Do nutrition rating systems promote a healthy diet? An evaluation of the Overall Nutritional Quality Index (ONQI) and risk of chronic disease

Abstract

Nutrition rating systems rank foods based on nutrient composition and aim to guide consumers in making healthier food choices. These rating systems have not been evaluated with respect chronic disease prevention. The NuVal™ Nutritional Scoring System is based on the Overall Nutritional Quality Index (ONQI) algorithm that incorporates over 30 dietary components, and recently was endorsed by the American College of Preventive Medicine. We examined whether the ONQI score predicted major chronic disease risk prospectively. A total of 62,287 healthy women from the Nurses’ Health Study and 42,559 healthy men from Health Professionals Follow‐Up Study were followed from 1986–2006. Dietary data were collected from questionnaires at baseline. Major chronic disease included incident CVD, cancer, diabetes and non‐trauma death. We documented 20,005 cases of chronic disease in women and 13,554 cases in men. The multivariate relative risk (RR) of chronic disease, comparing the highest to lowest quintile, was 0.91 (95%CI: 0.87–0.95) in women and 0.88 (95%CI: 0.83–0.93) in men. In women, the ONQI score was associated with lower risk of CVD (22% in women and men) and diabetes (15% in women, 18% in men), but not cancer. The ONQI score was inversely associated with all‐cause mortality (p‐trend<0.01). The NuVal™ Nutritional Scoring System may help consumers target foods that contribute to a healthy diet. Funded by NIH grants.