Mandatory & Universal Nutrition Labelling: Pressures and Interests
Newsletter Edition #232 [The Files In-Depth]
Hi,
Diet is a determinant of health. As is information. But there are interests intervening in the display of such information on what we consume.
In today’s edition we bring you a detailed story on the pressures operating on efforts towards front of pack nutritional labelling.
My colleague Laura Martin Agudelo has carefully examined these issues in the context of the challenges faced in the European Union, navigating the labyrinth of influences in its regulatory and legal systems.
Laura is part of the Geneva Health Files Fellowship program this year. Get in touch with her with your feedback.
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Priti
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I. ANALYSIS
Mandatory & Universal Nutrition Labelling: Pressures and Interests
As WHO urges widespread adoption of front-of-pack nutrition labels to curb diet-related diseases, Europe is lagging. Corporate and political resistance have stalled the ‘Nutri-Score’ proposal, drawing from the same old lobbying playbook once popularized by tobacco giants. Consumers and public health are paying the price.
By Laura Martin Agudelo
Agudelo is a Colombian journalist based in France. She reports on public health issues.
Email: laura.martin.agudelo@gmail.com
Ten years from now, half of the world’s population is expected to be living with obesity or overweight. These and other non-communicable diseases (NCD) in which unhealthy diets play a crucial role—cardiovascular illnesses, cancers, diabetes—already account for two-thirds of deaths globally.
One simple and cost-effective policy could help tackle this burden: nutritional labelling of food products. But its mandatory and widespread implementation has proven uneven—if not elusive.
As the World Health Organization launched a public consultation on the draft of its forthcoming Guideline on nutrition labelling policies, the topic is once again at the forefront (the consultations closed on October 11, 2024).
Nutrition labels are shown to improve the healthfulness of food purchases, according to WHO’s Department of Nutrition and Food Safety, which conducted a meta-analysis of randomized controlled trials that underpin these guidelines. These labels are a valuable and cost-effective tool to influence consumers’ decision-making and, as such, are crucial to people’s right to health and appropriate information. People with poor health literacy, who are at greater risk of diet-related NCDs, benefit the most.
So why aren’t they already featured in every food product we buy? As the WHO experts explain, their implementation still faces many challenges—chief among them industry interference.
Some 700 kilometers north from Geneva where these guidelines are being framed, another international institution offers a stark example of this dynamic. In Brussels, the European Commission had committed to propose a mandatory front-of-pack nutrition label for all EU countries by 2022. As 2025 approaches, no legal proposal has even entered the Parliament.
Long struggle to adopt a European front-of-pack nutrition label—in vain
The idea of implementing a harmonized, mandatory front-of-pack nutrition labelling system for processed foods in the EU has been around for more than a decade. In 2020, the European Commission’s “Farm-to-fork strategy” for healthy and sustainable diets put it back on the table; in 2021, the “Europe’s Beating Cancer Plan” also listed it as one of its actions. So far, little progress has been made, well beyond the initial deadline for introducing such a proposal in 2022.
In this story we try to examine why this has been such a contentious topic.
Front-of-Pack Nutrition Labelling: Nutri-Score, the most evidence-based and the most attacked
Unlike the detailed nutritional information found on the back of food packages, which has been mandatory in Europe since 2011, front-of-pack nutrition labelling (FOPNL) is a quickly visible, clearer, and easier-to-interpret way for consumers to assess the nutritional quality of the products they buy.
One such label, the graded and color-coded Nutri-Score (pictured), has been successfully tested in large, prospective epidemiological studies that demonstrate its association with a superior nutritional quality of the diet. It has also been associated with improved health outcomes for its users, who have a lower risk of weight gain, metabolic syndrome, cardiovascular diseases, and certain cancers.
The WHO has endorsed it and public health researchers have deemed it the most effective, evidence-based, and consumer-friendly among all the types of FOPNL reviewed by the Commission. Yet, it has been the preferred target of discredit campaigns and lobbying efforts by the agri-food industry and some government delegations in Brussels.
Internal documents from the European Commission, made public after a request by the NGO FoodWatch, revealed that in 2022 food industry stakeholders such as Kraft Heinz, Caobisco (the Association of Chocolate, Biscuit, and Confectionery Industries of Europe), the Bel Group (a multinational cheese marketer) and FoodDrinkEurope (which represents the European food and drink manufacturing industry) met several times with the Commission’s Directorate-General for Health and Food Safety and with the DG for Agriculture.
