Indices for the assessment of nutritional quality of meals: a systematic review

AbstractThis systematic review aimed to synthesise information on indices developed to evaluate nutritional quality of meals. A strategy for systematic search of the literature was developed using keywords related to assessment of meal quality. Databases searched included ScienceDirect, PubMed, Lilacs, SciELO, Scopus, Cochrane, Embase and Google Scholar. The literature search resulted in seven different meal quality indices. Each article was analysed in order to identify the following items: authors, country, year, study design, population characteristics, type of meal evaluated, dietary assessment method, characteristics evaluated (nutrients or food items), score range, index components, nutritional references, correlations performed, validation and relationship with an outcome (if existing). Two studies developed instruments to assess the quality of breakfast, three analysed lunch, one evaluated dinner and one was applied to all types of meals and snacks. All meal quality indices reviewed were based on the evaluation of presence or absence of food groups and relative contributions of nutrients, according to food-based guidelines or nutrient references, adapting the daily dietary recommendations to one specific meal. Most of the indices included three items as components for meal quality assessment: (I) total fat or some specific type of fat, (II) fruits and vegetables and (III) cereals or whole grains. This systematic review indicates aspects that need further research, particularly the numerous approaches to assessing meals considering different foods and nutrients, and the need for validation studies of meal indices.

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Evaluating the Consistency of the French Nutri-Score Front-of-Pack Scoring System with Canadian Dietary Guidelines

Current Developments in Nutrition ◽

10.1093/cdn/nzaa064_001 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1711-1711

Author(s):

Mavra Ahmed ◽

Kacie Dickinson ◽

Laura Vergeer ◽

Christine Mulligan ◽

Beatriz Franco-Arellano ◽

...

Keyword(s):

Nutritional Quality ◽

Saturated Fat ◽

Dietary Guidelines ◽

Food Groups ◽

Food Label ◽

Dietary Recommendations ◽

University Of Toronto ◽

High Consistency

Abstract Objectives Nutrient profiling (NP) models, underpinning front-of-pack (FOP) labelling, can guide consumers towards healthier food choices and should be aligned with food-based dietary guidelines. In France, [the FSAm/HCSP NP model], underpinning the Nutri-Score (NS) FOP, ranks foods on both nutrients-to-limit (saturated fat, sodium, sugar) and nutrients-to-encourage (e.g., protein, fibre, fruits, vegetables, legumes and nuts) and was found to adequately align with dietary recommendations in Europe. However, investigations on the comparable ranking of foods by the FSAm/HCSP NP model with the new Canadian dietary guidelines is lacking. The objective was to assess the ability of the NS to discriminate the nutritional quality of foods and beverages in the Canadian food supply and their consistency with nutritional recommendations according to the Canada's 2019 Food Guidelines (CFG). Methods Using the University of Toronto Food Label Information Program 2017 database (n = 17,360), the nutritional scores for prepackaged foods and beverages were derived using the NS. These scores correspond to five grades of nutritional quality, ranging from green (A; highest quality) to red (E; lowest quality). Scores were assessed as binary where A/B were considered ‘in alignment’ with CFG recommendations while C/D/E were considered ‘not in alignment’. Results The NS system classified 21% of products as A, ranging from 99% of legumes to 0.45% of the sugars/sweets. The NS was able to discriminate the nutritional quality of foods within the same food groups (based on display of three grades represented within the Nutri-Score). Overall, there was 73% agreement between NS and CFG, ranging from 48% for combination dishes to 95% for eggs/egg substitute categories. The classification of foods according to the NS was consistent with the CFG; foods for which consumption is recommended were more favourably classified (e.g., 76% of vegetables were classified as A or B) than foods for which consumption should be limited (e.g., 79% of snacks were classified as C/D/E). Conclusions The NS FOP system is an effective tool to discriminate products across and within food categories. The classification of different food groups in the NS displayed a high consistency with the new Canadian dietary guidelines. Funding Sources Sanofi-Pasteur University of Toronto Université Paris-Descartes Collaborative Grant.

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Performance of the Front-of-Pack Nutrition Label Nutri-Score to Discriminate the Nutritional Quality of Foods Products: A Comparative Study across 8 European Countries

Nutrients ◽

10.3390/nu12051303 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1303 ◽

Cited By ~ 2

Author(s):

Louise Dréano-Trécant ◽

Manon Egnell ◽

Serge Hercberg ◽

Pilar Galan ◽

Juliette Soudon ◽

...

