The Nutrivore Rating – The Paleo Mother

How Nutrient Profiling Might Inform Dietary Tips

It makes vastly extra sense to plot a nutrient profiling technique that merely displays the nutritive worth of a meals, after which to check how consuming extra nutrient-dense meals impacts illness threat. In truth, there was a 2104 examine of individuals over the age of 55 that confirmed that the upper the NRF9 of their food regimen as an entire, the decrease their threat of all-cause mortality—the very best NRF9 quartile had a 16% decrease probability of dying than the bottom NRF9 quartile. This examine helps to show that probably large well being good thing about a food regimen replete with nutrient-dense meals, however extra research like this that incorporate much more vitamins into the calculus are essential to advance this area of analysis.

For instance how necessary it’s to take a complete method to nutrient profiling, check out how ten entire meals rank, when utilizing 9, 15, 20 or 33 vitamins to quantify their nutrient density (within the NRF9, NRF15, NRF20 and Nutrivore Rating, respectively). The extra vitamins which might be included in a calculation, when following the NRF mannequin which doesn’t cap a nutrient at 100% DV, the upper the rating could be—that’s why each meals has the next rating when extra vitamins are taken into consideration. Nonetheless, look not solely on the order of the meals, and the way together with extra vitamins gives a extra full image of how nutrient-dense a meals is, but in addition the unfold between the scores. The extra vitamins used within the calculus, the simpler it’s to distinguish between probably the most nutrient-dense meals and the least. Given what a nutrient powerhouse liver is, it simply is sensible that its rating can be vastly increased than, say, rooster breast.

The above desk additionally helps for example how a single nutrient can dramatically shift the nutrient profiling rating of a particular meals. For instance, zinc will not be included within the NRF9 however is included within the different scores. Oysters are the highest meals supply of zinc, insufficiency of which impacts an estimated 73% of Individuals largely as a result of zinc-rich meals are few and much between and people which might be, like oysters, are usually not a typical meals on the Customary American Food plan. In truth, a single serving of oysters incorporates 174% DV of zinc! As quickly as zinc is added to the rating, oysters rank far more extremely, which is sensible since they’re such a worthwhile supply of nutritional vitamins, minerals and wholesome fat whereas being a useful supply of zinc!

The perception gleaned from nutrient profiling is profound. It emphasizes the worth of sure households of plant meals (particularly cruciferous greens, mushrooms, leafy greens, and recent herbs) whereas additionally elevating the worth of fish, shellfish and organ meat. On the identical time, it emphasizes the excessive caloric density and low nutrient density of grains and dairy merchandise.  This data can be tremendous helpful have been it included into the USDA dietary pointers, serving to individuals to determine probably the most nutritious meals to eat!

The Downside with Penalizing, Capping and Emphasizing

Some scores penalize for the presence of vitamins whose extra consumption have been (even loosely) linked to well being issues, like sodium, saturated fats, added sugars, and ldl cholesterol.

As I mentioned intimately in Eggs: Nutritious Protein or Ldl cholesterol Bomb?, dietary ldl cholesterol doesn’t enhance serum lipids for most individuals and is the spine of vitamin D and different steroid hormones. Dietary saturated fats is simply problematic when consumption exceeds about 15% of complete energy (though this does rely upon genetic predisposition, see Saturated Fats: Healthful, Dangerous, or Someplace In Between? and Genes to Know About: ApoE). Sodium is simply problematic when consumption exceeds about 7 grams per day, and there are research exhibiting that even this degree is simply worrisome when potassium consumption is concomitantly low, see Is Salt Paleo?. Added sugars change into problematic above about 10% of complete energy (and 25% of complete carbohydrates), see How Does Sugar Match right into a Wholesome Food plan? and TWV Podcast Episode 467: Can Consuming Sugar Each day Be Wholesome?. Most significantly, all of those vitamins are wholesome in average quantities, and solely unhealthy when the entire food regimen contains extra. And, all of those probably problematic vitamins are ample in quick meals, junk meals and different hyperpalatable manufactured meals which might be additionally low in important vitamins and really excessive in energy—because of this scores that penalize for these vitamins give most of these meals scores lower than zero!

