Calculation and Comparison of Nutrient Density/Quality Scores for Commonly Consumed Fresh Fruit

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Alim. Nutr., Araraquara ISSN 0103-4235 v. 23, n. 1, p. 7-14, jan./mar. 2012 ISSN 2179-4448 on line CALCULATION AND COMPARISON OF NUTRIENT DENSITY/QUALITY SCORES FOR COMMONLY CONSUMED FRESH FRUIT

Gail RAMPERSAUD* Maria Filomena VALIM** Sandy BARROS**

ABSTRACT: A number of methods have been developed Drug Administration (FDA) expressed interest in depicting to quantitatively describe the nutrient density/quality a nutrient density indicator on food labels24 and this was (ND/Q) of foods and beverages. Seventeen commonly followed by the development and implementation of consumed fresh fruits were evaluated using six published a variety of point-of-purchase or other nutrient rating ND/Q methods. Nutrient data for each fruit were obtained systems designed to help consumers make healthy food from the USDA National Nutrient Database for Standard choices.3,4,7,11,17 More recently, the Institute of Medicine Reference, Release 23. Numerical scores were produced convened a committee to examine front-of-pack nutrition and ranked for each fruit and method. The resulting ND/Q rating systems and symbols12 and the FDA is moving toward scores varied in range and magnitude but there was good establishing a voluntary program to convey the nutritional to strong correlation among methods. The relative scores value of food on front-of-pack although the nature and indicated that cantaloupe, strawberries, oranges, and design of a system is unknown at this time.27 Several food grapefruit generally had the highest ND/Q scores across all industry and manufacturing groups, including the American methods. Further analysis indicated that vitamins C and A, Beverage Association, Food Marketing Institute, and the nutrients common to all six methods, affected ND/Q scores Grocery Manufacturer’s Association have developed and substantially for some but not all fruits, suggesting that high approved front-of-pack systems that their members have values for specifi c nutrients may infl uence relative scoring begun implementing.1,6 and higher scores may not necessarily refl ect a greater There have been several proposed methodologies variety or balance of nutrients. Fresh fruits vary in their and algorithms to quantitatively describe the nutrient ND/Q as defi ned by several quantitative scoring systems. density, quality or profi le of foods as discussed by Zelman In this analysis, consistent results in how the fruits were & Kennedy29 and Rampersaud.13 Methodologies differ ranked were obtained when using six different methods to primarily by how many and which nutrients are considered, quantify ND/Q for select fresh fruit. as well as the mathematical construct of the algorithm. Most methods incorporate nutrients that should be encouraged in KEYWORDS: Fruit; nutrients; nutrient density; nutrient the diet (for example, vitamins, minerals) as well as nutrients quality; nutrient profi le. to limit (for example, fat, sodium). To date, there has been no consensus on a standard defi nition for nutrient-density INTRODUCTION or quantitative approach to depict the nutrient density of foods. In addition, there are few published sources that Recommendations in the 2010 Dietary Guidelines compute and compare different ND/Q methods for various for Americans (DGA) promote the consumption of nutrient- foods or beverages.5,8,13,15 dense foods and beverages.21 The 2005 DGA described The purpose of this article is to compute and nutrient-dense foods as those that provide substantial compare nutrient density/quality (ND/Q) scores for the amounts of nutrients (i.e., vitamins and minerals) and most commonly consumed fruits in the U.S. using six relatively fewer calories.22 The 2010 Dietary Guidelines methods. The fruits were scored and ranked to examine the Advisory Committee expanded on the defi nition by consistency with which the various methodologies ranked describing nutrient-dense foods as those that are naturally the fruit based on their scores as well as how individual rich in vitamins, minerals and phytochemicals and are lean nutrients affect scores and rankings. The purpose of this or low in solid fats and without added solid fats, sugars, analysis was not to determine the most applicable or suitable starches and sodium, and that retain naturally-occurring ND/Q method for fruit or other foods, but rather to provide components such as fi ber.23 In the past, the US Food and new data to the literature concerning scores specifi cally

* Food Science and Human Nutrition Department – Institute of Food and Agricultural Sciences – University of Florida – 32611-0720 – Gainesville – FL – USA. E-mail: gcr@uﬂ .edu. ** Florida Department of Citrus – 33850 – Lake Alfred – FL – USA.

