Ecological and/or Nutritional Scores for Food Traffic-Lights: Results of an Online Survey Conducted on Pizza in France

Understanding the hierarchy for consumers between different labels signaling various characteristics defining food sustainability is still an open question. A web survey was conducted in France to examine how providing different scores about the environment and/or nutrition could influence purchase intents for one pizza. 1200 participants were recruited in France in April 2021. They were asked about their purchase intents for one pizza, before and after seeing nutritional and/or ecological scores associated with colors going from green to red. A Global-Score synthetizing both nutritional and ecological dimensions was also tested. The results show that the appearance of scores and colors significantly affect the purchase intents for this pizza. Indeed, for each type of score (namely nutritional, ecological or global), the dominant effect comes from the reduction in purchase intents related to the red color, although green or yellow colors also change purchase intents but to a lesser extent. With the red color, the nutritional score leads to more significant decreases in purchasing intents than the ones related to the ecological score or the Global-Score. With an additional round, the appearance of another score complementing the alternative one underlines that the negative impact of the red color for one score on purchase intents is not outweighed by the positive impact of the green color for the other score.

Preoperative nutritional score predicts underlying liver status and surgical risk of hepatocellular carcinoma

Background: Given the scarce evidence regarding the impact of preoperative nutritional status on surgical outcomes of patients with hepatocellular carcinoma, predictive powers of nutritional/inflammatory scores for short-term surgical outcomes in patients with hepatocellular carcinoma were investigated. Methods: Outcomes of 1272 patients with hepatocellular carcinoma were reviewed, and predictive powers of nine nutritional/inflammatory scores for short-term surgical outcomes were compared using the receiver-operating characteristic curve analysis. Clinical relevance of the best nutritional score was then studied in detail to clarify its utility as an alternative predictive measure for surgical risk of patients with hepatocellular carcinoma. Results: Receiver-operating characteristic curve analysis showed the controlling nutritional status score has the best performance in prediction of morbidity after hepatectomy for hepatocellular carcinoma (area under the curve, 0.593; 95% confidence interval: 0.552–0.635; p < 0.001), and multivariate analysis confirmed its correlation with the risk of any morbidity (odds ratio per +1 point, 1.17; 95% confidence interval: 1.08–1.27; p < 0.001) and major morbidity (odds ratio per +1 point, 1.14; 95% confidence interval: 0.99–1.27; p = 0.052). The undernutrition grade based on the controlling nutritional status score showed strong correlation with the degree of fibrosis in the liver ( p < 0.001), platelet count ( p < 0.001), and indocyanine green retention rate at 15 min ( p < 0.001). In addition, the controlling nutritional status undernutrition grade well stratified the risk of postoperative morbidity especially in cirrhotic subpopulation (odds ratio, 1.17 per +1 point; 95% confidence interval: 1.05–1.29 for any morbidity and odds ratio, 1.20 per +1 point; 95% confidence interval: 1.03–1.40 for major morbidity). Conclusion: The controlling nutritional status score could be an alternative measure for underlying liver injury and the surgical risk of hepatocellular carcinoma.

Development and validation a novel preoperative comprehensive prognostic score based on inflammatory and nutritional score, coagulation indicator and tumor marker in esophageal squamous cell carcinoma

We herein propose a novel integrative score based on inflammatory and nutritional score, coagulation indicator and tumor marker, named comprehensive prognostic score (CPS), to predict postoperative survival in resectable esophageal squamous cell carcinoma (ESCC). We also aimed to establish and validate a nomogram based on CPS and other clinical features for individual survival prediction. A total of 490 resectable ESCC patients were randomly divided into either a training or validation cohort at a ratio of 7:3 for retrospective analysis. The CPS, based on squamous cell carcinoma antigen (SCCA), C-reactive protein to albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), and fibrinogen (FIB), was divided into two models to verify its prognostic value. The predictive model of CPS-based nomogram was established and validated in two cohorts. Patients with CPS low group in model 1 had better 5-year cancer-specific survival (CSS) than those in CPS high group (50.7% vs. 17.8%, P<0.001). For model 2, the 5-year CSS for CPS 0, 1 and 2 were 75.0%, 38.9% and 13.3%, respectively (P<0.001). CPS was confirmed as an independent prognostic score in both models. The CPS-based nomogram can accurately and effectively predict survival in resected ESCC. The CPS is a novel, simple, and effective predictor in resectable ESCC. Moreover, CPS has a potential independent prognostic value in predicting postoperative survival, which can accurately and effectively predict individual survival in resectable ESCC.

