Assessment of the impact of the Belgian and French food industry on obesity and population nutrition

Abstract   Major food industry players make commitments to improve food environments, but it remains unclear how well these commitments translate into practice. This study set out to quantitatively assess the nutrition-related commitments and practices, as well as the correlation between both, of major food companies in Belgium and France. The ‘Business Impact Assessment’ (BIA-Obesity) was applied to evaluate nutrition-related commitments and practices regarding product formulation, labelling, promotion and accessibility. Publicly available commitments were collected and companies given the opportunity to complete the information (2019-2020). Practices were evaluated applying following performance metrics: the proportion of products with Nutri-Score A or B, the percentage of products not-permitted to be marketed to children (World Health Organisation) and the proportion of ultra-processed food products (NOVA). Correlations between commitments and practices were calculated applying the Spearman's rank correlation coefficient. Overall BIA-Obesity scores for commitments were lower in France (median: 28%) than in Belgium (35%). Response rates in France (39%) were lower than in Belgium (56%). Median product portfolios in France contained less ultra-processed products (63%) and contained a higher proportion of products with a Nutri-Score A or B (38%) compared to Belgium (75% and 29%, respectively). In both countries a similar proportion of products was not-permitted to be marketed to children (81% in Belgium and 84% in France). Stronger company commitments did not translate into better performance metrics. Belgian food companies obtained a higher score for their nutrition-related commitments. French companies performed slightly better according to the performance metrics. In both countries there was ample room to improve commitments and practices. To improve food environments it is crucial to ensure that commitments are strengthened and translate into improved company practices. Key messages Food industry players make a range of nutrition and health related commitments, but these don’t necessarily result into better practices. The BIA-Obesity clearly identifies areas where food industry players can improve the comprehensiveness, specificity and transparency of their nutrition-related commitments and associated practices.

Front-of-pack nutrition labellings (FoPL) have gained traction in the European Union as tools to tackle the burden of nutrition-related chronic diseases.Multiple FoPL have been implemented by both governments and private actors.Under the European food labelling regulation, any FoPL is optional to display, although the legal framework is being revised for a harmonized FoPL to emerge.Since the implementation of the Nutri-Score in France in 2017, little data is available to understand the motivations and strategies underlying the adoption of the FoPL from a food business' perspective.A cross-sectional study was conducted in March 2021 on food businesses having adopted the Nutri-Score in France through an online questionnaire.In total, 121 businesses completed the questionnaire, representing 32% of companies adopting the scheme and covering a variety of company types.Engaged businesses had a rather healthier portfolio of products according to the Nutri-Score (on average, 69% of engaged products were A or B and 12% were D or E), with disparities between retailers and national brands.Businesses mostly reported their engagement was motivated by a will to be transparent (76%) and to simplify nutritional information (67%) but still 19% reported that they engaged following external pressures.External pressures were more likely to play a role in the engagement if the company engaged in 2020 compared to those engaged before 2018 (P = 0.032), if the company was larger (P = 0.044) and if the scope of engagement included D or E products (poorer nutritional quality) (P = 0.033).Our study showed that the Nutri-Score, as an optional measure, is mainly used by businesses, especially national brands, as a tool to promote rather healthier products, while companies with products of lower nutritional quality are more likely to engage following external pressure.This highlights the relevance of enforcing a mandatory FoPL system, in line with the Farm to Fork strategy.

Key messages:
Nutri-Score led to a selective use of the measure by food businesses, especially national brands, to promote rather healthier products.
The relatively low engagement of companies with low nutritional value products highlights the relevance of enforcing a mandatory FoPL system, in line with the Farm to Fork strategy.Major food industry players make commitments to improve food environments, but it remains unclear how well these commitments translate into practice.This study set out to quantitatively assess the nutrition-related commitments and practices, as well as the correlation between both, of major food companies in Belgium and France.The 'Business Impact Assessment' (BIA-Obesity) was applied to evaluate nutritionrelated commitments and practices regarding product formulation, labelling, promotion and accessibility.Publicly available commitments were collected and companies given the opportunity to complete the information (2019-2020).Practices were evaluated applying following performance metrics: the proportion of products with Nutri-Score A or B, the percentage of products not-permitted to be marketed to children (World Health Organisation) and the proportion of ultra-processed food products (NOVA).Correlations between commitments and practices were calculated applying the Spearman's rank correlation coefficient.Overall BIA-Obesity scores for commitments were lower in France (median: 28%) than in Belgium (35%).Response rates in France (39%) were lower than in Belgium (56%).Median product portfolios in France contained less ultra-processed products (63%) and contained a higher proportion of products with a Nutri-Score A or B (38%) compared to Belgium (75% and 29%, respectively).In both countries a similar proportion of products was not-permitted to be marketed to children (81% in Belgium and 84% in France).Stronger company commitments did not translate into better performance metrics.Belgian food companies obtained a higher score for their nutrition-related commitments.French companies performed slightly better according to the performance metrics.In both countries there was ample room to improve commitments and practices.To improve food environments it is crucial to ensure that commitments are strengthened and translate into improved company practices.

Key messages:
Food industry players make a range of nutrition and health related commitments, but these don't necessarily result into better practices.
The BIA-Obesity clearly identifies areas where food industry players can improve the comprehensiveness, specificity and transparency of their nutrition-related commitments and associated practices.

Background:
Ireland previously had widespread voluntary fortification but there has been a major decline in the number of food staples fortified with folic acid in Irish supermarkets in the past 15 years.In this research we set out to examine the level of folic acid in food staples in supermarkets with the leading market share in the Republic of Ireland.

Methods:
The food labels of food staples (breads, spreads, milk, cereals, cereal bars, yoghurt/yoghurt drinks) were photographed in supermarkets with the leading market share in the Republic of Ireland (Tesco's, Dunnes, SuperValu, Lidl, Aldi, and M&S) between 2017 and 2021.The data was extracted and collated in an excel spreadsheet.The data was analysed to examine the level of folic acid in each product.We compared the levels captured at the current times with the levels previously captured in 2017.

Results:
Preliminary analysis suggests that folic acid level in food staples in Ireland continues to decline.Folic acid was not found in any breads (except a number of gluten free breads), milks, spreads but was found in several cereals marketed mainly at children.

Conclusions:
This study reports on the declining levels of folic acid in the food chain in Ireland.The number of food staples fortified with folic acid continues to decline demonstrating that voluntary fortification in Ireland is no longer an effective measure for passively augmenting the folic acid levels of consumers.This is of concern due to the incidence of neural tube defects in Ireland largely preventable by folic acid.