Nutri Score : Nutrition Labelling Scheme

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Dr Michel ChauliacDirection générale de la santéMinistère des solidarités et de la santé, FranceNUTRI SCORE : NUTRITIONLABELLING SCHEMEA simple and readable graphic systemA triple objective- Inform the consumer at the time of purchase to include the nutritiondimension in the selection criteria (in addition to price, practicality,taste, notoriety, label .)- Encourage producers to improve the nutritional quality of products- Facilitate professional nutrition adviceFor the consumer a triple purpose:- Situate the nutritional quality of foods belonging to differentcategories (ex : biscuits/dairy products/beverages.)- Compare the nutritional quality of foods belonging to the samecategory (ex : breakfast cereals)- Compare the nutritional quality of the same food offered bydifferent brands ( ex : filled cereals)1

Time line decision processJanuary 2016July 2016DecreeVote of the Health LawMarch 2015Concertation4 logos suggestedJanvier 2016Steering committeeof a large scaleexperimentation inreal life conditionsJanuary 2014Proposal tothe MinisterMarch 2015 June 20151 Appui2 Rapport HCSPscientifique et Adaptationtechnique de Nutri-scorel’AnsesScore FSASince 2014more than 30scientific publicationson Nutri-scoreMarch 20163 Appui scientifiqueet technique del’Anses :Comparaison Nutriscore/SENSJanuary 2016Scientific Comitteeof the large scaleexperimentation inreal conditions1 Ra.pdf2 ?clefr 5193 53.pdfSept-dec 2016Field of the large scaleexperimentationApril 2016Protocole of thelarge scaleexperimentation inreal conditionsagreedOct-nov 2016Experimentaleconomy ort comite scientifique etiquetage nutritionnel 150317.pdf5 Modification desachats alimentaires enréponse à cinq logos nutritionnelsCrosetto et al., Cahiers de nutrition etdiététique Vol 52 – N 3 P. 129-133 - juin2017Comparative studies Alternatives proposed during theconcertation process Graphical formats compared– Nutriscore; SENS; MTL; ModifiedReference Intakes; no label Modification of purchasing behavior– Overall nutritional quality of theitems in the shopping cart (FSA score) Spontaneous understanding Types of studies– Large scale experimentation– Experimental economyNUTRISCORESENSNUTRI-REPERESMTL ‘Nutri-Couleurs2

Classification with Nutri score from themandatory nutritional declarationCalculation of the FSA/OFCOM scoreNutrients tolimit0-40 points Tableau de valeurs nutritionnellesEnergy (KJ)Sugars (g)Sat urated fatty acids (g)Sodium (mg)Adaptations for 3 food groups:- Added fats: butter, oils,.- CheesesFoods- Beverages(points)- Score FSABeverages(points)ColorMin to -10 to 2WaterMin to 1GreenGreen3 to 102 to 5Yellow11 to 186 to 9Orange19 to Max10 to MaxDarkListe d’ingrédientsFruits, veg, nuts (%)Fibres (g)Proteins (g)-15Elements toincrease0-15 points40Higher nutritional Lower nutritionalqualityqualityLarge scale experimentation 60 supermarkets– 10 for each label– 20 controls 4 regions10 weeksIntervention– Limited to 4 shelves : 1300 products Fresh ready to eat productsBreadIndustrial PastriesCanned prepared meals– Voluntary Between 63% et 86% of labeledproducts Data collected: cash receiptsInterviews for spontaneaousunderstanding3

Large scale experimentation main results Improvement of the shopping cartProxy of less affluentconsumers- 0,267 ( 4,5% FSA Score)-0,233 ( 3,9% FSA Score)- 0,312-0,198 ( 3,3 % FSA Score)- 0,051 Sub-group analysis- 0,229– Nutri-Score: No deterioration of the nutritional quality of the shopping–cart in any subgroupNutri-Score : Higher impact in subjects buying less expensive products Spontaneous understanding– Nutri score 92% ;– MTL 29%Experimental economyTest in experimentaleconomyImprovement of the FSA score (after/before a label) 5 labels tested( HSR NutriMark) Constitution of a shoppingcart before an afterexposure to a labelResults The Nutri-Score isassociated with the highestimprovement In particular fordisadvantaged groupsCrosetto et al., 20174

