Food Compass is a nutrient profiling system using expanded characteristics for assessing healthfulness of foods.

Nutrient profiling systems (NPS) aim to discriminate the healthfulness of foods for front-of-package labelling, warning labels, taxation, company ratings and more. Existing NPS often assess relatively few nutrients and ingredients, use inconsistent criteria across food categories and have not incorporated the newest science. Here, we developed and validated an NPS, the Food Compass, to incorporate a broader range of food characteristics, attributes and uniform scoring principles. We scored 54 attributes across 9 health-relevant domains: nutrient ratios, vitamins, minerals, food ingredients, additives, processing, specific lipids, fibre and protein, and phytochemicals. The domain scores were summed into a final Food Compass Score (FCS) ranging from 1 (least healthy) to 100 (most healthy) for all foods and beverages. Content validity was confirmed by assessing nutrients, food ingredients and other characteristics of public health concern; face validity was confirmed by assessing the FCS for 8,032 foods and beverages reported in NHANES/FNDDS 2015-16; and convergent and discriminant validity was confirmed from comparisons with the NOVA food processing classification, the Health Star Rating and the Nutri-Score. The FCS differentiated food categories and food items well, with mean ± s.d. ranging from 17.1 ± 17.2 for savoury snacks and sweet desserts to 81.6 ± 16.0 for legumes, nuts and seeds. In many food categories, the FCS provided important discrimination of specific foods and beverages as compared with NOVA, the Health Star Rating or the Nutri-Score. On the basis of demonstrated content, convergent and discriminant validity, the Food Compass provides an NPS scoring a broader range of attributes and domains than previous systems with uniform and transparent principles. This publicly available tool will help guide consumer choice, research, food policy, industry reformulations and mission-focused investment decisions.

Nutrient Profiling Systems, Front of Pack Labeling, and Consumer Behavior.

PURPOSE OF REVIEW: Guiding consumers toward more healthful food choices may help address the high prevalence of poor dietary quality and diet-related diseases. The use of front-of-package labels (FOPL) on food items is expanding to provide focused nutritional information or representations, often based upon nutrient profiling systems. RECENT FINDINGS: FOPL provide a source of nutrition and health information that is readily understood by consumers, including those with limited literacy. There is evidence that FOPL can shift consumer behavior toward more nutritious and healthful choices. However, assessments of the effectiveness of FOPL have been restricted in scope and rely largely on simulation models rather than real-world environments. FOPL are a direct source of nutritional guidance at the point-of-purchase and provide an opportunity to convey critical information on ingredients that are associated with health promotion and/or increased risk of non-communicable diseases. However, limited evidence regarding the most effective forms of FOPL to achieve behavior change and challenges from the food industry impedes the establishment of standardized nutrient profiles and algorithms. Future opportunities for FOPL include the potential for integrating nutritional profiles with non-nutrient factors affecting health such as food processing and environmental sustainability.

Systematic Review of Dietary Patterns and Sustainability in the United States.

Improving awareness and accessibility of healthy diets are key challenges for health professionals and policymakers alike. While the US government has been assessing and encouraging nutritious diets via the Dietary Guidelines for Americans (DGA) since 1980, the long-term sustainability, and thus availability, of those diets has received less attention. The 2015 Dietary Guidelines Advisory Committee (DGAC) examined the evidence on sustainable diets for the first time, but this topic was not included within the scope of work for the 2020 DGAC. The objective of this study was to systematically review the evidence on US dietary patterns and sustainability outcomes published from 2015 to 2019 replicating the 2015 DGAC methodology. The 22 studies meeting inclusion criteria reveal a rapid expansion of research on US dietary patterns and sustainability, including 8 studies comparing the sustainability of DGA-compliant dietary patterns with current US diets. Our results challenge prior findings that diets adhering to national dietary guidelines are more sustainable than current average diets and indicate that the Healthy US-style dietary pattern recommended by the DGA may lead to similar or increased greenhouse gas emissions, energy use, and water use compared with the current US diet. However, consistent with previous research, studies meeting inclusion criteria generally support the conclusion that, among healthy dietary patterns, those higher in plant-based foods and lower in animal-based foods would be beneficial for environmental sustainability. Additional research is needed to further evaluate ways to improve food system sustainability through both dietary shifts and agricultural practices in the United States.

