Just when we thought we had covered all the nutrition rating systems out there, here’s a new system being implemented at Whole Foods Market stores nationwide. ANDI, short for Aggregate Nutrient Density Index, is the brainchild of author, MD, and founder of Eat Right America, Dr. Joel Fuhrman.

The ANDI system is a part of a bigger initiative by Whole Foods, entitled Health Starts Here, which encompasses not just making healthy food available, but also providing education on what to do what with that food (culinary lessons, 28 day programs to jump start healthy eating habits…).

The healthy eating principles WFM is promoting are:

• plant based diet
• whole foods (less processed flours, for example)
• low fat – or the right fats (unsaturated, more from plants and less from animals)
• nutrient dense (that’s where ANDI comes in)

The ANDI score, based on a Dr. Fuhrman’s Nutrient Density Scoring System analyzes many nutrients in a food product

Calcium, Carotenoids: Beta Carotene, Alpha Carotene, Lutein & Zeaxanthin, Lycopene, Fiber, Folate, Glucosinolates, Iron, Magnesium, Niacin, Selenium, Vitamin B1 (Thiamin) Vitamin B2 (Riboflavin), Vitamin B6, Vitamin B12, Vitamin C, Vitamin E, Zinc, plus ORAC score X 2 (Oxygen Radical Absorbance Capacity is a method of measuring the antioxidant or radical scavenging capacity of foods).

The data for whole foods such as produce, grains, and legumes is relatively easy to analyze based on USDA databases. It is much more complicated to get accurate info for packaged or processed foods, especially because the ingredients in a processed food interact with each other and change the nutrition profile of a product.

Here is a table with some sample scores. The highest score is 1000, the lowest is close to zero.

This is a very interesting table, especially if one compares it to NuVal ranking which goes from 1-100. Take a look at these 4 healthy products and their scores:

• Kale – 1000
• Orange – 109
• Whole wheat bread – 25
• Olive oil – 9

A naive shopper may be led to believe that kale is the only product worth consuming. But all 4 of the aforementioned are healthy and needed by our bodies. Dr. Fuhrman addresses this:

Keep in mind that nutrient density scoring is not the only factor that determines good health. For example, if we only ate foods with a high nutrient density score our diet would be too low in fat. So we have to pick some foods with lower nutrient density scores (but preferably the ones with the healthier fats) to include in our high nutrient diet.

So wouldn’t it be more practical to create a scoring system that doesn’t require people to analyze a score , the product type, the required nutrients and then decide? The entire point is to simplify life for consumers, not complicate it!

Whole Foods is perceived as a healthier, albeit expensive, grocery retailer. But recently John Mackey, WFM CEO and founder, openly admitted that his chain sells lots of junk food. The Health Starts Here program may be a signal that Mackey is retuning to the roots of what WFM stood for in the seventies when just starting out.

The ANDI scores are an interesting first step in trying to help consumers better choose healthier foods, and it will be very interesting to see consumer response. We expect Whole Foods will continue to introduce and test additional tools to help their customers.

What to do at the supermarket:

Don’t let the Whole Foods health halo confuse you, as organic junk food is still junk food. Stick to the less processed products, of which Whole Foods has copious amounts, including in bulk (cheaper).

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This is a guest blog-post by  Professor Timothy D. Lytton

In my previous posts I have proposed that the FDA regulate front-of-package nutrition labels by better enforcement of existing regulations and by setting minimum standards for labels that rate the overall nutritional value of foods. By contrast, the Center for Science and the Public Interest as well as the Fooducate Blog have advocated that the FDA develop and impose on the food industry “a simple, uniform science-based system [that] would bring consistent and reliable information to the marketplace and help consumers choose more healthful diets.”

However, the high level of complexity involved in designing nutritional rating systems gives rise to two reasons to prefer a regulatory approach that merely sets minimum-standards.

