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. The current study investigates to what extent Nutri-Score aligns with the Dutch Health Council dietary guidelines and whether it can be used as an incentive for reformulation. Nutri-Score calculations were based on the Dutch Branded Food database (2018). The potential shift in Nutri-Score was calculated with product improvement scenarios. The Nutri-Score classification is in line with these dietary guidelines: increase the consumption of fruit and vegetables, pulses, and unsalted nuts. It is, however, less in line with the recommendations to limit (dairy) drinks with added sugar, reduce the consumption of red meat and replace refined cereal products with whole-grain products. The scenario analyses indicated that a reduction in sodium, saturated fat or sugars resulted in a more favourable Nutri-Score in a large variety of food groups. However, the percentage of products with an improved Nutri-Score varied greatly between the different food groups. Alterations to the algorithm may strengthen Nutri-Score in order to help consumers with their food choices.

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Evaluation of Nutrient Intake and Food Consumption among Dutch Toddlers

Nutrients ◽

10.3390/nu13051531 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1531

Author(s):

Elly Steenbergen ◽

Anne Krijger ◽

Janneke Verkaik-Kloosterman ◽

Liset E. M. Elstgeest ◽

Sovianne ter Borg ◽

...

Keyword(s):

Fatty Acids ◽

Dietary Intake ◽

Food Consumption ◽

Dietary Habits ◽

Saturated Fatty Acids ◽

Dietary Guidelines ◽

Food Groups ◽

Milk Products ◽

Health Council ◽

Dutch Health

Improving dietary habits at a young age could prevent adverse health outcomes. The aim was to gain insight into the adequacy of the dietary intake of Dutch toddlers, which may provide valuable information for preventive measures. Data obtained from the Dutch National Food Consumption Survey 2012–2016 were used, which included 672 children aged one to three years. Habitual intakes of nutrients were evaluated according to recommendations set by the Dutch Health Council. Specific food groups were evaluated according to the Dutch food-based dietary guidelines. For most nutrients, intakes were estimated to be adequate. High intakes were found for saturated fatty acids, retinol, iodine, copper, zinc, and sodium. No statement could be provided on the adequacy of intakes of alpha-linoleic acids, N-3 fish fatty acids, fiber, and iron. 74% of the toddlers used dietary supplements, and 59% used vitamin D supplements specifically. Total median intakes of vegetables, bread, and milk products were sufficient. Consumption of bread, potatoes and cereals, milk products, fats, and drinks consisted largely of unhealthy products. Consumption of unfavorable products may have been the cause of the observed high and low intakes of several nutrients. Shifting towards a healthier diet that is more in line with the guidelines may positively affect the dietary intake of Dutch toddlers and prevent negative health impacts, also later in life.

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Evaluation of a nutrient-rich food index score in the Netherlands

Journal of Nutritional Science ◽

10.1017/jns.2015.4 ◽

2015 ◽

Vol 4 ◽

Cited By ~ 12

Author(s):

Diewertje Sluik ◽

Martinette T. Streppel ◽

Linde van Lee ◽

Anouk Geelen ◽

Edith J. M. Feskens

Keyword(s):

Energy Density ◽

Saturated Fat ◽

Dietary Guidelines ◽

Dietary Quality ◽

Cereal Products ◽

Nutrient Density ◽

Rich Food ◽

The Individual ◽

Methodological Considerations ◽

Development And Validation

AbstractNutrient-rich food (NRF) index scores are dietary quality indices based on nutrient density. We studied the design aspects involved in the development and validation of NRF index scores, using the Dutch consumption data and guidelines as an example. We evaluated fifteen NRF index scores against the Dutch Healthy Diet Index (DHD-index), a measure of adherence to the Dutch dietary guidelines, and against energy density. The study population included 2106 adults from the Dutch National Food Consumption Survey 2007–2010. The index scores were composed of beneficial nutrients (protein, fibre, fatty acids, vitamins, minerals), nutrients to limit (saturated fat, sugar, Na) or a combination. Moreover, the influence of methodological decisions was studied, such as the choice of calculation basis (100 g or 100 kcal (418 kJ)). No large differences existed in the prediction of the DHD-index by the fifteen NRF index scores. The score that best predicted the DHD-index included nine beneficial nutrients and three nutrients to limit on a 100-kcal basis, the NRF9.3 with a model R2 of 0·34. The scores were quite robust with respect to sex, BMI and differences in calculation methods. The NRF index scores were correlated with energy density, but nutrient density better predicted the DHD-index than energy density. Consumption of vegetables, cereals and cereal products, and dairy products contributed most to the individual NRF9.3 scores. In conclusion, many methodological considerations underlie the development and evaluation of nutrient density models. These decisions may depend upon the purpose of the model, but should always be based upon scientific, objective and transparent criteria.

