Imagine a world where food on grocery store shelves is ranked by its healthiness, with simple, research-backed scores. In some countries, that world already exists.
Nutrient profiling systems, or NPSs, support clear front-of-package labels that assess food quality based on nutrient content. Nutri-Score in France is a rainbow-colored system grading foods from A to E. Health Star Rating in Australia is a five-star system rating foods in half-star increments. And the Traffic Light System in the UK labels nutrient levels as green, yellow or red.
In contrast, the U.S. lacks a front-of-package ranking system for food. Food Compass was recently developed out of Tufts University to help address this gap and shortcomings in other systems. But it uses nutritional information not currently available for most foods and consumers.
As a gastroenterologist and physician-scientist, I focus on making the latest microbiome and nutrition data more accessible to the public. Drawing on this research, I developed Nutrient Consume Score, or NCS, which rates foods from 1 to 100 using nutritional information available for all foods and incorporates factors important for a healthy microbiome.
But how do nutrient profiling systems work? And how do they compare to other nutrition guides for consumers?
Nutrient cyphers
Each nutrient profiling system uses different scoring algorithms, but most assign positive points to nutrients and foods that are typically underconsumed, such as fiber, fruits and vegetables. Conversely, negative points are given to overconsumed nutrients like sugar, saturated fat and sodium, which are often added to processed foods. These points are combined into a single score: higher scores indicate healthier foods, while lower scores indicate less healthy options.
For example, kale – rich in fiber, potassium and unsaturated fats, while low in sugar, sodium and saturated fats – would earn a high score. In contrast, Twinkies, which are high in sugar, sodium and saturated fats, but low in fiber, potassium and unsaturated fats, would receive a low score. A food like black olives, high in fiber but also high in sodium, would fall somewhere in between.
Nutrient profiling systems work similarly to the Nutrition Facts labels on the back or sides of food packages in helping consumers make informed choices. These labels provide information about a food’s nutrient content, including calories, macronutrients, and key vitamins and minerals. The values are determined through laboratory analysis and nutrient databases based on standardized serving sizes regulated by the Food and Drug Administration.
But NPSs differ in that they combine nutrition information into a single actionable score. This means you don’t have to spend time deciphering Nutrition Facts labels, which are often in small print and can be confusing to interpret.
Ultraprocessed profiling
Nutrient profiling system algorithms are all quite similar in their high ranking of unprocessed foods – beans, nuts, seeds, fruits, vegetables and whole grains – and low ranking of processed foods like hot dogs, soft drinks, cakes and cookies. They help people rebalance their diets that have been skewed by food processing, or the degree to which the ingredients have been altered.
They complement the NOVA classification system developed by researchers at the University of São Paulo, which categorizes foods based on their level of processing. This system introduced the term “ultra-processed foods,” which are foods that have undergone significant industrial processing and contain ingredients not typically found in home cooking.
While NOVA has linked ultra-processed foods to poor health outcomes like obesity, worse mental health, cancer and early death, it treats all such foods equally, overlooking differences like amount of sugar, sodium and other additives.
Nutrient profile systems help provide nuance by identifying healthier options within the ultra-processed category. For example, plant-based milks, such as almond or soy milk, may be classified as ultra-processed under the NOVA system, but they can have relatively higher NPS scores if they contain minimal added sugars and salt.
Ratios and bioactives in balance
While nutrient profiling systems can be useful for choosing healthier options, current systems have limitations. They don’t always align perfectly with other research, often overlook the bioactive chemicals that regulate microbiome and body processes, and may rely on incomplete data. Current systems also don’t account for the caloric and health effects of alcohol.
The Nutrient Consume Score I designed aims to address these gaps by incorporating these neglected components of food. For example, it uses food categories as proxies for areas with limited data, including bioactive compounds like polyphenols, omega-3 fats and fermentable fibers. Proxies for bioactive compounds found in unprocessed foods – such as fruits, vegetables, grains, beans, nuts and seeds – are integrated into the score’s core algorithm, which uses nutrient ratios to measure the degree of food processing.
