Assessing the Validity of Front-of-Pack Nutrition Labels for Evaluating the Healthiness of Mediterranean Food Choices: A Global Comparison
Abstract
:1. Introduction
2. Methods
2.1. Design and Sample
2.2. Calculation of the Weight of the Dishes
2.3. Dish Evaluation Tools
2.3.1. Mazocco Method
2.3.2. UK’s Traffic Light Labelling System
2.3.3. Health Star Rating (HSR)
2.3.4. Nutri-Score
2.3.5. Multiple Traffic Lights from Ecuador
2.3.6. Chilean Warning Labels
2.3.7. Uruguayan Warning Labels
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Front of Pack | Labelling System | Variables | Image Example |
---|---|---|---|
Mazzoco method [12] | Colour card | Na content and energy | |
UK [37] | Colours: green, amber, and red | Fat, saturated fats, sugars, and salt | |
Health Star Rating [20] | Stars: from 0.5 to 5 | Total energy, total sugars, and saturated fatty acids (risk components)Fibre, fruits and vegetables, nuts, legumes, and protein (healthy components) | |
Nutri-Score [7] | Colours (dark green, light green, yellow, light orange, and red) and letters (A–E) | Energy, total fat, saturated fatty acids, sugars, protein, salt, fibre, Na, fruits, vegetables, legumes, nuts, and olive oil | |
Multiple traffic lights from Ecuador [38] | Colours (green, yellow, and red) | Fat, sugar, and salt | |
Chilean warning labels [2] | High content labels | Added sugars, Na, saturated fats, and calories | |
Uruguayan warning stamps [39] | High content labels | Na, sugar, fat, and saturated fatty acids |
Dishes | Main Courses | Second Courses | Desserts | |
---|---|---|---|---|
Total selected (n) | 533 | 156 | 119 | 258 |
Duplicated (n) | 355 | 88 | 60 | 207 |
Total analysed (n) | 178 | 68 | 59 | 51 |
Total (%) | 38 | 33 | 29 | |
Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | |
Kcal/serving | 558.6 ± 310 | 472.9 ± 167 | 795.9 ± 396 | 403.0 ± 148 |
Kcal/100 g | 171.1 ± 101 | 134.7 ± 65.9 | 162.5 ± 93.6 | 231.5 ± 120 |
Fat (g/serving) | 31.6 ± 30 | 19.7 ± 14.1 | 55.7 ± 40.9 | 20.3 ± 13.3 |
Fat (g/100 g) | 9.8 ± 9.3 | 6.1 ± 6.0 | 11.6 ±10.0 | 12.6 ± 10.5 |
SFAs (g/serving) | 7.8 ± 6.4 | 5.1 ± 4.1 | 10.2 ± 7.5 | 9.0 ± 6.5 |
SFAs (g/100 g) | 2.8 ± 3.2 | 1.5 ± 1.5 | 2.1 ± 1.5 | 5.5 ± 4.6 |
Sugars (g/serving) | 18.8 ± 15.7 | 14.8 ± 15.2 | 10.8 ± 7.1 | 33.7 ± 13.3 |
Sugars (g/100 g) | 6.9 ± 7.3 | 3.5 ± 2.8 | 2.0 ± 1.3 | 17.2 ± 4.8 |
Fibre (g/serving) | 7.3 ± 10.6 | 11.0 ± 8.2 | 5.9 ± 3.5 | 3.7 ± 16.0 |
Fibre (g/100 g) | 2.0 ± 5.0 | 2.8 ± 1.9 | 1.1 ± 0.6 | 2.1 ± 9.1 |
Salt (g/serving) | 0.7 ± 1.6 | 0.7 ± 2.0 | 1.4 ± 1.5 | 0.0 ± 0.0 |
Salt (g/100 g) | 0.2 ± 0.3 | 0.2 ± 0.4 | 0.3 ± 0.3 | 0.0 ± 0.0 |
Na (mg/serving) | 610.6 ± 697 | 662.3 ± 883 | 925.6 ± 539 | 171.8 ± 113 |
Na (mg/100 g) | 167.8 ± 162 | 194.6 ± 216 | 186.7 ± 115 | 107.7 ± 95.2 |
Total Dishes (n = 178) | |||||||
