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.
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The attribute and domain scoring algorithm used to generate the Food Compass is available in the Supplementary Information. The NHANES data are publicly available at https://www.cdc.gov/nchs/data_access/ftp_data.html. The statistical coding is not available. The generated Food Compass, HSR and NOVA food processing classification scores for each of the 8,032 food items in the dataset are available in the Supplementary Information.
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This research was supported by Danone (N.H.E.-A., W.A.M., P.J., P.S., J.B.B. and R.M.) and the National Heart, Lung, and Blood Institute, National Institutes of Health (grant nos R01 HL130735 (R.M.) and 2 R01 HL115189 (D.M.)). The funders had no role in study design, data collection, data analysis or interpretation, drafting of the manuscript, or decision to submit the manuscript for publication. We thank S. Gerber (Tufts University) for helpful insights on processing attributes.
D.M. receives personal fees from Acasti Pharma, Barilla, Cleveland Clinic Foundation, Danone and Motif FoodWorks; is on the scientific advisory boards of Brightseed, Calibrate, DayTwo (ended June 2020), Elysium Health, Filtricine, Foodome, HumanCo, January Inc., Perfect Day, Season and Tiny Organics; and receives chapter royalties from UpToDate. J.B.B. reports personal fees from Guiding Stars Licensing Company. All other authors declare no competing interests.
Peer review information Nature Food thanks Mike Rayner, Cliona Ni Mhurchu and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.
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Mozaffarian, D., El-Abbadi, N.H., O’Hearn, M. et al. Food Compass is a nutrient profiling system using expanded characteristics for assessing healthfulness of foods. Nat Food (2021). https://doi.org/10.1038/s43016-021-00381-y