New nutrient profiling system grades healthfulness of foods
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Researchers have developed a novel nutrient profiling system that grades the healthfulness and harmfulness of foods based on their nutrients, ingredients, processing characteristics, phytochemicals and additives.
The Food Compass system offers a broader range of characteristics than other profiling systems in order to better guide patients, physicians and policymakers, according to the team that created it. Dariush Mozaffarian, BS, MD, MPH, DrPH, a cardiologist and dean of the Friedman School at Tufts University, and colleagues designed the tool to evolve as future evidence emerges on the nutritional impact on gastrointestinal health, immunity, brain health, bone health, and physical and mental wellbeing.
“Once you get beyond ‘eat your veggies, avoid soda,’ the public is pretty confused about how to identify healthier choices in the grocery store, cafeteria, and restaurant,” Mozaffarian said in a press release.
The scoring system
According to a study published in Nature Food, the Food Compass uses one consistent score that incorporates several attributes of food to rank “mixed dishes,” or a combination of foods, which other profiling systems address inconsistently.
When creating the tool, Mozaffarian and colleagues assessed upwards of 100 other nutrient profiling systems, national and international dietary guidelines, nutrient requirements for health claims and nutrients and ingredients linked to health outcomes. Their final algorithm included 54 attributes across 9 domains: nutrient ratios, vitamins, minerals, food-based ingredients, additives, processing, specific lipids, fiber and protein and phytochemicals. The researchers prioritized attributes related to obesity, diabetes, CVD, cancer and undernutrition, including trans fats, plant oils, artificial sweeteners, frying, fermentation, specific vitamins and high-fructose corn syrup, among other characteristics. The attributes were scored per 100 kcal.
Mozaffarian and colleagues tested their system on 8,032 foods and beverages that the researchers said are commonly consumed by Americans. The Food Compass ranked items from least healthful (score of 1) to most healthful (score of 100). The researchers established a score of 70 or greater as a “reasonable” health score for foods that should be encouraged. Meanwhile, foods and beverages that scored 31 to 69 should be consumed in moderation, while any item scored 30 or lower should be consumed minimally or avoided.
Healthfulness of popular foods
In an interview with Healio Primary Care, Mozaffarian said it was “surprising how well Food Compass performed, and how it can help discriminate between different choices.”
The mean Food Compass Score across all 8,032 food items was 43.2. Among 12 major food categories, the mean score varied from 16.4 for savory snacks and sweet desserts to 78.6 for legumes, nuts and seeds. For sugar-sweetened sodas and energy drinks, the mean score was 27.6, while 100% fruit or vegetable juices earned a score of 67. The Food Compass scored beef at 24.9, poultry at 42.6, seafood at 67, starchy vegetables at 43.2 and green vegetables at 88.2. Moreover, nearly all raw fruit items earned a score of 100, while sugary fruits like bananas, dates and figs scored above 70.
Food Compass can “help guide consumers, product labeling, government policy and industry reformulations toward genuinely healthier choices,” Mozaffarian said. The researchers plan on testing the system against health outcomes and international food databases.
“With its publicly available scoring algorithm, Food Compass can provide a nuanced approach to promoting healthy food choices – helping guide consumer behavior, nutrition policy, scientific research, food industry practices and socially based investment decisions,” Renata Micha, PhD, a previous faculty member at the Friedman School, now at the University of Thessaly in Greece, said in the release.
References:
Mozaffarian D, et al. Nature Food. 2021;doi:10.1038/s43016-021-00381-y.
Ranking healthful foods from first to worst. https://www.newswise.com/articles/ranking-healthfulness-of-foods-from-first-to-worst?sc=cwhr&xy=10046886/?ad2f=1&aid=758750. Published Oct. 14, 2021. Accessed Oct. 14, 2021.
Perspective
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Kristi L. King, MPH, RD, CNSC, LD
Choosing appropriate healthful foods can be confusing and stressful for some people. We know nutrition science is an ever-changing science that typically has some sort of “bad-guy villain” macronutrient, micronutrient or additive to blame and/or avoid. This makes educating the public extremely difficult for health care professionals, as trust in the ever-changing information goes out the door.
The Food Compass profiling system is an interesting one that looks at the whole food across 54 different categories, including vitamins, minerals, macronutrients, additives, ingredients, fiber, etc. Each food or beverage is given a score based on the healthfulness of the item, with a score of greater than 70 being the most healthful and consumed regularly, 31 to 69 healthful but should be used in moderation, and a score less than 30 should be minimally consumed. Not surprisingly, snacks and sweet desserts scored the least, and fruits, legumes and nuts scored the highest. However, this does raise some concerns as the vegetable category had an average of 69.1 — technically in the “moderation” category. Yet we know that vegetables are foods we should be striving to eat more often. Fruit juice appears to have a higher score, yet we recommend limiting juice consumption as many have added sugars and can quickly add up in calories. Also of concern, it takes into account processing of all kinds, including fermentation. It is unclear if “processed” foods cause the score to decrease or if some of the processes increase the score. For example, we know that sauerkraut is fermented cabbage and actually is beneficial to the gut compared with a snack food that is heavily processed.
Is the Food Compass profiling system perfect? No, but it is definitely a great step in looking at foods as a whole vs. individual ingredients or nutrients. Patients would love a system that could point them in the right direction in eating more healthfully. This could be used in menu planning or even at the grocery store when trying to choose between two items. Physicians will gravitate toward a system like this that they easily can refer patients to. It seems to be easily understood. However, for patients with specific diet restrictions, one would need to proceed cautiously. Once data are collected on foods outside of U.S., we may see this type of food profiling system be implemented as another data-driven tool in our health toolbox.
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