Comparison between the Choices Five-Level Criteria and Nutri-Score: Alignment with the Dutch Food-Based Dietary Guidelines

Abstract

The current food environment in the Netherlands is considered obesogenic. Eighty percent of the products in supermarkets are unhealthy. The Wheel of Five is the well-established, science-based Dutch food-based dietary guideline (FBDG) developed to stimulate healthier choices. In addition, simple directions on food packaging, such as front-of-package (FOP) health logos, could also be helpful. However, these tools should be in line with each other, in order not to confuse the consumer. To study this, we evaluated two FOP nutrient profiling systems (NPSs) for their alignment with the Wheel of Five: Choices five-level criteria and Nutri-Score. For this, a small but representative sample of 124 products was selected from the Dutch food composition database (NEVO). For these products, the scores for Choices and Nutri-Score were calculated using the published criteria, while compliance with the Wheel of Five was established by using the criteria from Netherlands Nutrition Center (NNC). The Wheel of Five food groups were used to categorize the products. Differences between the Wheel of Five and Choices are smaller than with Nutri-Score, concluding that Choices is more consistent with the Wheel of Five and might be an attractive alternation for a FOP health logo on the Dutch market.

A systematic assessment of the revised Nutri‐Score algorithm: Potentials for the implementation of front‐of‐package nutrition labeling across Europe

“…This model was originally developed for limiting the marketing of unhealthy foods to children and does not incorporate some recent dietary recommendations, such as reducing the intake of red meat and the importance of whole grains (Blomhoff et al., 2023; Willett et al., 2019). Alternative approach would be to use country‐specific FBDG (Huybers & Roodenburg, 2023; Konings et al., 2022), which are in Slovenia and not defined to a level that would allow meaningful comparison. Further research should also focus on the assessment of the evolution of NS using country‐specific FBDG where available.…”

“…Our literature review captured 30 papers: 24 original research (Angelino et al, 2023;Braesco et al, 2022;Bryngelsson et al, 2022;Cutroneo et al, 2022;de las Heras-Delgado et al, 2023;Dickie et al, 2022;Ebner et al, 2022;Fedde et al, 2022;Ferreiro et al, 2021;Fialon et al, 2022;Hafner & Pravst, 2021, 2023Huybers & Roodenburg, 2023;Katsouri et al, 2021;Kissock et al, 2022;Konings et al, 2022;Panczyk et al, 2023;Pitt et al, 2023;Pointke & Pawelzik, 2022;Rodriguez-Martin et al, 2023;Septia Irawan et al, 2022;Stiletto & Trestini, 2022;Borg et al, 2021;Valenzuela et al, 2022), 3 communication/correspondence (Carruba et al, 2022;Drewnowski et al, 2021;Hau & Lange, 2023), and 3 review papers (Peonides et al, 2022;van der Bend et al, 2022;Włodarek & Dobrowolski, 2022), originating from 19 countries (including 12 EU member states). The list of reported limitations (n = 20), their connections, and the numbers of mentions are presented in Figure 2.…”

“…However, the EC's proposal faced opposition from various stakeholders (Delhomme, 2021), particularly the food industry and certain agricultural sectors (such as cheese and cured meat) (Fialon et al., 2022; Stiletto et al., 2023). Additionally, some nutrition scientists and public health experts expressed concerns about the system's inadequate alignment with food‐based dietary guidelines (FBDG), potentially leading to conflicting information for consumers (Konings et al., 2022). The proposal of NS as a potential mandatory FOPNL in Europe triggered substantial concerns and criticisms, primarily centered around the NP algorithm and its grading system.…”

“…The proposal of NS as a potential mandatory FOPNL in Europe triggered substantial concerns and criticisms, primarily centered around the NP algorithm and its grading system. Although some criticisms were assigned as political (Julia et al., 2022), others referred to the scientific evaluation of NS alignment with FBDG (Borg et al., 2021; Konings et al., 2022).…”

Front-of-Pack Nutrition Labels: Comparing the Nordic Keyhole and Nutri-Score in a Swedish Context

“…In addition, the authors did not utilize the Nutri-Score 2022 algorithm. A 2022 study by Konings et al [ 36 ] compared how well two FOPNLs—the Choices five-level criteria, and the Nutri-Score—aligned to current Dutch food-based dietary guidelines. The authors found that the Choices five-level criteria aligned more closely with the food-based dietary guidelines, noting that many discrepancies were found between the Nutri-Score and the guidelines.…”