Can Nutri-Score be used to restrict food marketing to children? Results from the NewTools project

Abstract Background Food marketing influences the food choices of children, and measures to regulate food marketing is key. WHO Europe has developed a nutrient profile model for the purpose of restricting the marketing of unhealthy foods to children, classifying food into 22 categories with category-specific nutritional thresholds (the WHO-EURO). The Nutri-Score is a food label to help consumers make healthier food choices by classifying foods from A-E. The aim of this study was to evaluate if the Nutri-Score can effectively define products for the purpose of marketing restrictions towards children. Methods The study included data from the Norwegian food composition table (N = 1,944). Foods were categorized according to the WHO-EURO profile (permitted or not permitted to be marketed). Products with Nutri-Score A or B were considered eligible for marketing. Cross classification was used to assess agreement (%) between products classified as either permitted or not permitted by the Nutri-Score and the WHO-EURO. Results There was 84% agreement between WHO-EURO and Nutri-Score. Products not eligible for marketing according to WHO-EURO but permitted according to the Nutri-Score (5%) were for example some canned fruit, plain yoghurts, fatty fish, plant-based meat analogues, and salted nuts. Products permitted to be marketed according to the WHO-EURO, but not permitted according to the Nutri-Score (11%) were for example honey, some dried fruits and nuts mixes, breakfast cereals, ready meals, and refined grains. Conclusions Our study indicates that Nutri-Score can be used as a tool not only for front-of-pack labelling but also for defining foods for marketing restrictions towards children. Additional criteria to Nutri-Score A and B, such as presence of non-sugar sweeteners or added sugar, can also be applied to better align with the WHO-EURO. Using a common nutrient profile for multiple purposes may be beneficial to increase simplicity and to secure coherence in food policies. Key messages • Nutri-Score A and B aligns well with WHO-EURO for regulating food marketing to children. • Using a common nutrient profile for multiple purposes may be beneficial to secure coherence in food policies.