Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH Paris 13, 74 rue Marcel Cachin, F-93017, Bobigny Cedex, France.
Public Health department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Bobigny, France.
Int J Behav Nutr Phys Act. 2021 Mar 17;18(1):38. doi: 10.1186/s12966-021-01108-9.
The Nutri-Score summary graded front-of-pack nutrition label has been identified as an efficient tool to increase the nutritional quality of pre-packed food purchases. However, no study has been conducted to investigate the effect of the Nutri-Score on the shopping cart composition, considering the type of foods. The present paper aims to investigate the effect of the Nutri-Score on the type of food purchases, in terms of the relative contribution of unpacked and pre-packed foods, or the processing degree of foods.
Between September 2016 and April 2017, three consecutive randomized controlled trials were conducted in three specific populations - students (N = 1866), low-income individuals (N = 336) and subjects suffering from cardiometabolic diseases (N = 1180) - to investigate the effect of the Nutri-Score on purchasing intentions compared to the Reference Intakes and no label. Using these combined data, the proportion of unpacked products in the shopping carts, as well as the distribution of products across food categories taking into account the degree of processing (NOVA classification) were assessed by trials arm.
The shopping carts of participants simulating purchases with the Nutri-Score affixed on pre-packed foods contained higher proportion of unpacked products - especially raw fruits and meats, i.e. with no FoPL -, compared to participants purchasing with no label (difference of 5.93 percentage points [3.88-7.99], p-value< 0.0001) or with the Reference Intakes (difference of 5.27[3.25-7.29], p-value< 0.0001). This higher proportion was partly explained by fewer purchases of pre-packed processed and ultra-processed products overall in the Nutri-Score group.
These findings provide new insights on the positive effect of the Nutri-Score, which appears to decrease purchases in processed products resulting in higher proportions of unprocessed and unpacked foods, in line with public health recommendations.
Nutri-Score 是一种总结性的前置营养标签，已被确定为提高预包装食品购买营养价值的有效工具。然而，尚无研究调查 Nutri-Score 对购物车组成的影响，也没有考虑到食品类型。本文旨在调查 Nutri-Score 对食品购买类型的影响，包括未包装和预包装食品的相对贡献，或食品的加工程度。
在 2016 年 9 月至 2017 年 4 月期间，在三个特定人群中进行了三项连续的随机对照试验 - 学生（N=1866）、低收入人群（N=336）和患有代谢性心血管疾病的受试者（N=1180）- 以调查与参考摄入量和无标签相比，Nutri-Score 对购买意向的影响。利用这些合并数据，根据试验组评估购物车中未包装产品的比例，以及考虑加工程度（NOVA 分类）的食品类别分布。
参与者模拟带有 Nutri-Score 的预包装食品购物时，购物车中未包装产品的比例较高 - 尤其是未经加工的水果和肉类，即无 FoPL - 与使用无标签（差异 5.93 个百分点 [3.88-7.99]，p 值<0.0001）或参考摄入量（差异 5.27 [3.25-7.29]，p 值<0.0001）相比。这种更高的比例部分解释为 Nutri-Score 组总体上购买的预包装加工和超加工产品较少。
这些发现提供了 Nutri-Score 的积极影响的新见解，该评分似乎减少了对加工产品的购买，从而增加了未加工和未包装食品的比例，符合公共卫生建议。