Nutrient ratios – including carbohydrate-to-fiber, saturated fat-to-unsaturated fat and sodium-to-potassium – reflect the natural balance of nutritional content of the cells in unprocessed foods, which research has shown correlate with cardiometabolic health.
For example, the cell walls of plants provide structural strength and are rich in fiber, while their energy vesicles store carbohydrates. Fiber reduces sugar absorption and is fermented into the compound butyrate, which maintains blood sugar and regulates appetite.
The fat profiles of unprocessed foods are similar to the fat composition in cell membranes. Saturated fat-to-unsaturated fat ratios capture how different types of fat, affect inflammation and weight.
Finally, the potassium-to-sodium ratio reflects the natural function of cell membrane pumps, which concentrate potassium inside cells while transporting sodium out. This affects blood pressure as well as microbiome and metabolic health.
Research currently under peer review shows that the Nutrient Consume Score compares favorably with other systems. Derived from nutrition data from nearly 5,000 Americans, NCS sores are linked to blood pressure, waist circumference and weight. NCS has also been incorporated into a smartphone app intended for public use, currently in beta testing.
Empowering smart choices
While nutrient profiling systems are a promising tool for healthier food choices, they come with important caveats. Most studies testing how well they work focus on how two factors relate to each other rather than whether one directly causes the other. Correlation doesn’t prove causation.
Further studies are needed to assess whether these systems influence buying habits, consumption trends, and health outcomes like weight and blood pressure. Additionally, individual dietary needs can vary, and personalized algorithms could help refine these scores for tailored recommendations.
Despite these considerations, nutrient profiling systems are promising tools to combat rising rates of metabolic disease. Their use in Europe demonstrates their potential to shift consumer purchasing habits and inspire food companies to create healthier products.
Americans may one day see similar front-of-package labels in the U.S. Until then, smartphone technologies can offer a practical way to help consumers make smarter choices today.
Christopher Damman is Associate Professor of Gastroenterology, School of Medicine, University of Washington.
The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.
© The Conversation
62 Comments
GBR48
It doesn't make any difference to what people buy. The only people that think it does are the people who earn their wage by coming up with ideas like this.
wallace
Replace the bar code with a QR code containing all the information. Works at the check-out.
Mr Kipling
Much better to have a healthy diet overall not Ban certain foods. And getting some exercise wouldn't hurt either.
Zaphod
Simple rule: Shop around the edges of the supermarket, where all the perishable (aka real) foods are. Avoid the center where the overprocessed, forever-lasting stuff in funky wrapping is. No need to overthink this. (Although I suspect the "world-wide experts and institutions" recommend the opposite...)
Hawk
Excepting specific and individual requirements, the healthiest foods; meat, fruit, eggs, vegetables, don't need nutritional labels. Just eat a decent range of them.
Wick's pencil
I would rather they just focus on accurate labelling of ingredients, than on using algorithms based on the opinions of whoever creates them.
And as the article says: "individual dietary needs can vary".
Seems that the more these institutions of science do to try to improve people's health, the more their health worsens.
Hawk
There's just so much unnecessary and confusing noise around it, from a variety of sources. The basic rules I learned and followed when I was training pretty seriously in the 90s still broadly apply; fat doesn't make you fat, protein for growth and carbs for energy, eat more to bulk, eat less to cut.
virusrex
The same as the last time you made this irrational claim: This article is written accordingly to the scientific consensus of the experts in the field, the author is there with his credentials for anybody to see
Christopher Damman is Associate Professor of Gastroenterology, School of Medicine, University of Washington.
The problem is not that the experts of the world are wrong all the time as you are trying to misrepresent, but that having a deeply irrational antiscientific position by default makes random people on the internet more likely to be wrong than right.
The current period of time is where people live longer and healthier lives than even before, specially for those that actually follow dietary and lifestyle recommendations. Seeing how this progress can even offset the negative effect of systematically rejecting science by a segment of the population this must be a very important positive effect.
