How to solve the nutritional conundrum? News on the label front, review and outlook

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Consumers choose a variety of foods every day to buy, order, and consume. Few people are aware of the value of a balanced diet; many have the idea that to reduce weight one must ‘cut calories.’ The tables on the label-with the absolute values of energy and nutrients per 100 grams of product-tell little or nothing to the many who do not have the vaguest idea of their daily needs. Nor do they help in solving the nutritional conundrum. Which product, among several on the shelf, is preferable?

Incomprehensible news, little time. We then rely on the brand, the offer, the compulsion to repeat. And health is affected. (1) The brief scientific review to follow shows how synthetic,front-of-pack (FOP) labeling can contribute to solving the nutritional conundrum. Helping consumers choose, at a glance, the most suitable foods to compose a balanced diet. (2) The prospects, win-win, to follow.

Ineffective nutrition claims

Nutrition statements, generally placed on the back of food labels, are completely ineffective. Very few read them, very few of the few understand them, no one is able to relate their data to individual nutrition needs. Comparing the nutritional characteristics of various products on the shelf in turn requires no small amount of time and memory. Thus, the functions of ‘guiding purchases’ and ‘helping with consumer choices’ are lost. (3)

The ineffectiveness of the classical nutrition table is also blamed in the behavioral sciences on the excessive ‘cost of information’. That is, the time and effort required to decipher the content of the information and apply it to the practical case (‘preferable because and for whom?’). Therefore, consumers want to receive simplified news with the values that matter prominently displayed. (4) Perhaps with a suggestion on an objective basis, such as the NutriScore, and the help of an app consistent with it such as Yuka.

Summary news on the label front

The Global Syndemic-that is, the epidemic spread of serious Non Communicable Diseases (NCDs) related to obesity, overweight, and malnutrition-has spurred the search for useful tools to encourage healthier food choices by minimizing the consumption of junk food. (5) Nutrient profiles-that is, the classification of foods because of their nutritional values-were recommended by WHO for the specific purpose of guiding consumer choices in the simplest, color-coded way (e.g., by traffic-lights in the UK, keyhole system in Scandinavian countries, NutriScore in the rest of Europe) or a warning(as in Mexico).

The dominant industry lobby in turn developed the Facts Up Front, adopted in the U.S. as early as 2007, proposed in Europe as Guideline Daily Amounts (GDA). With the idea of indicating, on the label front, the contribution of a (variable) portion of the product to an unlikely ‘average daily requirement’ (6.7). And the goal of contrasting this monochromatic, appeal-less system with the more effective ones described above. In the U.S., consumer groups have challenged this system, threatening class actions against Big Food. Which instead, predictably, prevailed in Europe where GDAs were transposed into reg. EU 1169/11, under the name Reference Intake (‘Reference Intake’). (8)

Fig. 1. Examples of the application of the Facts Up Front system in labeling (Lim et al., 2020)

Reduce or interpret?

Synthetic front-of-label nutrition labels (FOPs) developed over the past two decades across Continents have been classified into two macro-categories:

reductive. The information on the back of the label is replayed without offering any interpretation of the data. News can be singular (kcal on the front label) or nutrients-specific (e.g., Reference Intake, kcal+fat+saturated fat+sugar+salt),

interpretive. In this case, graphic signs or scores help consumers evaluate the merits and/or flaws, i.e., nutritional profiles of products. Indicators can be nutrients-specific (e.g., Multiple Traffic Light) or summary (e.g., NutriScore, Health Star Rating). (9)

Fig. 2. Difference between reductive and interpretive FOPs, with their subcategories (Ikonen et al., 2020)

Comparing systems

Several scientific studies have compared the various nutrition information systems on the label front (FOP). Among the latest,

a laboratory research study (Crosetto et al., 2019) involved 691 volunteers to assess the impact of 5 different FOPs on the choices of 290 food items (39 product categories), also considering their prices. The NutriScore was found to be the most effective system in promoting the choice of balanced foods, with no correlation found between better nutritional profiles and higher prices, (10)

A large-scale randomized study (Dubois et al, 2020) was conducted on 1.7 million purchases of 1,266 products (4 product categories) in 60 supermarkets. Again, 4 different systems (FOPs) were considered, and NutriScore, once again, was found to be the most effective at encouraging healthier choices. With the only limitation being insufficient inhibition of junk food purchases or otherwise without FOPs. (11)

Puzzle solution, win-win

The nutritional conundrum is resolved in favor of labels that offer an additional service to consumers, the ability to make more logical and healthy choices on an objective basis. (12) With a number of knock-on benefits:

– producers are actually involved in the effort to reformulate (i.e., revise the recipes of) the products,

– distributors in turn can improve the nutritional and health characteristics of shelf offerings. Also on MDD (Marca Del Distributore) products, following the example of Intermarché. (13)

Fig. 3. Examples of the front-of-label nutrition information (FOP) used in the EU and outside the EU (Storcksdieck et al., 2020)

