nuvalI saw my first commercial for NuVal tonight. I guess I’ll be seeing them since I now live in Colorado, an area serviced by Kroger and their King Soopers chain of grocery stores.

If you haven’t heard of NuVal, it’s a newly contrived system for relaying nutritional information about food to consumers. Some people think the comprehensive listing of ingredients and nutritional contents currently found (and required by the FDA) on food are either too confusing or not helpful enough.

The solution proffered by NuVal is to mix all of the qualities of a certain food into a sort of “proprietary” algorithm and apply a numerical value score, ranging from 1 to 100. The closer to 100 the score gets, supposedly the better the food is for you.

I can appreciate the effort to try and make the shopping experience for people more intuitive, but I really don’t think NuVal is an appropriate solution.

First of all, their patent-pending algorithm is heavily biased against foods like red meat and eggs because it factors in cholesterol and saturated fat as bad things. Even though Ancel Keys himself acknowledged that dietary cholesterol has no connection to cholesterol in the blood. And any correlations between saturated fat and heart disease have been soundly refuted over and over. Heck, blood cholesterol doesn’t even correlate with heart disease.

“There’s no connection whatsoever between cholesterol in food and cholesterol in blood. And we’ve known that all along. Cholesterol in the diet doesn’t matter at all unless you happen to be a chicken or a rabbit.” Ancel Keys, Ph.D., professor emeritus at the University of Minnesota 1997.

But hey, the existing paradigm hates cholesterol and saturated fat, so lets keep going with that for now.

Regardless of all of that stuff, I think the system is largely a failure because it somehow makes foods that are not equivalent, seem equivalent. For example, both iceberg lettuce and spinach both get a score of 82. I mean come on, iceberg lettuce is essentially just cellulose and water. How can it possibly hold a candle to spinach, which actually has color to it.

Beyond that,  I don’t even see foods like liver on the list. There is an entire category for crackers, but liver couldn’t even be mentioned. If I had to give my own score for grass fed beef liver, it would probably be a 120 out of a 100. Richard Nikoley often refers to it as nature’s multivitamin. At least they are taking the time to warn people that Keebler Townhouse Bistro Multi Grain crackers are most deserving of their score of 2.

What we really need is a system called OldVal. Gather up a big list of foods, how about everything you find in the grocery store, and then for each traditional culture that has eaten that food in the past give it +10 points. Sure, that means that cannibalism will get a decent score, but it still makes more sense than basing everything on science that is readily disproven.

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12 Responses to NuVal, Too Abstract To Be Useful

  1. David-

    thank you for this post; I respect all well considered opinions. However, you make some overt factual errors. Iceberg lettuce, which is nutrient dilute- but nonetheless a source of some vitamins and minerals and a good source of fiber at a cost of almost no calories- does indeed score 82. Spinach, which is vastly more nutrient dense, scores 100.

    As for a ‘bias’ against meat and eggs: the only ‘bias’ in NuVal is FOR the public health. The system was designed to weight nutrients based on established health effects. The penalty for cholesterol is very slight- because not only are we aware of the ‘weak link’ between cholesterol and heart disease, my own lab has contributed to that literature! (See: Njike V, Faridi Z, Dutta S, Gonzalez-Simon AL, Katz DL. Daily egg consumption in hyperlipidemic adults–effects on endothelial function and cardiovascular risk. Nutr J. 2010 Jul 2;9:28; Katz DL, Evans MA, Nawaz H, Njike VY, Chan W, Comerford BP, Hoxley ML. Egg consumption and endothelial function: a randomized controlled crossover trial. Int J Cardiol. 2005 Mar 10;99(1):65-70).

    However, who in the US is ‘deficient’ in meat, or eggs, or protein? Just about nobody. But deficiency in produce intake prevails. The simple reality is that more produce intake would mean less chronic disease, and that is the only ‘bias’ reflected in NuVal scores.