First, there is little reason to suppose that government policymakers will be able to create a system that is superior to those developed by research scientists in academia and industry. Disagreement among experts in industry and academia as to the best approach to nutrient profiling—even after millions of dollars of investment and years of research—is significant and ongoing. By contrast, merely setting minimum standards is a less complex task that is more likely to generate consensus among experts, who do agree on many basic principles of nutrition. Setting minimum standards is a common regulatory tool well within the expertise of the FDA and likely to elicit few complaints about the agency acting beyond the powers delegated to it by Congress.

Second, allowing for experimentation and competition among private-sector groups is likely to advance knowledge in the area of nutrient profiling and food labeling more effectively than the development and imposition of a single, centralized government scheme. Minimum government standards will create space for genuine experimentation and competition aimed at advancing knowledge while eliminating merely profit-driven research and the use of front-of-package nutrition labels as just another marketing strategy. There is also reason to believe that market incentives, under certain circumstances, will produce high quality scientific information. While allegations of conflict of interest and “junk-science” surround manufacturer-sponsored front-of-package labels, such as Smart Choices, the same is not true of shelf labels developed by or for retail stores. The Guiding Stars and NuVal labels have been singled out for the scientific integrity of their ratings, even among critics of nutrient profiling generally. One reason may be that retail supermarkets are less interested in selling any particular type or brand of food, including their own their own store brands, than in attracting consumers into their stores. Whereas manufacturers have an incentive to adopt nutrient profiling schemes that favor their products—regardless of the product’s nutritional value—retail supermarkets draw customers into their stores by offering them reliable nutrient profile labels that, for some consumers, enhance their shopping experience.

The most effective role for government in the regulation of front-of-package nutrition labels is not to supplant private sector experimentation and competition but rather to ensure that it is not corrupted by unscrupulous companies willing to put profits ahead of scientific integrity.

Timothy D. Lytton is the Albert and Angela Distinguished Professor of Law at Albany Law School where he teaches regulatory law & policy, constitutional law, administrative law, and tort law. His article “Signs of Change or Clash of Symbols? FDA Regulation of Nutrient Profile Labeling” (forthcoming in Health Matrix, vol. 19, no. 2) is available online by clicking here. He is also working on an article about regulation of nutrition standards for school food. For more information, visit his Albany Law School faculty website.

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This is a guest blog-post by  Professor Timothy D. Lytton

In my previous post, I suggested that regulation of front-of-package nutrition labels should begin with better enforcement of existing standards. Existing regulations, I argued, already provide adequate tools to clamp down on misleading labels. I focused on the three most common types of front-of-package nutrition labels: (1) those that provide simple quantitative statements, (2) those that rate individual nutrients, and (3) those that present seals of approval. In this post, I suggest how existing standards might be further developed to regulate a fourth type of front-of-package label.

Rating Overall Nutritional Value: Guiding Stars & NuVal

The fourth type of front-of-package nutrition label rates the overall nutritional value of foods. For example, Hannaford Brothers’ Guiding Stars label rates foods on a scale of zero to three stars and the NuVal Nutritional Scoring System rates foods on a scale from one to one hundred.

The FDA could build on its existing regulations concerning the use of “healthy” claims to develop multiple threshold definitions for overall nutritional value, for example providing three threshold definitions that would create a four-point scale: (1) foods below the bottom threshold, (2) foods between the bottom and middle thresholds, (3) foods between the middle and top thresholds, (4) and foods above the top threshold. This could be accomplished by adding further gradation to the current FDA definition of “healthy,” as the agency has already done for some single nutrient claims (for example, “low sodium,” “very low sodium,” and “sodium free.”).

Thus, food ratings in a scheme like Hannaford Brothers’ Guiding Stars would have to meet the corresponding FDA threshold definitions—a food labeled with three stars would have to meet the FDA’s top threshold definition, a food labeled with two stars would have to meet the FDA’s middle threshold definition, and so on. For schemes with a higher level of gradation, like NuVal’s one to one-hundred ranking, the FDA could use the same four-point scale. Foods rated by NuVal in the top quartile (100-76) would have to meet the FDA’s top threshold definition, foods in the NuVal second quartile (75-51) would have to meet the FDAs middle threshold definition, and so on. Calibrating nutrient profile rating schemes to graduated FDA definitions of relative overall nutritional value, using the definition of “healthy” as a starting point, would provide consistency among schemes based on the federal government’s dietary guidelines and health recommendations.

