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Publication bias and Nutri-Score. Developers Nutri-Score confirm publication bias.

Publication bias and Nutri-Score. Developers Nutri-Score confirm publication bias.

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The full article is available on request. - Background - The front-of-pack label Nutri-Score is currently proposed as the system of choice in seven EU countries. However, there is still much scientific debate about the validation and efficacy of Nutri-Score and there is much discussion about author affiliation and study outcome. - Methods - Recent...

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... A public consultation conducted by the European Commission between December 2021 and March 2022 found that a graded indicator was considered the most useful for altering food purchasing behaviour and motivating food product reformulation by the industry [24]. On the other hand, the scientific evidence that the Nutri-Score FOPNL results in healthier food choices is debated [25][26][27][28][29]. The utilisation of a graded NPS, such as the Choices and Nutri-Score criteria, to inform the expansion of the current positive Keyhole logo into a graded FOPNL system could allow customers to identify the better options among the less nutritious options and minimise the adverse health effects of such products. ...
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Background: The 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. Objectives: The 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. Methods: In 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). Results: The 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%). Conclusions: The 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.
... Interpretaties studies gunstige versus ongunstige uitkomst uitgesplitst naar auteurs die wel of niet zijn verbonden met de ontwikkelaars van Nutri-Score op basis van compleet literatuuronderzoek volgens Peters en Verhagen [8] en volgens de ontwikkelaars van Nutri-Score, Touvier et al. [9]. (9,10) ...
... We hebben een antwoord[10] gepubliceerd op de weerlegging door team Nutri-Score[3] en zijn tot de conclusie gekomen dat wanneer we de weerlegging door Touvier et al. en onze studie samen nemen, de eindconclusie door geen van beide partijen kan worden ontkend: Er is een duidelijke overeenstemming tussen voorstanders en critici over het bestaan van publicatiebias achter de studies over Nutri-Score (zie ook Figuur 2).Wij zijn daarom van mening dat de evaluatie van Nutri-Score moet worden uitgevoerd door een onafhankelijke instantie. We stellen voor dat de EFSA deze belangrijke taak uitvoert, omdat we vraagtekens zetten bij de huidige situatie waarin de wetenschappelijke ontwikkeling, de evaluatie van de wetenschappelijke ontwikkeling en het bijwerken van de fouten in het algoritme allemaal worden uitgevoerd door de ontwikkelaars van Nutri-Score. ...
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Er is op dit moment onvoldoende wetenschappelijk bewijs om het gebruik van Nutri-Score als effectief instrument voor de volksgezondheid te benoemen. Daarnaast is er sprake van publicatiebias in het voordeel van Nutri-Score. Dat stellen Hans Verhagen en Stephan Peters. (Voeding Nu 2024, 4 pag 18-20.
... We have published a reply [4] to the rebuttal by team Nutri-Score [3] and concluded that when taking together the rebuttal by Touvier et al. [3] and our study [2], the final conclusion cannot be denied by either party: There is a clear suggestion of publication bias behind the studies about Nutri-Score, coming from either direction. ...
... No data was used for the research described in the article other than publicly available literature through PubMed. Figure 1: Coming from opposite parts of the spectrum of interpreting studies about Nutri-Score: Suggestion of publication bias cannot be denied (reproduced from Peters&Verhagen 2024 [4]) ...
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Nutri-Score and publication bias: it is time for an independent evaluation of the scientific substantiation of Nutri-Score. This is a rapid response in BMJ Global Health to the article: Besancon, S.; Beran, D.; Batal, M. A study is 21 times more likely to find unfavourable results about the nutrition label Nutri-Score if the authors declare a conflict of interest or the study is funded by the food industry. BMJ Glob Health 2023, 8, doi:10.1136/bmjgh-2023-011720.
Article
There is a high level of concern about the possible influence of commercial organizations on food-related research and professional bodies, including regulatory and advisory panels. This has contributed to an increased emphasis on the declaration and management of conflicts of interest (CoI) in the reporting, evaluation, and application of research in nutrition science. However, common perceptions of CoI in nutrition, and procedures for declaring and managing these, often lack intellectual rigor and consistency. This commentary highlights 3 main issues related to CoI in nutrition, particularly the emphasis on industry-related CoI relative to other sources of conflict and bias. 1) Considerations of CoI in nutrition are largely limited to financial or collaborative links to the food industry, disregarding other important sources of influence such as intellectual allegiances or nonindustry financial and professional incentives. 2) Associations with industry incur ad hominem, often punitive stigmatization of individuals and their research, and inappropriate downgrading or exclusion of evidence. This disproportionately affects expertise in the food and agricultural sciences, in which commercial collaborations are widely encouraged. 3) These practices and related approaches to managing CoI are applied without due consideration of the nature of the conflicts and activities involved, the qualifications of individuals, or the availability of other, objective methods and guidance for assessing research quality and risks of bias. Overall, recognition of the nature and range of CoI in nutrition and approaches to their identification and management lack consistency and balance. A singular and strict focus specifically on industry-related CoI may paradoxically exacerbate rather than mitigate imbalance and bias in the field. This commentary outlines the underlying issues and the need for more comprehensive and nuanced approaches to the assessment, reporting, and management of CoI in nutrition.
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To jest tłumaczenie [22] Peters, S.; Verhagen, H. Pochodzący z przeciwnych stron spektrum interpretacji badań dotyczących Nutri-Score: Nie można odmówić sugestii stronniczości publikacji. PharmaNutrition. - Kontekst - Etykieta Nutri-Score umieszczona na przodzie opakowania jest obecnie proponowana jako system z wyboru w siedmiu krajach UE. Jednakże nadal toczy się szeroka debata naukowa na temat walidacji i skuteczności Nutri-Score, a także na temat przynależności autora i wyników badań. - Metody - Niedawno opublikowaliśmy nasz artykuł: Nutri-Score i błąd publikacji: pełny przegląd literatury dotyczący uzasadnienia skuteczności logo Nutri-Score Peters & Verhagen, PharmaNutrition 27C (2024) 100380. Artykuł ten otrzymał artykuł z komentarzem twórców Nutri-Score: M. Touvier et al. 2024 „Odparcie artykułu opublikowanego przez S. Petersa i H. Verhagena”. Niniejszym przedstawiamy zaproszony komentarz do tego obalającego artykułu, który dodatkowo potwierdza zaobserwowaną stronniczość publikacji. - Wyniki - W tej odpowiedzi na obalenie odpowiadamy przede wszystkim na kwestie naukowe poruszone w odrzuceniu i wyjaśniamy więcej na temat naszego rzekomego konfliktu interesów oraz naszej motywacji do napisania artykułu. Co więcej, w zasadzie dziękujemy autorom artykułu obalającego tę tezę za – być może ironicznie, ale zasadniczo – potwierdzenie naszej analizy: istnieje stronniczość publikacji w stosunku do afiliacji. - Dyskusja - Ogólnie rzecz biorąc, dostępne dowody są wyraźnie ograniczone i stronnicze i potrzebne są dalsze badania, aby potwierdzić lub obalić skuteczność Nutri-Score. Kwestionujemy obecną sytuację, że rozwój naukowy, ocena rozwoju naukowego i aktualizacja błędów w algorytmie powinna być prowadzona tylko przez jedną grupę. Jak stwierdzono w artykule w PharmaNutrition, zalecamy, aby przed wprowadzeniem Nutri-Score do Europy, został on oceniony przez niezależny organ naukowy ds. żywności, taki jak m.in. EFSA.