A Nutrient Ratio-Based, Web-Enabled Food Quality Score Is Associated With Weight and Blood Pressure Compared With Leading Nutrient Profiling Systems

Document Type

Article

Publication Date

5-29-2026

Institution/Department

Center for Interdisciplinary Population & Health Research

Journal Title

Current developments in nutrition

Abstract

BACKGROUND: Rising prevalence of chronic cardiometabolic conditions may be partly driven by shifts in dietary patterns. Nutrient profiling systems (NPSs) aim to guide healthier food choices through labeling and consumer-facing technologies but vary in accessibility and how well they distinguish food healthfulness. OBJECTIVES: The primary objective was to compare a web-enabled, ratio-based NPS, Nutrient Consume Score (NCS), and its underlying nutrient ratios with 4 other leading NPSs, Nutri-Score, Health Star Rating, NOVA Classification, and Food Compass 2.0, by examining associations with obesity and blood pressure. Secondary objectives included assessing associations with cardiometabolic biomarkers and identifying food categories contributing most to each score. METHODS: Cross-sectional study of NHANES 2015-2016 data from 9971 adults aged ≥20 y were analyzed. Dietary intake was assessed using a single 24-h dietary recall (day 1), and NPS scores were calculated. Multivariable regression models adjusted for sociodemographic and health factors examined associations with obesity, blood pressure, and cardiometabolic biomarkers. Compositional analysis evaluated food categories driving scores. RESULTS: Higher NCS was associated with lower BMI [β = -0.64 kg/m per 10-unit increase; 95% confidence interval (CI): -0.86, -0.41; P < 0.0001], waist circumference (β = -1.63 cm; 95% CI: -2.23, -1.02; P < 0.0001), systolic blood pressure (β = -1.01 mm Hg; 95% CI: -1.67, -0.35; P < 0.0051), and diastolic blood pressure (β = -0.56 mm Hg; 95% CI: -0.90, -0.23; P < 0.0026), with effect sizes comparable with other NPSs. Calorie-to-weight, sodium-to-potassium, and saturated-to-unsaturated fat ratios were associated with weight outcomes, whereas sodium-to-potassium and carbohydrate-to-fiber ratios were associated with blood pressure outcomes. CONCLUSIONS: The NCS was associated with weight and blood pressure in this cross-sectional analysis, with effect estimates comparable in magnitude with other commonly used NPSs. These findings support the potential utility of a ratio-based, web-enabled NPS for assessing diet quality in relation to cardiometabolic risk factors.

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