This means of regulation would also allow for variation among schemes in terms of gradation and rankings. Those who design nutrient profile labeling schemes could experiment with greater and lesser levels of gradation, and rankings could vary so long as they met or exceeded minimum FDA threshold levels. The purpose of my proposal to formulate a four-tiered definition of “healthy” is not to create an FDA nutrient profile rating system to displace private-sector rating systems like Guiding Stars or NuVal. The purpose is merely to provide an easily understandable system of minimum thresholds to prevent abuse. Thresholds should be set in such a way as to prevent high ratings for foods of low nutritional value—like Froot Loops—while allowing for variation in different approaches that are consistent with these minimum thresholds. This regulatory approach does not interfere with private sector efforts to develop more complex nutrient rating schemes, so long as those schemes satisfy minimum standards that prevent ratings that are false or misleading.

In a subsequent post, I will discuss why FDA imposition of a uniform, mandatory front-of-package labeling system—as proposed by the Center for Science in the Public Interest—might not be the best regulatory approach.

Timothy D. Lytton is the Albert and Angela Distinguished Professor of Law at Albany Law School where he teaches regulatory law & policy, constitutional law, administrative law, and tort law. His article “Signs of Change or Clash of Symbols? FDA Regulation of Nutrient Profile Labeling” (forthcoming in Health Matrix, vol. 19, no. 2) is available online by clicking here. He is also working on an article about regulation of nutrition standards for school food. For more information, visit his Albany Law School faculty website.

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Have you noticed the slough of  “quick glance” nutrition information we’ve been bombarded with this year? Whether it’s the calorie count on menu items at fast food chains, or on products or shelves at the supermarket, many new nutrition graphics, icons, and slogans have entered our vocabulary in 2009. NuVal, Smart Choices, Traffic Lights, and a host of other front of pack labels stormed into shoppers’ lives this year (some earlier).

But did they help us improve our choices?

That’s the billion dollar question, which unfortunately does not have a simple answer. Hannaford, a grocery retailer that introduced Guiding Stars several years ago, claims that products marked with at least one “star” showed an uptick in sales. The system provides a score of zero, one, two, or three stars to each an every product sold in Hannaford supermarkets, based on its nutritional value.

NuVal, on the other hand, scores products from 0-100, and is currently offering nutrition information in less than 1000 supermarkets, mostly in the midwest. Anecdotal evidence shows that people are slightly improving choices.

In New York, where calorie labeling in fast food chains such as McDonald’s and Pizza Hut went into effect last year, no changes in people’s habits were recorded so far. And in the UK, where the Traffic Light System has been in use for several years on packaged foods, the verdict is mixed. One study, published by the Food Standards Agency (FSA), the British equivalent of the FDA, showed an improvement in people’s choices. But a recent study by Oxford University researchers showed no correlation between the traffic light symbols and people’s choice of a ready to eat sandwich.

What you need to know:

While the quick glance label may give you quick info, the “information” may not always be in your best nutritional interest. You need to understand that many times the front of pack (FOP) nutrition info is just another marketing tool used by food manufacturers and retailers to get you to think that a product is healthy, when in fact it’s not. The best example is Froot Loops, which received a “Smart Choice” accolade by a consortium of manufacturers and fig-leafs scientists from top universities. This for a cereal with 40% sugar by weight, controversial artificial colors, and trans-fat. Luckily the Smart Choices program was nixed several months after it launched.

