Does the Nutri-Score 2023 algorithm provide consistent classification across European food supplies? A cross-sectional study using branded food composition data from 14 countries.

Introduction: The Nutri-Score is a summary graded and colour-coded front of pack nutritional label providing an overall assessment of the nutritional value of prepacked products. While its 2023 update has been shown to be consistent with food-based dietary guidelines in the countries in which it has been adopted, its application has not been investigated in a wider geographical area. The objective of this study was to describe the classification of products according to the Nutri-Score in a large number of European Union (EU) countries. Methods: Branded food composition from 14 European countries was obtained from Euromonitor. Food products were classified according to the Nutri-Score algorithm, based on their content in energy (kJ/100 g), saturated fats (g/100 g), sugars (g/100 g), salt (g/100 g), proteins (g/100 g), dietary fibres (g/100 g) and fruit, vegetables and legumes (%/100 g). The distribution of the 2023 and 2015 Nutri-Score classifications was described across countries and food categories. Results: Overall, classification according to the 2023 Nutri-Score was consistent across 408 399 products from 14 countries and consistent with food-based dietary guidelines: >90% of frozen fruit and vegetables or >95% pulses were classified in the more favourable classes of the Nutri-Score (A/B), while >90% of discretionary foods such as chocolate confectionery and sweet biscuits were classified in the less favourable classes (D/E). Cross-country differences in classification reflected underlying variability in nutrient composition of products (eg, salt content in refined breads ranged from 1.05 to 1.23 g/100 g across countries). Conclusion: The Nutri-Score classification appeared consistent across a large geographical area, confirming its potential as an EU-wide front-of-package label. While some residual challenges remain for a limited number of specific product groups (eg, whole-grain pasta or rice), our findings indicate that the 2023 update represents a substantial improvement over the 2015 algorithm.