A prospective study published in The Lancet Regional Health – Europe (Deschasaux-Tanguy et al., 2024), conducted in 7 countries, shows the effectiveness of nutritional profiles developed with the Nutri-Score system in preventing the risk of cardiovascular diseases. (1)
1) Cardiovascular diseases, prevalence and risk factors
Cardiovascular diseases are the leading cause of death in Western Europe, with a prevalence of 33,5% of the total and 1,4 million deaths in 2019 alone.
Among the risk factors consolidated, for this type of disease:
– dietary factors are in second place with an estimated incidence of 30% of deaths from cardiovascular diseases. And it is important to underline how
– unbalanced diets, unlike other factors (i.e. genetic, environmental) can be modified with appropriate nutritional policies. (2)
2) Nutritional guidelines and FOPNL (Front-of-Pack Nutrition Labelling)
Nutritional guidelines have been developed in several European countries to provide benchmarks on food groups and recommendations on nutrient intakes, with the aim of preventing serious and chronic diet-related diseases. However, consumers need complementary information, on food labels, to limit the consumption of foods with unbalanced nutrient profiles.
Nutritional labels on the front of the pack are the most effective summary tool to help consumers understand the meaning of mandatory nutrition declarations on the back of the pack. (3) WHO (2017) recommended the use of FOPNL (Front-of-Pack Nutrition Labelling) to promote consumer nutrition education and at the same time food reformulation by companies. (4)
3) Nutri-Score, labelling and nutritional profiles
Nutri-Score is a front-of-pack nutritional labelling system developed to reflect, with a 5-letter logo and the same number of colours (from A, dark green, to E, dark orange), the nutritional profiles of individual foods.
The nutritional profiles were developed by the international scientific committee Nutri-Score through a calculation algorithm:
– originally developed by the Food Standards Agency in the UK and adapted for labelling purposes, as well as
– amended, in 2022-2023, to improve its consistency with nutritional guidelines. (5)
4) FOPNL and prevention of serious and chronic diseases
WHO stressed the importance of validating the nutritional profiles underlying a Front-of-Pack Nutrition Labelling (FOPNL) system through prospective studies on the associations between diet quality derived from the nutritional profile of the food products consumed and different health outcomes.
Previous studies have demonstrated the link between the consumption of food products with a higher Nutri-Score and several adverse health outcomes. Weight gain, metabolic syndrome, premature mortality, cardiovascular disease. The researchers therefore extended the investigation to a large pan-European population.
5) Nutri-Score and prevention of cardiovascular diseases. The study
The systematic review under examination (Deschasaux-Tanguy et al., 2024) included 345,533 participants from the European Prospective Investigation into Cancer and Nutrition (EPIC, 1992-2010) study, in 7 European countries. (5) Food intakes were assessed using country-specific dietary questionnaires.
Nutri-Score scores were calculated on each food, based on the values of energy, sugars, saturated fatty acids, salt, fiber, protein and the percentage content of fruit, vegetables and legumes. On this basis, an individual dietary index was obtained, that is, a weighted average of the Nutri-Score scores of the foods consumed by each participant, in relation to the energy intake.
The follow-up – whose average duration extended for 12,3 years (4,103,133 person-years) –recorded 16,214 first cardiovascular events and to correlate the consumption of foods with a higher Nutri-Score (which reflects a lower overall nutritional quality of the diet) to a higher risk of total cardiovascular events.
6) Provisional conclusions
The OECD (Organisation for Economic Co-operation and Development) estimated in 2022 that the application of the Nutri-Score nutritional labelling system in all participating countries would lead to a reduction of approximately 1,6 million cases of cardiovascular disease by 2050. (6)
The research under examination confirmed the value of Nutri-Score in the prevention of such diseases, myocardial infarction and stroke in particular, on a large sample of the population that well represents the variety of territories and cultures of the Old Continent. From Italy to Sweden, Spain and Germany, Denmark, the United Kingdom and Holland.
The European Parliament has in turn recognized, in a recent report already shared on this site, the fundamental role of Nutri-Score in the context of nutritional policies that the EU urgently needs to stem the haemorrhage of public health expenditure associated with obesity, overweight and related diseases. (7)
Dario Dongo
Footnote
(1) Deschasaux-Tanguy, Mélanie et al. (2024). Nutritional quality of diet characterized by the Nutri-Score profiling system and cardiovascular disease risk: a prospective study in 7 European countries. The Lancet Regional Health – Europe, Volume 46, 101006. Doi: 10.1016/j.lanepe.2024.101006
(2) Dario Dongo. Fiscal policies for balanced nutrition, WHO recommendations. FT (Food Times). July 4, 2024
(3) Dario Dongo. Codex Alimentarius, the NutriScore and the WHO guidelines. FT (Food Times). September 29, 2021
(4) WHO (2017). Tackling NCDs: ‘best buys’ and other recommended interventions for the prevention and control of noncommunicable diseases. ISBN: 978-92-4-009107-8
https://tinyurl.com/4h3hpwd8
(5) Denmark, Germany, Italy, Netherlands, Spain, Sweden, United Kingdom
(6) OECD (2022). Healthy eating and active lifestyles: best practices in public health
(7) Dario Dongo. Obesity, challenges and opportunities. EU report. GIFT (Great Italian Food Trade)
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.