    You are correct that dissimilar items can get similar scores- but so what? It may well be that the least nutritious vegetable and the most nutritious nut; or the least nutritious meat and the most nutritious beverage; or…whatever, tabulate the same when all of their nutrient components are considered. But who in the real world makes such trade-offs? NuVal is designed to empower real-world choices: this bread, or that; these chips, or those; this cut of meat, or that one. You can look across categories when helpful- the scale is universal- but comparing deli meats to salad dressings is unlikely to prove useful to anyone. A hammer is a good tool- but it still can be used badly. Ditto for NuVal.

    NuVal is, in fact, to our knowledge, the only nutritional guidance system to date- ever!- to correlate directly with health outcomes in a large cohort: Chiuve SE, Sampson L, Willett WC. The association between a nutritional quality index and risk of chronic disease. Am J Prev Med. 2011 May;40(5):505-13. The study, conducted at Harvard, included more than 100,000 people and the punch line is: the higher the average NuVal score of their foods, the lower their risk of dying prematurely from any cause.

    Finally, I must beg to differ with your assertion in the title. Too ‘abstract’? The system works as follows: 1 to 100, the higher the number, the more nutritious the food. That is about as far from abstract as things gets.

    With all due respect,
    David L. Katz, MD, MPH, FACPM, FACP
    Director, Yale University Prevention Research Center
    Principal Inventor, Overall Nutritional Quality Index (used in NuVal)

    • David Csonka says:

      Dr. Katz, thank you for taking the time to chime in here at my blog, I appreciate your responses to my criticism of the NuVal system.

      On the iceberg lettuce and spinach, upon looking back at the list I now notice that the spinach examples were labeled as “canned”, while the iceberg lettuce is labeled as “fresh”. I suppose this is has had an effect on the scoring mechanism?

      To further elaborate on some of my feelings, I believe the system is too abstract because it seemingly fails to take into account peripheral qualities of the food like production methods or environmental input.

      For instance, iceberg lettuce grown in a field devoid of micronutrient input due to poor farming methods will contain virtually nothing useful for humans, besides maybe fiber and water. Grown on a different farm it might be superior. Hard to know.

      The food nutrient values passed around the Internet do not reflect the current state of top soil in the USA. If it’s not in the soil, it won’t be in the food.

      Another example would be nuts. Foods like nuts which have a high polyunsaturated fat content are prone to rancidity if left out at room temperature for long periods. Rancid oils can increase oxidative stress, so that is obviously a problem.

      The same product can be markedly different from store to store simply because of storage protocols. So, in this case a generally health food like walnuts can be not so good for you.

      I understand what NuVal is trying to accomplish, but I feel that there is a lot of information that will be exceedingly difficult to capture with an index, information that is very important.

  2. David-

    I agree there is a lot of information that matters to you, me, and many others not captured in a NuVal score. But let’s be clear: NuVal isn’t taking any information away! That information simply isn’t available – at all- to inform decisions at point of purchase. NuVal does one thing well: make sense out of the ‘aggregate’ nutrition information that IS available. It does not presume to suggest that nutritional quality is the only thing that matters. Taste matters, and of course, it doesn’t measure that. Contamination matters. Environmental impact matters. (It may interest you to know we are collaborating with colleagues in Australia to work on a metric that incorporates NuVal and carbon footprint).

    Again, a hammer is a good tool- but it makes a lousy screw driver, or band saw. NuVal does one thing very well- it measures overall nutritional quality. That is very helpful. But there are other important tasks, for which other tools would be required. NuVal nowhere claims to be the one tool suited to do every job. For more on why the one job it does do well is important, please see: http://www.huffingtonpost.com/david-katz-md/holistic-nutrition_b_842627.html

    As for the canned spinach, yes, that would account for it; there is doubtless ‘stuff’ in that can other than spinach, and the lower NuVal score reflects whatever company that spinach is keeping.

