Complementary roles of Nutri-Score and NOVA in assessing pre-packaged food products available in Southeast Asia from an online food database

Aim: This study characterized pre-packaged foods in Southeast Asia using Nutri-Score, NOVA, and Multiple Traffic Light systems; cross-classified products by Nutri-Score and NOVA; and assessed their ability to discriminate products by nutrient content. Methods: Data were obtained from Open Food Facts in October 2024. Of 29,789 products identified in Southeast Asia, duplicates and products with incomplete information were excluded, resulting in 4,668 pre-packaged food products from eight Southeast Asian countries. Salt, sugar, total fat, and saturated fat contents were evaluated using the Multiple Traffic Light system. Nutri-Score data were available for 4,565 products, while 2,068 products had complete information for both Nutri-Score and NOVA and were included in cross-classification analysis. Spearman correlation analyses examined relationships among Nutri-Score, NOVA, and nutrient profiles. Results: Most products were of lower nutritional quality, with 52% classified as Nutri-Score D or E and 71% categorized as ultra-processed (NOVA 4). Multiple Traffic Light classification showed that beverages and sweet products had the highest proportion high in sugar, while beverages, cereals, and dish meals were most frequently high in salt. Sweets and snacks were the main contributors to products high in total fat and saturated fat. Cross-classification showed that as Nutri-Score decreased from A to E, the prevalence of ultra-processed foods consistently increased, while NOVA 1 became nearly negligible, indicating a trend between poorer nutritional quality and higher processing. Nutri-Score showed weak-to-moderate positive correlations with sugar (r = 0.355, p < 0.001), saturated fat (r = 0.364, p < 0.001), and salt (r = 0.190, p < 0.001). NOVA showed weaker but significant correlations with sugar (r = 0.149, p < 0.001) and salt (r = 0.138, p < 0.001). Conclusions: Nutri-Score was associated with nutrient-rich foods, while NOVA highlighted processing levels. Combined use offers a more comprehensive evaluation than either system alone. Integrating nutrient profiling and processing classification in front-of-pack labeling may guide consumer choices and public health efforts to reduce diet-related NCDs in Southeast Asia.