Most nutrient profiling systems (NPS) were designed exclusively for high-income countries to address chronic-disease risk and do not capture locally available foods, nutrient bioavailability, or the dual burden of undernutrition and noncommunicable diseases in low- and middle-income countries (LMICs). We developed and tested the Nutritional Value Score (NVS)—a novel NPS based on priority nutrients and dietary factors predictive of noncommunicable disease risk—to better identify foods with high nutritional value relevant to health priorities in high-income countries and LMICs alike, and to serve as a functional unit for environmental impact and affordability analyses. The NVS combines 7 weighted components—nutrient ratios (sodium:potassium, saturated:unsaturated fat, and carbohydrate:fiber), vitamins, minerals, protein (quality-adjusted), n–3 fatty acids, fiber, and Calories—scaled from 1 to 100, with a 25% penalty for ultraprocessed foods. It was applied to 289 commonly consumed foods in Indonesia, Bangladesh, Kenya, Nigeria, and the United States using local food composition data where available. We evaluated content validity, face validity, convergent and discriminant validity, and conducted various sensitivity analyses. The NVS identified organ meats, dark green leafy vegetables, fish, and seafood as the highest-scoring foods and soft drinks, grain-based baked sweets, instant noodles, packaged ultraprocessed snacks, and refined grains as the lowest. It showed stronger discrimination within fruits, vegetables, animal-source foods, and starchy staples than Nutri-Score or Health Star Rating (HSR). Correlations were moderate overall with Nutri-Score ( r = 0.58) and HSR ( r = 0.63) but weak for ultraprocessed foods ( r < 0.15). Rankings shifted notably when using mass-based compared with energy-based references units. The NVS better distinguishes foods with high nutritional value than popular existing NPS and supports more meaningful environmental impact and affordability comparisons than conventional mass-based or energy-based reference units. Although further criterion validation is needed, the NVS shows promise to guide policies and programs prioritizing nutritious foods globally.
Beal et al. (Sun,) studied this question.