Nutrient density: principles and evaluation tools.

Nutrient profiling is the technique of rating or classifying foods on the basis of their nutritional value. Foods that supply relatively more nutrients than calories are defined as nutrient dense. Nutrient profile models calculate the content of key nutrients per 100 g, 100 kcal, or per serving size of food. For maximum effectiveness, nutrient profile models need to be transparent, based on publicly accessible nutrient composition data, and validated against independent measures of a healthy diet. These rigorous scientific standards were applied to the development of the Nutrient-Rich Foods (NRF) family of nutrient profile models. First, the NRF models included nutrients to encourage as well as nutrients to limit. Second, NRF model performance was repeatedly tested against the Healthy Eating Index (HEI), an independent measure of a healthy diet. HEI values were calculated for participants in the 1999-2002 NHANES. Models based on 100 kcal and serving sizes performed better than those based on 100 g. Formulas based on sums and means performed better than those based on ratios. The final NRF9.3 index was based on 9 beneficial nutrients (protein; fiber; vitamins A, C, and E; calcium; iron; potassium; and magnesium) and on 3 nutrients to limit (saturated fat, added sugar, and sodium). Higher NRF9.3 scores were associated with lower energy density and more nutrient-rich diets. The nutrient density of foods, paired with a comprehensive program of consumer education, can become the foundation of dietary recommendations and guidelines.