There is one very important effect that front of pack nutrition labeling has had though. It has caused food manufacturers to take a look at their products and reformulate them to some extent in order to qualify as many as possible as nutritious. Even Froot Loops lost a bit of sugar and gained a bit of fiber. Granted, these are baby steps, but at least they are in the right direction.

What to do at the supermarket:

Since the front of pack labels have not been approved by the FDA and are not really regulated, there is a lot of wiggle room for manufacturers to sell you a “healthy story” rather than a healthy product.

We recommend that you read the nutrition label itself, along with the ingredient list. It will take another moment of your time, but you will know exactly what you’re getting. And if you need advice or help in choosing a product, Fooducate is always here to help.

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Nuval, the nutrition rating system that scores product from 0-100, announced this week the addition of a fourth supermarket chain as a partner – United Supermarkets, LLC of Lubbock, Texas, which operates 50 stores under the United Supermarkets, Market Street, and Amigos United names. Only 6 of the stores will be launching NuVal initially, beginning in March 2010. The rest will roll out during the remainder of 2010.

NuVal, originall called ONQI,  is a nutrition rating system developed by Dr. David Katz and other prominent scientists and nutrition experts in order to help shoppers make healthier choices at the supermarket. We explained the system and compared it to the (R.I.P) Smart Choices Program here.

NuVal is currently available at Price Chopper, Hy-Vee, and Meijer supermarkets in 19 states and over 500 supermarkets, according to company.

Coinciding with the PR, the NuVal website has been redesigned and it also includes a game called “Nutrition by the Numbers” where players have to rank 3 products by their NuVal score.

What you need to know:

This is a a small win for the NuVal licensing company, that had expected to be in thousands of supermarkets by this time when the program was announced last year. Nuval has yet to gain entry into one of the larger chains such as Kroeger, Publix, or Safeway.

We recently asked a NuVal board member why this is, but got a general answer that there is “a lot of work in progress.”

Here are a few thoughts on why NuVal is not as far ahead as it expected:

1. NuVal is not sponsored by food manufacturers, as Smart Choices was, and therefore its scores do not show on product packages. They appear on shelf tags together with the prices. Our sources tell us that this is causing a logistical nightmare as products are arranged on different shelves, prices change, and employees are not always aware of the new labeling.

2. NuVal’s competitors, especially Smart Choices and Guiding Stars, as well as individual efforts by some chains, have divided the industry, making it very hard for any player to gain substantially.

3. The recent inquiries by the FDA into “front of pack” nutrition labels may also have supermarkets sitting on the sidelines, waiting to see if a federally mandated standard will render existing systems useless or illegal.

4. Lastly, some supermarkets may find themselves in a conflict of interest. On one hand, providing consumers with more nutrition information is a good thing to do and builds loyalty. On the other, it may create a loss in revenue because customers will now buy less of the profitable junk foods and beverages. These profit-centers occupy substantial real estate in all modern supermarkets.

What to do at the supermarket:

Whether your local supermarket is participating in a nutrition labeling program or not, you can still make sound choices. The best advice is to buy minimally processed foods, with short, understandable ingredient lists. Make sure you get plenty of fruits and vegetables, limit your snacks to a very few, and opt to drink tap water instead of soft drinks.

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One of the interesting sessions here at the annual Food and Nutrition Conference in Denver hosted a panel of 3 experts who presented their views on what the rating systems are, why and how they were created, and how they will improve nutrition.

First up was  Susan Crockett, PhD, RD, FADA, who for the last 10 years has been with General Mills. She presented the Smart Choices program of Fruit Loop infamy, and addressed the specific backlash against pre-sweetened cereal. In her attempt to justify the benchmark that allows such a culinary and nutrition horror to be considered a smart choice, Dr. Crocket first provided a background on how General Mills is committed to health and nutrition. She then showed that the Smart Choice panel was composed of both industry and academic experts, and lastly dug deep into the numbers to show how the benchmark for cereals was chosen.