    Best,
    DK

  3. Debi says:

    Fascinating! Both sides of the story, that is. I give this blog and it’s responses, oh about a 90. You guys can fight it out. :)

  4. Kate says:

    Mr. Csonka,
    I would have to agree with you about where the NuVal system is lacking. I have been doing quite a bit of research on the the system and have yet to find an article about it where Dr. Katz has not commented and/or argued with the writer. He tends to come off as condescending, and I feel like the only people this system could possibly help, are the ones he is sweeping under the rug. When he says, “It may well be that the least nutritious vegetable and the most nutritious nut; or the least nutritious meat and the most nutritious beverage; or…whatever, tabulate the same when all of their nutrient components are considered. But who in the real world makes such trade-offs?” it is very obvious that he has never been a young woman who has a busy schedule, and a tight budget. When I was younger, I made those types of trade offs regularly i.e. grapes for cheese, pecans for chocolate, ice cream instead of potato chips. Many of us are thinking in terms of how we are eating, not what we are eating. I tend to group my foods as snack or meal choices. Veggies, meats, grains, and other starches are meal time foods, while dairy, fruit, and fats are typically my treats or snack foods. Our household tends to consume less processed foods, so I would have to disagree with Diet Coke at 15 scoring five more points Grape Juice.
    Thank you,
    Kate

    • Dear Kate-

      I am a physician who has been working in public health for years; my patients are routinely ‘down and out.’ My entire career it devoted to people who have trouble affording the advice we health promotion types routinely dispense. I am not sure how you reach the conclusion that I am condescending- it is no more justified than me concluding you must be arrogant based on the ‘tone’ of your note above. How well do we actually know one another?

      Regarding your general message: actually, we are agreeing. Sure, you make trade-offs in terms of what you can afford; you may buy cheese rather than grapes because of budget considerations, but you are deciding between grapes and cheese based on nutrition. The two foods have nothing to do with one another. I don’t think a nutritional comparison of grapes to cheese would be needed or helpful. However, perhaps NuVal would help identify the most nutritious cheese at a good price point.

      As for diet soda and grape juice, I confess my sympathies run your way; I never drink diet soda, and while I drink juice only occasionally, I do drink it. However, NuVal is based on science, not opinion. The science is clear that an excess of sugar and calories are a big part of what ails our society; whereas the science about harms, or benefits, of diet sodas is far less conclusive. Every decision about NuVal had to run the gauntlet of a dozen top nutrition and public health scientists from throughout North America; no one’s native preferences were indulged if there wasn’t adequate science to support them.

      Lastly, far from the ‘condescension’ you attribute to me, I am totally committed to fixing real-world challenges such as those you describe. With regard to food cost issues, we are among the only ones to study it- and found that the real issue is NOT that more nutritious foods consistently cost more (some do, of course), but that most people can’t identify the more nutritious foods that cost less! See: Katz DL, Doughty K, Njike V, Treu JA, Reynolds J, Walker J, Smith E, Katz C. A cost comparison of more and less nutritious food choices in US supermarkets. Public Health Nutr. 2011 Sep;14(9):1693-9

      My staff and I make as much empowering programming as possible available to all for free; please visit http://www.turnthetidefoundation.org/ to see how we are putting our efforts, and our own money, where my mouth is.

      Perhaps we will still disagree in the end, but I ask that you not rush to judgment about the character of someone you don’t know. Consider being at the receiving end of that.

      As for consistent defense of NuVal, of course! It cannot be ‘perfect’ any more than an iPhone or iPad or GPS system can be perfect- that’s why new and improved versions keep coming out (as they will for NuVal; version 2.0 is in the works now). NuVal is to my knowledge the best, most robustly tested, and most fully independent and objective nutrition guidance system there is. Defending what you believe in is not being ‘defensive’- it is what all good and devoted people do for the causes about which they are passionate.