Penalizing particular person meals for the presence of those vitamins doesn’t mirror the food regimen as an entire, and has the capability to undervalue in any other case nutrient-dense entire meals which may match right into a health-promoting food regimen, whereas not being obligatory to point out that quick meals and junk meals are unhealthy (they’re nutritionally void sufficient to have already got low scores!).

A few of these scores (just like the NDS) cap a nutrient’s contribution at 100% DV, whereas others acknowledge {that a} meals having greater than a 100% DV of a particular nutrient per serving makes that meals a really worthwhile supply of that nutrient! There’s no such factor as a nutritionally full meals, so the objective is nutrient sufficiency of the complete food regimen, not of anyone specific meals. Thus, it’s necessary to grasp the way to mix meals which might be good sources of various vitamins so as to obtain dietary nutrient sufficiency. Capping a nutrient’s contribution to the nutrient density rating at 100% hinders our potential to grasp the significance of meals combining for nutrient sufficiency. For instance, Brazil nuts are probably the most nutrient-dense nut attributable to their very excessive selenium content material—a 1-ounce serving delivers almost 1000% DV of selenium! However, in case you capped the contribution of selenium to the calculation of Brazil nut nutrient density, they’d erroneously seem like one of many lowest nutrient-density nuts. It simply is sensible to completely worth the superior selenium content material of Brazil nuts and have that mirrored in its nutrient density rating!

One other matter for dialogue is whether or not to weight sure vitamins extra in nutrient profiling.

It is sensible on the floor to depend these vitamins for which a bigger proportion of the inhabitants are poor greater than these vitamins for which only a few individuals are poor. However, right here’s the problem with that logic: the potential for overcorrection and easily shifting in the direction of completely different frequent nutrient deficiencies. If these meals which might be notably good sources of the vitamins that, for instance, an estimated 70% or extra of Individuals routinely don’t devour sufficient of (vitamin B9, vitamin D, vitamin E, choline, calcium, potassium, zinc, omega-3 fat, and polyphenols) had inflated scores on account of weighting these vitamins extra closely in nutrient profiling, meals sources of different vitamins find yourself being undervalued. This method has the capability to shift meals selections in a manner that would assist tackle some inhabitants degree nutrient deficiencies over the quick time period, however that’s not the identical factor as transferring in the direction of nutrient sufficiency, particularly over the long run.

Once we take a look at nutrient profiling strategies described within the scientific literature, it turns into abundantly clear {that a} nutrient-density rating greatest describes a meals when it contains as many vitamins as potential, when the contribution of vitamins are usually not capped at 100% DV, when they’re introduced relative to energy, when they aren’t weighted by meals teams, and when they aren’t normalized to a set scale.

Client-Targeted Nutrient Profiling

A number of different nutrient profiling strategies have been devised by non-researchers with the objective of teaching customers, such because the ANDI Rating, NuVal (primarily based on ONQI), Guiding Stars, and Vitamin IQ.

The ANDI rating could also be one of the vital complete nutrient profiling techniques, however the rating overemphasizes vitamins inherent to plant meals whereas deemphasizing vitamins inherent to animal meals, making a biased outcome. For instance, the ANDI rating incorporates individually into its calculation: beta carotene, alpha carotene, lycopene, lutein and zeaxanthin (all carotenoids); fiber and resistant starch (each fiber); glucosinolates and organosulfides (each organosulfur compounds); phytosterols, angiogenesis inhibitors, aromatase inhibitors, resveratrol and ORAC rating (most plant phytonutrients are antioxidants as are vitamin C and E). Alternatively, the rating omits protein, purposeful amino acids and peptides (like anserine, creatine, carnosine, carnitine, and taurine) and all varieties of health-promoting fat (like omega-3s, monounsaturated fat, CLA and MCTs).