Perspectives

The Food Information Regulation recognized the legitimacy of affixing summary nutritional information, on the front label of products sold in every EU member country. Also by means of symbols or graphic forms, ‘in addition to words or numbers, as long as the following requirements are met:

(a) are based on accurate and scientifically based consumer research and do not mislead consumers (…),
(b) their development results from consultation with a wide range of stakeholder groups,
(c) are intended to facilitate consumer understanding of the contribution or importance of the food to the energy and nutrient intake of a diet,
(d) are supported by scientifically based evidence showing that the average consumer understands such forms of expression or presentation,
(e) in the case of other forms of expression, they shall be based on the harmonized reference intakes set out in Annex XIII [Reference Intakes or Reference Intake, ed.] or, in the absence of such values, on generally accepted scientific advice concerning the intake of energy or nutrient elements,
(f) are objective and non-discriminatory,
(g) their application does not create obstacles to the free movement of goods‘ (EU reg. 1169/11, Article 35.1).

NutriScore

The NutriScore system, based on a uniform scientific literature that is being consolidated, now appears to be the best solution for balancing the needs of consumers (to receive help to eat better) with those of food chain operators (to improve the nutritional safety of their products, building consumer loyalty with a ‘health pact’).

‘Ensure healthy lives and promote well-being for all at all ages’ (#SDG3)

Public health is a collective effort to which everyone, including Italian institutions, must contribute. (14) With prevention first, also keeping in mind the third of theSustainable Development Goals (SDGs), in UN Agenda 2030. Remain protagonists of the problem or become actors in the solution?

Dario Dongo and Andrea Adelmo Della Penna

Notes

(1) Schulte-Mecklenbeck et al. (2013). A lack of appetite for information and computation. Simple heuristics in food choice. Appetite 71:242-251, doi:10.1016/j.appet.2013.08.008
(2) Bialkova et al. (2010). What determines consumer attention to nutrition labels? Food Quality and Preference 21:1042-1051, doi:10.1016/j.foodqual.2010.07.001
(3) Moorman et al. (2012). Unintended nutrition consequences: firm responses to the Nutritional Labeling act. Marketing Science 31(5):717-37, https://doi.org/10.1287/mksc.1110.0692
(4) Grunert et al. (2007). A review of European research on consumer response to nutrition information on food labels. Journal of Public Health 15(5):385-99, https://doi.org/10.1007/s10389-007-0101-9
(5) Lim et al. (2020). Competitive effects of front-of-package nutrition labeling adoption on nutritional quality labeling adoption on nutritional quality: evidence from facts up front-style labels. Journal of Marketing 84(6):3-21, doi:10.1177/0022242920942563
(6) Zhu et al. (2014). Heterogeneity in consumer responses to front-of-package nutrition labels: evidence from a natural experiment? Working Papers 27, Department of Agricultural and Resource Economics.
(7) Sophos (2017). Facts Up Front: front-of-pack labeling initiative. U.S. Chamber of Commerce Foundation
(8) For more details, see theebook ‘1169 Penalties. Reg. EU 1169/2011, food news, controls and penalties‘, at https://www.greatitalianfoodtrade.it/libri/1169-pene-e-book-gratuito-su-delitti-e-sanzioni-nel-food
(9) Storcksdieck et al. (2020). Front-of-pack nutrition labeling schemes: a comprehensive review. Publications Office of the European Union, doi:10.2760/436998
(10) Crosetto et al. (2019). Nutritional and economic impact of five alternative front-of-pack nutritional labels: experimental evidence. European Review of Agricultural Economics 47(2):785-818, doi:10.1093/erae/jbz037
(11) Dubois et al. (2020). Effects of front-of-pack labels on the nutritional quality of supermarket food purchases: evidence from a large-scale randomized controlled trial. Journal of the Academy of Marketing Science, https://doi.org/10.1007/s11747-020-00723-5
(12) Zhu et al. (2016). Information cost and consumer choices of healthy food. Amer. J. Agr. Econ. 98(1):41-53, doi:10.1093/ajae/aav057
(13) Ikonen et al. (2020). Consumer effects of front-of-package nutrition labeling: an interdisciplinary meta-analysis. Journal of the Academy of Marketing Science 48:360-383, https://doi.org/10.1007/s11747-019-00663-9
(14) The Italian government, after presenting a ridiculous (dis)information proposal on the label front, the so-called Nutrinform Battery, continues to oppose the choice of Nutriscore as the European model for FOP nutrition labeling. While childhood obesity and diabetes continue to run rampant. That’s enough! V. https://www. greatitalianfoodtrade.it/etichette/nutrinform-battery-l-etichetta-a-batteria-una-vergogna-italiana, https://www.egalite.org/diabete-di-tipo-2-lepidemia-avallata-dalla-politica/

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Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.

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Graduated in Food Technologies and Biotechnologies, qualified food technologist, he follows the research and development area. With particular regard to European research projects (in Horizon 2020, PRIMA) where the FARE division of WIISE Srl, a benefit company, participates.