Institutions of science do not blindly assume some thing "must" be right or wrong as done by the antiscientific propaganda groups, they simply examine if interventions work or not, adopt those things that do and improve on them. The article is very clear about this.
Zaphod
virus
Nobody has been saying that. The comments were about the endless appeal to authority with references to unnamed world-wide experts and respected institutions which are supposed to have a nebulous "consensus".
As for Christopher Damman, the issue is that he is unnecessarily complicating the issue. Nobody needs yet another "nutrient profiling system"; just tell us what is in the stuff.
Hawk
Nobody has been saying that.
A lot of people say that.
falseflagsteve
anything that encourages a healthier diet is welcome. I wish nutrition was taught at school from a young age as a compulsara subject. It can be very basic info for the youngest becoming more advanced with age. Mind you the mindset of the nations also needs to change to make a real difference.
People live long lives now but many have decades of low quality existence usually due to obesity, kept alive by daily medications.
Wick's pencil
Yes, basically avoid (or minimize) anything with a label.
virusrex
You just did "Although I suspect the "world-wide experts and institutions" recommend the opposite..."
This betrays not only that you had no interest to read the article, but that you automatically assume the scientific consensus is the opposite of what you claim, so you try to dismiss it as invalid preemptively and try to make an appeal to your own authority instead, which makes no sense from anonymous accounts.
There is nothing nebulous, no unnamed institutions, the consensus is real and clear even if you don't want to accept it, you have had every opportunity to offer ANY institution that refutes what the article claims and you always end up incapable of doing it, no institution dedicated to nutrition, no university, no ministry of health, no government portal about food, nutrition or health. Zero. What else is there to understand about it but that all of them confirm the consensus so you have no reference for a different conclusion?
Prove it, you need to offer evidence that the "complications" are unnecessary, that they bring no benefits. It also ignores the fact that the article clearly says that there is need to see if this approach actually helps or not.
This makes absolutely no sense, a label is information. Trying to make a false equivalence between less information and healthier food is not valid. For people that want to take better decisions information is very valuable.
Hawk
Right, but fruits, vegetables, meats, eggs, for example, don't come with nutritional labels. At least, not the ones I buy. Milk, yoghurt, sure but that's because they are packaged. Unless you're talking about 'grass-fed,' 'organic,' 'locally sourced' and the like. Which we're not. If you really want to know the nutritional information of an egg, you can check the internet.
wallace
Replacing the bar code with a QR code can provide the info. It is starting to happen.
virusrex
But if you had two options one with a label and one without it it would be irrational to think the one without it is "better". The article is about putting more information in the hands of the people that are buying food, and seeing if this correlates with better decisions, if this is the case (because the article concedes this is not a done conclusion) it would be a very clear advantage over just letting people research on their own (which is the current default).
There is no problem about buying things even without information about their nutritional value, some people are aware of it already. My problem is pretending that having less information somehow would make food healthier.
Hawk
So, at checkout, customers will stop to read the nutritional label of every different product they are buying? Have I got that right? If so, I'd hate to be in that line.
Daisaku
The QR code will act like the bar code at the cashier. No one will be required to read the QR code, but it can be there if customers want to see it with their smartphones at the pickup point. The information will include the food's calories. QR codes are already replacing the very dated bar code.
Hawk
So, do you propose putting a nutritional label on every single apple, potato, chicken drumstick and egg in the store? Or how about a general rule that states that if a food is unprocessed, and unpackaged, then it's generally (and we've already made room for specific dietary needs and requirements in previous comments) good to eat.
Hawk
So I did get it right. Then, what happens when the customer reads the information and decides it has too much potassium or whatever, and changes their mind? Refunds and heavily handled food back on the shelves. I'm still not seeing any benefits.
Daisaku
Next-generation QR-style codes will replace traditional barcodes by 2027. These codes will offer enhanced functionality, such as embedding sell-by dates, allergens, and recycling information.
https://tech.slashdot.org/story/24/12/30/2219222/qr-style-codes-could-replace-barcodes-within-two-years#:~:text=Traditional%20barcodes%20are%20set%20to,%2C%20allergens%2C%20and%20recycling%20information.