The ONQI is calculated primarily based on 16 vitamins, with penalties for five vitamins and corrections for fats and protein high quality and for glycemic load. Most notably, solely 5 minerals are included, solely three of the B nutritional vitamins are included, and solely two varieties of phytonutrients (flavonoids and carotenoids) are included, whereas vitamin Ok and choline are excluded. As well as, as a result of each ldl cholesterol and saturated fats are penalized (even though whether or not these are problematic is completely context-dependent), animal meals are penalized unnecessarily.

The Guiding Stars system rewards entire grains (regardless of their low nutrient-density in comparison with greens, fruits, legumes, nuts and seeds), and penalizes for complete fats, sodium, sugar and ldl cholesterol  And, the Vitamin IQ system additionally rewards entire grains, makes use of just a few vitamins in its dedication, and likewise penalizes for saturated fats and sodium. The online outcome for each of those scores is to overemphasize grains, which aren’t nutrient-dense by any goal measure, and deemphasize animal meals.

The Downside of Incomplete Knowledge

There’s one ultimate problem to nutrient profiling: incomplete information.

The US Division of Agriculture maintains arguably probably the most complete nutrient database on this planet, referred to as Meals Central, with expanded nutrient information compiled for over 7,000 fundamental meals and partial nutrient information (not less than what’s required on meals label) for almost 360,000 completely different branded meals. However, even this superb database is lacking some key data. Most of the primary entries are lacking measurements for some vitamins (generally vitamin D, vitamin B5, manganese, vitamin K2, and phytosterols) and sure vitamins aren’t included within the database in any respect (together with vitamin B7, iodine, polyphenols, CoQ10, and different purposeful compounds, together with most phytonutrients). Fiber will not be differentiated between soluble and insoluble, and the strategy used to measure fiber is thought to undercount resistant starch and oligosaccharides.

As well as, the entries typically present common measurements for frequent high quality meals merchandise, so it’s not potential to distinguish the nutrient content material of upper high quality choices. And, whereas many of those gaps could be crammed in from measurements introduced in scientific research, it’s shocking to find how incomplete human data is concerning the nutrient content material of frequent meals.

There’s actually no good answer, aside from to scour the scientific literature and different databases for as many vitamins as potential lacking from the USDA Meals Central database (which my crew and I are doing), label when a nutrient-density rating is calculated primarily based on incomplete information, and advocate for continued measurements of the nutrient content material of meals.

How the Nutrivore Rating Is Calculated

The Nutrivore Rating is at the moment probably the most complete, and least bias, technique for representing the inherent nutrient content material of meals, borne out of a complicated array of comparable, but all flawed, nutrient density scores, whereas recognizing the present limitations posed by incomplete information.

The Nutrivore Rating is calculated primarily based on 32+1 vitamins. The 32 main vitamins that go into the rating are:

The rating is calculated because the sum of every nutrient relative to its RDA or AI current in 100 grams of the meals, divided by the quantity of energy per 100 grams. Knowledge that’s not included within the Meals Central Database are obtained from scientific papers and different databases like Phenol Explorer each time potential. When a number of papers report the quantity of a nutrient for a selected meals, the very best worth is utilized, except there’s a transparent methodological benefit to at least one particular measurement, and offered it’s no multiple normal deviation from the imply of all obtainable information (through which case, the second highest worth is utilized following the identical statistical take a look at). Additionally, periodically two entries from the Meals Knowledge Central database are amalgamated to calculate the Nutrivore Rating when two highly-related meals (for instance, sockeye salmon and Coho salmon) have incomplete information. That is famous wherever it’s the case.

