Nutri-Score in the European Food Retail Supply: A Potential Incentive for Food Reformulation?

Background: To improve consumers' diet, policy measures such as food reformulation strategies and front-of-pack nutritional labels (FOPNLs) are implemented, aiming to guide consumers' food choice and to stimulate an improvement in food composition by manufacturers. The FOPNL Nutri-Score has been implemented in several European countries. Changes in food compositions in relation to the Nutri-Score over time have been limitedly studied.

Comparison of the nutritional composition and calculated Nutri-score classifications of the Dutch food retail supply in 2018 and 2020.

Objective: In the Netherlands, reformulation strategies have been established for several years, whereas Nutri-Score was implemented in 2024. Besides being a helpful tool for consumers to make healthier food choices, Nutri-Score also aims to stimulate food reformulation by food manufacturers. The present study investigates whether changes in food composition could have led to different calculated Nutri-Score classifications.

Nutri-Score 2023 update.

In 2023, the algorithm underlying the Nutri-Score front-of-pack label was updated to better align with food-based dietary guidelines (FBDGs) across countries engaged in the system. On the basis of a comparison of FBDGs and literature reviews with the current Nutri-Score classification, modification scenarios were developed and tested in nutritional composition databases of branded products in four countries. The updated Nutri-Score nutrient profile model allows a better discrimination between products, in closer alignment with FBDGs, while the updated algorithm adopts a stricter approach for products that are high in components of concern (including non-nutritive sweeteners) and low in favourable dietary components.

The effects of health-related food taxes on the environmental impact of consumer food purchases: secondary analysis of data from a randomised controlled trial in a virtual supermarket.

Objective: To measure the effects of health-related food taxes on the environmental impact of consumer food purchases in a virtual supermarket.

Design: This is a secondary analysis of data from a randomised controlled trial in which participants were randomly assigned to a control condition with regular food prices ( 152), an experimental condition with a sugar-sweetened beverage (SSB) tax ( 131) or an experimental condition with a nutrient profiling tax based on Nutri-Score ( 112). Participants were instructed to undertake their typical weekly grocery shopping for their households.

Nutritional composition of ultra-processed plant-based foods in the out-of-home environment: a multi-country survey with plant-based burgers.

Ultra-processed plant-based foods, such as plant-based burgers, have gained in popularity. Particularly in the out-of-home (OOH) environment, evidence regarding their nutritional profile and environmental sustainability is still evolving. Plant-based burgers available at selected OOH sites were randomly sampled in Amsterdam, Copenhagen, Lisbon and London.

Adherence to the EAT-Lancet Healthy Reference Diet in Relation to Risk of Cardiovascular Events and Environmental Impact: Results From the EPIC-NL Cohort.

Background The Healthy Reference Diet (HRD) was created to formulate dietary guidelines that would be healthy and sustainable. We aimed to construct a diet score measuring adherence to the HRD and to explore its association with cardiovascular events and environmental impact. Methods and Results We included 35 496 participants from the population-based EPIC-NL (European Prospective Investigation into Cancer and Nutrition-Netherlands) study.

Less meat in the shopping basket. The effect on meat purchases of higher prices, an information nudge and the combination: a randomised controlled trial.

Background: Reduced meat consumption benefits human and planetary health. Modelling studies have demonstrated the significant health and environmental gains that could be achieved through fiscal measures targeting meat. Adding other interventions may enhance the effect of a fiscal measure.

Evaluation of foods, drinks and diets in the Netherlands according to the degree of processing for nutritional quality, environmental impact and food costs.

Objective: This study investigates nutritional quality, environmental impact and costs of foods and drinks and their consumption in daily diets according to the degree of processing across the Dutch population.

Design: The NOVA classification was used to classify the degree of processing (ultra-processed foods (UPF) and ultra-processed drinks (UPD)). Food consumption data were derived from the Dutch National Food Consumption Survey 2012-2016.

Increasing Seaweed Consumption in the Netherlands and Portugal and the Consequences for the Intake of Iodine, Sodium, and Exposure to Chemical Contaminants: A Risk-Benefit Study.

Seaweed has a high potential for nourishing the future planet. However, besides being beneficial, it also contains adverse components; this poses the question whether consumption of seaweed foods overall contributes beneficially or detrimentally to human health, and hence if their consumption should be promoted or restricted. This study evaluated the impact of substituting regular foods with seaweed foods in the diet, both in terms of nutritional quality ( iodine and sodium) and food safety ( arsenic, cadmium, lead, and mercury).

Exploring culturally acceptable, nutritious, affordable and low climatic impact diet for Japanese diets: proof of concept of applying a new modelling approach using data envelopment analysis.

A future sustainable dietary pattern for Japanese is yet undefined. This study aimed to explore more sustainable Japanese diets that are nutritious, affordable and with low greenhouse gas emissions (GHGE) and particular emphasis on cultural acceptability. A newly developed data envelopment analysis (DEA) diet model was applied to 4-d dietary record data among 184 healthy Japanese men and 185 women volunteers aged 21-69 years.

Evaluation of Nutri-Score in Relation to Dietary Guidelines and Food Reformulation in The Netherlands.

An unhealthy dietary pattern is an important risk factor for non-communicable diseases. Front-of-Pack nutritional labels such as Nutri-Score can be used to improve food choices. In addition, products can be improved through reformulation.

Co-benefits from sustainable dietary shifts for population and environmental health: an assessment from a large European cohort study.

