Objective understanding of the Nutri-score front-of-pack label by European consumers and its effect on food choices: an online experimental study.
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ABSTRACT: Background
The effectiveness of Front-of-Pack nutrition Labels (FoPLs) may be influenced by national context. In light of the ongoing efforts to harmonize FoPLs across Europe, this study aimed to compare the effectiveness of five FoPLs (Health Star Rating system, Multiple Traffic Lights, Nutri-Score, Reference Intakes, Warning symbols) on consumer understanding and food choice in 12 European countries.Methods
In 2018-2019, for three food categories, approximately 1000 participants per country were asked to select which food they would prefer to purchase between three products with distinct nutritional quality profiles, and then to rank the products by nutritional quality. Participants (N?=?12,391 in total) completed these tasks first with no FoPL and then, after randomization to one of the five FoPLs, with a FoPL on the food packages. Associations between FoPLs and change in (i) nutritional quality of food choices and (ii) ability to correctly rank the products by nutritional quality were assessed with logistic regression models adjusted for sociodemographic and lifestyle characteristics of participants, conducted overall and by country.Findings
Compared with the Reference Intakes, the Nutri-Score (OR?=?3.23[2.75-3.81]; p?InterpretationIn the context of FoPL harmonization in Europe, these findings from an online experiment provide insights into the Nutri-Score's effectiveness on European consumers.
SUBMITTER: Egnell M
PROVIDER: S-EPMC7678195 | biostudies-literature | 2020 Nov
REPOSITORIES: biostudies-literature
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Project description:Abstract: In Europe, discussions are currently ongoing to harmonize front-of-pack nutritional labelling, while some countries have adopted or are considering implementing the Nutri-Score. However, its adaptability to multiple nutritional contexts in Europe requires further investigation. This study aimed to evaluate the applicability of the Nutri-Score in various European countries, regarding its ability to discriminate the nutritional quality of foods and its consistency with national dietary recommendations. The European Food Information Resource (EUROFIR) nutritional composition databases from eight European countries (Finland, France, Norway, Poland, Portugal, Slovakia, Sweden, and Switzerland) were used. The distribution of foods across the Nutri-Score classes within food groups was assessed, as well as the discriminating performance of the label, and the adequacy of nutritional recommendations. The Nutri-Score demonstrated high discriminating ability for all food groups, with similar trends in the eight countries, and consistency with nutritional recommendations. For instance, fruit and vegetable products were mainly classified in the two healthiest Nutri-Score categories, while sugar and animal fat products were mainly classified in the two less healthy categories of the Nutri-Score. Our results support the fact that the Nutri-Score would be a relevant tool to discriminate the nutritional quality of products within and across relevant food groups in different European countries, with consistency with nutritional recommendations.
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Project description:Since the implementation of the Nutri-Score on a voluntary basis in 2017 in France, very few studies have evaluated how the label was recognized and used by consumers. The goal of this study was to assess the evolution of awareness, support, and perceived impact on purchasing behaviors of the Nutri-Score in France. Between April 2018 and May 2019, a total of 4006 participants were recruited across three successive waves and answered questions regarding awareness of the Nutri-Score, support of the measure, and change of behavior following the implementation of the Nutri-Score via an online survey. Descriptive analyses to assess the evolution over time were performed, as well as logistic regression models to evaluate associations between the different outcomes and individual characteristics. From April 2018 to May 2019, the awareness of the Nutri-Score increased considerably, reaching 81.5% in May 2019. Since April 2018, a steady proportion of participants-9 out of 10-showed strong support toward the measure and a similar proportion, 87.2%, declared being in favor of making the Nutri-Score mandatory. The impact on purchasing behaviors appeared promising given the limited implementation of the label, with 42.9% of the participants reporting they modified their purchasing behaviors thanks to the measure. Multivariate analyses showed that the impact on purchasing behaviors of the Nutri-Score was greater over time, on younger populations and on frequent labeling readers. Our results suggested that the labeling system was well received and used by all socioeconomic groups, including subgroups who are more likely to have a lower-quality diet.
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Project description:ObjectiveTo determine if the Food Standards Agency nutrient profiling system (FSAm-NPS), which grades the nutritional quality of food products and is used to derive the Nutri-Score front-of-packet label to guide consumers towards healthier food choices, is associated with mortality.DesignPopulation based cohort study.SettingEuropean Prospective Investigation into Cancer and Nutrition (EPIC) cohort from 23 centres in 10 European countries.Participants521 324 adults; at recruitment, country specific and validated dietary questionnaires were used to assess their usual dietary intakes. A FSAm-NPS score was calculated for each food item per 100 g content of energy, sugars, saturated fatty acids, sodium, fibre, and protein, and of fruit, vegetables, legumes, and nuts. The FSAm-NPS dietary index was calculated for each participant as an energy weighted mean of the FSAm-NPS score of all foods consumed. The higher the score the lower the overall nutritional quality of the diet.Main outcome measureAssociations between the FSAm-NPS dietary index score and mortality, assessed using multivariable adjusted Cox proportional hazards regression models.ResultsAfter exclusions, 501 594 adults (median follow-up 17.2 years, 8 162 730 person years) were included in the analyses. Those with a higher FSAm-NPS dietary index score (highest versus lowest fifth) showed an increased risk of all cause mortality (n=53 112 events from non-external causes; hazard ratio 1.07, 95% confidence interval 1.03 to 1.10, P<0.001 for trend) and mortality from cancer (1.08, 1.03 to 1.13, P<0.001 for trend) and diseases of the circulatory (1.04, 0.98 to 1.11, P=0.06 for trend), respiratory (1.39, 1.22 to 1.59, P<0.001), and digestive (1.22, 1.02 to 1.45, P=0.03 for trend) systems. The age standardised absolute rates for all cause mortality per 10 000 persons over 10 years were 760 (men=1237; women=563) for those in the highest fifth of the FSAm-NPS dietary index score and 661 (men=1008; women=518) for those in the lowest fifth.ConclusionsIn this large multinational European cohort, consuming foods with a higher FSAm-NPS score (lower nutritional quality) was associated with a higher mortality for all causes and for cancer and diseases of the circulatory, respiratory, and digestive systems, supporting the relevance of FSAm-NPS to characterise healthier food choices in the context of public health policies (eg, the Nutri-Score) for European populations. This is important considering ongoing discussions about the potential implementation of a unique nutrition labelling system at the European Union level.
| S-EPMC7491938 | biostudies-literature
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