Additional, the Nutrivore Rating provides the very best worth of accessible information for one bonus nutrient (that’s the +1), relative to a threshold set utilizing epidemiological research for that nutrient, much like a %DV. The bonus nutrient at the moment could be any of: glucosinolates (the precursor for isothiocyanates and indoles), thiosulfinates, CoQ10, CLA, betaine, betalains, myo-inositol, ergothioneine, taurine and medium-chain triglycerides. The rationale why just one bonus nutrient is included within the Nutrivore Rating is as a result of incomplete information would imply much less frequent or understudied meals are unnecessarily penalized. The place the extent of a number of vitamins in a meals stay unknown, the Nutrivore Rating is marked with an asterisk to indicate that the rating is probably going underestimated for that meals and ought to be regarded as a minimal.

The Nutrivore Rating will not be corrected for nutrient bioavailability, nutrient absorption capability, or metabolic conversion inefficiencies. It’s true that particular isoforms of vitamins are extra simply absorbed and/or utilized by the physique. For instance, whereas vitamin K1 accounts for approximate 90% of the entire vitamin Ok within the food regimen, solely 10 to fifteen% of it’s absorbed within the digestive tract, the web impact being that vitamin K1 accounts for about half of the entire absorbed vitamin Ok, whereas vitamin K2 is very absorbable and represents the remaining 50% (see TWV Podcast Episode 417: Vitamin K2, Hype, or Important?).  Whereas vitamin Ok isoform information is obtainable for some meals within the USDA Meals Central database, as a common rule, nutrient isoform information is never obtainable, making correcting for absorption or utilization effectivity of various nutrient varieties not possible. It’s additionally true that sure combos of vitamins can both improve or hinder absorption. For instance, vitamin C can enhance iron absorption, fat can enhance carotenoid and vitamin Ok absorption, however zinc and copper compete for absorption as do calcium and magnesium. Nonetheless, this may’t be accounted for in a nutrient density rating for a person meals as a result of all vitamins current in a complete meal work together. And typically, absorption is influenced by components unbiased of meals. For instance, vitamin D standing influences calcium absorption; a functioning gallbladder is critical for environment friendly fats and fat-soluble vitamin absorption; and whereas folic acid is far more readily absorbed within the digestive tract than the energetic type of vitamin B9, L-methylfolate, these with MTHFR gene variants can’t covert folic acid effectively (see Paleo for Being pregnant and Lactation and Genes to Know About: MTHFR). So, as a result of nutrient absorption competitors or facilitation goes past a person meals and is as a substitute associated to the entire meals consumed at a meal in addition to different components corresponding to genetics, it is senseless to appropriate for these in a nutrient profiling technique. The Nutrivore Rating additionally doesn’t incorporate a satiety index, once more as a result of satiety is expounded to macronutrient and water combos from a complete meal somewhat than a person meals.

Quite than penalizing for the presence of vitamins whose extra is related to well being issues (like saturated fat, sodium and sugars), these vitamins are merely not included within the Nutrivore Rating calculation. It’s useful to notice that meals excessive in fat and sugars have the next vitality density, that means extra energy per gram or per serving of meals, which does decrease the Nutrivore Rating. As well as, the presence of antinutrients corresponding to phytates or oxalates are usually not taken into consideration. It is because the influence of antinutrients on nutrient absorption can be extraordinarily context dependent. For instance, our intestine micro organism can liberate a considerable quantity of the calcium, magnesium, iron, potassium and zinc certain to phytates for us, thereby releasing the certain minerals in addition to phosphorus and thereby enhancing their bioavailability. A wholesome, various intestine microbiome can usually degrade about half (about 500 to 600 mg day by day) of the phytate consumed within the common American food regimen. Different components influencing bioavailability embody well being of the gastrointestinal tracts, nutrient standing, aggressive binding with different vitamins, meal composition, numerous medication and dietary supplements, time of day and biorhythms, age and gender. It doesn’t make sense to attempt to mirror nutrient digestibility and absorption within the Nutrivore Rating when the system is so advanced and varies from particular person to particular person.