“There was a clear imbalance between the number of meetings held with commercial actors (seventeen) and those with civil society (just two),” Emma Calvert, from the European Consumer Organization (BEUC), told Geneva Health Files.
Although some industrials declared they would welcome harmonization of FOPNL, requests to make it voluntary or to draw exceptions for several products were widespread. Nutri-Score is particularly targeted. For example, the European Dairy Association declared it as “more a claim [that] and does not provide genuine information,” which is inaccurate since the algorithm that underlies it is based on the mandatory nutritional information displayed on the back of the packages.
In a meeting held on October 27, 2022, with the Commission’s DG for Agriculture, Federalimentare (the Italian food and beverage industry association) and the Italian permanent representation to the EU said that “no scientific evidence supports Nutri-Score”—in fact, over 130 peer-reviewed papers conducted in 20 countries do; it is the only FOPNL supported by such robust evidence.
In a previous meeting with the DG for Health, Italy had proposed the NutrInform Battery label as a valid alternative, even though this label relies on just four studies that examine only the consumer’s subjective understanding and not its effect on people’s health outcomes. And worse: the studies were mainly funded by Federalimentare, raising conflicts of interest concerns.
In an address to the European Parliament in 2021, Italy’s Prime Minister Giorgia Meloni had vowed to block “the folly” of Nutri-Score’s adoption, arguing it had no scientific basis and discriminated against Italian traditional products.
Finally, on November 4, 2022, in a note to the Commissioner for Health and Food Safety in preparation for the legal proposal on FOPNL, the Commissioner for Agriculture stated his lack of support for a Nutri-Score type of label, arguing that “a single score which combines different nutritional facts would be misleading and superficial,” even as he recognized “it offers greater readability.”
Two years after the initial deadline of 2022, no legislative proposal on this matter has been made, and “it remains uncertain when [it] will be tabled” according to the European Parliament itself. Aside from a symposium organized in April 2024 by the outgoing Belgian Presidency of the European Council, the subject has stalled.
“The Commission has no excuse,” Serge Hercberg, an epidemiologist whose team at Sorbonne University crafted and tested the Nutri-Score, told Geneva Health Files. “There is a scientific consensus about the benefits of FOPNL, particularly in favor of the Nutri-Score, and its applicability is proven,” he added. Seven countries (France, Belgium, Germany, Luxembourg, the Netherlands, Spain, and Switzerland) have already implemented it.
Moreover, several documents emanating from the Commission, especially the latest policy report by the Joint Research Centre, back it up (although the Nutri-Score label hasn’t been designated as the official candidate yet). “The reasons for this delay are not scientific; they are political,” he concluded.
The Secrecy Around The Impact Assessment Report
One document is still awaiting publication—the impact assessment report. The Commission routinely carries out such assessments (which tend to focus more on the economic impact) in preparation for new legislative proposals.
The Regulatory Scrutiny Board (RSB), an independent body, checks the reports and issues opinions. In February 2024, a request made by FoodWatch to access the opinion of the RSB on the draft of the assessment was denied on the grounds that disclosing it would jeopardize the decision-making process.
Such documents “are not normally published until the proposal for a regulation is released,” Suzy Sumner, Head of the Brussels FoodWatch Office, explained to Geneva Health Files, “but we argue that, as the proposal has disappeared off the agenda, we would like to know if it is really due to a negative opinion by the RSB or lobbying from industry.”
They appealed to the European Ombudsman, who concluded in a decision published on October 3, 2024, that the Commission’s refusal to grant public access to the documents is indeed “maladministration”. The Ombudsman urged the Commission to reconsider its initial position but the Commission still refused to disclose the requested documents.
After the European Parliament’s recent elections in June 2024 and the appointment of a new team of Commissioners (yet to be validated by the Parliament), will a proposal finally feature in the program for the next 5 years?
“We have hope, it hasn’t been definitely scrapped yet… but we will have to wait and see,” Calvert from BEUC said.
“The Commission claims to be serious about beating cancer but refuses to move on a simple tool which is proven to help. We have lost five years. It is time for the new Commission to take action”, Sumner from FoodWatch said after the release of the Ombudsman’s opinion.