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Comprehensive Nutrition Review of Grain-Based Muesli Bars in Australia: An Audit of Supermarket Products

Foods ◽

10.3390/foods8090370 ◽

2019 ◽

Vol 8 (9) ◽

pp. 370 ◽

Cited By ~ 4

Author(s):

Felicity Curtain ◽

Sara Grafenauer

Keyword(s):

Standard Deviation ◽

Dietary Fibre ◽

Saturated Fat ◽

Food Choices ◽

Nutritional Supplement ◽

Dietary Guidelines ◽

Whole Grain ◽

Added Sugars ◽

Policy Initiatives ◽

Nutrition Review

Muesli bars are consumed by 16% of children, and 7.5% of adults, and are classified as discretionary in Australian Dietary Guidelines, containing “higher fat and added sugars” compared with core food choices. This study aimed to provide a nutritional overview of grain-based muesli bars, comparing data from 2019 with 2015. An audit of muesli bars, grain-based bars, and oat slices was undertaken in January 2019 (excluding fruit, nut, nutritional supplement, and breakfast bars) from the four major supermarkets in metropolitan Sydney. Mean and standard deviation was calculated for all nutrients on-pack, including whole grain per serve and per 100g. Health Star Rating (HSR) was calculated if not included on-pack. Of all bars (n = 165), 63% were ≤ 600 kJ (268–1958 kJ), 12% were low in saturated fat, 56% were a source of dietary fibre, and none were low in sugar. Two-thirds (66%) were whole grain (≥8 g/serve), with an average of 10 g/serve, 16% of the 48 g Daily Target Intake. HSR featured on 63% of bars (average 3.2), with an overall HSR of 2.7. Compared to 2015, mean sugars declined (26.6 g to 23.7 g/100 g; p < 0.001), and 31% more bars were whole grain (109 up from 60 bars). Although categorised as discretionary, there were significant nutrient differences across grain-based muesli bars. Clearer classification within policy initiatives, including HSR, may assist consumers in choosing products high in whole grain and fibre at the supermarket shelf.

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Food sources of sodium, saturated fat, and added sugar in the Physical Activity and Nutrition for Diabetes in Alberta (PANDA) trial

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2017-0266 ◽

2017 ◽

Vol 42 (12) ◽

pp. 1270-1276 ◽

Cited By ~ 2

Author(s):

Ghada Asaad ◽

Catherine B. Chan

Keyword(s):

Type 2 Diabetes ◽

Saturated Fat ◽

Dietary Guidelines ◽

Food Sources ◽

Secondary Outcome ◽

Diabetic Patients ◽

Processed Meat ◽

Added Sugar ◽

Sugar Intake

Diabetic patients may find it difficult to achieve recommended nutrient intakes embedded within dietary guidelines. The objective of this analysis was to document total sodium, saturated fat, and added sugar intake as well as the main food sources of these nutrients in Canadian adults with type 2 diabetes before and after an intervention focused on healthy eating. Participants were enrolled in a single-arm dietary intervention trial designed to improve glycemic control and adherence to dietary recommendations. A 4-week menu plan and recipes were provided for participants along with a 6-week educational curriculum. Three repeated 24-h dietary recalls were collected at baseline and 3 months. Food sources of sodium, saturated fat, and added sugar were a secondary outcome derived from the dietary recalls. After 3 months, there was a reduction (p < 0.05) in sodium intake of 561 mg/day, which was mainly due to reduced consumption of processed meats, soups, and condiments. Significantly lower intake of processed meat contributed to –2.9 g/day saturated fat intake (p < 0.1) while added sugar intake declined by 7 g/day (p < 0.1), which was due to lower consumption of baked goods/desserts and chocolate (both p < 0.05). The intervention was beneficial for type 2 diabetes patients in terms of changing dietary habits. However, the majority of the participants still exceeded the dietary guidelines for sodium and saturated fat. In addition to the efforts of individuals and their healthcare providers, strategies to increase the nutritional quality of prepared foods could provide widespread benefits.

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How Successful Are U.S. Adults at Altering Nutrient Intakes and Meeting Dietary Guideline Recommendations?

