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

Abstract

The extent to which different front-of-pack nutrition labels (FOPNLs) agree or contradict each other has been insufficiently investigated. Considering the 2020 proposal from the European Commission to create a harmonized FOPNL, the aim of this study was to assess agreements and disagreements between two FOPNL schemes—the Keyhole and the Nutri-Score—in a Swedish context. The current Keyhole criteria and the updated Nutri-Score 2022 algorithm were applied to 984 food items and their nutrient compositions, obtained from the food database of the Swedish Food Agency. Agreements (Keyhole-eligible and Nutri-Score A or B; or not Keyhole-eligible and Nutri-Score C, D, or E) and disagreements (Keyhole-eligible and Nutri-Score C, D, or E, or not Keyhole-eligible and Nutri-Score A or B) were calculated as percentages for all items and by food group. An agreement was found for 81% of included items. The lowest level of agreement was found for the groups of flour, grains, and rice (62% agreement) and for plant-based meat and fish analogues (33% agreement). There is generally a good level of agreement between the Keyhole and the Nutri-Score for food items on the Swedish market. Large disagreements found for plant-based meat and fish analogues, and products based on cereals/grains, highlight important considerations for the development of a harmonized FOPNL within Europe.

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

“…For Food‐based limitations, this means that some limitations cannot be addressed directly. This includes whole grains that have been addressed in some NP models (e.g., whole grains were addressed within the Keyhole FOPNL system [Pitt et al., 2023]) but are not covered by NS2023. A major challenge for considering the content of whole grains in the profiling model is the lack of the legal definition in the EU (European Commission, 2023).…”

“…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.…”