      All best,
      DK

  5. Kate says:

    My singular problem is not the caloric contents of the foods, per se, but the usage of the term Nutritional Value. Diet Coke does indeed have less sugar and calories than grape juice, but Diet Coke is lacking the 180mg of Potassium and 100% RDA of Vitamin C. What Diet Coke isn’t lacking is 25g more sodium per serving. Sodium has a known link to hypertension and heart disease. At a time when our country is facing an obesity epidemic, while at the same time, an average of 70% of the general population isn’t meeting the RDA guide points for essential vitamins and nutrients, this is slightly disturbing. Without the required nutrition for energy production, people are more likely to become fatigued and depressed.
    Just a thought,
    Kate
    “Let food by thy medicine and medicine by thy food”

    America and Malnutrition: Vitamin Deficiencies and Poor Diets | Suite101.com http://heather-vazquez.suite101.com/america-and-malnutrition-a193556#ixzz1Zvky6Grt

    • Actually, the sodium in the diet soda is penalized. Bear in mind, 15 is not a very good score! Proponents of ‘diet’ soda feel it should score much higher.

      Despite the fact that diet soda is free of calories and sugar, and has some nutrients added to it- it scores poorly because it does not offer good nutrition. Most juices score considerably higher (some grape juice is actually stripped down, and then reconstituted with almost no nutrients from the grapes retained- it is likely such juice that scores lower than diet soda; concord grape juice with real nutrient value scores considerably higher). And, of course, beverages of genuine nutritional value- such as skim milk- score dramatically higher.

  6. Susan says:

    I am so grateful to NuVal for providing information that has already proven to be immensely helpful to my family. When I make a purchase, I read every ingredient of every item I purchase, analyze whether it’s organic, non-GMO, local, a reputable company, etc–and NuVal is now absolutely a part of my decision process.

    However, my husband cannot be bothered with “all that extra work and time”. He is motivated however to make healthy decisions and was so pleased though to come home last night and announce that he purchased the jelly with a score of 85 rather than the other jellies which had a score of 1.

    My teen son, despite my best efforts to encourage him to read the ingredients, in most cases can’t be bothered, but he is happy to purchase the high NuVal scored item. My daughter in college actually called me and told me she saw the commercial for NuVal and is using the scores in her purchases. In the real world, I realize there are more people like “them” (my family members), and not as many people like me. NuVal offers MORE information which is very easily obtainable right there at the purchase location. It has already reduced the issues (their poor purchase decisions-which drive me crazy) at our house because the decision process is netted out for those in our family who frankly are not going to spend the time to analyze most purchases.

    Nothing is ever perfect, and it would be great to include environmental impact, but NuVal significantly moves the decision making process for my family and millions more in a positive direction. If you believe as I do that every purchase is a vote and a message to food producers, NuVal is offering a tremendous service.

    Kudos to NuVal and Dr. Katz–who has clearly made improving lives through health his mission.

  7. Jeff Olson says:

    Mr. Csonka, You and David actually agree more than you know and/or disagree. David/David vs. Goliath (Food Industry).

    Kate, you and David agree more than you know too. Regarding “nutrient” deficiencies, guess what is the most important nutrient in broccoli? (see P.S. at end of post).

    All three of you are on the same side of the fence, that side being “students” of what you eat, with high regard for nature’s emergent wisdom and a shared concern for the woeful state of America’s health.

    NuVal is what it is… an evolving food GPS tool…that stands as the most scientifically rigorous measurement tool of overall nutrition quality (I am aware of). This does not mean one should discard “less quantitative, less techy” approaches… such as Pollan’s, “Eat (whole) food, mostly plants and not too much.” Listening to nature, believing in its nurture, remembering common sense and using Nuval, are not mutually exclusive. Until the world stops buying packaged, processed and industrialized food (not in our lifetime)… giving food a composite “ranking” of the very best available (nutritional) science, provides an immediate upgrade to the status-quo.

    Shoulder to shoulder. Upward and onward.
    Jeff
    P.S. Answer: broccoli is the most important nutrient in broccoli (got that from David).