Processing and Nutritional Quality of Breakfast Cereals Sold in Italy: Results from the Food Labelling of Italian Products (FLIP) Study

Abstract

This study aimed to compare the level of processing (as assessed by the NOVA classification) and the nutritional quality (as assessed by nutrition values, Nutri-Score and NutrInform battery) of breakfast cereals currently on the Italian market. A total of 349 items were found, mostly belonging to the NOVA 4 group (66.5%) and to Nutri-Score C and A (40% and 30%, respectively). The NOVA 4 products showed the highest energy, total fat, saturates, and sugar content per 100 g and had the highest number of items with Nutri-Score C (49%) and D (22%). Conversely, NOVA 1 products had the highest content of fibre and protein, the lowest amounts of sugars and salt, and 82% of them were Nutri-Score A, while few Nutri-Score B and C were found. Differences were attenuated when products were compared for their NutrInform battery, with NOVA 4 items showing only slightly fuller batteries for saturated fats, sugar, and salt than NOVA 1 and NOVA 3 products. Overall, these results suggest that the NOVA classification partially overlaps with systems based on the nutritional quality of foods. The lower nutritional quality of NOVA 4 foods may at least partially explain the association found between the consumption of ultra-processed foods and the risk of chronic diseases.

Nutrients or processing? An analysis of food and drink items from the UK National Diet and Nutrition Survey based on nutrient content, the NOVA classification and front of package traffic light labelling

“…This finding is in line with studies from other countries using different nutrient indices ( 23 , 28 ) . For example, comparing breakfast cereals across NOVA groups indicated that minimally processed foods were not always healthier based on their nutritional profile, with some ultra-processed foods also scoring well on NutriScore and differences being dependent on the serving size used for comparison ( 41 ) . Given the adverse impacts of high intakes of nutritionally poor foods high in fat, sugar and salt ( 42 – 44 ) , transnational corporations have reformulated their products to contain less fat, saturated fat, added sugar or salt ( 45 ) .…”

A systematic assessment of the revised Nutri‐Score algorithm: Potentials for the implementation of front‐of‐package nutrition labeling across Europe

“…The most commonly reported limitation (n = 15) was part of Other Dimensions of Food Quality, which was the lack of consideration of ultra-processed foods (UPFs). UPFs can sometimes achieve a better NS grade than less processed foods (Angelino et al, 2023;Ebner et al, 2022;Fedde et al, 2022;Hau & Lange, 2023). This was also commonly reported with reference to Food-based limitations such as oils (n = 10) (Hau & Lange, 2023;Septia Irawan et al, 2022) and cheeses (n = 9) (Ebner et al, 2022;Fialon et al, 2022), which can be less processed than UPFs but often get lower grades, which may indicate a noncompliance of NS with FBDG.…”

“…Our literature review captured 30 papers: 24 original research (Angelino et al, 2023;Braesco et al, 2022;Bryngelsson et al, 2022;Cutroneo et al, 2022;de las Heras-Delgado et al, 2023;Dickie et al, 2022;Ebner et al, 2022;Fedde et al, 2022;Ferreiro et al, 2021;Fialon et al, 2022;Hafner & Pravst, 2021, 2023Huybers & Roodenburg, 2023;Katsouri et al, 2021;Kissock et al, 2022;Konings et al, 2022;Panczyk et al, 2023;Pitt et al, 2023;Pointke & Pawelzik, 2022;Rodriguez-Martin et al, 2023;Septia Irawan et al, 2022;Stiletto & Trestini, 2022;Borg et al, 2021;Valenzuela et al, 2022), 3 communication/correspondence (Carruba et al, 2022;Drewnowski et al, 2021;Hau & Lange, 2023), and 3 review papers (Peonides et al, 2022;van der Bend et al, 2022;Włodarek & Dobrowolski, 2022), originating from 19 countries (including 12 EU member states). The list of reported limitations (n = 20), their connections, and the numbers of mentions are presented in Figure 2.…”

“…In beverages, the primary factor influencing the NS grade is often a single-key nutrient, mainly sugar, limiting options for reformulation (Zupanič et al, 2020). Conversely, breakfast cereals exhibit greater diversity (Angelino et al, 2023;Devi et al, 2014), encompassing various key constituents, including sugar, saturated fats, fiber, and protein, contributing to the final grade. Although reformulating breakfast cereals by increasing fiber or protein may enhance their nutritional profile and NS grade, it does not address the core issue of excessive added sugar (Prada et al, 2021).…”

Ultra-Processed Foods, Diet Quality and Human Health

“…The other studies published in this Special Issue focused on different aspects, such as the overlap between the NOVA classification and other systems. In this regard, Angelino and colleagues compared the level of processing (assessed by NOVA) and nutritional quality (assessed by nutritional values, the Nutri-Score and the NutrInform battery) of breakfast cereals available on the Italian market and found a partial overlap between the NOVA classification and the systems based on the nutritional quality of foods [ 17 ]. Similarly, Grech et al used data from the 2011–2012 National Nutrition and Physical Activity Survey, a large cross-sectional study representative of the Australian population, to compare the NOVA classification system with the Australian Dietary Guidelines (ADG) in classifying foods as healthy and unhealthy through their effectiveness in predicting energy overconsumption and body mass index (BMI) [ 18 ].…”