Methodology for the Determination of Fruit, Vegetable, Nut and Legume Points for Food Supplies without Quantitative Ingredient Declarations and Its Application to a Large Canadian Packaged Food and Beverage Database

Round 1

Reviewer 1 Report

The abstract covers the information presented in the manuscript and the key words are suitable for its presentation. The MS has an appropriate structure, the materials and methods are quite informative, the results are clearly presented, the tables are all necessary, complete and clearly presented. The references are adequate. In my opinion the work is of interest, however it present fails that should be corrected. See file attach.

Comments for author File: Comments.pdf

Author Response

Reviewer 1

 

 

Open Review

(x) I would not like to sign my review report 
( ) I would like to sign my review report 

English language and style

( ) Extensive editing of English language and style required 
( ) Moderate English changes required 
( ) English language and style are fine/minor spell check required 
(x) I don't feel qualified to judge about the English language and style 

 

	Yes	Can be improved	Must be improved	Not applicable
Does the introduction provide sufficient background and include all relevant references?	(x)	( )	( )	( )
Is the research design appropriate?	(x)	( )	( )	( )
Are the methods adequately described?	(x)	( )	( )	( )
Are the results clearly presented?	(x)	( )	( )	( )
Are the conclusions supported by the results?	(x)	( )	( )	( )

Comments and Suggestions for Authors

The abstract covers the information presented in the manuscript and the key words are suitable for its presentation. The MS has an appropriate structure, the materials and methods are quite informative, the results are clearly presented, the tables are all necessary, complete and clearly presented. The references are adequate. In my opinion the work is of interest, however it present fails that should be corrected. See file attach.

Response to Reviewer 1: We thank the reviewer for taking the time to review our manuscript, and for their positive comments on it. We have made their suggested changes to the manuscript, which are described further in our responses below. Please note that the line numbers refer to those displayed when “Track Changes” is turned on (causing the line numbering to start at 44); different numbers may be visible if this function is disabled.

 

 

Comment 1: Please define all acronyms for first mention in the Abstract, main text, and figure/table descriptions. FLIP (Food Label Information Program)

 

Response 1: We have ensured that all acronyms used throughout the abstract, main text, and figure/table captions and footnotes are defined for first mention. In the abstract, the FLIP acronym was removed and defined in full (lines 71-72).

 

 

Comment 2. Remove the point (Figure 1 caption).

 

Response 2: The point has been removed (Figure 1 caption).

 

 

Comment 3: [... fruit, vegetable, nut and legume] add (FVNL) (Table 2 caption).

 

Response 3: “(FVNL)” has been added after “fruit, vegetable, nut and legume” (Table 2 caption).

 

 

Comment 4: Remove [“(L.V., M.A., B.F.A., C.M. and K.D.)” from line 201, Methods section).

 

Response 4: “(L.V., M.A., B.F.A., C.M. and K.D.)” has been removed (line 254, Methods section).

 

 

Comment 5: Please define all acronyms for first mention in the Abstract, main text, and figure/table descriptions

 

Response 5: We have ensured that all acronyms used throughout the abstract, main text, and figure/table captions and footnotes are defined for first mention.

 

Author Response File: Author Response.docx

Reviewer 2 Report

I really enjoyed reading this paper, which is well written and provides clear and detailed description/explanation of the methodological steps followed by the authors to assign FVNL scores to the different food categories taken into account in the analysis. The data used are appropriate and allow for comparisons across and within food categories.

However, while my evaluation of the paper is positive, I believe that the authors should provide a more exhaustive discussion on why the proposed method is better than those already adopted in other countries (especially the nutri score). In other words, why would this method be superior to existing ones? This would offer more specific hints for the policy debate and clarify the positioning of the FVNL within the existing labeling schemes. 

A few minor comments are provided in the attached pdf. 

 

Comments for author File: Comments.pdf

Author Response

Reviewer 2

 

Open Review

(x) I would not like to sign my review report 
( ) I would like to sign my review report 

English language and style

( ) Extensive editing of English language and style required 
( ) Moderate English changes required 
(x) English language and style are fine/minor spell check required 
( ) I don't feel qualified to judge about the English language and style 

 

	Yes	Can be improved	Must be improved	Not applicable
Does the introduction provide sufficient background and include all relevant references?	(x)	( )	( )	( )
Is the research design appropriate?	(x)	( )	( )	( )
Are the methods adequately described?	(x)	( )	( )	( )
Are the results clearly presented?	(x)	( )	( )	( )
Are the conclusions supported by the results?	(x)	( )	( )	( )

Comments and Suggestions for Authors

I really enjoyed reading this paper, which is well written and provides clear and detailed description/explanation of the methodological steps followed by the authors to assign FVNL scores to the different food categories taken into account in the analysis. The data used are appropriate and allow for comparisons across and within food categories.

However, while my evaluation of the paper is positive, I believe that the authors should provide a more exhaustive discussion on why the proposed method is better than those already adopted in other countries (especially the nutri score). In other words, why would this method be superior to existing ones? This would offer more specific hints for the policy debate and clarify the positioning of the FVNL within the existing labeling schemes. 

A few minor comments are provided in the attached pdf. 

Response to Reviewer 2: We thank the reviewer for taking the time to review our manuscript, and for their positive comments on it. We have made their suggested changes to the manuscript, which are described further in our responses below. Please note that the line numbers refer to those displayed when “Track Changes” is turned on (causing the line numbering to start at 44); different numbers may be visible if this function is disabled.