7 RAMPERSAUD, G.; VALIM, M. F.; BARROS, S. Comparison of nutrient density/ quality scores for fresh fruit. Alim. Nutr., Araraquara, v. 23, n. 1, p. 7-14, jan./mar. 2012. for fruit and to build on previously published data on the obtained from the USDA database were included in the nutrient density of 100 percent fruit juices.13 analysis. Any methods that required an assessment of nutrient content by comparison to established criteria, other food products, or that included a subjective assessment of MATERIAL AND METHODS nutrient content or value were not included in the analysis. Six methodologies that met the criteria were Selection of Fresh Fruit for Evaluation identifi ed. For each method, the “%DV” is the percent of 25 The most commonly consumed fresh fruits in the the Daily Value (DV) contributed by that nutrient. There is U.S. were identifi ed using the USDA/Economic Research no DV for sugar so the upper limit of the daily sugar intake Service data that provides retail availability data, a proxy goal established by the World Health Organization/Food for consumption, for a variety of fresh fruits on a pound and Agriculture Organization was used for this analysis.28 per capita basis.20 For this evaluation, only fruits that had Some methods capped the %DV at 100% with the rationale at least a one pound per capita consumption rate for 2009 that levels above this are not likely to produce a health (the most recent data available as of this analysis) were in- benefi t and may, in some cases, have negative effects cluded. Fifteen fruit categories met this criterion: oranges on health.8 Other methods capped nutrients to mitigate and temples, tangerines and tangelos, lemons, limes, grape- excessively high scores as a result of nutrient fortifi cation fruit, apples, avocados, bananas, grapes, mangos, peaches or very high levels of single nutrients in foods.3,16 Each and nectarines, pears, pineapples, strawberries, and me- method incorporates various combinations of nutrients lons. Two fruits, lemons and limes, were excluded from the that should be encouraged in the diet (e.g., vitamins and analysis because they typically are not consumed in whole minerals) and those that should be limited in the diet (e.g., or in part as a serving of fruit similar to other fruits. fats, sugar, sodium, cholesterol). The following methodologies and algorithms were Source of Nutrient Data used to assess ND/Q: Nutrient data from the USDA National Nutrient Nutrient-Rich Foods (NRF) Index3 Database for Standard Reference, Release 2319 were used for the analysis. This open access database provides nutrient This methodology incorporates nine nutrients to data for a variety of foods and beverages and is designed encourage as well as three nutrients to limit. It is computed for the collection and dissemination of food composition based on the nutrient content of approximately 419kJ 18 data. Data for temples and tangelos are not included in (100kcal) of food or beverage: the database so the categories “oranges and temples” and “tangerines and tangelos” included only oranges and NRF Index = %DV protein + %DV dietary fi ber + %DV vitamin A + %DV vitamin C + %DV vitamin E + %DV calcium + %DV iron + tangerines, respectively. Nectarines are included in the %DV magnesium + %DV potassium - %DV saturated fat – database and are reported separately from peaches. The %DV sugar - %DV sodium “melon” category included summary data for three types of melons: watermelon, cantaloupe, and honeydew. Each Values for added sugars are not included in the has per capita consumption of at least one pound per year USDA National Nutrient Database for Standard Reference and were therefore analyzed individually. For grapefruit, and were assumed to be zero for fresh fruit. This method the database included separate information for pink/red capped all DV percentages at 100%. and white grapefruit and these two varieties of grapefruit were also analyzed separately. For six fruits (avocados, Food Quality Score (FQS)8 grapefruit, grapes, oranges, pears, and pineapple), the database included multiple entries with unique Nutrient This methodology incorporates eight nutrients to Databank (NDB) numbers. For these fruits, data from “all encourage and fi ve nutrients to limit. The authors evaluated commercial varieties” or “all areas” were used. For grapes, three nutrient density methodologies and found this method data for the European variety was used since they are the to be preferable. The numerator of the equation is specifi c most typically consumed as a whole fresh fruit. The fi nal for fruits and vegetables. This score is computed based on analysis included 17 unique fruits. the nutrient content of 100g of food or beverage: (%DV dietary fi ber + %DV vitamin A + %DV vitamin C + %DV vitamin E + Methodologies Used to Calculate Nutrient Density/ %DV folate + %DV calcium + %DV iron + %DV potassium) ÷ 8 Quality Scores FQS = ------(%DV energy [kcal] + %DV saturated fat + %DV cholesterol + Published methodologies that evaluated nutrient %DV sodium + %DV trans fat) ÷ 5 density or nutrient quality of foods were researched. Only those methods that provided a quantitative assessment of Values for trans fat were not included in the nutrient nutrient profi le or quality and produced a single numerical database and were assumed to be zero for fresh fruit. This score based on absolute nutrient values that could be method capped all DV percentages at 100%.