You may consider the Nutrivore Rating as a easy but complete illustration of the inherent vitamins inside a meals, and acknowledge that a wide range of components will decide whether or not or not your physique absorbs and makes use of all of these vitamins.

As a result of vitamins could be misplaced, fashioned and reworked by cooking, the Nutrivore Rating is calculated primarily based on the vitamins throughout the uncooked entire meals, except famous in any other case. Additionally, it’s uncommon for there to be nutrient information for various high quality ranges of a meals. For instance, the Meals Central database incorporates just one entry for olive oil, however analysis has proven that the polyphenol content material of virgin olive oil can vary from wherever between 50 to 5000 mg/kg, and the vitamin E content material can vary from 100 to over 1000 mg/kg. One other instance: regardless that locally-grown, in-season natural greens and fruit and identified to have increased nutrient density (because of being grown in increased high quality soil, picked ripe, and eaten a lot sooner after harvest), there aren’t any separate entries within the Meals Central database for natural versus conventionally-grown produce. Because of this, we will consider Nutrivore Scores at least or common worth and really feel assured that the trouble to hunt out increased high quality choices (grass-fed meat, wild-caught fish, recent cold-pressed extra-virgin olive oil, and native in-season greens and fruit) remains to be nutritionally worthwhile if at the moment not quantifiable.

As extra nutrient information change into obtainable, the Nutrivore Rating shall be up to date to mirror extra full dietary data. This clearly applies to lacking vitamin data from the Meals Central database, however there’s additionally the probability of including vitamins to the Nutrivore Rating calculation sooner or later. For instance, a protein digestibility rating, soluble versus insoluble fiber, hint minerals, purposeful nonproteinogenic amino acids and peptides, purposeful fatty acids, and vitamin-like compounds that aren’t at the moment utilized to calculate the Nutrivore Rating may all be added as soon as there may be adequate information to rationalize their inclusion. For now, extraordinarily sparse information makes this prohibitive, and equally would reward meals merely for being higher studied, not essentially for inherently increased dietary worth, relative to much less frequent meals.

Utilizing the Nutrivore Rating

It’s time for a optimistic method to dietary steering utilizing nutrient density as a fundamental precept.  The Nutrivore Rating is a obligatory foundational step in the direction of reaching this objective! By understanding the vitamins per calorie supplied by particular person meals through the Nutrivore Rating, along with recognition that sure vitamins are unique to particular meals teams, we will obtain nutrient sufficiency by select a wide range of nutrient-dense superfoods in addition to the very best Nutrivore Rating choices from the assorted foundational meals teams.

As I construct Nutrivore.com, the Nutrivore Rating is considered one of a number of instruments that I’m utilizing to speak which meals have probably the most to supply us. As you may see with the pattern nutrient card above, I’m additionally highlighting the vitamins per serving (somewhat than solely contemplating vitamins per calorie), together with that are wonderful sources (greater than 20percentDV) and that are good sources (10-20percentDV). I’m combining this dietary data with a overview of the scientific literature on the particular well being impacts of consuming a meals, and detailed data on what vitamins do within the physique and the way a lot of them we’d like. And, I’m creating academic assets on the way to choose numerous meals with complementary vitamin to realize nutrient sufficiency!

I’m constructing this web site exterior of any dietary dogma. Being a Nutrivore is concerning the total high quality of the entire food regimen, and never a few record of yes-foods and no-foods. Despite the fact that eliminating empty calorie meals helps to realize nutrient sufficiency with out overeating, no meals is strictly off-limits. On this manner, being a Nutrivore is a food regimen modifier somewhat than a food regimen itself—a Nutrivore method could be layered atop of different dietary buildings and priorities so as to meet a person’s particular well being wants and objectives.