Keyword(s):

Nutritional Quality ◽

Nutritional Composition ◽

European Countries ◽

Food Groups ◽

Dietary Recommendations ◽

Animal Fat ◽

Nutritional Recommendations ◽

Vegetable Products ◽

Quality Of Products

In Europe, discussions are currently ongoing to harmonize front-of-pack nutritional labelling, while some countries have adopted or are considering implementing the Nutri-Score. However, its adaptability to multiple nutritional contexts in Europe requires further investigation. This study aimed to evaluate the applicability of the Nutri-Score in various European countries, regarding its ability to discriminate the nutritional quality of foods and its consistency with national dietary recommendations. The European Food Information Resource (EUROFIR) nutritional composition databases from eight European countries (Finland, France, Norway, Poland, Portugal, Slovakia, Sweden, and Switzerland) were used. The distribution of foods across the Nutri-Score classes within food groups was assessed, as well as the discriminating performance of the label, and the adequacy of nutritional recommendations. The Nutri-Score demonstrated high discriminating ability for all food groups, with similar trends in the eight countries, and consistency with nutritional recommendations. For instance, fruit and vegetable products were mainly classified in the two healthiest Nutri-Score categories, while sugar and animal fat products were mainly classified in the two less healthy categories of the Nutri-Score. Our results support the fact that the Nutri-Score would be a relevant tool to discriminate the nutritional quality of products within and across relevant food groups in different European countries, with consistency with nutritional recommendations.

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The impact of environmental changes on the yield and nutritional quality of fruits, nuts and seeds: a systematic review

Environmental Research Letters ◽

10.1088/1748-9326/ab5cc0 ◽

2020 ◽

Vol 15 (2) ◽

pp. 023002 ◽

Cited By ~ 5

Author(s):

Carmelia Alae-Carew ◽

Salina Nicoleau ◽

Frances A Bird ◽

Poppy Hawkins ◽

Hanna L Tuomisto ◽

...

Keyword(s):

Systematic Review ◽

Nutritional Quality ◽

Environmental Changes ◽

The Impact

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Nutritional Quality of Breakfast Consumed by the Low-Income Population in Brazil: A Nationwide Cross-Sectional Survey

Nutrients ◽

10.3390/nu11061418 ◽

2019 ◽

Vol 11 (6) ◽

pp. 1418 ◽

Cited By ~ 4

Author(s):

Janice Ramos de Sousa ◽

Raquel B. A. Botelho ◽

Rita de Cássia C. A. Akutsu ◽

Renata Puppin Zandonadi

Keyword(s):

Fatty Acids ◽

Low Income ◽

Nutritional Quality ◽

Trans Fatty Acids ◽

Saturated Fatty Acids ◽

Monounsaturated Fatty Acids ◽

Food Groups ◽

Cross Sectional ◽

The Mean

Objective: This study aimed to characterize the nutritional quality of breakfast consumed by the low-income Brazilian population. Methods: A cross-sectional study was conducted with a sample of 1547 low-income individuals attending 36 Community Restaurants (CRs) in Brazil. Food consumption was analyzed by the frequency of food groups presented in the 24 h recall for three days. The nutritional consumption consisted of the analysis of the total energetic value (TEV) and the macronutrients, fibers, monounsaturated fatty acids, saturated fatty acids, trans fatty acids, calcium, and sodium. The nutrients were evaluated considering the percentage of contribution concerning the daily recommendation of consumption. Results: Among the 4641 breakfasts expected to be consumed and reported, 17.2% (n = 797) of the consumers did not consume breakfast. Therefore, we analyzed the 3844 breakfasts. The analysis of food groups showed a high consumption of dairy and cereals, and low consumption of fruits, roots/tubers, and meat/eggs. The percentages of energy contribution of the macronutrients in the TEV were adequate for a balanced diet. The mean intake of monounsaturated fatty acids was low, and the contribution percentages of saturated fatty acids and trans fatty acids were within the recommendations. The mean fiber intake of the breakfast was low, agreeing with the result of low fruit consumption. Calcium intake covered 73.49% of that expected for this meal, and sodium intake was adequate in breakfast. Conclusion: The individuals studied consumed a nutritionally balanced breakfast. Although dairy was one of the most consumed groups, calcium consumption was low, indicating the need to consume higher portions of food sources of this nutrient.