8 RAMPERSAUD, G.; VALIM, M. F.; BARROS, S. Comparison of nutrient density/ quality scores for fresh fruit. Alim. Nutr., Araraquara, v. 23, n. 1, p. 7-14, jan./mar. 2012.

Ratio of Recommended to Restricted (RRR) Nutrients16 For this method, DV percentages were not capped at 100%. This methodology produces a ratio based on six recommended food components to fi ve food components Statistical Analysis that are suggested to be restricted in the diet. All values are based on a serving of food or beverage (that is, the Nutrient density/quality scores were calculated and for each fruit and method a simple rank order from one to 17 was Reference Amount Customarily Consumed [RACC]):26 assigned with a rank of one representing the highest ND/Q (%DV protein + %DV dietary fi ber + %DV calcium + %DV iron + score. For each fruit, overall mean ranks were calculated %DV vitamin A + %DV vitamin C) ÷ 6 RRR = ------as an arithmetic mean of the individual ranks. Spearman (%DV energy [kcal] + %DV sugars + %DV cholesterol + and Kendall correlation coeffi cients for ND/Q scores were %DV saturated fat + %DV sodium) ÷ 5 calculated using SAS statistical software (Version 9.2, SAS Institute Inc., Cary, North Carolina, USA). This method capped all DV percentages at 100%.

Nutrient for Calorie (NFC)29 RESULTS

This methodology is based on 12 nutrients to Table 1 presents the ND/Q scores calculated for encourage and two nutrients to limit. All values are based each fruit. The magnitude and range of ND/Q scores varied substantially depending on the method. There was a good on a serving of food or beverage (RACC): to very strong correlation among scores for the various (%DV protein + %DV vitamin B12 + %DV vitamin C + %DV vitamin A + methods with absolute values of correlation coeffi cients %DV vitamin E + %DV calcium + %DV iron + %DV zinc + %DV potassium + %DV magnesium + %DV phosphorus + %DV dietary fi ber – ranging from 0.63 to 0.93 (Spearman) and 0.54 to 0.83 %DV saturated fat – %DV sodium) ÷ 14 (Kendall) (data not shown). NFC = ------The fruits were ranked from one to 17 based on energy [kcal] the highest and lowest ND/Q scores, respectively (Table 2). For all methods except one (FQS), cantaloupe ranked For this method, DV percentages were not capped as the fruit with the highest ND/Q score. Strawberries at 100%. were ranked highest based on the FQS method and second highest based on four other methods. In general, citrus 9 Calorie for Nutrient (CFN) fruits, including oranges, pink/red grapefruit, and white grapefruit, fi lled out the remaining top fi ve positions with The method is based on 13 food components, mangos and pineapple also ranking in the top fi ve for 29 expanded from the original nine. This methodology several methods. In general, apples, avocados, bananas, characterizes the number of calories that would need to grapes, and pears had the lowest ND/Q scores. Overall be consumed to obtain a certain amount of nutrients and, mean ranks were computed by averaging the individual therefore, unlike the other methods in this analysis, lower ranks (assigned from one to 17) for all fruits and methods, scores would be indicative of a food with higher ND/Q. All and are presented in Table 3, column A, along with highest values are based on 100g of food or beverage: and lowest ranks in parenthesis. Based on mean rank, energy [kcal] the fruits rank as follows from highest to lowest ND/Q: CFN = ------cantaloupe > strawberries > pink/red grapefruit > oranges (%DV protein + %DV thiamin + %DV ribofl avin + %DV niacin + > white grapefruit > pineapple > mangos > tangerines > %DV folate + %DV vitamin B6 + %DV vitamin B12 + %DV vitamin C + honeydew > watermelon > peaches > nectarines > bananas %DV vitamin A + %DV calcium + %DV magnesium + %DV iron + %DV zinc) ÷ 13 > avocados > grapes > pears > apples. For this method, DV percentages were not capped at 100%. DISCUSSION

