How should Food Compass be used in practice?

Food Compass is intended to help individuals and organizations meet their dietary goals. It is designed to be used along with food-based dietary guidelines and other criteria.  Within the parameters of your food-based dietary goals and dietary pattern, Food Compass can be used to help make choices based on the best available science.

What if I follow a special diet?

If you follow a special diet, for example DASH, Mediterranean, vegetarian, vegan, low-carb, keto, paleo, low-fat, or others, then Food Compass can help you select foods within your overall preferences that are more or less likely to contribute to your health and well-being.

Is Food Compass intended for patients with diabetes or other medical conditions?

Food Compass is designed for general nutritional guidance for the population.  Planned next steps include customization for specific disease conditions, such as for diabetes or obesity, which could alter the scoring and rankings.

How does Food Compass compare to other existing nutrient profiling systems?

One aim of this research was to improve upon existing, widely used nutrient profiling systems, such as Nutri-Score and Health Star Rating that are used in the EU, United Kingdom, Australia, and New Zealand.  We also compared Food Compass to NOVA, a classification system based on the processing of foods.  Our research assesses and reports on how Food Compass compares to these three other scoring systems.  See the Data page for some examples, and the full paper for ratings of more than 8,000 food and beverage items using all four systems.

Is Food Compass is a validated measure of the overall healthfulness of foods and beverages? How would one measure that?

Yes, Food Compass is validated against more nutritious diets as well as better health outcomes.  In our research, we have shown that people who eat more foods with higher Food Compass scores, and fewer foods with low Food Compass scores, have overall healthier diets.  In addition, eating foods and beverages with higher Food Compass scores is associated with many favorable health outcomes.  We conducted this analysis using a large, nationally representative dataset of almost 50,000 Americans and product-level dietary  data.  Our analyses considered and accounted for other critical factors in health outcomes, such as age, sex, race ,ethnicity, income, education, smoking, and physical activity.

Our research showed that individuals having diets with higher Food Compass scores had better health markers and lower risk of all-cause mortality.  This included lower blood pressure, lower LDL cholesterol, higher HDL cholesterol, lower body mass index, and lower hemoglobin A1c levels, as well as lower prevalence of metabolic syndrome and cancer and a higher prevalence of optimal metabolic health.

Why do some grain and cereal products score higher than animal products like eggs, cheese, or meat, and why do some plant-based products score lower than animal products?

The scientific evidence actually doesn’t strongly support making nutritional distinctions based on just the plant or animal origin of a food.  Animal products like fish and yogurt can be quite healthy, other minimally processed animal products like eggs, cheese, and unprocessed red meat are often fine in moderation, and others that are more highly processed should be minimized.  Similarly, plant-based foods can vary widely in healthfulness based on their contents of whole grains, fiber, protein, and other nutrients, and on their processing characteristics and additives. For example, Food Compass scores for white bread, white rice, and refined starch breakfast cereals are generally much lower than for most animal products.

Why is there so much variation in scores for different egg, poultry, fish, and red meat products?

The calculated scores are based on a nationally representative sample of food products eaten by Americans. These products are evaluated “as consumed.” So, the scores for an egg product reflects not just the eggs, but also the cooking and preparation: for example, the type of fat used, salt added, other ingredients (veggies, cheese, etc.), and so on. The same is true for poultry, fish, and red meat products.
We are working on scoring a much larger database of food and beverage products “as purchased” in the grocery store. Stay tuned for these scores. In the meantime, you can look for the scores for raw fish or eggs in the current dataset to see how these might score “as purchased.”

Why do some breakfast cereals score higher than some eggs, cheese, or red meat?

The current science supports eating foods rich in whole grains and dietary fiber (prebiotics for the gut microbiome) as a generally healthier choice than eggs, cheese, or red meat, which are also often fine in moderation.* The scoring of breakfast cereals depends on their balance of whole grains, fiber, protein, sodium, vitamins and minerals, added sugar, processing, and more. Cereals that score highly will tend to be mostly or all whole grain and high in minerals and dietary fiber, with few added sugars and sodium. Cereals that score poorly will tend to be mostly refined starch and added sugar. Cereals that score in the middle will tend to be a mix of whole grains, fiber, and added sugar. One of the major advances of Food Compass, compared to other common nutrient profiling systems, is the negative scoring of refined grains and starch, resulting in low scores for cereals, breads, and crackers that are mostly refined grains — even when they have no added sugars or are fortified with vitamins and minerals. Thus, cereals, breads, and crackers that contain mostly refined starch and/or sugar generally score lower than many egg, cheese, poultry, or red meat items.
The Food Compass system also includes negative processing points for artificial colorings, artificial flavorings, and corn syrup, but data on these additives were not available in the USDA Food and Nutrient Database for Dietary Studies (FNDDS) used for our research to-date. So, cereals containing these additives should score lower than reported in our current scoring summaries, and we hope to obtain and add such data in future work.
If you prefer eggs for breakfast, look for higher scoring egg preparations; and if you prefer breakfast cereal, look for higher scoring cereals. And even better, add other highest scoring foods to your plate — like vegetables and healthy oils to your eggs, and fruit and nuts to your cereal — to increase the Food Compass score and healthfulness of your meal.