Current Developments in Nutrition ◽

10.1093/cdn/nzaa061_056 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1428-1428

Author(s):

Alexandria Kluger ◽

Harris Lieberman ◽

Stefan Pasiakos ◽

Victor Fulgoni ◽

Claire Berryman

Keyword(s):

Saturated Fat ◽

Dietary Guidelines ◽

Self Report ◽

Dietary Intakes ◽

Nutrient Intakes ◽

Added Sugar ◽

Added Sugars ◽

Sodium Diet ◽

Special Diet ◽

Low Salt

Abstract Objectives The Dietary Guidelines for Americans (DGAs) recommend dietary patterns that limit added sugar, sodium, and saturated fat and emphasize nutrient-dense foods. It is unknown whether individuals who self-report adhering to a diet that alters nutrient intake are, in fact, meeting DGA recommendations. Objective: To compare dietary intakes and adherence to the DGAs in individuals who self-report following a special diet versus those who report following no diet. Methods NHANES 2003–2014 (≥19 y, n = 30,086) data were analyzed to determine % of the population answering yes or no to “Are you on any type of special diet?”. Individuals who answered yes, were further asked, “What kind of diet are you on?” and chose from a list of special diets (e.g., low salt or sodium; sugar free or low sugar). Mean nutrient intakes for each diet population were compared to the population following no diet. Individual usual intakes were estimated to determine the % of the population above or below nutrient-specific DGA recommendations. P < 0.01 was considered significant. Results In U.S. adults, 15.6 ± 0.3% answered yes when asked if they adhere to a special diet. Individuals who reported following a low sugar diet (n = 208) consumed 8.8 ± 0.7% total daily energy from added sugars, which was less than those following no diet (13.8 ± 0.1%; P < 0.01). Of individuals following a low sugar diet, 67 ± 4% met the recommendation to consume <10% energy from added sugar, which was a greater percentage than those following no diet (32 ± 1%; P < 0.01). Individuals who reported following a low salt/sodium diet (n = 580) consumed 3317 ± 110 mg/d sodium, which was less than those following no diet (3657 ± 17 mg/d; P < 0.01). Only 17 ± 2% of individuals following a low salt/sodium diet met recommendations to consume <2300 mg/d sodium, which was a greater percentage than those following no diet (10 ± 0%; P < 0.01). Conclusions American adults who self-report adhering to a low sugar or low salt/sodium diet consume less added sugar and sodium, respectively, than individuals who report following no diet. However, a substantial proportion of individuals following low sugar or low salt/sodium diets are still not meeting DGA recommendations. Funding Sources DMRP/USAMRDC. Views expressed are those of the authors and do not reflect official policy of the Army, DoD, or US Government.

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Focus group interviews with older Australians to explore their awareness of the national age-adjusted dietary recommendations and their suggestions for assisting them to meet these dietary targets

Australian Journal of Primary Health ◽

10.1071/py13008 ◽

2014 ◽

Vol 20 (2) ◽

pp. 182 ◽

Cited By ~ 4

Author(s):

Sonya Brownie ◽

Rosanne Coutts

Keyword(s):

Older People ◽

Focus Groups ◽

Food Choices ◽

Dietary Guidelines ◽

Nutrient Requirements ◽

Food Groups ◽

Dietary Recommendations ◽

Focus Group Interviews ◽

Media Campaigns ◽

Group Interviews

Promoting a healthy, nutritious diet is central to the goal of assisting individuals to age well. This study used focus groups to explore older people’s awareness of the current age-adjusted nutrient recommendations and age-adjusted core food groups, and to capture their views about these dietary guidelines. Thematic analysis was applied to aggregate data into categories of frequently occurring responses. Data were collected from five focus groups: a total of 29 participants, aged 60–98 years of age. Analysis of responses revealed that participants were generally unaware of government-endorsed dietary guidelines or nutrient recommendations for older people. Their suggestions for assisting older people to meet these age-adjusted dietary targets included: targeted media campaigns to raise awareness about older people’s nutrient requirements; the need for practical meal plans that do meet their dietary needs; and the removal of barriers to supermarket food choices, such as problems with opening jars and excessive packaging.

