Nutri-Score falls short: this is the proposal to add a labeling to ultra-processed food, Over the years, research in epidemiology and nutrition has made it possible to identify three dimensions of food that particularly influence the health of consumers: nutritional composition, degree of processing and the presence of contaminants, particularly pesticide residues.
Although each of these dimensions can influence health, none by themselves It alone summarizes the overall “health value” of foods . However, we sometimes hear it said that the fact that a food is “not ultra-processed” could be enough to guarantee a favorable nutritional quality of a food. Others tout its nutritional quality by refuting the dangers of ultra-processing and additives. The “halo” effect of organic is sometimes used to give an overall “healthy” image to a fatty, sweet or salty product. But even though organic, the product is still oily, sweet or salty!
Given your public health concerns, how can we better inform consumers about all these different health dimensions of the food? What are the scientifically most reliable indicators today?
Nutrition, ultra-transformation, contaminations: three essential dimensions
Scientific research has identified several dimensions of food that can influence health.
This is the case, first of all, of its composition nutritional value and its energy density. Certain nutrients (fibers, proteins, minerals, vitamins …) are favorable for health, while others (sugars, saturated fats, salt …) are quite unfavorable. It is well documented the detrimental impact of a diet that is too energetic and too rich in salt, sugar , saturated fatty acids and low in fiber, fruits and vegetables and legumes regarding the risk of various diseases (cancer, cardiovascular diseases, obesity, hypertension and type 2 diabetes) as well as their increase in mortality.
Among the other important dimensions for health, we can also cite its degree of transformation , and in particular the fact of being “ultra-processed” (expression that designates foods that have gone through multiple industrial processes with the addition of additives). Finally, the possible presence of pesticide residues used during production can also have health consequences.
Epidemiological work has confirmed the importance of each of these three dimensions , regardless of whether the other two are present, in the development of chronic diseases. Thus, several studies have shown that the detrimental effect of ultra-processed foods follows being significant , even having take into account the final nutritional quality of the diet.
In the end, it seems clear that both the nutritional composition and the level of ultra-processing, both together and separately, are capable of negatively affecting the risk of acquiring chronic diseases by different specific mechanisms (and probably in a complementary way). The same occurs with the role of pesticides when the nutritional quality of the diet is taken into account.
Even if we accept that the scientific evidence in these respects varies in its degree of reliability , the weight of each of these dimensions in terms of risk of chronic disease justifies that there is a duty to inform consumers about the presence and composition of these elements in each food.
Specifically, when choosing foods, the recommendations are relatively simple: it is better to consume “non-ultra-processed” foods , favoring those with the best nutritional composition. If, despite everything, you want to consume an ultra-processed food, again it is better to favor those with the most favorable nutritional composition.
But, how to inform consumers in a simple and understandable about these three dimensions?
Provide information on the nutritional dimension
Numerous national and international expert committees, including WHO, have proposed the implementation of simplified nutritional information systems in food packaging, with in order to help consumers to identify the nutritional quality of food at a glance and to be able to compare products with each other. It is to meet this demand that the Nutri-Score nutritional logo was designed (devised by the Nutritional Epidemiology Research Team (EREN), a team of independent academic researchers working for Inserm, INRAE, CNAM and the University of Paris 12).
Officially adopted in France, Belgium, Germany, Spain, the Netherlands, Luxembourg and Switzerland, this logo is based on an algorithm that integrates nutrients and elements whose consumption has been shown to have an impact on health . This algorithm has been the subject of numerous studies aimed at evaluating it, in the framework of large French and Spanish cohorts, and in the European EPIC cohort (carried out in 10 country European ses). All these studies have shown that the consumption of foods worse classified by the Nutri-score algorithm was prospectively associated with an increased risk of chronic diseases (cancers, cardiovascular diseases, weight gain, metabolic syndrome, etc.) and mortality.
Numerous studies have also validated the Nutri-score calculation method as well as its graphic format (gradual logo with five colors along with the letters from A to E), and its effectiveness has also been proven, according to the evaluation methodology of nutritional logos according to as recommended by the WHO .
But if the Nutri-score provides information on the general nutritional profile of the food, how can consumers be informed about its other health dimensions?
Inform so About the fact that a food is ultra-processed
During the last decades, eating habits have changed. Specifically, the consumption of ultra-processed foods has increased significantly : in many Western countries, these foods now provide more than half of the daily energy intake. They are often (but not always) characterized by lower nutritional quality than others, and by the presence of food additives, newly formed compounds (produced during processing processes), and packaging compounds and other contact materials.
