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A Perfect Score: NuVal ranks unprocessed wheat bran number one. RD ranks NuVal a zero.

Posted Aug 28 2010 10:38am
Wouldn’t it be great if we could easily assess a food, determine if it is good or bad, score it on its nutrition performance, using a single score? 

That’s just what Yale affiliated Dr. David Katz and his group of advisors decided to do, and have managed to convince Whole Foods and a range of other supermarkets to adopt. Sounds like a great idea, no?
NuVal, the Nutritional Scoring System scores ranks foods with a score from 1-100, the bigger the number the better (unlike the way many view larger numbers such as sizes and body weight). Perhaps with the exception of grade point average, SAT scores and salary, they would have done better to make the more desirable products associated with lower numbers.  But that’s a subject for another blog.
Here’s a description of how it works, taken from their website:
“The NuVal™ Nutritional Scoring System takes more than 30 different nutrients and nutrition factors into account when developing a Score. Nutrients with generally favorable effects on health are placed in the numerator: fiber, folate, Vitamins A, C, D, E, B12, and B6, potassium, calcium, zinc, omega-3 fatty acids, total bioflavanoids and carotenoids, magnesium, and iron. Higher values increase the NuVal™ Score. “
Nutrients with generally unfavorable effects on health decrease the NuVal™ Score and include: trans and saturated fats, sugar, sodium and cholesterol.
In addition to these two categories, “the NuVal™ System takes into account other key factors that measure the quality and density of nutrients, as well as the strength of their association with specific health conditions.”
And they recommend moving toward use of higher number foods to move to be healthier.

In many ways NuVal reminds me of the Rodale Press book, Eat This, Not That, a visually attractive glossy paperback of packaged food photos categorized as good and bad. The mere mention of it turns my stomach and makes me want to eat Twinkies (no, not the reduced fat ones). A top seller, no doubt, written by a non- nutrition professional who presents pairs of processed foods and declares one the winner. That is, based on some criteria he has decided (and doesn’t share) for each item. And, at least in his earliest books, the criteria appear to change. So one item may rank better given that it’s lower in saturated fat, but may be excessive in sodium. Yet on another page, the lower sodium food trumps the competitor, even if the calories are higher. Go figure.
The problem with NuVal
In this era of information overload—food rules and changing food science and recommendations that seemingly contradict, we get so much conflicting information that we no longer know what’s okay to eat. So in some ways this may seem like the perfect solution. Eat these, not those, good and healthy, versus bad and unhealthy. And move toward choosing the highest scored foods. What’s the problem, you ask?
These ratings basically do to foods what reputable organizations like the American Dietetic Association and the American Diabetes Association have worked for years to discourage. Namely, categorizing foods as good and bad, versus finding ways to have balance to our food eating. And there are a wealth of other concerns I have with it.
1) One size doesn’t fit all. You know that. So rating lite soy milk 82 and regular chocolate soy 68 might be fine for someone trying to reduce their caloric intake. But for the growing child? The athlete? The restrictive anorexic or bulimic? The elderly, struggling to get their needs met? See the problem? And to be penalized for higher calorie density?  We each have our individual health concerns and therefore need to personalize our approach to food selection. If I had kidney failure, a high potassium food, yielding a higher NuVal score would be undesirable. If I struggled with early satiety, fullness that comes quickly after eating, high fiber, low caloric density foods would not be appropriate. So the high scoring foods on NuVal’s list would be a problem for me.

2) Our perception of a food’s value can also have a negative effect on our eating. Remember when Snackwell’s came out in the 1980’s as one of the first fat fee cookies? Patients would come into my office and declare proudly that they had 5 Snackwell sandwich cookies.  They were drawn into the marketing message labeling them as a healthy, fat free item, and felt license to eat them, without regard to quantity. In fact, they contained about as many calories as the equivalent number of Oreos.
Similarly, score an item low and it becomes labeled as bad, or not good for you. You may start to see it as forbidden or “to be avoided”. You may end up eating the food, let’s say cupcakes for example, but without truly giving yourself permission. So you have a cupcake, but you don’t feel good about it. You may see it as having slipped from your healthy and desirable eating style. Perhaps you’ll start eating cupcakes when no one else is around, and leave no trace. And you’ll typically find yourself overeating in a “now or never” opportunistic way, overeating those forbidden, low-scoring cupcakes when you finally get the chance.

3) We don’t typically eat foods as single items. So the nutrition value of a single is less valuable, in fact useless, unless it is viewed as part of a whole. Let’s take today’s breakfast. While I couldn’t find an on line score for French toast, and since homemade versions are sure to vary, I will extrapolate the principles NuVal uses to rate it myself. I prepared it with my delicious homemade, low fiber challah bread, surely a low-ranking NuVal score. (Let me know if you’d like the recipe!) Then I added eggs—high in cholesterol, a NuVal negative.  So far it would hardly rank high as a healthy recommended breakfast food.
Yet the eggs are a valuable source of high quality protein, containing all 9 essential amino acids, the building blocks of protein, which NuVal gives no credit for.  And carotenoids, and vitamin D, two nutrients they do value. And add to this some berries, high in fiber, vitamin C and antioxidents, and a dollop of low fat yogurt. Maybe even a glass of low fat milk for some additional calcium and vitamin D.

And did I mention the pleasure factor? I so enjoyed my French toast this morning! It was delectable—the texture, the flavor and the sweetness from the drizzle of real maple syrup (high calorie density with little redeeming value)—a NuVal disaster I’m sure. (Quick tip—heat a small amount of syrup in a mini pitcher in the microwave for 10-12 seconds and it will both enhance the flavor and thin out the syrup, allowing you to use a smaller portion.)

And I suspect given how satisfied I felt eating this meal that I won’t be drooling over the muffins and pastries at the farmer’s market later. And I know I’ll be better fueled on my bike ride this afternoon, as opposed to if I had that perfect scoring unprocessed wheat bran! Ugghh!  So how useful was it to discredit my low fiber, non-fortified, white flour bread and French toast?

4) Even nutrients should be considered as part of the whole, not simply as their contribution to a single food. You may be hypertensive and trying to control your sodium intake. But that doesn’t mean that all items have to be low sodium. And then there’s the portion to consider. An ounce of pretzels (depending on the brand and the form) may fit just fine in a reduced sodium diet, for instance. But several ounces just wouldn’t work.

So if you struggle to manage the information overload and food selection, take this advice: pick the one or two nutrients truly relevant to you for your health and needs. High cholesterol your concern? Focus on the saturated and trans fat content of your food. But don't impose a strict rule that all foods must be low in saturated fat. Instead, consider your daily allowance to allow for some balance to your food selection. And some pleasure! And if a higher calorie intake is in order, then defy the masses and focus on your nutritional needs! Even if that means a lower NuVal score. And if you are struggling to break free from rigid rules resulting in a pattern of restricting and  overeating, than focus on getting what you really want to eat. Because ultimately, you'll be physically healthier by eating without extremes and psychologically better off as well.



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