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Aligning nutrient profiling with dietary guidelines: modifying the Nutri-Score algorithm to include whole grains

Abstract

Purpose

Whole grains, generally recognised as healthy choices, are not included in most nutrient profiling systems. We tested modifications to the Nutri-Score algorithm to determine whether including whole grains would provide an improved measure of food, and overall diet quality.

Methods

The whole-grain content of food, with a minimum cut-point of 25%, was added to the algorithm, following similar methods used to score other health-promoting components such as fibre. We applied and compared the original and the modified Nutri-Score to food composition and dietary intake data from Australia, France, the United Kingdom, and the United States.

Results

At the food level, correlations between whole-grain content and food nutritional score were strengthened using the modified algorithm in Australian data, but less so for the other countries. Improvements were greater in grain-specific food groups. The largest shift in Nutri-Score class was from B to A (best score). At the dietary intake level, whole-diet nutritional scores for individuals were calculated and compared against population-specific diet-quality scores. With modifications, correlations with diet-quality scores were improved slightly, suggesting that the modified score better aligns with national dietary guidelines. An inverse linear relationship between whole-diet nutritional score and whole-grain intake was evident, particularly with modifications (lower whole-diet nutritional score indicative of better diet quality).

Conclusion

Including a whole-grain component in the Nutri-Score algorithm is justified to align with dietary guidelines and better reflect whole grain as a contributor to improved dietary quality. Further research is required to test alternative algorithms and potentially other nutrient profiling systems.

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Abbreviations

AUSNUT :

Australian Food, Supplement and Nutrient Database

DALY :

Disability adjusted life years

FAQ :

Frequently asked questions

FNDDS :

Food and nutrient database for dietary studies

FOP :

Front-of-pack

FPED :

Food Patterns Equivalent Database

FSA :

Food Standards Agency

FVNLO :

Fruit, vegetables, nuts, legumes, oils

HDS :

Healthy Diet Score

HEI :

Healthy Eating Index

HEIFA :

Healthy Eating Index for Australian Adults

INCA :

Etude Individuelle Nationale des Consommations Alimentaires

NDNS :

National Diet and Nutrition Survey

NHANES :

National Health and Nutrition Examination Survey

NNPAS :

National Nutrition and Physical Activity Survey

NP :

Nutrient profiling

PNNS-GS :

Programme National Nutrition Santé Guideline Score

UK :

United Kingdom

US :

United States

WGI :

Whole Grain Initiative

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Funding

This research was funded by Cereal Partners Worldwide and General Mills, Inc.

Author information

Affiliations

Authors

Contributions

The author’s responsibilities were as follows: KRK, FV, KCM, AD, CJS, GM, JS, HM, NMM, and EJB designed research; KRK, FV, and KCM conducted research; KRK, FV, and KCM analysed data; KRK, FV, KCM, AD, CJS, GM, JS, HM, NMM, and EJB wrote the paper; KRK and EJB had primary responsibility for final content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Eleanor J. Beck.

Ethics declarations

Conflict of interest

FV is employed by MS-Nutrition. AD has received grants, contracts, and honoraria from entities, both public and private, with an interest in nutrient density of foods, meals, and the total diet. GM is employed by Cereal Partners Worldwide. JS is employed by General Mills, Inc. NMM has received funding for investigator-initiated grants from General Mills Bell Institute of Health and Nutrition, received speaker honoraria from Cereal Partners Worldwide and General Mills, Inc., is a member of the working group of the Whole Grain Initiative, and serves as an unpaid scientific advisor on the Oldways Whole Grains Council. EJB has received funding for presentations on whole grain by Quaker Oats and General Mills, Inc., and research funding from Cereals Partners Worldwide. She is a member of the working group of the Whole Grain Initiative. CJS is retired and has no conflicts of interest to report; previously, he has received funding for investigator-initiated grants from Cereal Partners Worldwide and Kellogg's, manufacturers of whole-grain breakfast cereals. He is a member of the European Healthgrain Forum and the Definitions Working Group of the Whole Grain Initiative. All the other authors report no conflicts of interest.

Availability of data and materials

Data described in the manuscript will be made available (where possible) upon request. Raw data relating to the Australian National Nutrition and Physical Activity Survey 2011–2012 and all UK data require access approval by the Australian Bureau of Statistics and UK Data Service, respectively.

Code availability

Code used in the statistical analysis will be made available (where possible) upon request.

Ethics approval

All surveys obtained full ethical approval from the necessary committees and comply with the guidelines from the Declaration of Helsinki. Permission to use and analyse the data was obtained through approved registration at the Australian Bureau of Statistics registration centre (Australia) and the UK Data Service (the UK). French and US data are publicly available.

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Kissock, K.R., Vieux, F., Mathias, K.C. et al. Aligning nutrient profiling with dietary guidelines: modifying the Nutri-Score algorithm to include whole grains. Eur J Nutr (2021). https://doi.org/10.1007/s00394-021-02718-6

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Keywords

  • Whole grain
  • Intake
  • Nutrient profiling
  • Nutri-Score
  • Nutrient density