Agricolae International13/01/2023 12:53

Netherlands stalls on nutriscore decision: Health Council: discrepancies with Dutch system. Scientists: clash of systems, not unsafe choices


The Netherlands stalls on nutriscore decision

Yesterday, State Secretary for Health, Welfare and Sport Maarten van Ooijen accepted the request of a group of scientists to revisit and further adapt the Nutriscore before its introduction.

A request supported by more than 180 nutrition scientists, practitioners and doctors, the Professional Association of Weight Consultants of the Netherlands (BGN), the Professional Association of Lifestyle Coaches of the Netherlands (BLCN), the Cooperative of Dietitians of the Netherlands (DCN), and the Alliance Nutrition for the Healthy Generation and the Partnership Overweight Netherlands (PON).

This is not an appeal against the Nutri-Score,' they write in a post, 'but an appeal for a 'foodchoice' logo that fits well with the Dutch dietary guidelines. The Nutri-Score algorithm, recently revised by the Health Council, has improved in indicating unhealthy choices, but for Dutch scientists it is still deficient in indicating healthy staple foods.

The adjustments proposed by the Health Council are necessary,' write Annet JC Roodenburg, Jacob (Jaap) C Seidell, Tiny Van Boekel, Kees de Graaf Samenwerkende GezondheidsFondsen (SGF), Ronald Jas, Nieuws voor dietisten, Koen Joosten, Liesbeth Van Rossum, Voedingscentrum, Ministerie van Volksgezondheid, Welzijn en Sport, Edgar van Mil, Frans Kok, Hans Kraak, Hans Verhagen, Ruben van Dorssen, Netwerk Kinderdiëtisten - so that the logo can actually provide a 'consumer manipulation' perspective so that they make healthy choices more often. And to give a real positive impulse for a healthier food environment.

In short, the Nutri-Score is not in line with Dutch dietary guidelines and the Schijf van Vijf, a kind of mechanism based on the food pyramid. This is a chart that invites the population to follow the dietary advice given by a qualified health organisation or company that is responsible for telling Dutch citizens what is part of a healthy eating pattern and what is not.

How can pizza get a healthy green A? Or why does olive oil get a C, while vegetable oil is in the Schijf van Vijf? A discrepancy that the Dutch do not like.

The Secretary of State was sensitive to the scientists' arguments and decided to take time: and last summer an international scientific committee got to work and proposed improvements.

And now the Health Council examined whether the revised Nutri-Score was in line with the dietary guidelines.

But from what has emerged, the Nutriscore seems to assume the same advantages and disadvantages for all products. At most, there is a shift in the number of points forming the boundary between A, B, C, D and E. In each case, however, everything passes through the same bar.

These fundamental differences make the discrepancies almost inevitable. "It is a clash of systems," says Marianne Geleijnse, vice-president of the Health Council and professor at Wageningen University who worked on the report with a range of scientists, from behavioural and nutrition scientists to paediatricians.

In order to eliminate the major friction between the Dutch System and the Nutri-Score, the international scientific committee targeted the algorithm. According to Joline Beulens, professor of epidemiology (UMC Amsterdam) and one of the two Dutch scientists serving on the committee, although dietary guidelines have the same scientific basis everywhere, the Nutri-Score algorithm, derived from a British method of counting nutrients in food, proved to be inelastic. It failed, for example, to increase the fibre component so that unpolished rice and whole-wheat pasta scored better than white varieties.

However, some progress was made. Some examples: sugar and salt already receive deduction points at the lowest levels. The maximum number of deduction points for protein has been reduced so that red meat less often gets the green score. A greater distinction is also made between saturated and unsaturated fat, so that olive oil now gets a green B.

Basically, the Health Council was not faced with the question of whether the Dutch system and the Nutri-Score fit perfectly. If they did, the answer would be 'no' in advance. The main question was how big the differences still were.

To find out, RIVM researchers ran the revised algorithm on the Levensmiddelendatabank (LEDA) and the Nederlands Voedingsstoffenbestand (NEVO). These contained tens of thousands of products, most of the supermarket offerings. It was checked whether products with an A or B (green) were present in the Guidelines for Good Nutrition or the 'Schijf van Vijf' and whether products with a C, D or E (red) were actually not included.

The more than 100 studies on the Nutri-Score, which French professor Serge Hercberg, the creator of the algorithm, frequently reviews, do not reassure Dutch scientists as well as Stephan Peters, food scientist and critical follower of the Nutri-Score.

In a virtual environment, consumers choose unhealthy products from three images. However, research in real supermarkets shows very small and less unambiguous effects. Furthermore, it has never been tested with a complete assortment. In larger groups, it shows that people who choose A or B eat healthier more often, but it has not yet been proven that the Nutri-Score improves public health.

The dilemma for the Secretary of State is: to introduce a faulty logo quickly or to delay until the situation has improved further, at the risk of being too late. The latter scenario is not far-fetched: the European Commission, which wants an EU-wide food choice logo, recently shelved the Nutriscore.

The Dutch Health Council has no say in the matter; the introduction is a political decision. But Geleijnse warns: 'Doing nothing is not necessarily the safe choice'.