To analyze the level of food processing, it was proposed in 2009 the NOVA classification and changed to 2016. It categorizes foods into four groups according to their degree of industrial processing : minimally processed or unprocessed foods (NOVA1), culinary ingredients such as sugar, salt, oil or butter (NOVA2 ), processed foods (NOVA3) and ultra-processed foods (NOVA4). Numerous studies have shown links between the consumption of ultra-processed foods according to NOVA4 classification and a higher risk of various chronic pathologies .
Nutritional and ultra-processing dimensions partially overlap: food ultra-processed are, on average, of lower nutritional quality . However, the level of ultra-processing alone is not sufficient to determine the potential effect of a food on health. Among the foods considered “not ultra-processed” according to NOVA, some are of poorer nutritional quality (those rich in saturated fat, sugar or salt, etc.). This is for example the case of pure grape juice, categorized NOVA1 and classified E by Nutri-score (contains more than 160 grams of sugar per liter). In total, in terms of your note in the Nutri-score, the 18, 2% of NOVA1 foods are classified as C , 7.4% as D and 3.3% as E. It also occurs conversely: some ultra-processed products may have poorer nutritional quality. This is particularly the case for fruit compotes with no added sugar or whole sandwich breads, rated A by Nutri-score. An analysis of 00232. 522 ultra-processed foods (NOVA 4) from the Open Food Facts database (2009) found that, while the 79% of ultra-processed foods are classified as C, D and E, the 13% get B and 8% get A.
In fact, the NOVA classification does not take into account the variability in the nutritional composition of the products within each of its categories. For example, for culinary ingredient products (NOVA2), there is no differentiation between vegetable and animal fats, not even between different vegetable oils. This does not allow us to recognize those whose nutritional composition is the most favorable and should be favored (olive oil or rapeseed better than sunflower, corn, peanut, coconut, palm oil and others). However, this information is provided by Nutri-score.
Thus, we can clearly appreciate the interest of using and crossing various indicators in our day-to-day life. France, like other countries, has also integrated the concept of ultra-processed foods in its nutritional recommendations for the population with the idea of limiting their consumption. Unfortunately, information on “ultra-processed” products has not yet been implemented in food labeling. To reduce the proportion of ultra-processed foods, and for the moment, we can advise the choice of foods that have the shortest possible ingredient lists and with the least amount of those additives or substances that the consumer does not usually have in their kitchen.
How to report pesticide residues? A growing number of studies (particularly within the framework of the French NutriNet-Santé cohort ) observed a lower risk of chronic pathologies in the major consumers of organic products or those less exposed to pesticide residues .
There is already an informative logo in Europe, the Union Ecolabel European, which corresponds to a quality label that certifies ica that a marketed product complies with the organic farming regulations of the European Union, based on the ‘ban on synthetic fertilizers and pesticides’ .
Finally, it should be remembered that, with regard to the presence of pesticide residues, the fact that a food comes from organic farming does not necessarily mean that it is of good nutritional quality . In addition, it can be organic, but also ultra-processed. This is the case, for example, for organic forms of spreads, prepared salads, cakes, cold cuts or breakfast cereals. An organic cookie certainly contains less pesticide residue, but its nutritional quality will remain limited, and most of the time it is ultra-processed.
Transform information labels food, but not in any way Several initiatives have recently emerged that attempt to combine at least two of the dimensions of the degree of health of the food, if not all three.
If they cannot be combined in the same algorithm, they can, on the other hand, be associated graphically. For example, it would be possible to add a black border to the Nutri-score for ultra-processed foods, while for organic foods the corresponding official label can be displayed next to it.
In this way, the consumer would have, at a glance, information on the main health dimensions of food, all important and to take into account, without obfuscating any of them. He could thus knowingly choose the foods that are the most favorable for his health: 1) those not ultra-processed (without black border) favoring the best valued by Nutri-Score, 2) yes, despite everything and for reasons of taste, cost or practicality, you want to select an ultra-processed food (with a black border), choose those with the most favorable Nutri-Score, and 3) give preference to BIO foods whenever there is the option (especially regarding the vegetable foods).
Authors: Serge Hercberg, Emeritus Professor of Nutrition at the University of Soborna in Paris, physician at the Department of Public Health of the Avicenne Hospital (AP-HP), Research Team in Nutritional Epidemiology, U 1153 Inserm, Inra, Cnam from the University of Soborna in Paris; Emmanuelle Kesse-Guyot, director of research in nutritional epidemiology; Inrae Mathilde Touvier, Director of the Nutritional Epidemiology Research Team, U 1153 Inserm, Inra, Cnam Inserm from the Soborna University in Paris; Pilar Galán, nutritionist, Director of Research at INRAe, Research Team in Nutritional Epidemiology, U 1153 Inserm by the University of Soborna in Paris.
This article was originally published in The Conversation . You can read the original article here .
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