“The nutritional label is not enough if the consumption of ultra-processed foods is not reduced”. This is what has been established by a study by the Department of Epidemiology and Prevention of Irccs Neuromed, in collaboration with the University of Insubria of Varese and Como, the University of Catania and Mediterranea Cardiocentro of Naples. Published in the ‘British Medical Journal’, the study analyzed the combined health impact of the ‘Nutri-Score’ labeling system and the degree of food processing. “Foods are not only characterized by their composition and nutritional quality, but also by the degree of processing to which they are subjected – the researchers observe – This last element is crucial for knowing the real effect of food on health, and its indication on labels would help consumers to choose with greater awareness. ” The study by Neuromed by Pozzilli (Is), to which the BMJ also dedicated an editorial, investigated which aspect of nutrition best defines the risk of mortality. Researchers monitored the health status of over 22,000 people participating in the ‘Moli-healthy’ epidemiological project for 12 years and correlated it with their eating habits, taking into consideration both nutritional aspects and those related to the degree of food transformation. . “Our results – says Marialaura Bonaccio, epidemiologist of the Department of Epidemiology and Prevention of the Irccs Neuromed of Pozzilli and first author of the study – confirm that the consumption of both low nutritional quality foods and ultra-processed foods increases significantly the risk of mortality, in particular from cardiovascular diseases. However, when we jointly took into account both the nutritional content of the diet and its degree of industrial processing, it emerged that the latter aspect is the most important in highlighting the greater risk of mortality. In fact, over 80% of the foods classified as unhealthy by the Nutri-Score are also ultra-processed. This suggests that the increased risk of mortality is not due directly (or exclusively) to the low nutritional quality of some products, but to the fact that these are also over-processed “. “It is estimated that one in five deaths in the world is due to improper nutrition, for a total of 11 million deaths a year – recalls Augusto Di Castelnuovo, researcher at the Mediterranea Cardiocentro in Naples -. This is why improving eating habits is at the top of the priority list of public health agencies and governments around the world ”. A suggested solution for making healthier food choices “is to use a labeling system for commercial products. Already used for some time on a voluntary basis in some European countries, such as France and Spain, food labels are now being examined by the European Commission. which would like to identify a single system to be applied in all Member States – recalls Neuromedi – The ‘Nutri-Score’, developed in France, is given as a favorite. The system evaluates the nutritional quality of a food (for example based on the content of fat, salt, fiber), with a scale of five colors, ranging from green (healthier food) to red and to which the first five letters of the alphabet, ABCDE, correspond “. But nutritional quality isn’t the only factor to consider. “The Nova classification, in particular, instead of evaluating a food on the basis of nutritional characteristics, looks rather at how much that product has been processed at an industrial level – continues Neuromedi – The Nova system specifically identifies the so-called ultra-processed foods, that is those foods made in part or entirely with substances that are not routinely used in cooking (hydrolyzed proteins, maltodextrins, hydrogenated fats) and which generally contain various additives, such as dyes, preservatives, antioxidants, anti-caking agents, flavor enhancers and sweeteners. part of this category sweetened and carbonated beverages, prepackaged baked goods, spreads, but also apparently unsuspected products, such as rusks, some breakfast cereals, crackers and fruit yoghurt “. “According to the Nova system, proposed a decade ago by a team of Brazilian researchers, a slice of meat would be preferable to a vegan hamburger, simply because the former has not undergone industrial manipulation and probably does not contain food additives, while the latter it is the result of an articulated industrial process at the end of which the percentage of food remaining intact becomes marginal “. “The goal of helping people make healthier food choices is certainly to be shared – comments Licia Iacoviello, Director of the Department and Full Professor of Hygiene at the University of Insubria in Varese and Como – However, the ‘Nutri-Score’ , as well as other labeling systems, developed in Italy and in other countries, risks only partially conveying the message aimed at improving choices at the table. While the letters and colors of the ‘Nutri-Score’ help us to quickly compare products of the same category, allowing us to choose the best one from a nutritional point of view, this system does not however provide any indication on the degree of transformation of the food. Our data indicate that there is a need to consider not only the nutritional characteristics, but also the degree of processing of the food. This is why we think, also in harmony with other international researchers, that every nutritional labeling system should be integrated with information regarding the level of transformation ”. “For a prevention strategy that is truly effective, we must focus above all on those foods that the Nutri-Score classifies as valid from a nutritional point of view but which are also highly processed – explains Giuseppe Grosso, associate professor at the University of Catania – This is the case, for example, of some beverages which, despite having a reduced sugar content, thus being adequate on a nutritional level so as to earn a letter B in the ‘Nutri-Score’, are in fact very processed. But also yoghurt and cold desserts, which boast little fat but contain a substantial list of food additives. “” A common defect of all nutritional labeling systems is to isolate the single product from the global diet – explains Giovanni de Gaetano, president of Irccs Neuromed of Pozzilli – For to really improve nutrition, we should go back to the ancient lesson of the Mediterranean diet, which is a lifestyle characterized by a sap iente choice of foods and the way to combine and consume them. It is not a shopping list, but it reflects a century-old history that risks disappearing if we consider food as atoms that do not communicate with each other. We must also remember that the diet of the Mediterranean peoples is mainly based on fresh or minimally processed products. Therefore, a complete preventive action at the table should also pay attention to industrial processing which, if excessive, represents a documented threat to our health “.