"QR-style codes could replace barcodes 'within two years' It is the zebra-striped tag that has become ubiquitous over the last 50 years, but the barcode's days could be numbered. The global organisation overseeing their use has said a more powerful alternative will be readable by retailers everywhere within two years."
https://www.theguardian.com/technology/2024/dec/30/barcodes-could-be-superseded-by-a-more-powerful-alternative-by-the-end-of-2027#:~:text=QR%2Dstyle%20codes%20could%20replace%20barcodes%20'within%20two%20years',-Retailers%20already%20trialling&text=It%20is%20the%20zebra%2Dstriped,retailers%20everywhere%20within%20two%20years.
Hawk
Ah...click. Customers can check the QR code in the aisles before going to the checkout. LOL, silly me. Sorry, wallace and Daisaku. My bad.
Daisaku
If the customer wants to read the QR code that would be done at the point of pickup not at the cashier where the items are already in a basket and the cashier scans the prices in. It will replace the barcode but I guess not many customers will use it in the beginning.
Luddites can take the easy option of placing their items in a basket and handing them over to the cashier for payment. I guess they would use cash only since it's too complicated to pay by their smartphone.
virusrex
Why would this terribly inefficient thing would be necessary? You can put the information where the product is on display (for example where the price is exhibited) this would perfectly accomplish the role of being a "label" informing the customers about the properties of the product.
That is where it begins to become irrational, it would make for example raw milk "better" than the ultraprocessed soy milk which obviously is not the case. It means conflagrating two independent things as if they were correlated, less-packaged flour or sugar would not become better, prewashed and cut vegetables don't become worse nutritionally.
Hawk
That would be better.
I said milk, and anything packaged or processed - so cut and washed vegetables, has labels. Give me an example using apples. Are golden delicious really that different from Granny Smith?
Wick's pencil
Considering that my comment was in response to:
my comment makes perfect sense. Healthiest foods generally have no (or minimal) labels. Labels tend to be associated with processed (less healthy) foods. I never said that adding a label to a healthy food magically renders it unhealthy.
You simply didn't get it or you're just doing mental gymnastics to try to prove me wrong.
wallace
Take a simple item like rolled oats. I have eaten them for breakfast for decades. They contain trace elements of zinc. If my wife eats them she breaks out in painful hives.
We need smart shopping carts that record the items placed in the basket so when we arrive at the cashier there is an itemized receipt waiting. Quick pay with the phone.
The smart shopping cart could have a screen that can be used to give info on any food item.
Hawk
I love being downvoted for admitting I was wrong and apologising. It reminds me of the class and calibre of my fellow posters.
Hawk
wallace,
I've used a similar system. You get some kind of hand-held scanner and scan your items as you put them in your cart. Then you give the scanner to the cashier who handles payment. No info beyond price, as I recall.
It is (was?) called SHOP'nGO.
GuruMick
If I have to deal with more old people squinting and reading labels on food they have bought a hundred times before while blocking aisle access I,m going straight to the alcohol drink section......that cant be healthy....
falseflagsteve
Wallace
Not my cup of tea. I pay with cash only believe that Cash is King. I only go to tills with a person there and will not rely on needing technology to purchase products, especially from any device.
wallace
My wife needs to read the food labels every time because of her food allergies.
wallace
Those days are numbered. There are already many self-check outs.
virusrex
And the argument still applies, something do not automatically becomes worse by being more processed, nor it becomes better when it is less packaged. Having labels is not the same as having nutritional information in the label, specially in the way the article is arguing as useful.
That would be the argument you are trying to defend, that a golden delicious would be automatically better if it has no labels, no nutritional information; and Granny Smith would be worse if it has it. In reality both things are unrelated, and giving more information to people to make better decisions can be very beneficial.
