Interview with Raphael Sirtoli, co-founder of Nutrita: is FOP food labelling built on junk science ?

More than ever, the Covid-19 crisis has made nutrition a key issue. With its “Farm to Fork” strategy, the European Union intends “to ensure a transition to a sustainable food system which guarantees food security and access to a healthy diet produced on a healthy planet”. As part of that transition, the Commission is considering the implementation of a new front-of-pack (FOP) food labelling system for the whole of Europe.

In this exclusive interview with the European Scientist, Raphael Sirtoli, co-founder of the Nutrita app, PhD Health Sciences candidate at the University of Minho and MSc in Molecular Biology from Staffordshire University, answers our questions about food labelling and the broader impact of nutrition on health.

The European Scientist: As a nutritional expert, we see you pay a lot of attention to food labelling. Why is helping consumers make decisions about their food choices important? And how do we do it? You’ve created an application for that purpose. Can you tell us more about it?

Raphael Sirtoli: To be frank, there is a lot of junk science funneled into food labelling. This is a significant problem given how we all rely on it to know what’s in our food and how it might affect our health. Good food labelling should be relevant and accurate, but what we have now is neither.

This pushed me and my colleagues to create Nutrita Pro, an app helping you make smarter food choices. People are guided by our scores that focus on nutritional value (nutrient density score) and metabolic effects (keto score and insulin score), like blood sugar control, fat burning and ketone levels. They’re all based on clinical research and machine learning techniques.

TES: In the United Kingdom, health authorities have introduced a traffic light system that allows you to mark food. This system has been in place for eight years. What lessons can we learn from it? Is there any tangible evidence now that this has had a real impact on consumer behaviour?

RS: Evidence for the effectiveness of the British Food Standard Agency Nutrient Profiling System on health outcomes is lacking. There are a few inconclusive associational studies with unreliable self-reported diet data, but no interventional trials to speak of.

As for consumer behavior effects, a randomized field trial in Bogota, Colombia used an equivalent French system based on the British one and found uninspiring results [study]. People spent $0.18 more on average, spending 21% more on healthier items than controls, with no change for less healthy items. Expenditure estimates were higher among customers who knew about the food labelling system on campus and were also 10% more likely to buy a healthier item than the control customers were. Interestingly, the concentration of protein in the purchases from those consumers was greater.

TES: The European Union is currently debating the possibility of introducing an EU-wide food labelling system, with one of the main candidates being the French Nutriscore. What do you think of this labelling system, and of the idea of imposing it on all European countries?

RS: Nutri-score is a result of ‘science by consensus’. In other words, it’s a Frankenstein of food industry propaganda and archaic governmental guidelines. This is also true of the British Food Standard Agency Nutrient Profiling System and any other future system built on the same foundations.

I am against legally imposing food labelling methods across the EU because, when we get it wrong (and we will get it wrong because we haven’t learned from our past mistakes), we’ll be able to limit the damage rather than spread it far and wide. I would prefer consumers to be exposed to different labelling methods and have them ‘vote’ for the system that they prefer. Good science at least stands a chance of competing in that context.

TES: In February, the French doctor and nutritionist Philippe Legrand explained to us that “the lipid pillar of this Nutriscore algorithm is wrong (because it is dated) and in total contradiction with the ANSES ANC.” There are still too many negative preconceptions about diets, especially about fat. Can we rely on a system that reinforces certain negative preconceptions?

RS: Philippe Legrand is right that Nutriscore shouldn’t be penalizing “high fat” foods. However, he’s wrong to say that the correct weighting should reflect the French government’s recommended daily allowance (RDA) of 35 to 40% of energy from fat, as this range is also fictitious scientifically speaking. It is well known that high-fat diets (e.g. ketogenic diets) can be healthy and even demonstrate therapeutic efficacy (see Virta Health studies). Nevertheless, high-fat diets can also be unhealthy, depending on the kind of fat you consume for example. These discussions require nuance, neither of which is found in the French RDA for dietary fat or Nutriscore.

TES: An Italian alternative, called Nutrinform, claims to limit itself to providing objective information on the amounts of nutrients in relation to the recommended daily values. How do you rate this approach?

RS: Nutrinform uses levels of battery charge instead of color coding to inform consumer choice. It doesn’t use standardized portion sizes and thus renders comparisons with multiple foods difficult if not impossible. It takes a step towards removing the default penalization of high-fat foods. It’s an attempt to do better than Nutriscore and maybe more so to present ‘traditional (fatty) foods’ such as Parmesan in a favorable light. However, the scientific fundamentals underlying it also appear misguided.

TES: The COVID-19 pandemic will force consumers to rethink the way they eat. In our columns, Professor Aseem Malhotra discussed the link between obesity, Type 2 diabetes, and severe cases of Covid-19, and stressed the need to prevent the disease by paying more attention to one’s diet. What general advice would you give to people who wish to have a healthy and balanced diet?

RS: I entirely agree with Dr.Malhotra about the fact that nutrition plays a key role in our health and consequently our resilience in the face of viruses, including SARS-COV-2. The chorus of doctors pushing healthy lifestyle choices as an important strategy to fight COVID-19 is vanishingly small.

I would summarize my recommendations as follows:

Food

Avoid flour products (e.g. bread, pasta), high omega-6 seed oils (e.g. soybean oil, corn oil, rapeseed oil) and sugar (e.g. soda, fruit juice, candy). Include lots of animal sourced foods at every meal (e.g. beef, shellfish, fish, eggs). Eat two to three meals a day and thus avoid snacking.

Sleep/light

Get seven to eight hours of sleep regularly, starting before midnight preferably. Get as much sunlight as possible throughout the day (without getting sunburned), preferably starting early in the morning.

Temperature

Get used to cold showers and cold exposure more generally in a progressive manner (see the Wim Hof technique). Temperature control is fundamental to proper immune system function, yet it is all but ignored by the field of immunology.

Exercise/movement

Do not be sedentary (e.g. use reminders to get up from your chair and take a walk). If you can, prioritize that which will help you put on muscle mass: for instance, gymnastics, swimming, or weightlifting would be preferable to running or yoga.

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