Nutrient profiling for the reformulation of pizza: Modelled impact on nutritional intake in the US adult population
Authors: Masset Gabriel , Vlassopoulos Antonis , Lehmann Undine 
Published: November 2023

IntroductionApproximately an eighth of the US population consumes pizza on any given day; with higher intakes of sodium and saturated fat observed on days pizza is consumed. Food reformulation, targeted to relevant product categories, has the potential to improve nutritional intakes of the general population. The Nestlé Nutritional Profiling System (NNPS) was designed specifically for food reformulation, setting category‐specific nutrient targets, including for pizza.ObjectiveTo model the effect of pizza reformulation on the nutritional intake of NHANES 2011–12 adult participants, using the NNPS nutrient targets.MethodsDietary intakes of 4948 participants aged 19+ years were derived from the first 24hr‐recall. The nutritional composition of all pizzas in the FNDDS 2011–12 (n=69 food codes) were tested against the NNPS criteria, using the 140g RACC serving size. Pizzas were classified as NNPS ‘Pass/Yes’ if all nutrient targets were met (i.e. energy (E), total fat (TF), saturated fat (SFA), sodium (Na), added sugars and protein). In a reformulation scenario, pizzas classified NNPS ‘Fail/No’ were replaced by the closest NNPS Pass pizza based on a Euclidean distance calculated using all NNPS nutritional factors. Nutritional intakes were compared between non‐pizza consumers (NON) and pizza consumers before (CONS) and after ‘reformulation’ (NNPS), as well as in the whole population. All analyses were conducted using the ‘survey’ package of R.ResultsAmong the target sample, 11% of participants reported consuming pizza, with a higher prevalence of consumption among younger participants (pchi‐sq<0.01) but no significant difference between genders (pchi‐sq=0.079). 20 of the 69 pizzas were classified NNPS Pass; E, TF, SFA, and Na content was significantly lower in NNPS Pass compared to NNPS Fail pizzas. Pizza consumers (CONS) had significantly higher intake of E, TF, SFA, and Na compared to non‐consumers (NON) (pt‐test<0.01 in all cases, Figure). Among pizza consumers (CONS), substituting NNPS Fail with NNPS Pass pizzas (NNPS scenario) led to reductions of average intakes of E (−51 kcal), TF (−10 g), SFA (−3.7 g), and Na (−189 mg). Yet, intake of these nutritional factors remained higher than among non‐pizza consumers. When including the complete population, the NNPS scenario was associated with small (−0.3 to −1.5%) but significant reductions of E, TF, SFA, and Na intakes.ConclusionThis modeling case study showed that targeted food reformulation may improve nutritional intake of the general population by helping individuals to achieve healthier diets through small dietary shifts. Results need to be confirmed including reformulation efforts in other food categories and countries. Nevertheless, only 8% of NHANES pizza consumers opted for an existing NNPS Pass pizza. Among other reasons, this highlights the need to account for individuals’ taste preferences to ensure a relevant public health impact of reformulation. Further research needs to assess which population could benefit most from food reformulation (e.g. genders, age groups, socio‐economic strata) and which food categories should be prioritized.Support or Funding InformationAll authors are employed by Nestec SA.