Let us say that we commend General Mills that contribute 5% of pretax profit to nutrition and wellness programs. That was about $80M last year. But let’s not forget that this is a huge profit driven enterprise. The company and its peers has seen consumer confusion regarding nutrition labels and decided to handle it as a business opportunity. Working with “non-industry” experts is a way to lend credibility to the program. However, many experts are affiliated in some way or another with the industry.

As to sugar in cereal – the Smart Choices panel took a recommendation for 10% of daily calories from added sugar. In a 2000 calorie a day diet, that means 200 calories. They divided the 200 calories into 4 eating events of 50 calories. 12 grams of sugar, which is what you’ll find in Froot Loops, Apple Jacks, and others, add up to 48 calories per serving. And that, by their book is a Smart Choice. Wonderful, no?

We were left with some hope, as Dr. Crocket said that Smart Choices is continually evolving, and that with time benchmarks will be adapted to feedback from the field.

Next speaker was Annette Maggi, MS, RD, LD, FADA from NuVal. Maggi is the director of the business arm of NuVal, which licenses its 1-100 rating system to supermarkets for display on shelf tags. The NuVal system was not funded by the industry, rather by a group of scientists with a stated goal of becoming a nutrition GPS at the supermarket. The idea is to tag every single product in the supermarket with a score. That way, in the supermarket, people can compare products within a category.

So far 33,000 products have been scored. In an earlier talk we had with Prof. Keith Ayoob, of the Nuval Scientific board, he said that the group was working on rating over 100,000 items in supermarkets. The Nuval algorithm is quite complex when compared to Smart Choices, with hundreds of factors taken into consideration for each product.

Without referring specifically to Smart Choices, Maggi stated that one of the clear advantages of NuVal was its independence. A Kraft PR spokesperson tried to refute that statement in the ensuing Q&A by mentioning that the wife of one of the NuVal board members has a conflict of interest.

Last to present was Susan Moores, MS, RD who does not represent any rating system, but has been working with grocers on a variety of health and nutrition issues over the years. She provided an interesting viewpoint whose main message was stop looking for the numbers and the stickers, focus on the food: “A number will not put a meal on the table”.

Moores said that the nutrition labels have had an effect on industry. Food manufactures have reformulated products to get better scores. For example, the notorious Froot Loops lowered sugar by one gram and upped fiber by one gram. Supermarkets who adopt one system or other are able to differentiate themselves.

Mostly though, these programs have created controversy and chaos. And wherever there is a mess, there’s an opportunity for dietitians to help their clients  with guidance and sound advice.

The session was very informative, but did not provide any substantially new information. Our position is that any industry funded rating system is inherently flawed because of the direct conflict of interest between companies’ need to sell more processed food to make more money, and consumers’ need to get away from these types of foods.

What to do at the supermarket:

Skip the health claims, benchmarks, and other marketing tricks. Learn to read a nutrition panel and familiarize yourself with ingredients to watch out for in the ingredient list. When sugar is the first ingredient in a cereal, that is not a smart choice, no matter how many PhDs in the room will tell you it is.

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The Tufts University Friedman School of Nutrition Science and Policy is one of the nation’s foremost leaders in the field of nutrition. They are hosting the 4th annual Friedman Symposium this weekend, a 2 day affair devoted to current affairs in the nutrition and diet arena.

Fooducate was lucky to partake in the conference as an online participant. (thank you Mark Krumm,  Director, Events & Marketing at Tufts, for helping set us up).

Judging from the titles and professional experience of the presenters and lecturers present, the people seated at the Jaharis Conference Center represented a highly capable group. Could some magic happen here that would help put America back on the health track? Read more…

We are blogging live have concluded live blogging from The 4th annual Friedman School Symposium at Tufts University – Nutrition Agenda 2009 & Beyond.

This morning’s topic is Nutrition Labeling and Scoring 2.0: What have we learned? What do we need to know?

Here is the list of speakers and presentations for this morning.

Click Refresh in your browser to get updated.

