The Nutrivore Rating – The Paleo Mother

How Nutrient Profiling Might Inform Dietary Pointers

It makes vastly extra sense to plan 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 reality, there was a 2104 examine of individuals over the age of 55 that confirmed that the upper the NRF9 of their weight-reduction plan as an entire, the decrease their threat of all-cause mortality—the very best NRF9 quartile had a 16% decrease likelihood of dying than the bottom NRF9 quartile. This examine helps to show that probably large well being advantage of a weight-reduction plan replete with nutrient-dense meals, however extra research like this that incorporate much more vitamins into the calculus are essential to advance this subject of analysis.

For instance how essential it’s to take a complete strategy to nutrient profiling, check out how ten complete 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 are included in a calculation, when following the NRF mannequin which doesn’t cap a nutrient at 100% DV, the upper the rating will be—that’s why each meals has the next rating when extra vitamins are taken under consideration. Nevertheless, 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 additionally the unfold between the scores. The extra vitamins used within the calculus, the better it’s to distinguish between probably the most nutrient-dense meals and the least. Given what a nutrient powerhouse liver is, it simply is smart that its rating could be vastly larger than, say, hen breast.

The above desk additionally helps as an instance how a single nutrient can dramatically shift the nutrient profiling rating of a selected meals. For instance, zinc just isn’t 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 People largely as a result of zinc-rich meals are few and much between and people which are, like oysters, aren’t a typical meals on the Customary American Food plan. In reality, a single serving of oysters comprises 174% DV of zinc! As quickly as zinc is added to the rating, oysters rank far more extremely, which is smart since they’re such a precious 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 similar time, it emphasizes the excessive caloric density and low nutrient density of grains and dairy merchandise.  This info could be tremendous helpful have been it included into the USDA dietary tips, serving to individuals to establish 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 improve serum lipids for most individuals and is the spine of vitamin D and different steroid hormones. Dietary saturated fats is barely problematic when consumption exceeds about 15% of complete energy (though this does rely on genetic predisposition, see Saturated Fats: Healthful, Dangerous, or Someplace In Between? and Genes to Know About: ApoE). Sodium is barely problematic when consumption exceeds about 7 grams per day, and there are research exhibiting that even this stage is barely worrisome when potassium consumption is concomitantly low, see Is Salt Paleo?. Added sugars grow to be 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 reasonable quantities, and solely unhealthy when the entire weight-reduction plan contains extra. And, all of those probably problematic vitamins are considerable in quick meals, junk meals and different hyperpalatable manufactured meals which are additionally low in important vitamins and really excessive in energy—for this reason 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 weight-reduction plan as an entire, and has the capability to undervalue in any other case nutrient-dense complete meals which may match right into a health-promoting weight-reduction plan, whereas not being needed to indicate 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 selected nutrient per serving makes that meals a really precious supply of that nutrient! There’s no such factor as a nutritionally full meals, so the aim is nutrient sufficiency of the whole weight-reduction plan, not of anyone explicit meals. Thus, it’s essential to grasp mix meals which are 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 skill 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 the event 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 smart to totally 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 smart 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 are significantly good sources of the vitamins that, for instance, an estimated 70% or extra of People routinely don’t devour sufficient of (vitamin B9, vitamin D, vitamin E, choline, calcium, potassium, zinc, omega-3 fat, and polyphenols) had inflated scores because of weighting these vitamins extra closely in nutrient profiling, meals sources of different vitamins find yourself being undervalued. This strategy has the capability to shift meals decisions in a manner that might assist handle some inhabitants stage 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 finest describes a meals when it contains as many vitamins as doable, when the contribution of vitamins aren’t capped at 100% DV, when they’re offered relative to energy, when they aren’t weighted by meals teams, and when they aren’t normalized to a hard and fast scale.

Shopper-Centered Nutrient Profiling

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

The ANDI rating could also be one of the crucial complete nutrient profiling methods, however the rating overemphasizes vitamins inherent to plant meals whereas deemphasizing vitamins inherent to animal meals, making a biased consequence. 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 kinds 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 kinds of phytonutrients (flavonoids and carotenoids) are included, whereas vitamin Okay and choline are excluded. As well as, as a result of each ldl cholesterol and saturated fats are penalized (even if whether or not these are problematic is solely context-dependent), animal meals are penalized unnecessarily.

The Guiding Stars system rewards complete 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 Diet IQ system additionally rewards complete grains, makes use of only some vitamins in its willpower, and likewise penalizes for saturated fats and sodium. The web consequence 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 closing problem to nutrient profiling: incomplete knowledge.