I see Nutrivore because the pure extension of my science-grounded method, and one that can enable me to each degree up the depth of my assets for my long-time readers who love my science deep dives, but in addition meet individuals the place they’re and embrace the concept even a small first step is value celebrating. (See additionally What Is a Nutrivore?, Ditching Food plan Dogma, My Private Journey with the Autoimmune Protocol and My Private Journey as a Blogger).

My imaginative and prescient for Nutrivore.com is extraordinarily bold: An in depth academic useful resource devoid of dietary dogma and as a substitute purely primarily based on scientific research and nutrient profiling to quantify nutrient density, all with the objective of serving to individuals obtain dietary nutrient sufficiency (a.okay.a. Nutrivore) by way of knowledgeable day-to-day selections.

The Nutrivore Rating is a measure of a lot vitamins, relative to the day by day worth (DV), a meals incorporates per calorie. A nutrient-dense powerhouse superfood is any meals with a Nutrivore Rating increased than 800. Excessive nutrient-density meals have a Nutrivore Rating between 400 and 800. Medium nutrient-density meals have a Nutrivore Rating between 150 and 400. And, low nutrient-density empty-calorie meals have a nutrivore rating lower than 150. Bear in mind, there aren’t any yes-foods and no-foods on a Nutrivore method, however as a substitute what issues is whether or not the food regimen as an entire meets the physique’s dietary wants. General dietary nutrient sufficiency is simple to realize by deciding on a wide range of the very best Nutrivore Rating meals inside every meals class.

To this point, I’ve calculated the Nutrivore Rating of about over 7,500 completely different meals, and boy there have been some surprises!  Do you know that golden kiwis are a bit of extra nutrient-dense than inexperienced kiwis? Or that darkish meat turkey is extra nutrient-dense than mild meat turkey? Or that maple syrup and molasses have a medium nutrient-density rating and that molasses is extra nutrient-dense than cheese or pears?! Or that Asian pears are probably the most nutrient-dense Rosaceae household fruit (the apple and stone fruit household). Or that blackberries, strawberries and raspberries are all extra nutrient-dense than blueberries? You’ll be capable of discover all of this data in my new e-book, Information to Nutrivore!

Introducing the Information to Nutrivore E-E book!

Information to Nutrivore lays the muse for Nutrivore as a common well being method, a base dietary philosophy devoid of dogma, on high of which you’ll layer extra meals focus or eliminations to fulfill particular person wants. On this sense, being a Nutrivore is a food regimen modifier somewhat than a food regimen itself.

With this beautifully-designed e-book, you’ll:

• find out how a Nutrivore method can enhance well being
• admire what important and nonessential vitamins do within the physique
• get sensible recommendations on the way to enhance nutrient-density
• study the way to use the Nutrivore Rating to decide on more healthy meals
• discover detailed vitamin data on the Prime 100 Nutrivore Rating Meals
• evaluate the nutrient-density versus energy-density of meals teams
• simply implement Nutrivore with handy-dandy visible guides and reference tables!

The Information to Nutrivore explains the way to eat a Nutrivore food regimen and introduces the Nutrivore Rating, probably the most complete and least-biased technique to evaluate the nutritive worth of particular person meals.  Detailed vitamin data for the Prime 100 Nutrivore Rating Meals is summarized with stunning graphics for every meals. And, the Information to Nutrivore contains evaluation of meals teams, concerns when getting ready Nutrivore meals, sensible tricks to enhance the nutrient density of your food regimen, and a look-up desk for the Nutrivore Rating of roughly 300 meals.

Nutrivore Scores of Frequent Meals

And, whilst you watch for Information to Nutrivore and Nutrivore.com, right here’s the Nutrivore Scores of some frequent meals!

