Complementarity between the updated version of the front-of-pack nutrition label Nutri-Score and the food-processing NOVA classification

Objective: To compare the initial and the updated versions of the front-of-pack label Nutri-Score (related to the nutritional content) with the NOVA classification (related to the degree of food processing) at the food level.Design: Using the OpenFoodFacts database - 129,950 food products - we assessed the complementarity between the Nutri-Score (initial and updated) with the NOVA classification through a correspondence analysis. Contingency tables between the two classification systems were used.Settings: The food offer in France.Participants: Not applicable.Results: With both versions (i.e. initial and updated) of the Nutri-Score, the majority of ultra-processed products received medium to poor Nutri-Score ratings (between 77 center dot 9 % and 87 center dot 5 % of ultra-processed products depending on the version of the algorithm). Overall, the update of the Nutri-Score algorithm led to a reduction in the number of products rated A and B and an increase in the number of products rated D or E for all NOVA categories, with unprocessed foods being the least impacted (-3 center dot 8 percentage points (-5 center dot 2 %) rated A or B and +1 center dot 3 percentage points (+12 center dot 9 %) rated D or E) and ultra-processed foods the most impacted (-9 center dot 8 percentage points (-43 center dot 4 %) rated A or B and +7 center dot 8 percentage points (+14 center dot 1 %) rated D or E). Among ultra-processed foods rated favourably with the initial Nutri-Score, artificially sweetened beverages, sweetened plant-based drinks and bread products were the most penalised categories by the revision of Nutri-Score while low-sugar flavoured waters, fruit and legume preparations were the least affected.Conclusion: These results indicate that the update of the Nutri-Score reinforces its coherence with the NOVA classification, even though both systems measure two distinct health dimensions at the food level.