MAKING NUTRIENT-RICH FOOD CHOICES FIRST: KEY TO A HEALTHFUL DIET
Volume 78, Number 5 September/October 2007
Conclusion
To be effective, nutrition education messages need to focus on positive ways to encourage people to make healthful food choices over time, rather than emphasizing good or bad foods, nutrients to avoid, or calories alone (9,21). Nutrient density is a positive approach with the potential to help consumers choose naturally nutrient-rich foods first and less nutrient-dense foods as calories allow. This concept is compatible with the American Dietetic Association’s position that “the total diet or overall pattern of food eaten is the most important focus of a healthful eating style” and that “all foods can fit within this pattern, if consumed in moderation with appropriate portion size and combined with regular physical activity” (21). For example, consumers can meet their nutrient needs within their calorie limits by basing diets on nutrient-dense foods (e.g., low-fat or fat-free dairy foods, regular and whole grains, lean meats, poultry, fish or legumes, fruits and vegetables) while balancing with small amounts of lower-nutrient, higher-energy foods to achieve an overall healthful pattern (21). Scientific research is underway to create an easy-to-use tool (i.e., nutrient density score and consumer application) that will help people readily identify and enjoy nutrient-rich foods and beverages among all basic food groups.
Nutrient density is receiving increasing support as a means to help Americans adopt more healthful diets. However, it is important to appreciate that health is not the single or most important factor driving consumers’ food choices (6,9,21). Taste and food preferences, convenience, lifestyle, cost, attitudes and beliefs, social/cultural influences, the media, and food safety considerations are among other factors impacting food choices (6,9,21). For example, food prices and diet costs may be a limiting factor for consumers wishing to adopt a more nutrient-dense diet. A recent cross-sectional study in more than 1,400 adults found that higher quality diets (i.e., less energy-dense) cost more than energy-dense diets (22). The findings led the researchers to suggest that the relatively low cost of energy-dense diets may contribute to the high rates of obesity and diabetes among low-income populations (22). The researchers also suggest that economic, environmental, and policy measures may be needed to supplement nutrition education (22).
Another study found that food groups and individual foods within food groups differ in their nutrient-to-price ratio (23). In this study, dairy foods were reported to have a high nutrient quality relative to price. Among dairy foods, milk had a higher nutritional quality-to-price ratio than either cheese or yogurt, and milk was the least expensive source of energy (23). The researchers suggest that healthful diets can be obtained at a moderate cost by preferentially selecting foods within food groups with the highest nutritional quality-to-price ratio (23).
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