• Arugula – 2019
• Avocado – 251
• Beef Liver – 4021
• Bell Peppers, Pink – 1358
• Blueberries – 396
• Brazil Nuts – 694
• Broccoli – 2833
• Butternut Squash – 670
• Cheddar Cheese – 126
• Chia – 450
• Hen, Breast – 309
• Cremini Mushrooms – 2279
• Eggs – 355
• Garlic – 5622
• Inexperienced Leaf Lettuce – 2245

• Kale – 4233
• Mango – 342
• Oranges – 408
• Oysters – 2255
• Potato – 273
• Rice, White – 66
• Salmon, Wild Atlantic – 868
• Spinach – 4548
• Strawberries – 762
• Sugar, Granulated – 1
• Candy Potato – 379
• Walnuts – 303
• Watercress – 6929
• Wheat Flour, All-Function – 70
• Yogurt, Greek, Entire – 178

And, don’t overlook to seize my free Nutrivore Rating Information to Meals Teams!

“*” signifies required fields

Citations

Chiuve SE, Sampson L, Willett WC. The affiliation between a dietary high quality index and threat of power illness. Am J Prev Med. 2011 Might;40(5):505-13. doi: 10.1016/j.amepre.2010.11.022. PMID: 21496749; PMCID: PMC3100735.

Darmon N, Briend A, Drewnowski A. Vitality-dense diets are related to decrease food regimen prices: a neighborhood examine of French adults. Public Well being Nutr. 2004 Feb;7(1):21-7. doi: 10.1079/phn2003512. PMID: 14972068.

Darmon N, Darmon M, Maillot M, Drewnowski A. A nutrient density normal for greens and fruits: vitamins per calorie and vitamins per unit value. J Am Food plan Assoc. 2005 Dec;105(12):1881-7. doi: 10.1016/j.jada.2005.09.005. PMID: 16321593.

Drewnowski A , Burton-Freeman B . A brand new category-specific nutrient wealthy meals (NRF9f.3) rating provides flavonoids to evaluate nutrient density of fruit. Meals Funct. 2020 Jan 29;11(1):123-130. doi: 10.1039/c9fo02344e. PMID: 31938797.

Drewnowski A, Dwyer J, King JC, Weaver CM. A proposed nutrient density rating that features meals teams and vitamins to higher align with dietary steering. Nutr Rev. 2019 Jun 1;77(6):404-416. doi: 10.1093/nutrit/nuz002. PMID: 31222368; PMCID: PMC6489166.

Drewnowski A, Fulgoni V third. Nutrient profiling of meals: making a nutrient-rich meals index. Nutr Rev. 2008 Jan;66(1):23-39. doi: 10.1111/j.1753-4887.2007.00003.x. PMID: 18254882.

Drewnowski A, Fulgoni VL third. Nutrient density: ideas and analysis instruments. Am J Clin Nutr. 2014 Might;99(5 Suppl):1223S-8S. doi: 10.3945/ajcn.113.073395. Epub 2014 Mar 19. PMID: 24646818.

Drewnowski A, Maillot M, Darmon N. Testing nutrient profile fashions in relation to vitality density and vitality value. Eur J Clin Nutr. 2009 Might;63(5):674-83. doi: 10.1038/ejcn.2008.16. Epub 2008 Feb 20. PMID: 18285808.

Drewnowski A, Smith J, Fulgoni VL third. The New Hybrid Nutrient Density Rating NRFh 4:3:3 Examined in Relation to Inexpensive Nutrient Density and Wholesome Consuming Index 2015: Analyses of NHANES Knowledge 2013-16. Vitamins. 2021 Might 20;13(5):1734. doi: 10.3390/nu13051734. PMID: 34065287; PMCID: PMC8160959.

Drewnowski A. Idea of a nutritious meals: towards a nutrient density rating. Am J Clin Nutr. 2005 Oct;82(4):721-32. doi: 10.1093/ajcn/82.4.721. PMID: 16210699.

Drewnowski A. Defining nutrient density: growth and validation of the nutrient wealthy meals index. J Am Coll Nutr. 2009 Aug;28(4):421S-426S. doi: 10.1080/07315724.2009.10718106. PMID: 20368382.

