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. 2022 Feb;61(1):541-553.
doi: 10.1007/s00394-021-02718-6. Epub 2021 Nov 24.

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

Katrina R Kissock  1   2 , Florent Vieux  3 , Kevin C Mathias  4 , Adam Drewnowski  5 , Chris J Seal  6 , Gabriel Masset  7 , Jessica Smith  8 , Heddie Mejborn  9 , Nicola M McKeown  10   11 , Eleanor J Beck  12   13
Affiliations

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

Katrina R Kissock et al. Eur J Nutr. 2022 Feb.

Erratum in

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.

Keywords: Intake; Nutri-Score; Nutrient density; Nutrient profiling; Whole grain.

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Conflict of interest statement

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.

Figures

Fig. 1
Fig. 1
Effect of whole-grain modification to Nutri-Score class for all foods compared with the original Nutri-Score algorithm for Australia (A; n = 5647), France (B; n = 1304), the UK (C; n = 5261), and the US (D; n = 5011)ab. aHigher Nutri-Score class denotes better nutritional quality of foods. bFrance has a different scale for y-axis due to a minimal number of included foods
Fig. 2
Fig. 2
Effect of whole-grain modification to Nutri-Score class for grain-specific food groups compared with the original Nutri-Score algorithm for Australia (A; n = 499), France (B; n = 52), the UK (C; n = 574), and the US (D; n = 383)ab. aHigher Nutri-Score class denotes better nutritional quality of foods. bFrance has a different scale for y-axis due to a minimal number of included foods
Fig. 3
Fig. 3
Relationship between whole-grain intake, whole-diet nutritional score for the original and modified Nutri-Score algorithm, and national diet-quality score for Australia (A), France (B), the UK (C) and the US (D)ab. aLower whole-diet nutritional score indicates better nutritional quality of diet. bNC non-consumers; HEIFA Healthy Eating Index for Australian adults, PNNS-GS2 Programme National Nutrition Santé—Guidelines Score 2, HDS Healthy Diet Score, HEI Healthy Eating Index
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