Evaluation of Nutri-Score and NewTools-score in a Norwegian setting using a reference standard based on nutrition experts’ ranking of foods’ healthiness

By:
Mari Mohn Paulsen, Lisa Bucher Holm, Anna Amberntsson, Marianne Hope Abel, Lene Frost Andersen
Date:
2025
Resource type:
Peer review
Link:

This study evaluates the validity of the Nutri-Score (2023 version) and the NewTools-score—a revised version adapted for Norway—using a reference standard created from healthiness rankings by 29 Norwegian nutrition experts. These experts rated 100 commonly consumed foods based on alignment with the Norwegian Food-Based Dietary Guidelines (FBDGs). Results showed that both nutrient profiling models had high overall agreement with the expert assessments, with the NewTools-score displaying improved alignment across several food groups, particularly for refined vs. wholegrain products, fat content in dairy, and plant-based substitutes.

Key insights include:
        •        Nutri-Score showed good performance but had discrepancies, particularly for full-fat vs. reduced-fat dairy, refined vs. whole grain products, and certain fish and plant-based items.
        •        NewTools-score, tailored to align with Nordic nutrition priorities, had better agreement (47% of foods) and fewer large discrepancies (17% vs. 22% for Nutri-Score).
        •        Nutrition experts showed excellent agreement (Cronbach’s alpha = 0.98), validating the robustness of the reference standard.
        •        The study highlights the need to localize nutrient profiling systems to reflect regional dietary guidelines and food cultures for effective front-of-pack labeling.

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