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Dietary Intake, Cost, and Affordability by Socioeconomic Group in Australia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182413315 ◽

2021 ◽

Vol 18 (24) ◽

pp. 13315

Author(s):

Meron Lewis ◽

Sarah A. McNaughton ◽

Lucie Rychetnik ◽

Mark D. Chatfield ◽

Amanda J. Lee

Keyword(s):

Saturated Fat ◽

Dietary Guidelines ◽

Healthy Foods ◽

Nutrition Survey ◽

Added Sugar ◽

Low Socioeconomic ◽

Socioeconomic Groups ◽

National Nutrition Survey ◽

Healthy Diets ◽

Discretionary Choices

Few Australians consume diets consistent with the Australian Dietary Guidelines. A major problem is high intake of discretionary food and drinks (those not needed for health and high in saturated fat, added sugar, salt and/or alcohol). Low socioeconomic groups (SEGs) suffer particularly poor diet-related health. Surprisingly, detailed quantitative dietary data across SEGs was lacking. Analysis of the most recent national nutrition survey data produced habitual intakes of a reference household (two adults and two children) in SEG quintiles of household income. Cost and affordability of habitual and recommended diets for the reference household were determined using methods based on the Healthy Diets Australian Standardised Affordability and Pricing protocol. Low SEGs reported significantly lower intakes of healthy food and drinks yet similarly high intakes of discretionary choices to high SEGs (435 serves/fortnight). Total habitual diets of low SEGs cost significantly less than those of high SEGs (AU$751/fortnight to AU$853/fortnight). Results confirmed low SEGs cannot afford a healthy diet. Lower intakes of healthy choices in low SEGs may help explain their higher rates of diet-related disease compared to higher SEGs. The findings can inform potential policy actions to improve affordability of healthy foods and help drive healthier diets for all Australians.

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Evaluating the Consistency of the French Nutri-Score Front-of-Pack Scoring System with Canadian Dietary Guidelines

Current Developments in Nutrition ◽

10.1093/cdn/nzaa064_001 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1711-1711

Author(s):

Mavra Ahmed ◽

Kacie Dickinson ◽

Laura Vergeer ◽

Christine Mulligan ◽

Beatriz Franco-Arellano ◽

...

Keyword(s):

Nutritional Quality ◽

Saturated Fat ◽

Dietary Guidelines ◽

Food Groups ◽

Food Label ◽

Dietary Recommendations ◽

University Of Toronto ◽

High Consistency

Abstract Objectives Nutrient profiling (NP) models, underpinning front-of-pack (FOP) labelling, can guide consumers towards healthier food choices and should be aligned with food-based dietary guidelines. In France, [the FSAm/HCSP NP model], underpinning the Nutri-Score (NS) FOP, ranks foods on both nutrients-to-limit (saturated fat, sodium, sugar) and nutrients-to-encourage (e.g., protein, fibre, fruits, vegetables, legumes and nuts) and was found to adequately align with dietary recommendations in Europe. However, investigations on the comparable ranking of foods by the FSAm/HCSP NP model with the new Canadian dietary guidelines is lacking. The objective was to assess the ability of the NS to discriminate the nutritional quality of foods and beverages in the Canadian food supply and their consistency with nutritional recommendations according to the Canada's 2019 Food Guidelines (CFG). Methods Using the University of Toronto Food Label Information Program 2017 database (n = 17,360), the nutritional scores for prepackaged foods and beverages were derived using the NS. These scores correspond to five grades of nutritional quality, ranging from green (A; highest quality) to red (E; lowest quality). Scores were assessed as binary where A/B were considered ‘in alignment’ with CFG recommendations while C/D/E were considered ‘not in alignment’. Results The NS system classified 21% of products as A, ranging from 99% of legumes to 0.45% of the sugars/sweets. The NS was able to discriminate the nutritional quality of foods within the same food groups (based on display of three grades represented within the Nutri-Score). Overall, there was 73% agreement between NS and CFG, ranging from 48% for combination dishes to 95% for eggs/egg substitute categories. The classification of foods according to the NS was consistent with the CFG; foods for which consumption is recommended were more favourably classified (e.g., 76% of vegetables were classified as A or B) than foods for which consumption should be limited (e.g., 79% of snacks were classified as C/D/E). Conclusions The NS FOP system is an effective tool to discriminate products across and within food categories. The classification of different food groups in the NS displayed a high consistency with the new Canadian dietary guidelines. Funding Sources Sanofi-Pasteur University of Toronto Université Paris-Descartes Collaborative Grant.