Background: Unhealthy diets, the rise of non-communicable diseases, and the declining health of the planet are highly intertwined, where food production and consumption are major drivers of increases in greenhouse gas emissions, substantial land use, and adverse health such as cancer and mortality. To assess the potential co-benefits from shifting to more sustainable diets, we aimed to investigate the associations of dietary greenhouse gas emissions and land use with all-cause and cause-specific mortality and cancer incidence rates.

Methods: Using data from 443 991 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a multicentre prospective cohort, we estimated associations between dietary contributions to greenhouse gas emissions and land use and all-cause and cause-specific mortality and incident cancers using Cox proportional hazards regression models.

Can Healthy and Sustainable Dietary Patterns That Fit within Current Dutch Food Habits Be Identified?

This study investigated major healthy and sustainable dietary patterns in the Dutch population. Two 24-hour dietary recalls were collected in 2078 participants aged 19-79 years in the Dutch National Food Consumption Survey 2012-2016. Dietary patterns were identified using reduced rank regression.

A social cost-benefit analysis of meat taxation and a fruit and vegetables subsidy for a healthy and sustainable food consumption in the Netherlands.

Background: Implementation of food taxes or subsidies may promote healthier and a more sustainable diet in a society. This study estimates the effects of a tax (15% or 30%) on meat and a subsidy (10%) on fruit and vegetables (F&V) consumption in the Netherlands using a social cost-benefit analysis with a 30-year time horizon.

Methods: Calculations with the representative Dutch National Food Consumption Survey (2012-2014) served as the reference.

Educational differences in healthy, environmentally sustainable and safe food consumption among adults in the Netherlands.

Objective: To assess the differences in healthy, environmentally sustainable and safe food consumption by education levels among adults aged 19-69 in the Netherlands.

Design: This study used data from the Dutch National Food Consumption Survey 2007-10. Food consumption data were obtained via two 24-h recalls.

Are our diets getting healthier and more sustainable? Insights from the European Prospective Investigation into Cancer and Nutrition - Netherlands (EPIC-NL) cohort.

Objective: To identify differences in dietary quality, dietary greenhouse gas (GHG) emissions and food consumption over 20 years in a Dutch cohort.

Design: Participants (n 8932) filled out an FFQ in 1993-1997 and in 2015. The Dutch Healthy Diet index 2015 (DHD15-index) score, GHG emissions and consumption of food groups (g/4184 kJ (1000 kcal)) were compared between the time points with paired t tests.

Reducing GHG emissions while improving diet quality: exploring the potential of reduced meat, cheese and alcoholic and soft drinks consumption at specific moments during the day.

Background: The typical Western diet is associated with high levels of greenhouse gas (GHG) emissions and with obesity and other diet-related diseases. This study aims to determine the impact of adjustments to the current diet at specific moments of food consumption, to lower GHG emissions and improve diet quality.

Methods: Food consumption in the Netherlands was assessed by two non-consecutive 24-h recalls for adults aged 19-69 years (n = 2102).

Healthy diets with reduced environmental impact? - The greenhouse gas emissions of various diets adhering to the Dutch food based dietary guidelines.

Objective: To determine the differences in environmental impact and nutrient content of the current Dutch diet and four healthy diets aimed at lowering greenhouse gas (GHG) emissions.

Methods: GHG emissions (as proxy for environmental impact) and nutrient content of the current Dutch diet and four diets adhering to the Dutch food based dietary guidelines (Wheel of Five), were compared in a scenario study. Scenarios included a healthy diet with or without meat, and the same diets in which only foods with relatively low GHG emissions are chosen.

Does a better adherence to dietary guidelines reduce mortality risk and environmental impact in the Dutch sub-cohort of the European Prospective Investigation into Cancer and Nutrition?

Guidelines for a healthy diet aim to decrease the risk of chronic diseases. It is unclear as to what extent a healthy diet is also an environmentally friendly diet. In the Dutch sub-cohort of the European Prospective Investigation into Cancer and Nutrition, the diet was assessed with a 178-item FFQ of 40 011 participants aged 20-70 years between 1993 and 1997.

Salt Reductions in Some Foods in The Netherlands: Monitoring of Food Composition and Salt Intake.

Background And Objectives: High salt intake increases blood pressure and thereby the risk of chronic diseases. Food reformulation (or food product improvement) may lower the dietary intake of salt. This study describes the changes in salt contents of foods in the Dutch market over a five-year period (2011-2016) and differences in estimated salt intake over a 10-year period (2006-2015).

Development and evaluation of the Dutch Healthy Diet index 2015.

Objective: To update the Dutch Healthy Diet index, a measure of diet quality, to reflect adherence to the Dutch dietary guidelines 2015 and to evaluate against participants' characteristics and nutrient intakes with the score based on 24 h recall (24 hR) data and FFQ data.

Design: The Dutch Healthy Diet index 2015 (DHD15-index) consists of fifteen components representing the fifteen food-based Dutch dietary guidelines of 2015. Per component the score ranges between 0 and 10, resulting in a total score between 0 (no adherence) and 150 (complete adherence).

Are more environmentally sustainable diets with less meat and dairy nutritionally adequate?

Objective: Our current food consumption patterns, and in particular our meat and dairy intakes, cause high environmental pressure. The present modelling study investigates the impact of diets with less or no meat and dairy foods on nutrient intakes and assesses nutritional adequacy by comparing these diets with dietary reference intakes.

Design: Environmental impact and nutrient intakes were assessed for the observed consumption pattern (reference) and two replacement scenarios.

How may a shift towards a more sustainable food consumption pattern affect nutrient intakes of Dutch children?

Objective: Food has a considerable environmental impact. Diets with less meat and dairy reduce environmental impact but may pose nutritional challenges for children. The current modelling study investigates the impact of diets with less or no meat and dairy products on nutrient intakes.