Linking sustainability to the healthy eating patterns of the Dietary Guidelines for Americans: a modelling study.

BACKGROUND: Evidence-based nutrition policy is a key mechanism to promote planetary health. In the USA, the Dietary Guidelines for Americans are the foundation of nutrition policy and guide more than US$80 billion in federal spending. Recent attempts have been made to incorporate sustainability into the development of the Dietary Guidelines. However, the sustainability of the 2015-20 Dietary Guidelines remains unclear; research has not yet assessed the environmental impacts of the distinct healthy patterns recommended by the policy. METHODS: In this modelling study done at the University of New Hampshire (Durham, NH, USA), we analysed the healthy US-style (US), healthy Mediterranean-style (MED), and healthy vegetarian (VEG) patterns recommended in the 2015-20 Dietary Guidelines for Americans. Food groups and subgroups consisted of 321 commonly consumed foods, with group composition predetermined by the US Department of Agriculture. We compiled and used multiple datasets to assign environmental burdens to foods, focusing on six impact categories of policy importance: global warming potential, land use, water depletion, freshwater and marine eutrophication, and particulate matter or respiratory organics. We did life cycle impact assessments for each of the three diet patterns and compared the six impact categories between the patterns. We also analysed the proportion contribution of the food groups to each impact category in each of the diet patterns. FINDINGS: The US and MED patterns had similar impacts, except for freshwater eutrophication. Freshwater eutrophication was 31% lower in the US pattern than the MED pattern, primarily due to increased seafood in the MED pattern. All three patterns had similar water depletion impacts, with fruits and vegetables as major contributors. For five of the six impacts, the VEG pattern had 42-84% lower burdens than both the US and MED patterns. Reliance on plant-based protein and eggs in the VEG pattern versus emphasis on animal-based protein in the other patterns was a key driver of differences, as was a lower overall protein foods recommendation in the VEG pattern. INTERPRETATION: The recommended patterns in the Dietary Guidelines for Americans might have starkly different impacts on the environment and other dimensions of human health beyond nutrition. Given the scale of influence of the Dietary Guidelines for Americans on food systems, incorporating sustainability into their development has the potential to have great benefit in terms of long-term food security. FUNDING: None.

Evaluation of tracheal imaging by optical coherence tomography.

BACKGROUND: Optical coherence tomography (OCT) is a new technology capable of generating high resolution cross-sectional images of complex tissue in real time. Analogous to ultrasound, OCT measures backscattered light intensity using coherence interferometery to construct topographical images of complex tissue. Since OCT uses infrared light rather than acoustic waves, its spatial resolution is exceptionally high (2-10 microm). Recent advances in data acquisition, analysis, and processing enable real-time imaging, and make OCT a potentially valuable tool for pulmonary airway diagnostic applications, including assisting directed airway biopsies. OBJECTIVE: This study evaluates feasibility of OCT for delineating proximal airway microstructures in various animal as well as human tracheas. METHODS: Excised trachea samples from New Zealand white rabbits, Duroc pigs, and human trachea were imaged using a compact, 1,300-nm broad-band superluminescent-diode-based prototype fiber OCT device we constructed. The resulting structural OCT images were compared to conventional hematoxilin and eosin (HE) stained histological sections from the same samples. RESULTS: OCT was able to delineate microstructures such as the epithelium, mucosa, cartilage, and glands in all samples. CONCLUSION: These findings suggest that integration of OCT with flexible fiberoptic bronchoscopy could enhance pulmonary diagnostic medicine and detection of pathologic tissue changes in various respiratory diseases.