Complementarity between the updated version of the front-of-pack nutrition label Nutri-Score and the food-processing NOVA classification.

To compare the initial and the updated versions of the front-pf-pack label Nutri-Score (related to the nutritional content) with the NOVA classification (related to the degree of food processing) at the food level. Using the OpenFoodFacts database -129,950 food products-, we assessed the complementarity between the Nutri-Score (initial and updated) with the NOVA classification through a correspondence analysis. Contingency tables between the two classification systems were used. The food offer in France. Not applicable. With both versions (i.e. initial and updated) of the Nutri-Score, the majority of ultra-processed products received medium to poor Nutri-Score ratings (between 77.9% and 87.5% of ultra-processed products depending on the version of the algorithm). Overall, the update of the Nutri-Score algorithm led to a reduction in the number of products rated A and B and an increase in the number of products rated D or E for all NOVA categories, with unprocessed foods being the least impacted (-3.8 percentage points (-5.2%) rated A or B and +1.3 percentage points (+12.9%) rated D or E) and ultra-processed foods the most impacted (-9.8 percentage points (-43.4%) rated A or B and +7.8 percentage points (+14.1%) rated D or E). Among ultra-processed foods rated favourably with the initial Nutri-Score, artificially-sweetened beverages, sweetened plant-based drinks and bread products were the most penalized categories by the revision of Nutri-Score while low-sugar flavoured waters, fruit and legume preparations were the least affected. These results indicate that the update of the Nutri-Score reinforces its coherence with the NOVA classification, even though both systems measure two distinct health dimensions at the food level.