Front-of-pack labelling system
A proposal to help people make healthier food choices is to use a front-of-pack labelling system for commercial products. Already used on a voluntary basis in some European countries, such as France and Spain, front-of-pack labels are now being examined by the European Commission in order to adopt a harmonised and mandatory nutrition labelling scheme in all Member States. The Nutri-Score, developed in France, is given as a favourite. This system shows nutritional quality of a food (on the basis, for example, of the content of fat, salt, fibre, etc.) by a five-colour scale (from dark green to dark orange) associated with letters, from A to E.
But nutritional composition is not the only factor to take into consideration when looking at diet-health relationship. The NOVA classification , in particular, instead of evaluating a food on the basis of nutritional characteristics, looks rather at how much that product has been processed, mostly at industrial level. NOVA specifically identifies the so-called ultra-processed foods, i.e. those foods made in part or entirely with substances not routinely used in the kitchen (hydrolysed proteins, maltodextrins, hydrogenated fats, etc.) and which generally contain various additives, such as dyes, preservatives, antioxidants, anti-caking agents, flavour enhancers and sweeteners. This category includes the usual suspects: sugary and carbonated drinks, pre-packaged baked goods and spreads. But also apparently innocent products must be regarded as ultra-processed. It is the case of rusks, some breakfast cereals, crackers and fruit yoghurt.
According to the NOVA system, proposed a decade ago by a team of Brazilian researchers, a slice of unprocessed meat is healthier than a vegan hamburger, simply because the former has not undergone industrial manipulation and possibly does not contain food additives, while the latter is the result of an articulated industrial processing at the end of which the percentage of whole food is negligible.
“The goal of helping people make healthier food choices is certainly a priority,” says Licia Iacoviello, Director of the Department and Professor of Hygiene at the University of Insubria in Varese and Como. “However, the Nutri-Score, as well as other labelling systems, developed in Italy and in other countries, only partially transfer the message aimed at improving food choices. While the letters and colours of the Nutri-Score may help to quickly compare products belonging to the same category, allowing people to choose the best one from a nutritional point of view, they do not provide any indication on food processing degree. This is why we believe, in agreement with other researchers worldwide, that every nutritional labelling system should be integrated with information regarding the level of processing.”
Giuseppe Grosso, associate professor at the University of Catania, explains: “For a truly effective prevention strategy, we shall focus on those foods that the Nutri-Score classifies as healthy from a nutritional point of view but which are also highly processed. This is the case, for example, of some beverages which, despite having a reduced sugar content, thus being adequate on a nutritional level, so as to earn a letter B in the Nutri-Score, are in fact highly processed. Or even some types of yogurt and cold desserts that are low in fat although containing a full-bodied list of food additives.”
Giovanni de Gaetano, President of the IRCCS Neuromed in Pozzilli, comments: “A weakness common to all front-of-pack labelling systems is that they isolate a single food from the overall diet. To really improve nutrition, we should go back to the ancient lesson of the Mediterranean diet, which is a lifestyle characterized by a wise choice of foods and the way to combine and consume them. It is not a shopping list, but it reflects a century-old history that risks disappearing if we consider food as atoms that do not communicate with each other. We must also remember that the diet of Mediterranean people is mainly based on fresh or minimally processed products. Therefore, an effective preventive strategy should pay attention also to industrial processing which, if excessive, represents a documented threat to our health.”