Abstract
Nutrient profiling systems (NPS) aim to discriminate the healthfulness of foods for front-of-package labelling, warning labels, taxation, company ratings and more. Existing NPS often assess relatively few nutrients and ingredients, use inconsistent criteria across food categories and have not incorporated the newest science. Here, we developed and validated an NPS, the Food Compass, to incorporate a broader range of food characteristics, attributes and uniform scoring principles. We scored 54 attributes across 9 health-relevant domains: nutrient ratios, vitamins, minerals, food ingredients, additives, processing, specific lipids, fibre and protein, and phytochemicals. The domain scores were summed into a final Food Compass Score (FCS) ranging from 1 (least healthy) to 100 (most healthy) for all foods and beverages. Content validity was confirmed by assessing nutrients, food ingredients and other characteristics of public health concern; face validity was confirmed by assessing the FCS for 8,032 foods and beverages reported in NHANES/FNDDS 2015–16; and convergent and discriminant validity was confirmed from comparisons with the NOVA food processing classification, the Health Star Rating and the Nutri-Score. The FCS differentiated food categories and food items well, with mean + s.d. ranging from 16.4 + 17.7 for savoury snacks and sweet desserts to 78.6 + 17.4 for legumes, nuts and seeds. In many food categories, the FCS provided important discrimination of specific foods and beverages as compared with NOVA, the Health Star Rating or the Nutri-Score. On the basis of demonstrated content, convergent and discriminant validity, the Food Compass provides an NPS scoring a broader range of attributes and domains than previous systems with uniform and transparent principles. This publicly available tool will help guide consumer choice, research, food policy, industry reformulations and mission-focused investment decisions.
Generated Summary
The study introduces the Food Compass, a nutrient profiling system (NPS) designed to assess the healthfulness of foods. The research aims to improve upon existing NPS by incorporating a broader range of food characteristics, attributes, and uniform scoring principles. It employs a comprehensive approach, evaluating 54 attributes across nine health-relevant domains, including nutrient ratios, vitamins, minerals, food ingredients, additives, processing, specific lipids, fiber and protein, and phytochemicals. The methodology involved developing and validating the Food Compass, assessing its content, face, convergent, and discriminant validity. Content validity was confirmed by assessing the content, while face validity was confirmed by scoring 8,032 foods and beverages from the NHANES/FNDDS 2015-16 database. The Food Compass scores each food item based on the presence and/or amounts of attributes scored as beneficial or detrimental. The final Food Compass Score (FCS) ranges from 1 (least healthy) to 100 (most healthy). The study compared the Food Compass with the NOVA food processing classification, the Health Star Rating, and the Nutri-Score. This publicly available tool is designed to guide consumer choices, research, food policy, industry reformulations, and mission-focused investment decisions.
Key Findings & Statistics
- The study evaluated 54 attributes across nine health-relevant domains.
- The Food Compass Score (FCS) ranged from 1 (least healthy) to 100 (most healthy).
- The mean ± s.d. FCS for savory snacks and sweet desserts was 16.4 + 17.7, while for legumes, nuts, and seeds, it was 78.6 + 17.4.
- The mean ± s.d. FCS for all 8,032 unique foods and beverages was 43.2 ± 28.5.
- Among 12 major food categories, the FCS varied from 16.4 ± 17.7 for savory snacks and sweet desserts to 78.6 ± 17.4 for legumes, nuts, and seeds (Fig. 2).
- The interquartile range (25th to 75th percentiles) was narrowest for savory snacks and sweet desserts (2.0–23.2) and meat, poultry, and eggs (22.9-45.5) and was broadest for beverages (8.1-58.8).
- The mean ± s.d. FCS was 27.6 ± 28.7 for sugar-sweetened sodas and energy drinks versus 67.0 ± 18.4 for 100% fruit or vegetable juices; 24.9 ± 6.9 for beef, 42.6 ± 12.0 for poultry and 67.0 ± 18.9 for seafood; and 43.2 ± 14.0 for starchy vegetables versus 88.2 ± 14.5 for green vegetables.
- Within NOVA = 1, the FCS was 100 each for raw raspberries and raw avocado, 83 for raw banana, 77 for raw fig, 55 for 100% apple juice, 51 for whole boiled egg and 49 for whole milk.
- Within NOVA=2, the FCS was 85 for olive oil, 19 for lard, 8 for unsalted butter and 1 for white granulated sugar.