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Contribution of Dairy Foods to Energy and Nutrient Intakes in Children and Adults: Analysis of Nhanes 2015–2018

Current Developments in Nutrition ◽

10.1093/cdn/nzab053_014 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1021-1021

Author(s):

Christopher Cifelli ◽

Julie Hess ◽

Victor III Fulgoni

Keyword(s):

Vitamin D ◽

Vitamin A ◽

Vitamin B12 ◽

Saturated Fat ◽

Dietary Guidelines ◽

Health Concern ◽

Food Groups ◽

Food Category ◽

Dairy Foods ◽

Total Fat

Abstract Objectives Dairy foods are foundational foods in healthy eating patterns. Consumption of dairy foods helps both children and adults meet the recommendations of a variety of essential nutrients. Accordingly, the objective of this study was to determine the contribution of total dairy, milk, cheese, and yogurt to energy and nutrient intake in children and adults. Methods Twenty-four-hour dietary recall data from children age 2–18 (n = 5038) and adults age 19–99 (n = 9813) participating in the National Health and Nutrition Examination Survey (NHANES) 2015–2016 and 2017–2018 were analyzed. Intakes (both absolute amounts and as a percentage of total intake) of energy and nutrients were determined for all food groups using the USDA food category system. Data were generated on an as consumed basis and on a disaggregated basis; the latter approach reallocated energy and nutrients from milk and cheese found in other foods (e.g., pizza) back to the respective dairy food group. Total dairy was defined as milk, cheese, and yogurt in this analysis. Results On a disaggregated basis, total dairy provided 14.2% and 9.7% of total kcal/d in children and adults, respectively. At current consumption levels, milk, cheese, and yogurt contributed 61.6% of calcium, 65.8% of vitamin D, 22.8% of potassium, 23.7% of protein, 38.5% of vitamin A, 38.3% of vitamin B12, 31.1% of riboflavin, 36.3% of phosphorus, 22.7% of zinc, and 18.1% of magnesium in children, on average. Dairy foods also contributed 19% of total fat, 31.1% of saturated fat, 13.9% of sodium, and 4.7% of added sugar to the diets of children. Similarly, in adults, milk, cheese, and yogurt contributed 49.5% of calcium, 45.9% of vitamin D, 11.6% of potassium, 15.7% of protein, 26.6% of vitamin A, 24.9% of vitamin B12, 18.6% of riboflavin, 25% of phosphorus, 15.5% of zinc, and 9.4% of magnesium to the diet, on average. Total dairy also provided 14.2% of total fat, 24.8% of saturated fat, and 10.1% of sodium in adults. Milk was the top source of calcium and vitamin D in both children and adults. Conclusions Milk, cheese, and yogurt remain significant sources of key nutrients for children and adults, including three out of the four underconsumed nutrients of public health concern (vitamin D, calcium, and potassium) as defined by the 2020 Dietary Guidelines for Americans. Funding Sources National Dairy Council.

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Exploring Food Guidance Approaches for Seniors in Antigonish, NS: Is There Still Gold at the End of the Rainbow?

Canadian Journal of Dietetic Practice and Research ◽

10.3148/cjdpr-2019-002 ◽

2019 ◽

Vol 80 (3) ◽

pp. 137-139

Author(s):

Lindsay Maccharles ◽

Ann Fox

Keyword(s):

Rural Communities ◽

Environmental Issues ◽

Food Choices ◽

Dietary Guidelines ◽

Food Groups ◽

Portion Sizes ◽

Point Of Purchase ◽

Social Eating ◽

Guidance Needs ◽

Source Of Information

Purpose: As Canada rethinks approaches to food guidance, insights into the needs of seniors in rural communities are important to ensure their nutrition issues are addressed. This study aimed to explore the food guidance needs and wants of a group of seniors living in Antigonish, Nova Scotia. Methods: Three focus groups were held with a total of 12 participants over the age of 65 years, living independently in the community. Seniors were asked about their views on Canada’s Food Guide (CFG) and the Brazilian Dietary Guidelines (BDG). Results: Participants identified CFG as a trusted source of information and related well to the food groups and directive statements. Portion sizes were confusing and advice on food choices was not seen as being realistic in terms of cost and availability. The holistic nature of the BDG was appealing but guidance on processed food and social eating was not seen as relevant. Neither guidance tool addressed concerns about sustainability and environmental issues. Point of purchase nutrition information was preferable to receiving it from health professionals. Conclusion: CFG was seen as a trusted source of advice; however, locally accessible guidance on affordability and environmental issues related to food choice is needed for this group.

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