America Division of Agriculture maintains arguably probably the most complete nutrient database on the earth, known as Meals Central, with expanded nutrient knowledge compiled for over 7,000 fundamental meals and partial nutrient knowledge (a minimum of what’s required on meals label) for almost 360,000 completely different branded meals. However, even this wonderful database is lacking some key info. Most of the important 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 just isn’t 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 usually present common measurements for frequent high quality meals merchandise, so it’s not doable to distinguish the nutrient content material of upper high quality choices. And, whereas many of those gaps will be stuffed in from measurements offered in scientific research, it’s stunning to find how incomplete human information 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 doable lacking from the USDA Meals Central database (which my workforce and I are doing), label when a nutrient-density rating is calculated primarily based on incomplete knowledge, and advocate for continued measurements of the nutrient content material of meals.

How the Nutrivore Rating Is Calculated

The Nutrivore Rating is at present 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 knowledge.

The Nutrivore Rating is calculated primarily based on 32+1 vitamins. The 32 major 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 every time doable. 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 1 particular measurement, and offered it’s no multiple commonplace deviation from the imply of all accessible knowledge (through which case, the second highest worth is utilized following the identical statistical check). 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 knowledge. That is famous wherever it’s the case.

Additional, the Nutrivore Rating provides the very best worth of obtainable knowledge for one bonus nutrient (that’s the +1), relative to a threshold set utilizing epidemiological research for that nutrient, just like a %DV. The bonus nutrient at present will 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 knowledge 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 just isn’t 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 overall vitamin Okay within the weight-reduction plan, solely 10 to fifteen% of it’s absorbed within the digestive tract, the online impact being that vitamin K1 accounts for about half of the overall absorbed vitamin Okay, whereas vitamin K2 is extremely absorbable and represents the remaining 50% (see TWV Podcast Episode 417: Vitamin K2, Hype, or Important?).  Whereas vitamin Okay isoform knowledge is accessible for some meals within the USDA Meals Central database, as a common rule, nutrient isoform knowledge is never accessible, making correcting for absorption or utilization effectivity of various nutrient varieties unimaginable. It’s additionally true that sure combos of vitamins can both improve or hinder absorption. For instance, vitamin C can improve iron absorption, fat can improve carotenoid and vitamin Okay absorption, however zinc and copper compete for absorption as do calcium and magnesium. Nevertheless, 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 elements impartial of meals. For instance, vitamin D standing influences calcium absorption; a functioning gallbladder is important 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 all the meals consumed at a meal in addition to different elements reminiscent of genetics, it is unnecessary 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 said to macronutrient and water combos from a complete meal relatively than a person meals.

Somewhat 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 power density, which means extra energy per gram or per serving of meals, which does decrease the Nutrivore Rating. As well as, the presence of antinutrients reminiscent of phytates or oxalates aren’t taken under consideration. It is because the affect 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, numerous intestine microbiome can usually degrade about half (about 500 to 600 mg day by day) of the phytate consumed within the common American weight-reduction plan. Different elements influencing bioavailability embrace well being of the gastrointestinal tracts, nutrient standing, aggressive binding with different vitamins, meal composition, numerous medicine 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 possibly can consider the Nutrivore Rating as a easy but complete illustration of the inherent vitamins inside a meals, and acknowledge that a wide range of elements will decide whether or not or not your physique absorbs and makes use of all of these vitamins.

As a result of vitamins will be misplaced, fashioned and reworked by cooking, the Nutrivore Rating is calculated primarily based on the vitamins throughout the uncooked complete meals, except famous in any other case. Additionally, it’s uncommon for there to be nutrient knowledge for various high quality ranges of a meals. For instance, the Meals Central database comprises just one entry for olive oil, however analysis has proven that the polyphenol content material of virgin olive oil can vary from anyplace between 50 to 5000 mg/kg, and the vitamin E content material can vary from 100 to over 1000 mg/kg. One other instance: though locally-grown, in-season natural greens and fruit and identified to have larger nutrient density (because of being grown in larger 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. For that reason, we are able to consider Nutrivore Scores at least or common worth and really feel assured that the trouble to hunt out larger 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 precious if at present not quantifiable.

As extra nutrient knowledge grow to be accessible, the Nutrivore Rating shall be up to date to mirror extra full dietary info. This clearly applies to lacking vitamin info 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 present utilized to calculate the Nutrivore Rating may all be added as soon as there may be adequate knowledge to rationalize their inclusion. For now, extraordinarily sparse knowledge makes this prohibitive, and equally would reward meals merely for being higher studied, not essentially for inherently larger dietary worth, relative to much less frequent meals.