2 Nutrient Density Score (NDS) The methodologies used in the analysis differed in several ways. The NRF Index was the only method to base This method is based on 16 nutrients to encourage nutrient data on energy content (100kcal). The FQS, CFN, and was developed for fruits and vegetables. All values are and NDS methods used food weight (100g) and the RRR based on 100 g of food or beverage: and NFC methods used serving size (RACC). The methods (%DV protein + %DV dietary ﬁ ber + %DV vitamin A + %DV thiamin + differed based on the numbers and types of nutrients %DV riboﬂ avin + %DV niacin + %DV pantothenic acid + %DV vitamin B6 + included. All methods included nutrients to encourage, %DV folate + %DV vitamin B12 + %DV vitamin C + %DV vitamin E + with the number of nutrients ranging from six to 16. Four %DV vitamin D + %DV calcium + %DV iron + %DV magnesium) ÷ 16 NDS = ------methods (NRF Index, FQS, RRR, and NFC) incorporated energy [kcal] data for nutrients to limit in the diet, for instance saturated

9 RAMPERSAUD, G.; VALIM, M. F.; BARROS, S. Comparison of nutrient density/ quality scores for fresh fruit. Alim. Nutr., Araraquara, v. 23, n. 1, p. 7-14, jan./mar. 2012.

Table 1 – Nutrient density/quality (ND/Q) scores for select fresh fruit. Method NDB Fruit NRF Indexb FQSb RRRb NFCb CFNc NDSb Numbera Apples 09003 48 5 0.7 0.036 37.7 3.5 Avocados 09037 47 3 2.3 0.038 22.3 5.5 Bananas 09040 53 5 0.9 0.041 19 5.2 Cantaloupe 09181 250 35 6.2 0.31 2.9 28.5 Pink/red grapefruit 09112 196 26 4.5 0.16 5.9 15.2 White grapefruit 09116 145 25 3.2 0.155 6.0 14.9 Grapes 09132 51 5 0.7 0.039 22.1 4.1 Honeydew 09184 126 11 1.6 0.093 9.1 9.7 Mangos 09176 172 20 2.2 0.126 6.9 13.1 Nectarines 09191 87 9 1.2 0.068 16.3 6.6 Oranges 09200 162 31 3.4 0.183 5.0 18.1 Peaches 09236 99 11 1.2 0.077 14.6 7.2 Pears 09252 49 6 0.8 0.037 39.9 3.4 Pineapple 09266 134 24 3.4 0.140 6.0 14.4 Strawberries 09316 170 45 5.9 0.276 3.4 25.5 Tangerines 09218 150 17 2.5 0.111 8.3 11.0 Watermelon 09326 119 13 1.8 0.089 10.1 8.7 Abbreviations: NRF=Nutrient Rich Foods; FQS=Food Quality Score; RRR=Ratio of Recommended to Restricted Nutrients; NFC=Nutrient for Calorie; CFN=Calorie for Nutrient; NDS=Nutrient Density Score. a NDB=Nutrient Databank. bHigher values indicate higher ND/Q. cLower values indicate higher ND/Q.

Table 2 – Ranking of select fruits based on nutrient density/quality (ND/Q) scores. Method Ranka NRF Index FQS RRR NFC CFN NDS 1 cantaloupe strawberries cantaloupe cantaloupe cantaloupe cantaloupe 2 pink/red grapefruit cantaloupe strawberries strawberries strawberries strawberries 3 mangos oranges pink/red grapefruit oranges oranges oranges 4 strawberries pink/red grapefruit pineapple pink/red grapefruit pink/red grapefruit pink/red grapefruit 5 oranges white grapefruit oranges white grapefruit pineapple white grapefruit 6 tangerines pineapple white grapefruit pineapple white grapefruit pineapple 7 white grapefruit mangos tangerines mangos mangos mangos 8 pineapple tangerines avocados tangerines tangerines tangerines 9 honeydew watermelon mangos honeydew honeydew honeydew 10 watermelon peach watermelon watermelon watermelon watermelon 11 peach honeydew honeydew peach peach peach 12 nectarines nectarines nectarines nectarines nectarines nectarines 13 bananas pears peaches bananas bananas avocados 14 grapes apples bananas grapes grapes bananas 15 pears bananas pears avocados avocados grapes 16 apples grapes apples pears apples apples 17 avocados avocados grapes apples pears pears Abbreviations: NRF=Nutrient Rich Foods; FQS=Food Quality Score; RRR=Ratio of Recommended to Restricted Nutrients; NFC=Nutrient for Calorie; CFN=Calorie for Nutrient; NDS=Nutrient Density Score. aRanked from highest ND/Q score (1) to lowest ND/Q score (17).