Drewnowski A. The Nutrient Wealthy Meals Index helps to determine wholesome, inexpensive meals. Am J Clin Nutr. 2010 Apr;91(4):1095S-1101S. doi: 10.3945/ajcn.2010.28450D. Epub 2010 Feb 24. PMID: 20181811.

Fernández-Ríos A, Laso J, Campos C, Ruiz-Salmón I, Hoehn D, Cristóbal J, Batlle-Bayer L, Bala A, Fullana-I-Palmer P, Puig R, Aldaco R, Margallo M. In direction of a Water-Vitality-Meals (WEF) nexus index: A overview of nutrient profile fashions as a basic pillar of meals and vitamin safety. Sci Whole Environ. 2021 Oct 1;789:147936. doi: 10.1016/j.scitotenv.2021.147936. Epub 2021 Might 21. PMID: 34082212.

Fulgoni VL third, Keast DR, Drewnowski A. Growth and validation of the nutrient-rich meals index: a instrument to measure dietary high quality of meals. J Nutr. 2009 Aug;139(8):1549-54. doi: 10.3945/jn.108.101360. Epub 2009 Jun 23. PMID: 19549759.

Imai C, Takimoto H, Fudono A, Tarui I, Aoyama T, Yago S, Okamitsu M, Sasaki S, Mizutani S, Miyasaka N, Sato N. Software of the Nutrient-Wealthy Meals Index 9.3 and the Dietary Inflammatory Index for Assessing Maternal Dietary High quality in Japan: A Single-Middle Start Cohort Examine. Vitamins. 2021 Aug 19;13(8):2854. doi: 10.3390/nu13082854. PMID: 34445014; PMCID: PMC8400739.

Maillot M, Darmon N, Darmon M, Lafay L, Drewnowski A. Nutrient-dense meals teams have excessive vitality prices: an econometric method to nutrient profiling. J Nutr. 2007 Jul;137(7):1815-20. doi: 10.1093/jn/137.7.1815. PMID: 17585036.

Miller GD, Drewnowski A, Fulgoni V, Heaney RP, King J, Kennedy E. It’s time for a optimistic method to dietary steering utilizing nutrient density as a fundamental precept. J Nutr. 2009 Jun;139(6):1198-202. doi: 10.3945/jn.108.100842. Epub 2009 Apr 1. PMID: 19339707.

Mobley AR, Kraemer D, Nicholls J. Placing the nutrient-rich meals index into observe. J Am Coll Nutr. 2009 Aug;28(4):427S-435S. doi: 10.1080/07315724.2009.10718107. PMID: 20368383.

Murakami Ok, Livingstone MBE, Fujiwara A, Sasaki S. Software of the Wholesome Consuming Index-2015 and the Nutrient-Wealthy Meals Index 9.3 for assessing total food regimen high quality within the Japanese context: Totally different dietary issues from the US. PLoS One. 2020 Jan 30;15(1):e0228318. doi: 10.1371/journal.pone.0228318. PMID: 31999772; PMCID: PMC6992222.

Murakami Ok, Livingstone MBE, Fujiwara A, Sasaki S. Reproducibility and Relative Validity of the Wholesome Consuming Index-2015 and Nutrient-Wealthy Meals Index 9.3 Estimated by Complete and Temporary Food plan Historical past Questionnaires in Japanese Adults. Vitamins. 2019 Oct 21;11(10):2540. doi: 10.3390/nu11102540. PMID: 31640242; PMCID: PMC6836176.

Streppel MT, Sluik D, van Yperen JF, Geelen A, Hofman A, Franco OH, Witteman JC, Feskens EJ. Nutrient-rich meals, cardiovascular illnesses and all-cause mortality: the Rotterdam examine. Eur J Clin Nutr. 2014 Jun;68(6):741-7. doi: 10.1038/ejcn.2014.35. Epub 2014 Mar 19. PMID: 24642783.