---|---|---|---|---|---|---|---|
MAZOCCO | UK | HSR | NUTRI-SCORE | ECUADOR | CHILE | URUGUAY | |
MAZOCCO | — | — | — | — | — | — | — |
UK | 0.2049 | — | — | — | — | — | — |
HSR | 0.2928 | 0.3367 | — | — | — | — | — |
NUTRI-SCORE | 0.2318 | 0.1796 | 0.2252 | — | — | — | — |
ECUADOR | 0.1554 | 0.4921 | 0.2723 | 0.0835 | — | — | — |
CHILE | 0.1608 | 0.5234 | 0.316 | 0.176 | 0.3783 | — | — |
URUGUAY | 0.1694 | 0.404 | 0.1945 | 0.1946 | 0.3759 | 0.3052 | — |
First Dishes (n = 68) | |||||||
MAZOCCO | UK | HSR | NUTRI-SCORE | ECUADOR | CHILE | URUGUAY | |
MAZOCCO | — | — | — | — | — | — | — |
UK | 0.1521 | — | — | — | — | — | — |
HSR | 0.2087 | 0.2168 | — | — | — | — | — |
NUTRI-SCORE | 0.285 | 0.1508 | 0.2149 | — | — | — | — |
ECUADOR | 0.07 | 0.5723 | 0.1247 | 0.1835 | — | — | — |
CHILE | 0.0976 | 0.3083 | 0.1993 | 0.178 | 0.3083 | — | — |
URUGUAY | 0.2554 | 0.4389 | 0.3798 | 0.1551 | 0.3337 | 0.1831 | — |
Second Dishes (n = 59) | |||||||
MAZOCCO | UK | HSR | NUTRI-SCORE | ECUADOR | CHILE | URUGUAY | |
MAZOCCO | — | — | — | — | — | — | — |
UK | 0.0093 | — | — | — | — | — | — |
HSR | 0.1782 | 0.2223 | — | — | — | — | — |
NUTRI-SCORE | 0.2643 | 0.0332 | 0.0707 | — | — | — | — |
ECUADOR | * −0.059 | 0.3891 | 0.1227 | * −0.0802 | — | — | — |
CHILE | 0.072 | 0.5155 | 0.2441 | 0.0157 | 0.3591 | — | — |
URUGUAY | 0.1324 | 0.3542 | 0.0499 | 0.1347 | 0.426 | 0.2761 | — |
Desserts (n = 51) | |||||||
MAZOCCO | UK | HSR | NUTRI-SCORE | ECUADOR | CHILE | URUGUAY | |
MAZOCCO | — | — | — | — | — | — | — |
UK | 0.3816 | — | — | — | — | — | — |
HSR | 0.3938 | 0.307 | — | — | — | — | — |
NUTRI-SCORE | 0.0354 | 0.1056 | 0.1121 | — | — | — | — |
ECUADOR | 0.3831 | 0.4096 | 0.2317 | * −0.0099 | — | — | — |
CHILE | 0.2508 | 0.5598 | 0.2557 | 0.1115 | 0.3343 | — | — |
URUGUAY | 0.0743 | 0.3481 | 0.069 | 0.1223 | 0.3112 | 0.3493 | — |
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Fernandez-Alonso, J.; Lamas-Mendoza, M.d.M.; Rodriguez-Sanchez, N.; Galloway, S.D.R.; Gravina, L. Assessing the Validity of Front-of-Pack Nutrition Labels for Evaluating the Healthiness of Mediterranean Food Choices: A Global Comparison. Nutrients 2024, 16, 2925. https://doi.org/10.3390/nu16172925
Fernandez-Alonso J, Lamas-Mendoza MdM, Rodriguez-Sanchez N, Galloway SDR, Gravina L. Assessing the Validity of Front-of-Pack Nutrition Labels for Evaluating the Healthiness of Mediterranean Food Choices: A Global Comparison. Nutrients. 2024; 16(17):2925. https://doi.org/10.3390/nu16172925
Chicago/Turabian StyleFernandez-Alonso, Julia, María del Mar Lamas-Mendoza, Nidia Rodriguez-Sanchez, Stuart D. R. Galloway, and Leyre Gravina. 2024. "Assessing the Validity of Front-of-Pack Nutrition Labels for Evaluating the Healthiness of Mediterranean Food Choices: A Global Comparison" Nutrients 16, no. 17: 2925. https://doi.org/10.3390/nu16172925