Nutri-Score in Portugal: Abolished Two Months After ApprovalINTERVIEW WITH MICHELE CARRUBA - HEALTHNEWS
- 16 July 2024
- Posted by: Competere
- Categories: Empowering Consumers, highlights, News
Michele Carruba, director of the Center for Obesity Studies and Research at the University of Milan and Member of our Scientific Board, was interviewed by the Portuguese magazine HealthNews to evaluate front-of-pack nutritional labelling systems like the Nutri-Score.
Read the full interview in Portuguese on HealthNews or the English version below.
On 4 April, the Portuguese government announced the adoption of the Nutri-Score system. A measure applauded by the main Portuguese consumer protection organisation, DECO-Proteste. Now it’s repealing it. How do you see this reversal?
Could you explain the main scientific criticisms of Nutri-Score in more detail?
First, the Nutri-Score system primarily serves as an interpretative tool rather than an educational one, offering little to enhance consumer knowledge or nutritional awareness. Its scoring principles, often unintelligible and opaque, require non-critical acceptance by consumers. It also fails to guide the overall composition of a diet or facilitate the combination of different foods.
Second, the Nutri-Score disproportionately emphasizes nutrients with negative impacts, assigning up to 40 negative points compared to a maximum of 15 positive points for beneficial nutrients. This imbalance suggests a focus more on discouraging certain foods rather than promoting healthy options.
Third, the Nutri-Score evaluates food based on a 100-gram serving rather than actual portion sizes, which can be misleading. For example, a vegetable pizza might score well per 100 grams but is typically consumed in much larger portions, potentially distorting dietary guidance. Similarly, olive oil, though calorie-dense, is usually consumed in smaller amounts than Nutri-Score’s 100-gram assessment, skewing its perceived impact.
Furthermore, the Nutri-Score’s rigid classification of nutrients as ‘favorable’ or ‘unfavorable’ oversimplifies the complexities of diet, clashing with the holistic approach widely endorsed by the scientific community, such as in the Mediterranean diet. Rather than isolating individual food items, a comprehensive dietary strategy focusing on a balanced selection and combination of foods is preferable for managing health conditions like obesity or NCDs.
Finally, the Nutri-Score lacks the specificity needed to assist individuals with particular dietary needs. It does not highlight the primary factors that influence its ratings, nor does it offer specific insights into energy content, saturated fats, sodium, or sugars—key information for people managing conditions such as obesity, high cholesterol, hypertension, or diabetes.
Why do you think that in some countries, such as France, there is greater support for the Nutri-Score compared to other countries such as Italy and the Netherlands?
There are several reasons for this. The system was developed in France, where there is evidently a deep-rooted cultural belief that obesity can be addressed with a label on food products. France has historically favoured a top-down approach, where the state dictates what is good or bad based on an algorithm developed by scientists, who are presumed to be infallible. However, science is fallible, and it is not the state’s role to determine what is good or bad. Moreover, on a more pragmatical level, there appear to be commercial interests in France that would greatly benefit from the adoption of the Nutri-Score.
The process of reviewing and updating the Nutri-Score algorithm has been criticised for a lack of transparency. How do you see this process and what changes would you suggest?
Does it seem credible to propose changing an algorithm just to appease those who complain about the poor classification of their products? This suggests that it is more of a commercial tool than a public health instrument. We are dealing with food geopolitics.
In your opinion, what would be the ideal role of an independent scientific authority, such as EFSA, in evaluating and validating the Nutri-Score?
I am very supportive of the idea that the Nutri-Score should be evaluated by the EFSA, as it will be assessed strictly on scientific grounds.
Significant bias has been reported in the studies supporting the Nutri-Score. What impact does this bias have on the reliability of the results presented?
No compelling evidence has been presented to demonstrate a preventive effect on obesity. In fact, judging from epidemiological data, there is no difference in obesity prevalence in countries before and after the adoption of the Nutri-Score, or between those that have approved it and those that have not.
How do you assess the influence of the creators of the Nutri-Score on the peer review process and the publication of nutrition labelling studies?
An important process for public health cannot be managed by an individual but must be overseen and guided by public institutions. These institutions should rely on the opinions of a multitude of scientists, represented not by single individuals but by accredited scientific societies.
If Nutri-Score is not the answer, what other measures would you suggest to combat obesity and improve public nutrition?
First and foremost, all countries must acknowledge that obesity is a chronic, relapsing syndemic disease and organize their national health systems to prevent and treat this illness. An important component is nutritional education at the school level, which has been proven effective in reducing the prevalence of the disease. We advocate for the Mediterranean diet, not just as a dietary regimen, but as a method for a balanced lifestyle. The causes of obesity are numerous and vary from individual to individual. To achieve personalized solutions, it is urgent to engage citizens to make conscious and informed choices, which means providing them with the necessary knowledge. We need to empower individuals with knowledge, not predefined choices.
How can we ensure that the interventions proposed to combat obesity, such as changing the food environment or taxing sugary drinks, are based on solid scientific evidence?
Scientific evidence does not support the effectiveness of taxing individual dietary elements, such as sugars, and even less so a single product within a product class, like sugary drinks. The only scientifically valid approach is to inform and educate, allowing consumers the freedom to make their own informed choices.
Given that the DGAV has expressed reservations about Nutri-Score, how do you believe Portugal should proceed in regulating nutritional labelling?
I suggest other proposals aimed at educating citizens in a context of caloric abundance and reduced energy expenditure. It’s preferable to use nothing than to use something incorrect, which can have numerous damages. We must avoid the rush to find seemingly easy solutions that allow scientists and politicians to ease their consciences without truly addressing the problem, as exemplified by the Nutri-Score. Obesity is a complex and multifactorial problem that requires comprehensive solutions. Caloric abundance is a novelty that humanity is not accustomed to. For millions of years, humans faced hunger. We need to reprogram our way of life, embracing a balanced lifestyle for improved longevity and well-being.
What nutritional labelling model do you think would be most appropriate for Portuguese food products?
The Nutrinform Battery, proposed by the Italian government, is based on the universally accepted GDA (Guideline Daily Amounts) principles recognized worldwide. It does not dictate what is good or bad but provides consumers with information so that they can make free and informed choices, understanding the composition and quantity of what they consume. In doing so, people can better plan their lifestyle accordingly.
