Overall nutritional quality index

Lifestyle Fitness Coaching

ONQI - Understanding the Overall Nutritional Quality Index
Test of the National Death Index. The Nuval Nutrition Scoring System enables consumers to make better decisions when purchasing food items in a struggle-free manner. After adjustment for confounders, women in the highest compared to lowest quintile of the ONQI-f score had a relative risk of chronic disease of 0. I should have read the nutrition label during the purchasing process. Am J Health Promot.

Background:

Adherence to the Overall Nutritional Quality Index and Risk of Total Chronic Disease

Is this for real - are grocery stores really going to be putting the ONQI values next to food items? This is a great idea. It removes all the marketing hype from "lite" and "low fat. I can't wait to see these scores in my grocery store. I appreciate the thorough explanation. Can't wait to see this in my grocery store. This system is brilliant! The information provided within this site is strictly for the purposes of information only and is not a replacement or substitute for professional advice, doctors visit or treatment.

The provided content on this site should serve, at most, as a companion to a professional consult. The ONQI scoring system was associated with modestly lower risk of chronic disease and all-cause mortality.

Nutrient profiling is an effort to rank or classify foods based on nutrient composition. A rapidly growing application for these profiles is front-of-package food product labeling. Front-of-package labeling has emerged recently from many sources, 4 including manufacturers, 5 food sellers, 6 health organizations, 7 other non-industry companies 8 and government sponsored programs. Although these labels intend to provide consumers simplified nutrition information, the numerous labeling schemes on supermarket shelves often are conflicting, and may foster confusion among consumers.

The validity of these systems to provide sound guidance is not well established. A few algorithms have been validated using qualitative research methods, 10 including comparison with rankings by an expert panel. In this analysis, the authors evaluated whether the ONQI algorithm predicted lower risk of chronic disease over 20 years within two large cohort studies of health professionals.

Dietary data were collected with a and item FFQ administered to the women and men respectively in The ONQI algorithm was created by a multidisciplinary panel of nutrition and public health experts and has been described in detail previously. Nutrients were considered for inclusion if there was an established relationship with one or more health outcomes, if they were of established public health importance, if changes in intake on a population level would be of public health benefit, if the nutrient was available in nutrient databases and if inclusion of the nutrient in the algorithm enhanced performance in developmental validation testing.

The basic nutrients in the algorithm are listed in Table 1. Nutrients with generally favorable effects on health contribute to the numerator of the ONQI score, where higher values increase the score.

Nutrients with generally unfavorable effects on health are placed in the denominator, where higher values decrease the score. The micronutrients included in the ONQI algorithm were each given a trajectory score, which addresses how the nutrient value of a food compares to the recommended daily intake of that nutrient, and how the consumption of the food influences the trajectory of total daily intake of the nutrient.

For most nutrients, the target for the trajectory score is the recommended daily intake of that nutrient, as determined by the Estimated Average Requirements of the Dietary Reference Intakes or the Dietary Guidelines for Americans, The trajectory score is calculated as the ratio of the concentration of the nutrient in a food to the recommended concentration of that nutrient in the overall diet. The trajectory score is weighted further by coefficients based on the prevalence, severity, and strength of association of the nutrient with risk of chronic disease including cardiovascular disease, cancer and diabetes , as determined through a review of the literature and expert panel consensus.

The ONQI algorithm also incorporates measures of energy density and macronutrient quality. Protein quality of a food was determined based on the distribution of essential amino acids, fat quality was calculated as the percentage of total fat that is unsaturated and the glycemic load serves as a proxy for carbohydrate quality. Further details and a full list of references can be found in the ONQI reference manual.

For each food item, a commonly used portion size was specified e. A simple summation of the scores would lead to a greater score with greater food intake, regardless of the quality of food.

In a secondary analysis, a score that used the energy value of foods, rather than servings, to weight the ONQI-f score was not associated with risk of chronic disease data not shown.

The reproducibility and validity of the FFQ are high when compared with multiple 1-week diet records and biochemical markers. The primary endpoint for this study, major chronic disease, was defined as the initial occurrence of CVD, diabetes, cancer or nontrauma death. When participants reported incident CVD or cancer on a follow-up questionnaire, permission to obtain the medical records was obtained.

Study physicians who were blinded to exposure data reviewed the records. For myocardial infarction, the WHO criteria was used, along with cardiac-specific troponin levels, when available. A supplementary questionnaire was mailed to each participant confirm the self-report of diabetes diagnosis on any biennial questionnaire. Deaths were reported by next of kin, coworkers, or postal authorities or through the National Death Index 26 and cause of death was confirmed by reviewing medical records or autopsy reports.

All causes of deaths, except those resulting from external causes e. Each participant contributed follow-up time from the return of the baseline questionnaire until the date of diagnosis of the first event CVD, diabetes or cancer , date of death or end of follow-up June in women, February in men.

Because BMI may mediate the association between diet and chronic disease risk, models with and without BMI 8 categories are presented.

A trend test was computed by using the median values for quintiles modeled as a continuous variable. The median 10 th —90 th percentile of the ONQI-f score was As expected, the intake of nutrients in the numerator was higher, and nutrients in the denominator were lower, with greater ONQI-f scores.

Women and men who consumed a diet with a higher average ONQI-f score were less likely to smoke and to use aspirin regularly and were more likely to have prevalent hypercholesterolemia and a lower BMI. Individuals with higher ONQI-f scores consumed fewer calories, more alcohol and exercised more. Over 20 years of follow-up, there were 20, cases of major chronic disease, including 3, cases of CVD, 4, cases of diabetes and 9, cases of cancer among women and 13, cases of major chronic disease, including 4, cases of CVD, 2, cases of diabetes and 4, cases of cancer among men.

After adjustment for confounders, women in the highest compared to lowest quintile of the ONQI-f score had a relative risk of chronic disease of 0. The relative risk of chronic disease among men, comparing the highest to lowest quintile of the ONQI-f score, was 0.

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Examples of Overall Nutrition Quality Index (ONQI) Scores