Utilizing the Nutrivore Rating

It’s time for a constructive strategy to dietary steerage utilizing nutrient density as a fundamental precept.  The Nutrivore Rating is a needed foundational step in the direction of attaining this aim! By understanding the vitamins per calorie provided by particular person meals by way of the Nutrivore Rating, along with recognition that sure vitamins are unique to particular meals teams, we are able to 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’ll be able to see with the pattern nutrient card above, I’m additionally highlighting the vitamins per serving (relatively 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 info with a overview of the scientific literature on the precise well being impacts of consuming a meals, and detailed info on what vitamins do within the physique and the way a lot of them we’d like. And, I’m creating academic assets on choose numerous meals with complementary vitamin to attain nutrient sufficiency!

I’m constructing this web site outdoors of any dietary dogma. Being a Nutrivore is concerning the total high quality of the entire weight-reduction plan, and never a couple of listing of yes-foods and no-foods. Although eliminating empty calorie meals helps to attain nutrient sufficiency with out overeating, no meals is strictly off-limits. On this manner, being a Nutrivore is a weight-reduction plan modifier relatively than a weight-reduction plan itself—a Nutrivore strategy will be layered atop of different dietary buildings and priorities so as to meet a person’s particular well being wants and targets.

I see Nutrivore because the pure extension of my science-grounded strategy, and one that can permit me to each stage up the depth of my assets for my long-time readers who love my science deep dives, but additionally meet individuals the place they’re and embrace the concept that 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 aim of serving to individuals obtain dietary nutrient sufficiency (a.ok.a. Nutrivore) by way of knowledgeable day-to-day decisions.

The Nutrivore Rating is a measure of a lot vitamins, relative to the day by day worth (DV), a meals comprises per calorie. A nutrient-dense powerhouse superfood is any meals with a Nutrivore Rating larger 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. Keep in mind, there aren’t any yes-foods and no-foods on a Nutrivore strategy, however as a substitute what issues is whether or not the weight-reduction plan as an entire meets the physique’s dietary wants. Total dietary nutrient sufficiency is straightforward to attain 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 somewhat extra nutrient-dense than inexperienced kiwis? Or that darkish meat turkey is extra nutrient-dense than gentle 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 info in my new e-book, Information to Nutrivore!

Introducing the Information to Nutrivore E-E book!

Information to Nutrivore lays the inspiration for Nutrivore as a common well being strategy, a base dietary philosophy devoid of dogma, on high of which you’ll be able to layer extra meals focus or eliminations to fulfill particular person wants. On this sense, being a Nutrivore is a weight-reduction plan modifier relatively than a weight-reduction plan itself.

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

• find out how a Nutrivore strategy can enhance well being
• admire what important and nonessential vitamins do within the physique
• get sensible recommendations on improve nutrient-density
• study use the Nutrivore Rating to decide on more healthy meals
• discover detailed vitamin info on the High 100 Nutrivore Rating Meals
• examine 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 eat a Nutrivore weight-reduction plan and introduces the Nutrivore Rating, probably the most complete and least-biased technique to evaluate the nutritive worth of particular person meals.  Detailed vitamin info for the High 100 Nutrivore Rating Meals is summarized with lovely graphics for every meals. And, the Information to Nutrivore contains evaluation of meals teams, issues when making ready Nutrivore meals, sensible tricks to improve the nutrient density of your weight-reduction plan, and a look-up desk for the Nutrivore Rating of roughly 300 meals.

Nutrivore Scores of Frequent Meals

And, whilst you look ahead to 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, Purple – 1358
• Blueberries – 396
• Brazil Nuts – 694
• Broccoli – 2833
• Butternut Squash – 670
• Cheddar Cheese – 126
• Chia – 450
• Rooster, 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, Complete – 178

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

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Citations

Chiuve SE, Sampson L, Willett WC. The affiliation between a dietary high quality index and threat of persistent illness. Am J Prev Med. 2011 Could;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 weight-reduction plan 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 commonplace 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 steerage. 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 Could;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 power density and power value. Eur J Clin Nutr. 2009 Could;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 Could 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 establish wholesome, reasonably priced 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 Complete Environ. 2021 Oct 1;789:147936. doi: 10.1016/j.scitotenv.2021.147936. Epub 2021 Could 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. Utility 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 Research. 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 power prices: an econometric strategy 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 constructive strategy to dietary steerage 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 apply. J Am Coll Nutr. 2009 Aug;28(4):427S-435S. doi: 10.1080/07315724.2009.10718107. PMID: 20368383.

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

Murakami Okay, 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.