Comparison of nutrient profiling models for assessing the nutritional quality of foods: a validation study

Abstract

Nutrient profiling (NP) is a method for evaluating the healthfulness of foods. Although many NP models exist, most have not been validated. This study aimed to examine the content and construct/convergent validity of five models from different regions: Australia/New Zealand (FSANZ), France (Nutri-Score), Canada (HCST), Europe (EURO) and Americas (PAHO). Using data from the 2013 UofT Food Label Information Program (n15342 foods/beverages), construct/convergent validity was assessed by comparing the classifications of foods determined by each model to a previously validated model, which served as the reference (Ofcom). The parameters assessed included associations (Cochran–Armitage trend test), agreement (κ statistic) and discordant classifications (McNemar’s test). Analyses were conducted across all foods and by food category. On the basis of the nutrients/components considered by each model, all models exhibited moderate content validity. Although positive associations were observed between each model and Ofcom (all P trend<0·001), agreement with Ofcom was ‘near perfect’ for FSANZ (κ=0·89) and Nutri-Score (κ=0·83), ‘moderate’ for EURO (κ=0·54) and ‘fair’ for PAHO (κ=0·28) and HCST (κ=0·26). There were discordant classifications with Ofcom for 5·3 % (FSANZ), 8·3 % (Nutri-Score), 22·0 % (EURO), 33·4 % (PAHO) and 37·0 % (HCST) of foods (all P<0·001). Construct/convergent validity was confirmed between FSANZ and Nutri-Score v. Ofcom, and to a lesser extent between EURO v. Ofcom. Numerous incongruencies with Ofcom were identified for HCST and PAHO, which highlights the importance of examining classifications across food categories, the level at which differences between models become apparent. These results may be informative for regulators seeking to adapt and validate existing models for use in country-specific applications.

Facilitating Consumers Choice of Healthier Foods: A Comparison of Different Front-of-Package Labelling Schemes Using Slovenian Food Supply Database

“…The proportion of healthier products per food category, evaluated by Ofcom [42] and FSANZ [13], were consistent with previous studies. A good correlation of the Ofcom and Nutri-Score was also shown in our previous study for many food categories, except for cooking oils and yogurt products [13]. The difference between Ofcom and Nutri-Score in yogurt products is due to different categorisations of yogurt drinks, which fall into different categorisation groups (drink/food).…”

“…Product barcodes were used to avoid duplicates. Foods in the database were categorised using a classification system developed within the Global Food Monitoring Initiative (GFMI) [13]. For the purpose of this study, we included all foods with labelled nutrition composition information and sales data in the following five food categories, with notable prevalence of the Slovenian Protective Food symbol and/or nutrition/health claims (N = 1.370): Cereal and cereal products (breakfast cereals, pasta), dairy (cheese, yoghurt products), edible oils and emulsions (cooking oils).…”

“…For each front-of-package nutrition labelling scheme, the proportion of "healthier" products was calculated. The following criteria were used for the different nutrient profiling systems: Keyhole, Protective Food symbol, Dutch Choices symbol, Finnish Heart Symbol: permitted to carry health symbol; Ofcom, WHOE: permitted for marketing to children; FSANZ: permitted to carry health claims; Nutri-Score: rated as dark green A or light green B (the same approach was used previously [13]); HSR: scored 3.5 or more (the same approach was used previously [12]); Traffic Light system: no red lights.…”

“…While nutritional labelling of the front-of-pack presents a very powerful tool to inform consumers, the information provided on food labels need to be trustworthy. To sustain/increase consumer trust in food labelling, it is critical to minimise confusion due to the use of different health-related information on food packages [12,13].…”

Applying Nutrient Profiling Systems to Packaged Foods and Drinks Sold in Jamaica

“…In the absence of any formative food composition data, it is imperative to test how foods available in Jamaica perform using different NPSs. Other countries have compared how different NPSs might apply to the products available in their country, such as in Canada [24,25], Mexico [26] and Colombia [27]. The findings here on the share of products with excess NOCs under the PAHO compared to the Chile NPS are consistent with the studies done elsewhere; the PAHO NPS would identify a larger percentage of packaged products as having excess NOCs.…”