Our brief summary:

1. Each nutrition rating system was eloquently presented.

2. Inconvenient issues were swept under the rug.

3. The food industry still controls what goes on the food packages, not the FDA.

4. The tower of babel of front of pack labels will only confuse consumers more in the coming years. As Barbara Schneeman of the FDA said – what will a consumer think when she sees a product that is a “Smart Choice, did not get a guiding star , is high in calcium, but got a 30 NuVal score.”?

5. As it stands, we recommend ignoring front of pack labels, and focusing on minimally processed foods.

for the entire session … Read more…

The Tufts University Friedman School of Nutrition is hosting its fourth annual nutrition symposium on Friday and Saturday (9/11-12/09). This year’s conference, Nutrition Agenda 2009 and Beyond, will dedicate a half  day to presentations and discussions about Nutrition Labeling and Scoring. (download program PDF here). Not surprisingly, the event is sponsored by the food industry.

The past year has seen an explosion in food labeling and scoring system introductions, and it will be very exciting to hear from the inventors and initiators of these systems what they’ve learned so far, consumer reaction, and of course what they think of their competition.

We’ll be participating online, and also live-blogging and twittering each session as it progresses.

Especially interesting to hear will be remarks from Dean of the nutrition school, Dr. Eileen Kennedy, who is also chairman of Smart Choices. She has been thrust into the spotlights after an interview last week in the New York Times where she said Froot Loops are a smart nutritional choice.

Hopefully there will be some Q&A sessions, so if any of you dear readers are interested in asking a question, drop us a line or send us a twit. We’ll try to accommodate…

Here’s the lineup for tomorrow morning:

8:30am NuVal Nutrition Scoring System Update
David L. Katz, MD, MPH, FACPM, FACP
Chief Science Officer, NuVal
Power in Numbers: How the breadth and depth of the NuVal system can position it to be the universal standard for all nutritional guidance systems.

9:00am Guiding Stars (Hannaford Supermarkets) Program Update
Jeffrey Blumberg, PhD, Tufts University, Friedman School
The Guiding Stars Program: Evaluating and Extending Nutrition Profiling

9:30am Nutrient Rich Foods Index
Victor Fulgoni, PhD
Nutrition Impact, LLC
Nutrient Rich Foods Index and Relationship to Better Nutrition and Health Status

10:00am Refreshment Break – wonder if they’ll serve healthy snacks…

10:20am Smart Choices Program Update
Joanne Lupton, PhD
Texas A&M University
The hope is that the Smart Choices Program will be the most widely used front-of-pack labeling program in the United States, and ultimately assist people in making positive dietary changes to help enhance public health.

10:50am FDA Perspective on Labeling and Scoring
Barbara O. Schneeman, Ph.D.
Director of the Office of Nutrition, Labeling, and Dietary Supplements in the Center for Food Safety and Applied Nutrition at the Food and Drug Administration

11:20am Panel Discussion

Food Label are an immensely important issue in public health. They are also very controversial and misleading. That is why many aspects are tightly regulated by the FDA.

Unfortunately the sly food manufacturers have figured out ways to impress upon consumers only the good side of their products, misleading shoppers into buying processed foods disguised as healthy. Our fear is that some of the new labeling schemes will only worsen the situation.

Stay tuned for tomorrow…

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The “Smart Choices” front of package food labeling scheme officially launches this week. 500 Packaged foods from ConAgra, General Mills, Kellogg’s, Kraft, PepsiCo, Sun-Maid, Tyson and Unilever are already approved.

The program hopes to take nutrition confusion out of your life by presenting a simple green check mark on the front of packaged foods that have passed a nutrition benchmark.

While we applaud the initiative to simplify food nutrition information, Smart Choices has substantial drawbacks, which we outlined in the past.

Granted, there are several advantages, such as simplicity, uniformity across brands, and the front-and-center calorie information provided on some labels. However, we think that this industry backed initiative, along with fifteen others was born in a vacuum created by the lack of initiative of the FDA.

Here are six reasons why Smart Choices won’t really help shoppers. Read more…