10 RAMPERSAUD, G.; VALIM, M. F.; BARROS, S. Comparison of nutrient density/ quality scores for fresh fruit. Alim. Nutr., Araraquara, v. 23, n. 1, p. 7-14, jan./mar. 2012.

Table 3 – Overall average rank and highest/lowest ranks based on six methods used to calculate nutrient density/quality (ND/Q) for select fresh fruit.a (A) (B) (C) Rank Fruit, Fruit, (highest, lowest rank) Fruit, (highest, lowest rank) (highest, lowest rank) minus Vitamin Cb minus Vitamin C, Vitamin Ac 1 cantaloupe (1, 2) cantaloupe (1, 1) strawberries (1, 3) 2 strawberries (1, 4) pink/red grapefruit (2, 2) oranges (2, 9) 3 pink/red grapefruit (2, 4) mangos (3,7)) cantaloupe (1, 13) 4 oranges (3, 5) strawberries (3, 7) peaches (2, 14) 5 white grapefruit (5, 7) watermelon (3, 8) nectarines (4, 12) 6 pineapple (4, 8) tangerines (5, 8) pink/red grapefruit (2, 13) 7 mangos (3, 9) peaches (5, 10) mangos (5, 15) 8 tangerines (6, 8) oranges (5, 9) tangerines (7, 11) 9 honeydew (9, 11) nectarines (7, 9) white grapefruit (6, 11) 10 watermelon (9, 10) avocados (3, 16) avocados (1, 16) 11 peaches (10, 13) white grapefruit (10, 15) honeydew (4, 16) 12 nectarines (12, 12) honeydew (10, 16) pineapple (5, 16) 13 bananas (13, 15) pineapple (11, 15) bananas (7, 14) 14 avocados (8, 17) bananas (12, 15) watermelon (4, 15) 15 grapes (14, 17) pears (11, 16) pears (5, 16) 16 pears (13, 17) apples (13, 17) apple (10, 17) 17 apples (14, 17) grapes (15, 17) grapes (15, 17) a Rankings were based on the arithmetic mean of the rankings (one to 17) for all six methods. Highest, lowest represents the highest and lowest rank attained among methods. b ND/Q scores were calculated removing vitamin C from the equations. c ND/Q scores were calculated removing vitamin C and vitamin A from the equations. fat, added sugar, sodium, and cholesterol. Since fresh fruit Three methods (NRF Index, FQS, and RRR) capped DV are generally very low in or devoid of these nutrients, the percentage values at a maximum of 100%. Fruits with inclusion of them had little impact on the scores presented ND/Q scores affected by the 100% DV cap were oranges, here. Methods also differed in the comparative variable(s), pink/red grapefruit, white grapefruit, cantaloupe, pineapple, that is, the denominator of the equation. Two methods used strawberries and mangos (vitamin C) and cantaloupe nutrients to limit in the denominator (FQS, RRR), two (vitamin A). These fruits still had the highest ND/Q scores methods used energy (NFC, NDS), and one method used even when the cap was applied, suggesting that these fruits nutrients to encourage in the denominator (CFN). Higher provided a range of other nutrients in substantial amounts scores were indicative of higher ND/Q for all methods that helped contribute to their high relative ND/Q scores. except the CFN method for which lower scores were Each of the methodologies took into account nutrient indicative of a higher ND/Q. and energy content. Four nutrients were common to all six Despite various differences, there was a substantial methods: vitamin A, vitamin C, calcium, and iron. Calories, consistency among methods with regard to the relative protein, and fi ber were represented in fi ve methods, and ranking of the ND/Q of the fruits (Table 2), and this vitamin E, magnesium, saturated fat, and sodium were consistency was confi rmed by the fairly strong correlation represented in four methods. Because vitamin C, vitamin coeffi cients among methods. This consistency has also A, calcium, and iron were common to all methods, the been observed in other studies that compared ND/Q scores impact of these individual nutrients on ND/Q scores was for similar foods or beverages using various methods.8,13 further investigated. Fruits are not generally good sources The percent differences between the highest and lowest of calcium or iron. Data used for this analysis showed scores for any method were somewhat similar, representing that oranges provided the highest amount of calcium per a range from 81% to 93%. The consistency in the fi ndings 100g (~4% of the DV) and avocados provided the highest also suggests that methods that included fewer nutrients in amount of iron (~3% of the DV). Because these low the calculation (for example, NRF Index, FQS, and RRR) amounts were not expected to greatly impact the ND/Q may be as reliable at predicting relative ND/Q scores for scores they were not considered further in this analysis. fresh fruit as methodologies that included more nutrients, Many fruits are good or excellent sources of vitamin C at least for the specifi c methods included in this analysis. and the fruits ranked as follows with regard to vitamin C

