The idea that what we eat directly affects our health is an old one; Hippocrates recognized this as early as 400 BC. But identifying healthier foods in the supermarket aisle and on restaurant menus is becoming increasingly challenging. Now researchers at the Friedman School of Nutrition Science and Policy in Tufts have shown that a holistic food profiling system, Food Compass, identifies better overall health and a lower risk of mortality.
In an article published in Nature communication on Nov. 22, researchers assessed whether adults who ate more foods with higher Food Compass scores had better long-term health outcomes and found that they did.
Introduced in 2021, Food Compass provides a holistic measure of the whole nutritional value of a food, drink or mixed meal. It measures nine domains of each item, such as nutrient ratios, food-based ingredients, vitamins, minerals, degree of processing and additives. Based on scores of 10,000 commonly consumed foods in the US, researchers recommend foods with scores of 70 or higher as foods to encourage; foods with scores of 31-69 that should be eaten in moderation; and anything rated 30 or lower should be consumed sparingly. For this new study, Food Compass was used to score a person’s entire diet, based on the Food Compass scores of all the foods and drinks they regularly consume.
“A nutrient profiling system is meant to be an objective measure of how healthy a food is. If it achieves its goal, then individuals who eat more foods with higher scores should have better health,” said Meghan O’Hearn, a PhD student at the Friedman Institute of Medicine. School and the lead author of the study.
For this validation study, researchers used nationally representative nutritional records and health data from 47,999 U.S. adults ages 20-85 who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999-2018. Deaths were determined by linkage to the National Death Index (NDI).
Overall, researchers found that the average Food Compass diet score of the nearly 50,000 subjects was only 35.5 out of 100, well below the ideal. “One of the most alarming discoveries was just how poor the national average diet is,” O’Hearn said. “This is a call to action to improve nutritional quality in the United States.”
When people’s Food Compass diet scores were assessed against health outcomes, multiple significant associations were seen, even adjusting for other risk factors such as age, gender, race, ethnicity, education, income, smoking, alcohol consumption, physical activity, and diabetes status . A higher Food Compass diet score was associated with low bloodpressure, blood sugar, blood cholesterol, body mass index, and hemoglobin A1c levels; and lower prevalence of metabolic syndrome and cancer. A higher Food Compass diet score was also associated with a lower risk of mortality: For every 10-point increase, there was a 7 percent lower risk of death from all causes.
“When looking for healthy food and drink, it can be a bit wild west,” says Dariush Mozaffarian, Jean Mayer Professor of Nutrition and dean of policy at the Friedman School. “Our findings support the validity of Food Compass as a tool to guide consumer decisions, as well as industry reformulations and public health strategies to healthier food and drinks.”
Compared to existing nutrient profiling systems, Food Compass offers a more innovative and comprehensive assessment of nutritional quality, researchers say. For example, rather than measuring levels of dietary fat, sodium or fiber individually, a more nuanced and holistic view is needed, evaluating the ratio of saturated to unsaturated fat; sodium to potassium; and carbohydrates to fiber.
Food Compass also raises scores for ingredients shown to have a protective effect on health, such as fruits, non-starchy vegetables, beans and legumes, whole grains, nuts and seeds, seafood, yogurt and vegetable oils; and lowers scores for less healthy ingredients such as refined grains, red and processed meats, and ultra-processed foods and additives.
Researchers designed Food Compass with the ever-evolving field of nutritional science in mind, and their multidisciplinary team – comprised of researchers with expertise in epidemiology, medicine, economics and biomolecular nutrition – will continue to evaluate and adapt the tool based on the most acute – edge nutrition research.
“We know Food Compass isn’t perfect,” Mozaffarian said. “But it provides a more comprehensive, holistic assessment of a food’s nutritional value than existing systems, and these new findings support its validity by showing that it predicts better health.”
These findings are timely given the release of the new one US National Strategy on Hunger, Nutrition and Health. One of the pillars of this strategy is to “enable all consumers to make healthy choices and have access to healthy choices” through measures such as updating food labels and making them easier to interpret, creating healthier food environments and creating a healthier food supply.
“This study further validates Food Compass as a useful tool for defining healthy eating. We hope that the Food Compass algorithm – publicly available to all – can help guide front-of-pack labeling; workplace purchasing choices , in the hospital and school cafeterias; health-care healthier eating incentive programs and federal nutrition programs; industry reformulations; and government policies around food,” O’Hearn said.
Researchers plan to work on a simplified version that requires fewer nutrients, as well as versions tailored to specific conditions such as diabetes and pregnancy or to the populations of other countries. The research team is also interested in adding Food Compass domains based on other aspects of food, such as environmental sustainability, social justice or animal welfare.
“We look forward to continuing to find ways to improve the Food Compass system and get it to more users to help clear up confusion about healthier choices,” said Mozaffarian.
Meghan O’Hearn et al, Validating Food Compass with Healthy Diet, Cardiometabolic Health and Mortality Among US Adults, 1999–2018, Nature communication (2022). DOI: 10.1038/s41467-022-34195-8
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