- Within NOVA=3 (processed), food items with FCS > 70 included fresh, frozen and canned cooked asparagus (100), salted mixed nuts (97), salted roasted peanuts (88), restaurant meals such as broiled halibut (95) and mussels with tomato-based sauce (95), and pico de gallo salsa (80).
- The overall correlation between the Food Compass and the HSR was moderate (Spearman’s r=0.67).
- The HSR explained only ~45% (0.67×0.67) of the variation described by the FCS.
- For fruits, the correlation between the Food Compass and HSR was highest (r=0.70), while it was lowest for savory snacks and sweet desserts (r=0.35), legumes, nuts and seeds (r=0.30), and grains (r=0.22).
- The overall correlation between the Food Compass and the Nutri-Score was moderate (r=0.57 (~33% of variation explained)).
Other Important Findings
- The Food Compass provides a comprehensive assessment of nutrient and ingredient characteristics, additional food components, and processing parameters in a uniform fashion across food categories.
- The FCS differentiated food categories and food items well, providing important discrimination of specific foods and beverages as compared with NOVA, the Health Star Rating, or the Nutri-Score.
- The study’s findings suggest that the Food Compass may better reflect current evidence on health harms of processed refined grains and low-fat processed meats, the health benefits of unsaturated fats from plant sources, and the minor health relevance of total fat.
- The FCS emphasizes both adverse characteristics and beneficial attributes.
- The FCS incorporates not only macronutrients, vitamins, and minerals but also multiple health-related food ingredients, phytochemical contents, specific lipids, and processing features.
- The FCS utilizes updated evidence for the health effects of both established and emerging factors.
- The use of distinct scoring domains facilitates joint consideration of different aspects of foods while also preventing undue influence of any one attribute or domain.
- The scoring of attributes per 100 kcal provides a more comparable assessment across foods and beverages than by weight or serving size.
- The FCS scores all items uniformly using the same attributes, domains, algorithm, and cut-off points.
- Compared with the FCS, the Nutri-Score often scored 100% juices much lower and pre-sweetened coffees, energy drinks and fruit drinks much higher.
- Both the Nutri-Score and the HSR often gave healthier scores than the FCS to processed foods rich in refined grains and starch, and much lower scores than the FCS to foods rich in healthful unsaturated plant oils.
Limitations Noted in the Document
- The study acknowledges limitations, including the potential for the Food Compass to be less applicable in certain contexts, such as when product data are more limited.
- The study notes that some Food Compass attributes with known health effects, such as iodine and trans fats, were unavailable in FNDDS.
- The potential differential scoring of naturally occurring versus fortified vitamins, minerals, trace lipids, or fibers requires further study.
- The study’s methodology, attribute weights, and scoring schemes are based on existing evidence, and the authors acknowledge that the inclusion of emerging science might increase the risk of controversy.
Conclusion
The Food Compass represents a significant advancement in nutrient profiling by offering a more comprehensive and nuanced approach to assessing the healthfulness of foods. The study’s findings highlight the limitations of existing NPS and demonstrate the Food Compass’s capacity to better differentiate food categories and items, providing a more accurate reflection of current scientific evidence. The Food Compass’s ability to incorporate a broader range of attributes, consider both beneficial and detrimental factors, and use uniform scoring principles makes it a valuable tool. The tool’s open-source algorithm and potential for use in various applications, including consumer guidance and industry reformulations, emphasize its significance. As the authors state, “The Food Compass is a credible, transparent tool for science-based assessment of the overall healthfulness of diverse foods, snacks, beverages and mixed dishes”. The study emphasizes the need for a holistic assessment of foods, incorporating diverse attributes and updated evidence, which can improve consumer choices, inform food policy, and guide industry practices. The research findings suggest the Food Compass may better reflect current evidence on health harms of processed refined grains and low-fat processed meats, the health benefits of unsaturated fats from plant sources, and the minor health relevance of total fat. This tool has the potential to drive positive changes in the food environment, leading to improved public health outcomes. The study concludes by emphasizing that, “The FCS, with strengths of objectivity, diverse health-relevant attributes, universality of scoring and additive discriminatory ability, has corollary limitations in its parsimony and ease of scoring.” The Food Compass, while offering a comprehensive and objective approach, acknowledges the ongoing need for further research and refinement to address limitations and adapt to evolving scientific understanding and data availability. The public availability of the scoring algorithm and data opens avenues for collaborative research and refinement and further application of the Food Compass to the food industry.