Nutritional quality of diet characterized by the Nutri-Score profiling system and cardiovascular disease risk: a prospective study in 7 European countries

Nutritional quality and on-package marketing of pre-packaged foods and non-alcoholic beverages for sale in Senegalese supermarkets

BACKGROUND

The high availability and marketing of unhealthy foods has contributed to unhealthy diets. Unhealthy diets are a major risk factor for a range of non-communicable diseases (NCDs). However, the availability and marketing of pre-packaged foods haven't been assessed in Senegal. Nutrient profiling models have been developed to identify less healthy foods that could be subject to marketing restrictions, particularly when targeted at children. The aim of this study was to assess the nutritional quality and on-pack promotion of pre-packaged food sold in major supermarkets in Senegal using the Nutrient Profile Model for the WHO African Region (NPM-WHO/AR), the Nutri-Score labelling system and the NOVA classification.

METHODS

A cross-sectional survey was conducted in two major supermarkets in Dakar between August and September 2021. Data were collected for all pre-packaged foods, with the exception of the fresh food and alcoholic beverages categories. Pre-packaged foods were classified into fifteen food categories and five beverage categories according to the NPM-WHO/AR, with the exception of the categories "fresh and frozen meat, fish and sea food" and "fresh and frozen fruits and vegetables, legumes and tubers". Nutritional information was extracted from product labels and products were evaluated using 3 classification systems: NPM-WHO/AR, Nova classification as an indicator of the degree of food processing and Nutri-Score, a nutritional labelling system based on a 5-colour scale from dark green to red, associated with letters ranging from A (high nutritional quality) to E (low nutritional quality), established according to nutritional value and fruits, vegetables and legumes content. Depending on the classification system used, foods were rated on the basis of the nutritional information declared as relevant for this rating. Thus, 5,542 products were evaluated for their nutritional composition, 5,280 products were evaluated according to the NPM-WHO/AR and 5,407 products were evaluated according to both the Nutri-Score and the Nova classification. A pre-packaged food was classified as "non-permitted" to be marketed to children if the content of defined nutrients exceeded the threshold set in the model for the corresponding product category. Data analysis was performed using RStudio.

RESULTS

Ultra-processed foods (71.1%) and processed foods (18.8%) were the most common in Senegalese supermarkets. According to the Nutri-Score, pre-packaged foods were most frequently classified as Nutri-Score D (24.4%) and Nutri-Score E (22.1%). Almost 63.3% of the products were classified as non-permitted to be marketed to children according to the NPM-WHO/AR. Of these foods, 12.5% had on-pack promotions. Non-permitted foods to be marketed to children with the highest number of on-pack promotions were "breakfast cereals" (50.0%), "chocolate and sugar confectionery" (31.3%), "milk and dairy based drinks" (28.1%) and "cakes, sweet biscuits and pastries" (17.7%). However, the comparison between the NPM-WHO/AR and the Nutri-Score showed that some NPM-WHO/AR prohibited foods were classified into Nutri-Score A and B.

CONCLUSIONS

This study shows that pre-packaged foods available in major supermarkets in Senegal are predominantly non-permitted to be marketed to children. In the context of increasing levels of obesity and diet-related NCDs, effective policies should be established to regulate the promotion of these foods.

Ultra-Processed Foods Marketed in Türkiye: An Analysis of Nutritional Quality and Packaging Sustainability

This study aimed to evaluate the nutritional profile and packaging recycling status of ultra-processed foods (UPFs) sold in chain markets across Türkiye. In this regard, the nutritional quality and recyclability status of the packages of UPFs, as defined by NOVA, sold in five major supermarket chains across Türkiye were examined. The energy and nutrient content displayed on UPF labels were analysed, and their nutritional profiles considered using the Nutri-Score algorithm. The study also documented the frequency of recycling symbols on the packaging. Of the 1365 UPFs examined across 13 categories, 61.6% were identified as having an unhealthy nutritional profile (Nutri-Score Grades D and E), whereas only 16% were classified as healthy (Grades A and B). Categories predominantly containing unhealthy products included milk and dairy, sauces and dressings, frozen and dehydrated meals, processed meats, along with various snacks and desserts like salty and sweet snacks, candies, chocolates and ice cream. Notably, candies, chocolates, and salty and sweet snacks were identified as the most energy-dense UPF categories. In terms of packaging, 84.4% of UPFs used at least one recycling symbol, 55.3% of these used plastic material and 38.2% used the Green Dot symbol. The results of the study may guide UPF nutrient profile reformulations and contribute to epidemiological studies analysing the relationship between UPF consumption and public health. Furthermore, these results highlight the necessity for more defined national regulations on the recycling of food packaging within the context of food system sustainability.