Are naturally occurring vs. fortified vitamins and minerals scored differently?

Not yet.  It might be helpful to score naturally occurring vs. fortified vitamins and minerals separately.  However, current food composition databases don’t allow this discrimination for most nutrients, making this a potential priority for companies to report on in the future.

Isn’t processing of food the most important consideration?

We don’t believe an algorithm based on processing alone is sufficiently consistent with the scientific evidence for the full health effects of foods. Such a system does not help distinguish between different processed foods, which might have very different impacts on health.  Processing is one factor – and an important one, which is part of the Food Compass score – but other factors should be considered as well.

Will Food Compass work perfectly for every product?

The Food Compass is based on 54 attributes of each item, selected based on the strength of scientific evidence for their average impacts on human health. Other compounds and characteristics present in food could also matter. The Food Compass maps those attributes to measure differences in 9 distinct dimensions, like the points of a compass, and then combines the dimensions into a single score for overall contribution to a healthy diet. We aimed to make the scoring system as accurate and consistent as possible, based on the best current science.  But any scoring system that is consistent and objective across thousands of foods, beverages, and mixed meals will work better for some aspects of diet quality than for others. The aim is the best possible scoring across a multitude of food choices.

Is the science and scoring of the Food Compass complete?

Like all science, our work on Food Compass is iterative, and we will continue to update the algorithm based on our research and the latest science. We believe the evidence supports Food Compass as the best overall nutrient profiling system available today, but of course it’s not perfect. We look forward to continuing to improve it. See Current Work for our ongoing goals.

* In randomized controlled trials, consumption of whole grain foods improves glucose-insulin control, LDL cholesterol, and possibly vascular function and inflammation;1 while dietary fiber reduces blood pressure and LDL cholesterol.  Consistent with these benefits, intake of foods containing whole grains or dietary fiber is associated in long-term observational studies with lower risk of long-term weight gain, diabetes, coronary heart disease, and certain cancers.2-5

Conversely, intakes of refined grains, starches, and added sugars are associated with adverse health outcomes, including long-term weight gain, diabetes, and coronary heart disease.6-9 Metabolic feeding studies confirm harms of refined carbohydrates,10 while clinical trials demonstrate weight loss and improved blood sugar control on diets that reduce refined carbohydrates and glycemic load.11-13 For foods containing a mix of grains and/or sugars, the ratio of total carbohydrate to fiber provides one useful measure of healthfulness, aiming to balance the relative proportions of whole grains, bran, refined starch, and sugars.14-17  Food Compass incorporates each of these factors, including contents of whole grain, dietary fiber, added sugar, and the ratio of carbohydrate to fiber; as well as other factors like protein, sodium, vitamins and minerals, degree of processing, and more.

In contrast to evidence for benefits of whole grains and dietary fiber and harms of refined starches and sugars, the current science suggests that several minimally processed animal products are generally neutral for major health endpoints. In prospective observational studies, intakes of eggs and poultry are generally not associated with risk of cardiovascular events, diabetes, or cancers.5,18-21 In a few studies among patients who already have diabetes, eating eggs and dietary cholesterol is linked to higher risk of cardiovascular events, suggesting a potential interaction for cardiovascular endpoints between insulin resistance and dietary cholesterol, but more research is needed on this.  In some long-term observational cohorts, cheese intake associates with modestly lower risk of stroke and diabetes; in other studies it appears more neutral.22-24  Dairy consumption is linked to higher risk of certain cancers.5

Intake of processed meats (i.e., red meat or poultry preserved with sodium or other additives) is associated with higher risk of heart disease, stroke, and diabetes, while unprocessed red meats are associated with higher risk of diabetes but have generally smaller associations with cardiovascular events.19,25,26  The high salt content, and possibly other preservatives like nitrites, in processed meats likely contribute to the higher risk of cardiovascular events.27 Heme iron, a risk factor for diabetes in animal experiments, gestational diabetes, and inborn errors of iron metabolism such as hemochromatosis, may also partly explain the higher risk of diabetes seen with both processed and unprocessed red meats.28-30  Red meat consumption is also associated with higher risk of cancer, in particular colorectal cancer.5  Red meats are also sources of nutrients, like protein, vitamin B12, and zinc.  Food Compass incorporates and balances these various characteristics, including amounts of red meat, protein, vitamins, salt, nitrates, and processing, among other attributes.

Many minimally processed egg, poultry, and cheese items score in the middle of the Food Compass range, i.e. foods to be eaten in moderation.  Many unprocessed meats score between 31-38, i.e. foods at the lower end of the moderation range.  Processed meats, and some unprocessed meats with more additives, generally score below 30, as foods to be minimized. 

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