24 Avril 2017Notification of theapplication decree to EUTime line decision processJanuary 2016July 2016DecreeVote of the Health LawMarch 2015Concertation4 logos suggested31 octobre 2017Signature of theapplicationdecreeMinistrers ofHealth,agriculture andeconomyJanvier 2016Steering committeeof a large scaleexperimentation inreal life conditions27 April 2017Signature ofthe Nutri-scorecharter by 4companiesMarch 2017MinisterDECISION tochoose theNUTRI-SCOREJanuary 2014Proposal tothe MinisterMarch 2015 June 20151 Appui2 Rapport HCSPscientifique et Adaptationtechnique de Nutri-scorel’AnsesScore FSASince 2014more than 30scientific publicationson Nutri-scoreMarch 20163 Appui scientifiqueet technique del’Anses :Comparaison Nutriscore/SENSJanuary 2016Scientific Comitteeof the large scaleexperimentation inreal conditions1 Ra.pdf2 ?clefr 5193 53.pdfSept-dec 2016Field of the large scaleexperimentationApril 2016Protocole of thelarge scaleexperimentation inreal conditionsagreedOct-nov 2016Experimentaleconomy studyMarch 20174 Résults of the large .fr/IMG/pdf/rapport comite scientifique etiquetage nutritionnel 150317.pdf5 Modification des5Résults of theexperimental economystudyachats alimentaires enréponse à cinq logos nutritionnelsCrosetto et al., Cahiers de nutrition etdiététique Vol 52 – N 3 P. 129-133 - juin2017% of Products in the different categories of theNutri score according to the food group(French market)ABCDEBreakfast cerealsn 4266247441Fresh ready to eatproducts n 1195252730171Canned preparedmeals n 42350361230Bread andindustrial pastriesn 408161441272Fresh dairyproducts n 1529192646915

Half pack provides:MED MEDEnergy89kcal4.5%FatsLOWSaturates SugarsHIGHSalt4.7g1.1g0.1g1.13g7%6% 1%19%Of your reference intakesThis pack provides:MED HIGHEnergyFatsSaturates552kcal 20.8g 9.2g28% 30% 46%LOWSugarsHIGHSalt7.2g 3.30g8% 55%Of your Reference intakeDiversity of cooked dishes6

Examples on Breakfast cerealsExemple d’application du NutriScore7

Current situation Operational Decree signed by Ministers ofHealth, agriculture and economy the 31st ofOctober 3 main producers and 3 main retailers engaged(Fleury Michon, McCain, Danone, Auchan,Leclerc, Intermarché), many demands First packages with Nutri-Score in stores inSeptember 2017 A strong demand from consumers to haveonly one system : Nutri score Nestle; Coca Cola, Pepsi Cola, Mars, Mondelez,Unilever to introduce the MTL per portion? Towards a European harmonisationscientifically based ?WHO EuropeFrance's recent decision to recommend the Nutri-Scoresystem is an important step forward for nutrition in the WHOEuropean RegionFrance has largely based its decision on the availableevidence on this subject, an approach that deserves to bewelcomedWHO/ Europe congratulates France for this initiative whichvalues consumer-friendly labeling systems8

- Nutri-Score: No deterioration of the nutritional quality of the shopping cart in any subgroup -Nutri-Score : Spontaneous understanding -Nutri score 92% ; -MTL 29% - 0,312 - 0,229 - 0,051 Proxy of less affluent consumers Higher impact in subjects buying less expensive products Experimental economy Test in experimental economy 5 .

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