11 RAMPERSAUD, G.; VALIM, M. F.; BARROS, S. Comparison of nutrient density/ quality scores for fresh fruit. Alim. Nutr., Araraquara, v. 23, n. 1, p. 7-14, jan./mar. 2012. content (per 100g): strawberries > oranges > pineapple 100g basis, watermelon, strawberries, white grapefruit and > cantaloupe > mangos > white grapefruit > pink/red cantaloupe had the lowest energy content and except for grapefruit > tangerines > honeydew > grapes > avocados watermelon, these fruits were ranked consistently high with > bananas > watermelon > peaches > nectarines > apples > regard to ND/Q. Watermelon had one of the lowest energy pears. The amount of vitamin C provided per 100g ranged values yet ranked in the mid range with respect to ND/Q. from 7% DV (pears) to 98% DV (strawberries). Only three Relative to the other fruits in the analysis, watermelon fruits provided less than 10% DV for vitamin C (per 100g): ranked fairly low in key nutrients such as fi ber, potassium, pears, apples, and nectarines. In general, the vitamin C folate, and vitamin C. When nutrient content is high, energy rankings are fairly representative of the overall rankings content is expected to make less of an impact on scores and based on ND/Q scores (Table 2). Vitamin A precursors are vice versa. less widely distributed in these fruits compared to vitamin A limitation of current ND/Q approaches is that C. Cantaloupe provided the highest amount of vitamin A phytochemicals were not included in any methodology and provided approximately three times the amount as the used in this analysis. Fruits contain a wide range of next highest source (pink/red grapefruit). Only fi ve fruits phytochemicals, ranging from anthocyanins and resveratrol provided more than 10% of the DV for vitamin A per 100 in dark-colored grapes, quercetin in apples, to fl avanones g: cantaloupe, pink/red grapefruit, mangos, tangerines and such as hesperidin and naringin in citrus. Phytochemicals watermelon. in foods have been associated with benefi cial effects It was considered whether vitamin C, and to a toward health.10,14 In order to incorporate phytochemicals lesser extent vitamin A, might have a substantial bearing into a ND/Q methodology, intake reference standards and on the rankings for these fruits and whether successively more comprehensive and complete food phytochemical removing these nutrients from the ND/Q equations would databases need to be established. Another limitation is that substantially change ND/Q rank. After removing vitamin the practice of assigning a rank based on ND/Q score fails C from all equations, cantaloupe still ranked the highest to discriminate for relative differences between any two (Table 3, column B). Mean rankings for pineapple, white scores. For one method, the difference between the highest grapefruit and oranges decreased the most after removing and second highest scores may be small while for another vitamin C suggesting that the ND/Q scores for these fruits method the difference may be large. Therefore, the rankings are especially sensitive to this nutrient. Mean rankings are not refl ective of whether small or large differences exist for several fruits improved after removing vitamin C, among the scores for any given method. including watermelon, peaches, and avocados, all of which tended to have lower amounts of vitamin C compared to the other fruits. After additionally removing vitamin A CONCLUSION from all equations, several fruits (strawberries, oranges, and cantaloupe) continued to rank high (Table 3, column Fresh fruits vary in their ND/Q as determined by C). Some fruits dropped in rank (mangos, watermelon) several quantitative scoring systems. These results indicate because they contained higher amounts of vitamin A that cantaloupe, strawberries, oranges, and grapefruit and were more sensitive to the removal of that nutrient, consistently have a higher ND/Q compared to other while others benefi ted from higher rankings (peaches, commonly consumed fresh fruit. This analysis demonstrated nectarines). Rankings for cantaloupe, strawberries, and that using six different methods to quantify ND/Q for select pink/red grapefruit were consistently high despite removing fresh fruit produced consistent results. However, for some both vitamins, suggesting that these fruits provided a fresh fruit ND/Q scores may be sensitive to key nutrients range of other nutrients in substantial amounts that, taken such as vitamin C and vitamin A, suggesting that high collectively, contributed to their higher ND/Q scores. values for specifi c nutrients may infl uence relative scoring Removal of both vitamins A and C from the equations and higher scores may not necessarily refl ect a greater resulted in less consistent rankings among methods. This is variety or balance of nutrients. This analysis was not noted by comparing the highest and lowest ranks for each designed to determine the most applicable ND/Q method, equation iteration (Table 3, columns A, B, and C, highest but contributes to the limited body of data that quantifi es and lowest ranks in parenthesis) and observing that the and compares ND/Q methods for various foods. range between low and high ranks generally widened as nutrients were sequentially removed from the equations. ACKNOWLEDGMENTS The observed substantial drop in scores for some fruits after removal of vitamin C or vitamin A also illustrates how The authors thank Mark Brown, PhD, for consultation higher ND/Q scores may not necessarily refl ect a greater and assistance with statistical evaluation. variety or balance of nutrients. The magnitude of ND/Q scores can be disproportionally affected by energy content, particularly RAMPERSAUD, G.; VALIM, M. F.; BARROS, S. when energy forms the basis for all nutrient values (NRF Estimativa e comparação de vários índices utilizados para Index) or when energy alone constitutes the numerator or cálculo de densidade nutricional/qualidade de frutas. Alim. denominator of the algorithm (NFC, CFN, NDS). On a Nutr., Araraquara, v. 23, n. 1, p. 7-14, jan./mar. 2012.