 

We would like to clarify that, to our knowledge, no previous methodologies for estimating fruit, vegetable, nut and legume (FVNL) points in the absence of quantitative ingredient declarations (QUIDs) have been published or adopted in other countries. In countries where nutrient profiling models with FVNL components have been adopted (e.g., the FSANZ NPSC and Health Star Rating system in Australia and New Zealand; the Ofcom Nutrient Profile Model in the UK; and the Nutri-Score in several European Union countries), QUIDs are mandatory and can therefore be used to estimate FVNL points according to the methodology for applying these nutrient profiling models developed by government policymakers, academics and other relevant stakeholders. Our methodology for estimating FVNL points is intended for use in countries with food supplies where QUIDs are not mandatory (i.e., most countries outside of the European Union, the UK, Australia and New Zealand) and therefore cannot be used to quantify the FVNL content of foods. We feel that these points have been clearly elucidated in the Introduction and Discussion of the paper.

 

 

Comment 1: I would suggest to remove acronyms from the abstract and just define them in the main body of the text.

 

Response 1: Given the 200-word limit of the abstract, it is necessary to use some acronyms; however, we have tried to limit our use of them. We have removed the “FLIP” acronym from the abstract and defined it in full (lines 71-72). The other acronyms (NP, FVNL) are used repeatedly throughout the abstract; defining them in full would prevent us from limiting the abstract to ≤200 words.

 

 

Comment 2: Food products for children often have very specific characteristics that differentiate them from those for adult consumption. I would be careful here.... I believe that the authors should be more specific here (for instance, what age?) or just avoid including "children"....

 

Response 2: We recognize that food products intended for children may have different characteristics than those intended for adults. However, it is difficult to be specific in this sentence when different policies to limit unhealthy food marketing to children often differ between countries/territories in terms of their targeted age group and other characteristics (e.g., which digital and traditional forms of advertising are included). We have changed this sentence to “marketed to children and adolescents under 18 years of age” (page 2, lines 88-89, Introduction section), as this is the age group definition used by the World Health Organization in their recommendations concerning food marketing to children¹.

 

^1”Background” section, page 1, paragraph 4:

https://www.euro.who.int/__data/assets/pdf_file/0017/322226/Tackling-food-marketing-children-digital-world-trans-disciplinary-perspectives-en.pdf?ua=1%EF%BB%BF#:~:text=law%20applicable%20to%20the%20child,and%2019%20years%20of%20age.

 

 

Comment 3: If necessary, I would leave this to a footnote...

 

Response 3: “(L.V., M.A., B.F.A., C.M. and K.D.)” has been removed as per Reviewer 1’s suggestion (line 254, Methods section).

 

 

Author Response File: Author Response.docx

Reviewer 3 Report

Thank you for this interesting paper. I have only 1 comment and 2 questions:

Please use words opposed to abbreviations  - took me long time to figure out what everthing means

1) DO you think the scores will ever be included on labels?

2) Perhaps the main message on every label is how to improve the score? Nothing wrong with white bread if you eat a lentil salad with it!

Author Response

Reviewer 3

 

 

Open Review

(x) I would not like to sign my review report 
( ) I would like to sign my review report 

English language and style

( ) Extensive editing of English language and style required 
( ) Moderate English changes required 
(x) English language and style are fine/minor spell check required 
( ) I don't feel qualified to judge about the English language and style 

 

	Yes	Can be improved	Must be improved	Not applicable
Does the introduction provide sufficient background and include all relevant references?	(x)	( )	( )	( )
Is the research design appropriate?	(x)	( )	( )	( )
Are the methods adequately described?	(x)	( )	( )	( )
Are the results clearly presented?	(x)	( )	( )	( )
Are the conclusions supported by the results?	(x)	( )	( )	( )

Comments and Suggestions for Authors

Thank you for this interesting paper. I have only 1 comment and 2 questions:

Please use words opposed to abbreviations  - took me long time to figure out what everthing means

1) DO you think the scores will ever be included on labels?

2) Perhaps the main message on every label is how to improve the score? Nothing wrong with white bread if you eat a lentil salad with it!

Response to Reviewer 3: We thank the reviewer for taking the time to review our manuscript, and for their positive feedback on it. As per the suggestion of Reviewers 1 and 2, we have ensured that all abbreviations used in the abstract, main text, and figure/table captions and footnotes have been defined in full the first time that they appear. However, removing all abbreviations would lengthen the manuscript considerably, and we feel that the increased wordiness may reduce the clarity of the manuscript.

It is difficult to answer the reviewer’s questions without more information, and it is unclear whether they are referring to FVNL points or nutrient profiling scores. Changes may be made to front-of-pack labels in countries where nutrient profile models with FVNL points have already been implemented (e.g., Australia, New Zealand, the UK and several European Union countries). For example, the Health Star Rating system is currently under review after 5 years of implementation in Australia and New Zealand, and may be subject to future labelling changes. In the Results and Discussion section (lines 263-265), we note the importance of having clear methods to estimate FVNL, as they are a component of many NP methods used in public health nutrition policies (“With NP models becoming increasingly used for various public health nutrition policy objectives, it is important to ensure consistency in the application of these models and in the interpretation of the nutritional quality of comparable foods.”).

 

Author Response File: Author Response.docx