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Frequently Consumed Foods and Energy Contributions among Food Secure and Insecure U.S. Children and Adolescents

Nutrients ◽

10.3390/nu12020304 ◽

2020 ◽

Vol 12 (2) ◽

pp. 304 ◽

Cited By ~ 1

Author(s):

Heather A. Eicher-Miller ◽

Carol J. Boushey ◽

Regan L. Bailey ◽

Yoon Jung Yang

Keyword(s):

Food Security ◽

Children And Adolescents ◽

Dietary Assessment ◽

Age Groups ◽

Assessment Tools ◽

Nutritional Risk ◽

Food Groups ◽

Dietary Recommendations ◽

Chi Square ◽

Food Security Status

Food insecurity is associated with nutritional risk in children. This study identified and compared the most frequently consumed foods, beverages, and food groups and their contributions to energy intake among U.S. children and adolescents (6–11, 12–17 years) by food security status. Dietary intake from the day-1, 24-h dietary recall, and household child food security status were analyzed in the 2007–2014 National Health and Nutrition Examination Survey (n = 8123). Foods and beverages were classified into food categories, ranked, and compared by weighted proportional frequency and energy contribution for food security groups by age. Significant differences between household child food security groups were determined using the Rao-Scott modified chi-square statistic. The weighted proportional frequency of beverages (including diet, sweetened, juice, coffee, and tea) and their energy was significantly higher among food insecure compared with food secure while the reverse was true for water frequency among 12–17 years. Beverage and mixed dish frequency were higher among food insecure compared with food secure 6–11 years while the reverse was true for frequency and energy from snacks. Frequency-differentiated intake patterns for beverages and snacks by food security across age groups may inform dietary recommendations, population-specific dietary assessment tools, interventions, and policy for food insecure children.

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Food and beverage purchases in corner stores, gas-marts, pharmacies and dollar stores

Public Health Nutrition ◽

10.1017/s1368980016002524 ◽

2016 ◽

Vol 20 (14) ◽

pp. 2587-2597 ◽

Cited By ~ 19

Author(s):

Caitlin E Caspi ◽

Kathleen Lenk ◽

Jennifer E Pelletier ◽

Timothy L Barnes ◽

Lisa Harnack ◽

...

Keyword(s):

Nutritional Quality ◽

Healthy Eating Index ◽

Traditional Food ◽

Dietary Recommendations ◽

Food Stores ◽

Sweetened Beverages ◽

Food Retailers ◽

Corner Stores ◽

Food And Beverage

Abstract Objective Little is known about customer purchases of foods and beverages from small and non-traditional food retailers (i.e. corner stores, gas-marts, dollar stores and pharmacies). The present study aimed to: (i) describe customer characteristics, shopping frequency and reasons for shopping at small and non-traditional food retailers; and (ii) describe food/beverage purchases and their nutritional quality, including differences across store type. Design Data were collected through customer intercept interviews. Nutritional quality of food/beverage purchases was analysed; a Healthy Eating Index-2010 (HEI-2010) score for purchases was created by aggregating participant purchases at each store. Setting Small and non-traditional food stores that were not WIC-authorized in Minneapolis and St. Paul, MN, USA. Subjects Customers (n 661) from 105 food retailers. Results Among participants, 29 % shopped at the store at least once daily; an additional 44 % shopped there at least once weekly. Most participants (74 %) cited convenient location as the primary draw to the store. Customers purchased a median of 2262 kJ (540 kcal), which varied by store type (P=0·04). The amount of added sugar far surpassed national dietary recommendations. At dollar stores, participants purchased a median of 5302 kJ (1266 kcal) for a median value of $US 2·89. Sugar-sweetened beverages were the most common purchase. The mean HEI-2010 score across all stores was 36·4. Conclusions Small and non-traditional food stores contribute to the urban food environment. Given the poor nutritional quality of purchases, findings support the need for interventions that address customer decision making in these stores.

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A method to improve the nutritional quality of foods and beverages based on dietary recommendations

European Journal of Clinical Nutrition ◽

10.1038/sj.ejcn.1602548 ◽

2006 ◽

Vol 61 (4) ◽

pp. 461-471 ◽

Cited By ~ 57

Author(s):

C A J Nijman ◽

I M Zijp ◽

A Sierksma ◽

A J C Roodenburg ◽

R Leenen ◽

...