No it does not, you are making a false correlation, as if the nutritional value is in any way related to the nutritional label, a vegetable is not "healthy" because it does not have labels, and the worst food you can think of would not be less unhealthy if it is not labeled in any way. This is still wrong.
You are making a false correlation in your comment, that is what the argument helps debunking, precisely because it makes no sense to say that adding a label to healthy food makes it unhealthy is why it should be easy to understand that the reciprocal situation (saying that a food is unhealthy just because it has not label) is also nonsensical. Both things are completely unrelated. No need for mental gymnastics, you yourself have accepted the reasoning you use is invalid.
Hawk
virusrex,
That would be the argument you are trying to defend, that a golden delicious would be automatically better if it has no labels, no nutritional information; and Granny Smith would be worse if it has it. In reality both things are unrelated, and giving more information to people to make better decisions can be very beneficial.
Translation: No.
Anyway, you've blown past the point. The foods I mentioned don't need nutritional information labels because, in general, they are healthy. I suppose that's why, in every country I've ever lived in at least, they don't have nutritional information labels. Go on, have a last word because I know you must, and have a happy new year.
I'll just post my original comment again:
"Excepting specific and individual requirements, the healthiest foods; meat, fruit, eggs, vegetables, don't need nutritional labels. Just eat a decent range of them."
Daisaku
Healthy foods are not healthy for all people. Milk allergy comes to mind.
Hawk
Yes. People who are allergic to milk might want to avoid buying milk. Great point.
Daisaku
And all food items containing milk. Label reading is required and often the print is very small and could be resolved using a QR code.
Peanuts are another even in small qualities in other food items.
Hawk
Right. Again, food that is packaged or processed should have nutritional labels. A peanut, however, does not. It contains peanuts.
Daisaku
For people with serious food allergies, the labels are very important.
Raw Beer
You are essentially restating WP's point. In case you missed it.
So why is he "still wrong"?
Raw Beer
Yeah, I just want to know what I am buying, and I'll decide what is healthy or not, not some biased "institute of science".
Hawk
If you are seriously allergic to bananas, and you buy and eat a bunch of bananas, I don't know what to tell you. If you want a pack of cookies, and they happened to be made with banana extract (or something), then that should be included on the label.
wallace
Food labels do not only say what the food item is, like "Apples" or "Cooking Apples" but also the prefecture or country of origin.
Why are some people hung up about food labels when they are not required to read them?
Zaphod
virusrex
LOL.... as Scott Adams often points out, a certain percentage of the population is simply unable to understand sarcasm.
Zaphod
Daisaku
Allergies are a different issue. If you demand that only food that can not cause allergic reaction in all people, there is no such thing as healthy food any more, since it is possible to be allergic against practically everything. That argument is a distraction.
Pukey2
I really do wish nutritional labels on food in Japanese include saturated fat and also sugars, and not just carbohydrates. Not all carbs are the same. And please specify the fat, whether it's palm fat, or other vegetable fats, etc.
And frankly, I'm absolutely shocked at how much fat and salt some processed products contain.
Daisaku
You have failed to understand my comments. I didn't post anything in your comment. People mentioned "healthy" foods. I pointed out some people are allergic to "healthy foods" and pointed out the importance of labeling. When QR codes become available they can contain all the necessary info.
GuruMick
But who can read the tiny print on labels without a microscope.?
When I bring my microscope to the department store I am looked askance by all and sundry .
And allergies...dont get me started....natures way of weeding out the weak
Hawk
I'll try again, I guess. People were talking about whole, unprocessed, unpackaged foods. An apple. A steak. A carrot. An egg. Not extracts, essences, trace amounts and cross-contaminants that may or may not be present in processed foods.
For the tenth time, if you are allergic to apples, DO NOT BUY AND EAT AN APPLE!
smithinjapan
"Imagine a world where food on grocery store shelves is ranked by its healthiness, with simple, research-backed scores. In some countries, that world already exists."
I can, pretty easily. I can also imagine the price tags ranking accordingly just because the shops could do so.
wallace
The article is about if foods should be ranked and labeled according to how healthy they are.
