A New Carbohydrate Food Quality Scoring System to Reflect Dietary Guidelines: An Expert Panel Report

Abstract

Existing metrics of carbohydrate food quality have been based, for the most part, on favorable fiber- and free sugar-to-carbohydrate ratios. In these metrics, higher nutritional quality carbohydrate foods are defined as those with >10% fiber and <10% free sugar per 100 g carbohydrate. Although fiber- and sugar-based metrics may help to differentiate the nutritional quality of various types of grain products, they may not aptly capture the nutritional quality of other healthy carbohydrate foods, including beans, legumes, vegetables, and fruits. Carbohydrate food quality metrics need to be applicable across these diverse food groups. This report introduces a new carbohydrate food scoring system known as a Carbohydrate Food Quality Score (CFQS), which supplements the fiber and free sugar components of previous metrics with additional dietary components of public health concern (e.g., sodium, potassium, and whole grains) as identified by the Dietary Guidelines for Americans. Two CFQS models are developed and tested in this study: one that includes four dietary components (CFQS-4: fiber, free sugars, sodium, potassium) and one that considers five dietary components (CFQS-5: fiber, free sugars, sodium, potassium, and whole grains). These models are applied to 2596 carbohydrate foods in the Food and Nutrient Database for Dietary Studies (FNDDS) 2017–2018. Consistent with past studies, the new carbohydrate food scoring system places large percentages of beans, vegetables, and fruits among the top scoring carbohydrate foods. The whole grain component, which only applies to grain foods (N = 1561), identifies ready-to-eat cereals, oatmeal, other cooked cereals, and selected whole grain breads and crackers as higher-quality carbohydrate foods. The new carbohydrate food scoring system shows a high correlation with the Nutrient Rich Food (NRF9.3) index and the Nutri-Score. Metrics of carbohydrate food quality that incorporate whole grains, potassium, and sodium, in addition to sugar and fiber, are strategically aligned with multiple 2020–2025 dietary recommendations and may therefore help with the implementation of present and future dietary guidelines.

Multiple Metrics of Carbohydrate Quality Place Starchy Vegetables Alongside Non-starchy Vegetables, Legumes, and Whole Fruit

“…The new CFQS-4 model ( 7 ) added sodium and potassium to the 10:1:1 model ( 3 ) to better align with DGA recommendations. Most CF quality metrics have not yet included these important elements.…”

“…In one of the CQI models, the ratio of fiber to free sugar was also considered ( 3 , 6 ). A newly developed CFQS-4 index added sodium, and potassium to fiber and free sugar to assess carbohydrate quality ( 7 ). These five methods were used in the present study to assess nutritional density of carbohydrate-rich foods, ranging from grains and cereals to tubers, vegetables, and fruit.…”

Perspective: Potatoes, Quality Carbohydrates, and Dietary Patterns

“…A detailed comparison of the value and issues related to the GI are well described elsewhere [ 27 , 28 ]. The Carbohydrate Quality Index (CQI) is calculated based on the free sugar and fiber content of foods with >40% carbohydrate by dry weight, with the Carbohydrate Food Quality Score (CFQS) additionally taking into account the potassium, sodium, or whole-grain content of foods [ 29 , 30 ]. The CQI and CFQS use a point system, with foods receiving 1 point if they meet criteria for lower free sugar and sodium or higher fiber and potassium ( Table 1 ).…”

“…Then, the CFQS-5 includes whole grains in addition to the same metrics as the CFQS-4 ( Table 1 ). The CQI and CFQS metrics are intended to align carbohydrate scores with the recommendations from the Dietary Guidelines for Americans for reducing sodium and free sugars and increasing fiber, potassium, and whole-grain intake [ 29 ]. Although the CQI and CFQS do not consider energy, fat, or protein, they correlate well with other indices of food quality.…”

“…Although the CQI and CFQS do not consider energy, fat, or protein, they correlate well with other indices of food quality. For instance, they show a strong correlation with the Nutrient-Rich Food 9.3 score, which is calculated on 9 nutrients to encourage (protein, dietary fiber, vitamins A, C, and E, calcium, iron, magnesium, and potassium) and 3 nutrients to limit (saturated fat, sodium, and added or total sugar) [ 29 ].…”