The ABC’s of Ecological and Nutrition Labels. The Impact of Label Theme and Complexity on the Environmental Footprint of Online Grocery Choices

Current food production and consumption patterns pose serious threats to our global environment. The goal of the current research is to investigate whether the presence of specific informational cues, i.e., ecological labels and nutrition labels, can improve the environmental impact of food choices. Two online experiments were carried out in which young adults were asked to select products in a grocery shop setting, and to indicate quantities (in grams) for a hypothetical one-person meal. In the first experiment (N = 142), we varied the theme (sustainability vs. nutrition vs. control) of the labels alongside the products. The labels displayed a summarized product score (i.e., the products’ actual nutri-score), but this was either presented as the nutritional score or as the ecological score of that product. In the second experiment (N = 250), we again varied this label theme as well as the level of complexity, namely interpretative (i.e., simple) vs. reductive (i.e., detailed). While the results of the first experiment revealed no impact of the labels, the results of the second experiment suggest that labels with a sustainability theme can influence young adults to compose a more sustainable meal with less meat, and with a lower carbon and blue water footprint. The labels’ level of complexity did not impact the different eating outcomes. In conclusion, while these results point to the potential use of labels with a sustainability theme, it is important to note that the results did not consistently replicate across studies and analyses and should therefore be interpreted with caution. A possible explanation for the effect of eco-themed labels might be that they trigger pro-environmental objectives during decision-making, and prime people to consider the sustainability of their food choices.

Associations between First Trimester Maternal Nutritional Score, Early Markers of Placental Function, and Pregnancy Outcome

This study investigated the associations between maternal adherence to a healthy diet, first trimester placental markers, and pregnancy outcome. Singleton spontaneous pregnancies were enrolled at 11+0–13+6 gestational weeks in a prospective cohort study. A nutritional score (0–10) measuring the adherence to a healthy diet was calculated. A transabdominal ultrasound scan for placental marker assessment was performed (uterine artery (UtA) doppler, placental volume). Biochemical placental markers were recorded (Pregnancy Associated Plasma Protein A (PAPP-A), free β- Human Chorionic Gonadotropin (HCG)). Birth outcomes were obtained from medical records. Associations between the maternal nutritional score, first trimester placental markers, and pregnancy outcome were investigated by using multi-adjusted general linear models. In total, 112 pregnancies were enrolled with a median nutritional score of 7 (range 3–10). Median gestational age at birth was 277 days (range 203–296). The nutritional score was positively associated with PAPP-A concentrations, whereas a negative association was detected with the UtA mean pulsatility index and placental volume. A positive association was detected between nutritional score and gestational age at birth. This study demonstrates that a first trimester nutritional score as a measure of adherence to a healthy diet is significantly associated with early biochemical and ultrasound markers of placental development, with further association with gestational age at birth.

A digital meal nutritional score may influence food choices in a workplace restaurant: A pilot study

IntroductionFood choice is complex. Digital nutrition applications are emerging to help decisions about food choices. Nestlé's Meal Nutritional Score (MNS) is a number between 0 and 100 that provides a measure of the extent to which a meal meets US dietary recommendations. The objective was to evaluate if the MNS influences food choices in a workplace restaurant.Materials and MethodsA workplace education campaign ran over two weeks in order to introduce the MNS to employees. This was done during the lunch break at the entrance to the cafeteria of Nestlé's research centre, which serves around 250 hot meals at lunchtime every day. Employees choose between a typical Western meal, a healthy meal and a vegetarian meal. During the campaign, and for three weeks afterwards, LED screens displayed the MNS for the three different types of meal, every day. Employees’ voluntary feedback on the MNS was collected using a closed-ended questionnaire. Descriptive analyses were done for the scores and sales of each type of meals for one week before the education campaign, immediately after the campaign and three weeks later. Data are reported as mean ± 1 standard deviation.ResultsFeedback was obtained from 152 employees, of whom 96% said the MNS helped them to understand the nutritional balance of the meals, and 38% said the MNS influenced their meal choices. The MNS scores pre-campaign, post-post campaign and 3 weeks later were 52 ± 14, 50 ± 16 and 56 ± 11 for the Western meal; 54 ± 14, 62 ± 6 and 67 ± 6 for the healthy meal and 64 ± 11, 57 ± 14 and 57 ± 12 for the vegetarian meal, respectively. The percentage of sales pre-campaign, post-post campaign and 3 weeks later were 48 ± 10%, 43 ± 9% and 33 ± 9% for the Western meal; 25 ± 10%, 30 ± 8% and 36 ± 10% for the healthy meal, and 27 ± 4%, 27 ± 4% and 30 ± 8% for the vegetarian meal, respectively.DiscussionThe number of people selecting the healthy meal, which usually had the best score, increased during the three weeks following the education campaign, suggesting that the MNS positively influences food choices. The MNS may also help chefs to design more nutritionally balanced meals. Longer-term follow up is necessary to evaluate if these are sustained behaviour changes as well as to test the impact of the MNS in a different workplace environment.