Fossil
Sage advice .!.
virusrex
Good to see you now understand the original argument you were supporting had no merit, labeling something or not would make no difference to their nutritious value, so saying one is generally healthier is a mistake.
That is not a logic argument, because this is not about making a 100% or 0% decision, for example someone trying to eat fruits in general without a serious preference could easily benefit from comparing the nutritional value between several kinds of fruit, something that the nutritional information would really help with.
That is not your original comment, and it has been argumented against in the previous comment already.
I am refuting the original claim that people should consider non labeled things healthier, that is still completely wrong, unhealthy things without nutritional information are not by this fact less unhealthy, so making it a deciding factor makes no sense.
Everybody can have their own personal biases, rational or not, but having more information would not be less helpful, except of course for people that would need to be in denial so being confronted with objective information would make that more difficult.
And those that are unable to accept the value of science will keep saying that the consensus is not real, proving it by bringing exactly zero examples of institutions that contradict that consensus, thus proving the opposite of what they claim.
There is no need to have tiny print on labels, is as necessary as having tiny prices tags.
Is about the value of doing it and how it can help people make better decisions, as long as it can be confirmed that it does not gets in the way.
Hawk
HawkToday 08:35 am JST
You were saying?
Hawk
But I said I'd give you the last word. Thanks for the discussion.
virusrex
Corrected, but still the arguments remains the same.
Food being healthy is not related to being unlabeled, nor being labeled is related to unhealthiness.
People can easily benefit from a label that allows meaningful comparisons that lets them makes better decisions, "Healthy" is not something absolute that is either present or not, but a quantifiable thing that applies to the specific situation of the person and that can be compared between food for huge convenience.Hawk
Just out of interest, are fruits, vegetables and meats, in moderate amounts, unhealthy?
Eggs, who knows? They still can't figure that out. It changes every year.
virusrex
Generally speaking no, but the point is that food is not more nor less unhealthy according to a label.
The presence or absence of nutritional information is not (by itself) an indicator of healthiness, but it can be extremely convenient for people that want to decide what to include in their diets according to their specific needs.
Hawk
Hence, no label. Generally speaking is what I've been doing the whole time. And just to nitpic a little, food is more or less healthy according to what it says on the label. If it says it's full of preservatives, sweeteners, artificial flavours, and artificial colouring, it's probably unhealthier than, say, a pumpkin that says "pumpkin" on it. But you're right, the mere act of placing a label on a food doesn't change its level of healthy.
Also true. But already, when I need to check which has more manganese, a kiwi or a peach, I have this cool app on my phone. It's called the internet.
Hawk
Actually: "Also true to a point." But we just agreed that fruits, vegetables and meats - foods which don't require nutritional labels - are not unhealthy. So, in the case of those foods and a few others, the absence of a label does indicate that it's, generally speaking, healthy.
virusrex
Hence, the presence or absence of label is irrelevant to the nutritional value of food.
Opposite relationship, what you are claiming is that one apple would magically become less healthy if a mistaken label is applied to it or if someone just scribbled wrong nutritional values on it.
What actually happens is that labels can make evidence how healthy food is (as long as they are correct) but they are not magical things that decide by themselves this value.
So according to you two pumpkins from the same field would be healthy or not depending on what label they have? that makes no sense.
That is like saying that one pastry full of preservatives, sweeteners, artificial flavors and coloring would become more healthy as long as it is sold without any label (like for example in a bakery or donut shop).
And yet people consider useful to have that information already available without having to search for the specific variety of food. I mean, supermarkets also have homepages with the prices of everything written on the internet, but people like having the prices there to see on every product as well.
No it does not, you are making an invalid correlation from two independent things. Bread, donuts, street food, etc. are also frequently sold without labels, that does not make them "generally speaking" healthy. It just mean that is how they are sold. The nutritional value of something is not decided by it having or not a label. Not even "generally" that is the part where the logic simply does not hold.