Recently, a discussion came up with a friend about the concept of health ratings on food. It was suggested that, in the future, supermarket receipts could include a health rating for the food we purchase.
I bristled a bit, because such a system would depend on being able to say, with reasonable correctness, what is “healthy.” Yes, we could say “carrot” is healthier than “potato chip” but do we know enough about nutrition to craft such a scale beyond broad distinctions? Could we say with certainty whether an apple should have a higher score than an orange, or that low-fat cheese is absolutely better for you than full-fat?
Of course, there already are rating systems in place, and my friend’s point was that nutrition science hasn’t stopped just because we’ve created them. We continue to experiment and learn, and, as necessary, update such rating systems. The fact that we don’t know everything doesn’t mean that we shouldn’t publish the information that we do know.
Here in the Northeast, there’s a grocery chain that uses the NuVal system. Short for “nutritional value,” it was developed by a panel of scientists and academics from a variety of discplines, including biochemistry, endocrinology, and more. The system ranks items in the grocery store on a scale of 1 – 100, with 1 being the least healthy and 100 the most healthy. The score is displayed on the shelf label. But what exactly is this score?
The team worked for two years, referring to the most comprehensive science available, to develop the Overall Nutritional Quality Index (ONQI™), a patent-pending algorithm which converts complex nutritional information into a single, easy-to-use score. The ONQI™ algorithm is now the scientific engine behind the NuVal System, and together they are helping people make faster, easier, and better decisions about the foods they buy.
That is to say, the NuVal system seeks to apply a mathematical formula to food, in order to provide a quick gauge of healthfulness at the point of purchase and, hopefully, encourage better food choices. The score is the result of that formula. The effort should be lauded, as the translation of complex information into easily understandable terms is of the utmost importance when referring to food, medicine, and health. However, I have reservations about the actual process of this particular system.
At the very basest level, the scale works by taking a score of “good” nutrients (among them such things as fiber, potassium, calcium omega-3s, iron, vitamins, etc.) to use as numerator, and a score of “bad” nutrients (saturated fat, trans fat, cholesterol, sugar, sodium) as a denominator, dividing to achieve the score. While the nutrients are weighted differently, potential pitfalls exist nevertheless. One question springs to mind immediately: Does the scale differentiate between naturally occurring sugar and added sugar?
Presently on food labels, there is no requirement to state the amount of natural sugar and the amount of added sugar as separate numbers. In the case of fruits, this is not a problem (at least, I hope we’re not getting added sugar in our apples…) but with something like dairy, it’s a much bigger issue. A container of yogurt that has no added sugar can still have several grams of it naturally occurring, and thus cannot be directly compared to a yogurt that has sugar added. My assumption is that it is not distinguished for the purposes of the NuVal scale or the “bad” denominator, and sugar is sugar, lowering the score whether it’s an apple or a piece of candy.
And therein lies the problem. Leaving aside my hesitance to label foods and their components as categorically ‘good’ or ‘bad,’ such as the scale seeks to do, we’re once again trying to reduce foods to delivery systems for these nutrients. We’re once again ignoring the possible synergistic ability of the nutrients to create, as Michael Pollan might say, a food that is more than the sum of its nutrient parts. A scale such as NuVal tells us that nutrients cannot exist in any type of grey area. They are either good for us, or bad for us. As we’ve learned in recent history, this is not always the case. We’ve uncovered distinctions in types of cholesterol, and no longer can speak of it as solely a “bad” thing. We’ve learned after years of demonizing fat that it, too, has its place as a positive nutrient for the human body, depending on the type of fat. We’re beginning to understand that food and the food needs of the human body are far more complex than simply saying X is bad and Y is good.
For NuVal, the most interesting example comes in the case of fish. The concerns about mercury in our diets are acknowledged by the scale’s creators, but are subsequently ignored due to the belief that fish have more benefit than risk:
Regarding mercury content in certain seafood, the scientific literature shows that the net effect of eating fish regularly is a health benefit, in spite of the associated toxins. Consequently, the NuVal Scores provide reliable guidance to the role fish should play in the diet.
The NuVal score does not take into account “toxins” in food, stating that there is currently no standard for measuring toxins. While this is true, the fact that the creators specifically acknowledge that toxins cannot be gauged and are therefore ignored suggests to me a flaw in trying to create this scale in the first place. While fish are widely considered healthy, to not include their most detrimental factor in a scale measuring healthfulness artificially inflates their health score. Ignoring a known facet related to healthfulness hinders the integrity of attempting to use a mathematical formula, which should be immune to the whims of the people using it. If we are ignoring the mercury in fish in order to not lower its NuVal score, can we not also choose to ignore the cholesterol in egg yolks, because that’s where the vitamins are? Can we not ignore the sugar in fruit? The saturated fat in peanut butter? Perhaps the answer is not to ignore the toxins, but to first seek to create a standard for measuring them that could then be included in the score calculation.
This and many other issues suggest that food science still has a lot to learn. Science is never-ending, and that’s a good thing. All forward motion counts, and, as my friend pointed out, we should be sharing the most up-to-date breakthroughs. But we could perhaps find a way to impart the scientific information we have at the time more clearly, with greater weight given to accuracy of the science and the journalism than to snappy headlines that overpromise health benefits.
My friend asked, pragmatically, what I suggest, then, for a population that needs the information, but likely isn’t going to take the time to do a lot of in-depth analysis. A good question. The problem is that different things will work well for different people and their bodies. So really, the answer is, “Do what works for you.” But it’s hard to sell that, journalistically, when we crave specific advice. The answer, then, perhaps, is to make the information we have clear and understandable in a way that engages the reader and encourages continued interaction with health materials. If science is ongoing, so, too, must be the reading and understanding of that science by as many people as possible.
One day, maybe we’ll get to the point scientifically that we can say we’ve discovered the optimal diet, with the optimal amount of x, y, z nutrients. But I think we’re far away from that. Until we’re closer, I’m hesitant to rely on any type of scale that quantifies food by good/bad nutrients. I’m hesitant to rely on a scale that tells me skim milk is healthier than whole, because of that demonic fat.
If we must create a scale, perhaps we could consider one that ranks the amount of processing of a particular food: No processing for fresh fruits/veggies, some processing for flours, rices, and items with small lists of ingredients, all the way up to “there’s not really any actual food in here.” (Looking at you, Cheez-Wiz.)
I’m guessing we’re not going to see that any time soon, though. So for now, for me, it’s common sense. It’s fresh fruits and veggies in abundance and foods that are minimally processed. It’s cooking. NuVal may provide a guide, but for me, it’s a guide taken with a grain of salt.
Do you agree, disagree? Is there a rating system for foods at your grocery store and does it have any effect on your purchasing decisions when you shop?