it, completely denies the importance of the science behind the Nutri-Score (including many studies that have validated its algorithm and demonstrated its interest). This denial of science, or its questioning (with the casting of the doubt on the studies that disturbs them) is part of the usual strategies of lobbies that do not respect the fact that Nutri-Score is widely supported by the scientific community: 417 European scientists and 30 associations from all over Europe representing thousands of experts in Nutrition, Dietetics, Public Health, Health Education, Pediatrics, Cancerology, Cardiology and many other disciplines, have signed a call for the European Commission to adopt the Nutri-Score as a mandatory nutrition logo for Europe (37) given the scientific basis on which it is based. The WHO International Agency for Research on Cancer (IARC), based on available scientific data, also highlighted the superiority of the Nutri-Score over other nutritional front-of-pack labels and called for its adoption in Europe (38). In France, 42 learned societies and associations of public health actors supported the development of the Nutri-Score (39). More than 1,000 French health professionals have also launched an appeal to fight lobbying aimed to distort the Nutri-Score (40).
Today, the detractors of Nutri-Score completely deny science and the opinion of scientists. Worse, we can see that economic lobbies and their political relays, even though they have no particular scientific skills, do not hesitate to express themselves as if they were nutritionists and to use and abuse science to criticize Nutri-Score. Industry-funded studies biased towards specific results are being promoted and cherry-picking of scientific results put forward to discredit the entire process. They take outrageous positions on issued that are obviously well known to academic scientists (about ultra-processed foods, additives, portions, elements to be included in the calculation of a nutrient profile, graphic format, etc.) who have established their decisions on scientific bases (it’s their job!), in order to build and validate Nutri-Score.
We are witnessing the development of a new form of lobbying in which economic and political actors substitute themselves to public health experts and give their opinion on what should or should not be a nutritional label on the front of packages by arguing and questioning the choices of scientists who are experts in this field! And yet, only real scientific arguments produced by real experts without any link or conflict of interests should guide public health policy decisions…
So what will be the weight of these economic and political lobbies in the final decision of the EU concerning the obligation to display Nutri-Score in Europe and, if they do not block the European decision, will they obtain an exemption for certain products? In a few months, we will know if the European political authorities will take their decision by privileging public health or economic interests! In the meantime, it is beneficial to constantly debunk these fake news whose purpose is to discredit a disturbing public health tool that they consider opposed to their commercial interests.
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A summary of this text was published in French in the Revue du Praticien :
Démystifier les fake news concernant Nutri-Score. Hercberg S, Galan P, Kesse E, Deschasaux M, Srour B, Touvier B. Revue du Praticien, 72, 6, 599-604, juin 2022.
[1] The history of the Nutri-Score and the lobbying that was developed to prevent its establishment in France is described in detail in Serge Hercberg’s book «Mange et tais-toi: un nutritionniste face au lobby agroalimentaire» published by HumanSciences (all copyrights are donated to Foundations)
NUTRI-SCORE 