12 RAMPERSAUD, G.; VALIM, M. F.; BARROS, S. Comparison of nutrient density/ quality scores for fresh fruit. Alim. Nutr., Araraquara, v. 23, n. 1, p. 7-14, jan./mar. 2012.

RESUMO: Vários métodos foram desenvolvidos e pu- 7. KATZ, D. et al. The stratifi cation of foods on the basis blicados com o objetivo de quantifi car por meio de um ín- of overall nutritional qualilty: the overall nutritional dice a densidade nutricional e ou a qualidade de alimentos quality index. Am. J. Health Promot., v. 24, p. 144-145, e bebidas. Neste trabalho foram estimados os índices de 2009. densidade nutricional de dezessete frutas mais consumidas nos Estados Unidos utilizando seis métodos diferentes. 8. KENNEDY, E . et al. Alternative approaches to the Os dados nutricionais utilizados no cálculo dos índices calculation of nutrient density. Nutr. Rev., v. 66, de cada fruta foram obtidos na USDA National Nutrient p. 703-709, 2008. Database for Standard Reference, Release 23 e os índices 9. LACHANCE, P.; FISHER, M. Educational and estimados foram classifi cados em ordem decrescente de technological innovations required to enhance the acordo com o método utilizado. Os resultados mostraram selection of desirable nutrients. Clin. Nutr., v. 5, uma ampla faixa de variação na magnitude dos índices p. 257-567, 1986. de densidade nutricional, mas com alta correlação entre as metodologias utilizadas. As frutas melão (cantaloupe), 10. LIU, R. Health benefi ts of fruit and vegetables are from morango, laranja e grapefruit apresentaram, de maneira additive and synergistic combinations of phytochemicals. consistente, os mais altos índices de densidade nutricional Am. J. Clin. Nutr., v. 78, p. 517S-520S, 2003. entre os vários métodos utilizados. Foi observado que os 11. LUPTON, J. et al. The smart choices front-of-package teores de vitaminas A e C, dois nutrientes computados na nutrition labeling program: rationale and development maioria dos métodos, podem infl uenciar os resultados e of the nutrition criteria. Am. J. Clin. Nutr., v. 91, alterar a ordem de classifi cação de algumas frutas. 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