Front-of-pack (FOP) labelling systems to improve the quality of nutrition information to prevent obesity: NutrInform Battery vs Nutri-Score

Abstract

Many systems for classifying food products to adequately predict lower all-cause morbidity and mortality have been proposed as front-of-pack (FOP) nutritional labels. Although the efforts and advances that these systems represent for public health must be appreciated, as scientists involved in nutrition research and belonging to diverse Italian nutrition scientific societies, we would like to draw stakeholders' attention to the fact that some FOP labels risk being not correctly informative to consumers' awareness of nutritional food quality. The European Commission has explicitly called for such a nutrition information system to be part of the European "strategy on nutrition, overweight and obesity-related issues" to "facilitate consumer understanding of the contribution or importance of the food to the energy and nutrient content of a diet". Some European countries have adopted the popular French proposal Nutri-Score. However, many critical limits and inadequacies have been identified in this system. As an alternative, we endorse a new enriched informative label-the NutrInform Battery-promoted by the Italian Ministry of Health and deeply studied by the Center for Study and Research on Obesity, Milan University. Therefore, the present position paper limits comparing these two FOP nutritional labels, focusing on the evidence suggesting that the NutrInform Battery can help consumers better than the Nutri-Score system to understand nutritional information, potentially improving dietary choices. LEVEL OF EVIDENCE: II. Evidence was obtained from well-designed controlled trials without randomization.

Keywords: Dietary choice; Education; Food; Food portions; Nutrition; Obesity; Participation; Policy; Prevention; Public health.

Fig. 1

The Nutri-Score labelling system. This system is a summary, colour-coded, graded FOP label that shows a scale of five colours, from dark green to red. The Nutri-Scoresystem combines positive characteristics (i.e., fruit, vegetables and nuts, fibre, protein and seed, walnut and olive oils content) with negative characteristics (i.e., energy, total sugar, saturated fatty acids and sodium content) to achieve a score between – 15 (most healthy) and + 40 (least healthy). As shown, this score is reduced to a combination of a letter (A to E), where A reflects the highest nutritional quality and E the lowest

Fig. 2

The NutrInform Battery labelling system. To be underlined that all values expressed are relative to the individual serving of 40 g. Each box contains a quantitative indication of the individual portion's energy, fat, saturated fat, sugar, and salt content. The energy content is expressed both in joules and calories. The contents of fat, saturated fat, sugar and salt are expressed in grams. The " battery" symbol shows the percentage of the individual portion's energy, fat, saturated fat, sugar and salt toward the recommended daily intake. The recommended daily intake amounts in the EU are energy, 8400 kJ / 2000 kcal; fat, 70 g; saturated fat, 20 g; sugars, 90 g; salt, 6 g. The charged portion of the battery graphically represents the percentage of energy or nutrients contained in the individual portion, allowing you to quantify it visually as well. The sum of what one eats during the day can "fill" the battery charge without going overboard, not to exceed the recommended daily intake