An Evaluation of the Nutri-Score System along the Reasoning for Scientific Substantiation of Health Claims in the EU-A Narrative Review

In this narrative review, the scientific evidence in support of the front-of-pack label (FOPL) Nutri-Score system is evaluated along with the reasoning for scientific substantiation of health claims in the EU. A health claim could be phrased as 'Nutri-Score as an FOPL system results in an increased purchase of healthier foods by consumers'. Peer-reviewed scientific literature as found in Pubmed under search terms "NutriScore" and "Nutri-Score" that investigate the effects of the Nutri-Score on food purchases were evaluated. In total, eight papers were identified. Only three studies were conducted in real-life settings, and five were on online purchases. In the EU, health claims are evaluated by the European Food Safety Authority (EFSA). Considering the three basic questions that EFSA uses to evaluate scientific substantiation of health claims, it appears that the (i) food/constituent (the Nutri-Score system) is sufficiently defined/characterised, and (ii) the evidence is sufficient to appraise the system as 'beneficial to human health'. However, the scientific evidence for a (iii) cause-and-effect relationship is contradictory and limited. In conclusion, based on the EFSA approach for substantiation of health claims, there is insufficient evidence to support a health claim based on the Nutri-Score system, since a cause-and-effect relationship could not be established.