Nutri-Score creator doubles down on system accuracy amid industry opposition

28 Feb 2024 --- Serge Hercberg, professor of nutrition at the faculty of medicine at Sorbonne Paris North University, France, whose work forms the basis of the Nutri-Score, speaks to Nutrition Insight about our recent interview with Stephan Peters, manager of dairy, nutrition, health and sustainability at the Dutch Dairy Association.

In the interview, Peters questioned the validity of the Nutri-Score and outlined the arguments presented in his recent literature review of scientific papers about the front-of-pack nutritional labeling system.

The literature review, conducted alongside Dr. Hans Verhagen, a scientific and regulatory expert at the Dutch Food Safety and Nutrition Consultancy and former senior science coordinator at the European Food Safety Authority (EFSA), argues that the majority of positive papers on the topic were published by the actors associated with the Nutri-Score. 

“Concerning the paper by Peters and Verhagen, it represents an emblematic example of the strategy of lobbyists trying to cast doubt on the front-of-pack nutrition label Nutri-Score and to discredit a public health measure they consider as opposed to their interest,” Hercberg tells us. 

“This article is riddled with inaccuracies, inconsistencies and errors. The text presents biased arguments leading to erroneous conclusions,” he continues. “As such, it does not meet the standards of a true scientific article.”

Arguments against
A chief argument made by Hercberg against the paper criticizing the Nutri-Score, published in the journal PharmaNutrition, is that the Dutch Dairy Association funds it and that its authors are working for organizations involved in lobbying against the Nutri-Score, including the Dutch Dairy Association and Verhagen’s consultancy that includes the European Association of Sugar Manufacturers among its clients.

“Using the appearance of a scientific article, it is a pamphlet written by two authors that work for an industry trying to cast doubt on academic science and to make serious accusations toward public research teams to discredit the front-of-pack nutrition label Nutri-Score,” Hercberg says.

Nutri-Score validation studies have been conducted only with public funding and in collaboration with other research teams or public institutions, such as the WHO, its official blog states.He further argues that the paper by Peters and Verhagen targets a recent article published in BMJ Global Health, which finds that a study is 21 times more likely to find unfavorable results about Nutri-Score if the authors declare a conflict of interest or if the study is funded by a food industry player. 

A post responding to the paper published on the official Nutri-Score blog and supported by 16 scientists working in the field of food and nutrition suggests that the paper attempts to minimize the link between economic conflict of interest or funding and study results.

Responding to the accusation that most positive studies on the ranking system are conducted by academic researchers who developed the Nutri-Score, stating that the validation studies on it have been conducted only with public funding and in collaboration with other research teams or public institutions, such as the WHO. 

The authors of the blog post state that it is hypocritical to accuse the Nutri-Score developers of bias without acknowledging their own conflict of interest. 

Errors
The Nutri-Score blog post further questions the validity of Peters’ and Verhagen’s paper, stating that it is full of “inaccuracies, inconsistencies, errors and biased arguments leading to erroneous conclusions.”

These include discrepancies and inconsistencies in the inclusion and exclusion criteria of scientific papers in the review, misclassification of papers as favorable, neutral or unfavorable to the Nutri-Score, errors in the number of studies included, inconsistencies between text and tables, biased definitions and conflict of interest. 

Correcting for the perceived errors in the review, the Nutri-Score post states that “Of the 69 studies considered favorable to the Nutri-Score, only one (1,4 %) included declarations of a conflict of interest or indicated that the authors had received funding from a structure linked to a food company.”

“Conversely, 10 of the 24 studies presenting results which are unfavorable to Nutri-Score (41.7%) included a conflict of interest by the authors or had received funding from food professional organizations defending the interest of food companies or agro-food sectors.” 

It concludes that the probability for an article to show results that are unfavorable to the Nutri-Score is 33 times higher when a paper is funded by the food industry or when the authors declare a conflict of interest.

In April, the Belgian EU council presidency is set to hold a scientific symposium to discuss the implementation of an EU-wide front-of-pack nutrition labeling system. Nutri-Score is currently the frontrunner labeling system within the blog. In a recent interview with Nutrition Insight, Herberg expressed his support for the EU-wide adoption of the system. 

By Milana Niklova