ArticleNutrients2025
The Nutrient Profiling of Swedish Food Products-A Study of the Alignment of the Multi-Level Criteria for the Choices and Nutri-Score Systems with the Nordic Keyhole Logo.
Article in Nutrients, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Article
- Perspective: What is the Likely Impact of the Proposed Food and Drug Administration Front-of-Package Criteria on the Labeling of Foods?Current developments in nutrition · 2026Article
- Revision of the Choices Nutrient Profiling System.Nutrients · 2026Review
- Associations Between Anorexia Nervosa Severity, Liver Dysfunction, and Cobalamin Serum Concentration.Neuropsychiatric disease and treatment · 2025Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundThe European Commission has called for a harmonised front-of-package nutritional label (FOPNL) system in the European region. The Keyhole is a widely adopted positive FOPNL used in several Nordic countries. The Nutri-Score is a five-level graded FOPNL, more recently introduced in Western Europe. Both FOPNLs are supported by intrinsically different nutrient profiling systems (NPSs). A third NPS is the Choices NPS, which originally supported a positive FOPNL similar to the Keyhole and has been expanded into a five-level NPS.
objectivesThe main objective of this study was to investigate the overall alignment between both the Choices and Nutri-Score multi-level NPSs and the Keyhole NPS. Furthermore, food group-based alignment was analysed to understand the main sources of misalignment.
methodsIn this study, we extracted 1064 food/drink items from the food and beverage database of the Swedish Food Administration. All products were assessed according to all three NPSs, and alignment was assessed, using the Keyhole NPS as a recommendation-based reference. Two definitions of alignment were examined-healthier (more lenient, i.e., two highest grades) and healthiest (stricter, i.e., only the highest grade).
resultsThe overall alignment between the Choices and Keyhole NPSs was similar to that between the Nutri-Score and Keyhole NPSs (89% and 85% alignment under the healthiest definition, i.e., stricter). However, two food groups showed poor alignment between the Nutri-Score NPS and the Keyhole NPS (~60%). Under the healthier (more lenient) definition, the alignment for both the Choices and Nutri-Score systems with the Keyhole system was lower (86% and 79%).
conclusionsThe alignments and misalignments between the Choices/Nutri-Score systems and the Keyhole system prompt important considerations for future developments of FOPNL systems for the Nordic countries. Extending the Keyhole NPS to include a multi-level criterion could potentially help consumers identify healthier choices, even for less nutritious foods.
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