New battles, same strategies: The rise of the lobby against nutritional labelling
Front-of-pack nutrition labelling is but one of several “best buy” policies aimed at fostering favorable food environments—along with taxation, marketing bans, or sale restrictions. Consistent evidence supports their benefits in tackling the burden of NCDs such as obesity, cardiovascular conditions, and cancers.
FOPNL “is cost-effective because it gives health and economic benefits,” Kremlin Wickramasinghe, an adviser at the WHO Regional Office for Europe, explained during the 2024 European symposium on FOPNL systems. But only a harmonized and mandatory label will yield significant results: “Voluntary policies do not give the intended public health impact; we have learned that from evidence” he said.
The forthcoming WHO recommendations on nutrition labelling also stress that FOPNL should be applied universally to avoid their selective display in a subset of products, which would hamper consumers’ ability to compare them. (Additional clarifications sent to WHO went unanswered by the time this story went to print.)
A recent example sheds light on the shortcomings of voluntary policies: Danone, a French food industry giant, just announced it would remove the Nutri-Score from some of its products—they had been downgraded by an update of the label’s algorithm.
In the WHO European Region, where no country is on track to halt the rise of obesity rates to meet global targets by 2025, less than half of Member States have some FOPNL system in place today, neither mandatory nor harmonized. “But when countries try to implement these policies, one of the main barriers is industry opposition,” said Wickramasinghe.
The EU example above is a case in point, and it is not the only one: such measures have encountered the same corporate resistance in Southeast Asia and South America. “The tactics are similar in every region,” he explained, “for example, they will tell the governments: this is bad for the economy; or say: we can do better things.”
A recent WHO report on the commercial determinants of NCDs in Europe highlights that “specific powerful industries,” including the ultra-processed food one, “spend significant resources to oppose public interest regulation,” thus fueling ill-health and premature mortality. It emphasizes an “industry playbook” common to four major corporations (tobacco, ultra-processed foods, fossil fuels, and alcohol), involving strategies like political lobbying and disinformation.
Such strategies are particularly visible in the case of Nutri-Score.
Take disinformation—which itself serves political lobbying. Meetings in Brussels where its opponents tell Commission staff that it is not supported by scientific evidence are an example, in private, of what largely happens in public. Fake news aimed at discrediting the label have been circulating for years on social media, explained Hercberg’s team.
For instance, the claim that the label is useless because “olive oil is lesser ranked than breakfast cereals, yet the former is healthy and the latter unhealthy”. This is aimed at confusing consumers about its objective, which is not to classify foods in a binary of “healthy” vs. “unhealthy” but rather to compare the nutritional quality of foods of the same category where a comparison is relevant for consumption (different kinds of oils, or different kinds of cereals, for example).
Moreover, such claims have been rendered moot by the update of the algorithm in 2024 that further downgraded products high in sugar and upgraded vegetable oils with low levels of saturated fatty acids, and that also included artificial sweeteners whose potential association with increased risk of diabetes and cardiovascular diseases had recently been highlighted. “But that hasn’t stopped the industry or their political allies from continuing to spread misinformation,” said Hercberg.
Graver still, these “information battles” also take place in the academic arena where scientists with conflicts of interest instill doubt about the evidence supporting Nutri-Score. A study is 21 times more likely to find unfavorable results about this label if the authors declare a conflict of interest or the study is funded by the food industry, according to a 2023 paper published in the BMJ Global Health.
“Some detractors who have financial ties with the industry have even come up with the idea of an ‘academic conflict of interest’: because we developed the Nutri-Score as part of our research, the peer-reviewed papers we authored exposing its results should be disregarded, they claim… This is absurd,” explained Hercberg.
Such strategies recall those once popularized by the tobacco industry, as another BMJ paper found. In particular, “information management” tactics involving “funding and disseminating research favorable to commercial interests, and challenging unfavorable evidence.” This study, which draws other parallels between Big Tobacco and the ultra-processed food industry, warns of the latter’s attempts to shape health policy even at a global level, including at the WHO.
In the end, Nutri-Score—or any other FOPNL—is but one of many nutritional interventions aimed at tackling NCDs. Its mandatory deployment could even serve as a nudge to further implement these complementary policies, considering that, on average, less than half of the recommended “best buy” measures are currently in place in European countries. Its cost-effectiveness—and relative simplicity to implement compared to other nutritional policies—suggests it should be easy to adopt. But strong resistance shows that, for now, it is not.
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