Keyword(s):

Nutritional Quality ◽

Dietary Recommendations

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A proposed method to determine fumonisin exposure from maize consumption in a rural South African population using a culturally appropriate FFQ

Public Health Nutrition ◽

10.1017/s1368980012004946 ◽

2012 ◽

Vol 17 (1) ◽

pp. 131-138 ◽

Cited By ~ 4

Author(s):

Martani Lombard ◽

Nelia Steyn ◽

Hester-Mari Burger ◽

Karen Charlton ◽

Wentzel Gelderblom

Keyword(s):

Focus Group ◽

Oesophageal Cancer ◽

Dietary Assessment ◽

Assessment Method ◽

Food Groups ◽

Snowball Sampling ◽

Focus Group Discussions ◽

Group Discussions ◽

Food Items ◽

Increased Risk

AbstractObjectiveTo develop an FFQ for estimating culture-specific maize intake that can distinguish between home-grown and commercial maize. Home-grown maize is more likely to be contaminated with fumonisins, mycotoxins that are associated with increased risk of oesophageal cancer.DesignAn existing FFQ developed for use in urban Xhosa populations was used as the initial framework for the maize-specific FFQ (M-FFQ). The existing questionnaire contained 126 food items divided into ten food groups (bread, cereals, vegetables, fruit, meat, dairy, snacks, condiments, beverages and fat). The M-FFQ was developed based on additional data obtained from a literature search, 24 h recalls (n159), in-depth interviews (n4), focus group discussions (n56) and expert consultation. Food items available in local shops (n3) were compared with information obtained from focus group discussions.SettingFive villages in two rural isiXhosa-speaking areas of the Eastern Cape Province, known to have a high incidence of oesophageal cancer, were randomly selected.SubjectsWomen aged 18–55 years were recruited by snowball sampling and invited to participate.ResultsThe final M-FFQ comprised twenty-one maize-based food items, including traditional Xhosa dishes and beverages. The questionnaire focused on maize-specific dishes and distinguished between home-grown maize and commercial maize consumption.ConclusionsA culturally specific dietary assessment method was designed to determine maize consumption and therefore fumonisin exposure. The questionnaire will be tested against 24 h recalls and other methods to determine its validity, after which it will be used in various epidemiological studies to determine fumonisin exposure.

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Nutritional quality of foods and beverages on child-care centre menus in Mexico

Public Health Nutrition ◽

10.1017/s1368980012004387 ◽

2012 ◽

Vol 16 (11) ◽

pp. 2014-2022 ◽

Cited By ~ 11

Author(s):

Sara E Benjamin Neelon ◽

Hortensia Reyes-Morales ◽

Jess Haines ◽

Matthew W Gillman ◽

Elsie M Taveras

Keyword(s):

Child Care ◽

Nutritional Quality ◽

Energy Content ◽

High Energy ◽

Whole Grains ◽

Nutrition Intervention ◽

Food Groups ◽

Child Care Centre ◽

Food Category

AbstractObjectiveThe purpose of the present study was to assess the nutritional quality of foods and beverages listed on menus serving children in government-sponsored child-care centres throughout Mexico.DesignFor this cross-sectional menu assessment, we compared (i) food groups and portion sizes of foods and beverages on the menus with MyPlate recommendations and (ii) macronutrients, sugar and fibre with Daily Reference Intake standards.SettingMenus reflected foods and beverages served to children attending one of 142 government-sponsored child-care centres throughout Mexico.SubjectsThere were fifty-four distinct menus for children aged 4–6 months, 7–9 months, 10–12 months, 13–23 months, 24–47 months and 48–72 months.ResultsMenus included a variety of foods meeting minimum MyPlate recommendations for each food category except whole grains for children aged 48–72 months. Menus listed excessive amounts of high-energy beverages, including full-fat milk, fruit juice and sugar-sweetened beverages for children of all ages. The mean daily energy content of menu items yielded an average of 2·76 MJ for infants, 4·77 MJ for children aged 13–23 months, 5·36 MJ for children aged 24–47 months and 5·87 MJ for children aged 48–72 months. Foods and beverages on menus provided sufficient grams of carbohydrate and fat, but excessive protein.ConclusionsMenus provided a variety of foods but excessive energy. Whole grains were limited, and high-energy beverages were prevalent. Both may be appropriate targets for nutrition intervention. Future studies should move beyond menus and assess what children actually consume in child care.

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How many meals should I eat each day?

EDIS ◽

10.32473/edis-fs313-2018 ◽

2018 ◽

Vol 2018 (4) ◽

Author(s):

Wendy Dahl ◽

Zainab Alyousif

Keyword(s):

Older Adults ◽

Nutritional Quality ◽

Good Health ◽

Food Groups ◽

Healthy Older Adults ◽

Total Food

For older adults who want to stay healthy, it’s a common question. Should I eat three meals a day or is two meals adequate? Also, should I eat snacks between my meals? For healthy older adults, the number of meals may not matter as much as the total food eaten in a day. It is the nutritional quality of your meals and snacks and the total calories eaten that are most important. Aiming to meet the recommended servings of food groups, i.e. fruits, vegetables, grains, protein foods, and dairy will help promote good health and prevent illness.

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