Nutritional Scoring Systems At Retail

lemon-juice

While most produce items receive the highest scores, attention to nutrition throughout the store and extended to the community may provide the much-needed ‘halo effect.’

In recent years, the introduction of nutritional scoring systems has helped supermarkets evolve from food stores to nutrition classrooms. Based on good-for-you scales and displayed as stars or numbers, the leading scoring systems separate nutrition champions from lightweights based on proprietary grading systems. The net result is tools that help American shoppers make smart decisions on how to best feed themselves and their families in a healthful way.

The marketplace is led by three major scoring systems — Guiding Stars, NuVal, and ANDI — that vary in scoring algorithms and formats. The Guiding Stars program awards foods meeting its nutrition standards with one, two, or three stars. NuVal assigns a point value from 1 to 100 and ANDI, in use only in select Whole Foods Market locations, scores foods from 1 to 1000. Stores that license one of these systems are expected to use the system throughout the store. In contrast to front-of-pack information, a food’s score generally appears on the shelf and on display signage rather than on the item itself.

A “Starring” Role In Produce

“Guiding Stars is a whole store program that helps in any department,” says Sue Till, client services manager of Scarborough, ME-based Guiding Stars Licensing Company. “Consumers already know that produce is a homerun for healthy eating. Stores supplement Guiding Stars with creative marketing that makes the produce department come alive and helps drive home the health message.”

Nuval Lettuce

Most fresh fruits and vegetables score 100 within the NuVal ratings, with the exception of some varieties, such as iceberg lettuce because its nutrient content is lower than darker lettuce.

“In produce, Guiding Stars are more evident than elsewhere in the store, because they appear by each item and also on hanging signage in the department,” says Kitty Broihier, MS, RD, consultant, Guiding Stars. “Most fruits and vegetables have three stars, but shoppers can visit the Hannaford store website to check the rating and see what’s seasonally available and on sale.”

Till calls out the Guiding Stars Good Ideas cross-merchandising program that shows shoppers how to build a healthy meal with fruits and vegetables. “In addition to traditional signage, produce departments might display a picture of the item, its stars, and information on taste and usage; for example, making a healthy parfait with strawberries,” says Till.

Produce personnel help educate shoppers. “We hear that produce managers love Guiding Stars because it is simple and engages shoppers of all ages, including kids,” says Till. “However, training of produce department staff is essential, particularly in stores that have high employee turnover or hire new personnel on a regular basis.”

Many stores employ supermarket dietitians who can help educate shoppers. “I begin my Guiding Stars discussion in produce, where I remind shoppers to choose a colorful diet,” says Allison J. Stowell, MS, RD, registered dietitian for the Guiding Stars Licensing Program. “I also explain to shoppers why value-added items such as salad kits and produce companions like vegetable dips, candied dried fruit, and croutons might have fewer or even no stars.”

Scoring System As A Supermarket GPS

“NuVal is the shopper’s GPS for nutrition,” says David L. Katz, MD, principal inventor, Overall Nutritional Quality Index (ONQI), New Haven, CT, and chief science officer, NuVal, LLC, Quincy, MA. “It guides shoppers who don’t know where to go in the store to find the most nutritious foods.” NuVal scores favor pure foods, such as fruits and vegetables, over processed foods.

“Most fresh fruits and vegetables score 100, with the exception of coconut and avocado because of their fat content, and iceberg lettuce because its nutrient content is lower than darker lettuce,” explains Anne Bernier, senior operations director, NuVal. “Apple juice scores lower than apples because it is processed and contains less fiber. Salad kits score lower because dressing and toppings add calories, fat, and/or sugar.”

ANDI food score at Whole Foods

ANDI is used only in select Whole Foods Markets. A food’s score generally appears on the shelf and on display signage rather than on the item itself.

“When we first introduced NuVal, we put signage above our wet wall and on our coffin displays and bins that included an overview of each produce item, a photo, information on the item, storage tips, and NuVal score,” says Ellie Wilson, MS, RDN, senior nutritionist, Price Chopper Supermarkets, Schenectady, NY. “NuVal scores also appeared in our produce ads for four years. Shoppers, especially men and kids, tell us how much they love the numbers. NuVal gives people the confidence that they are making better choices.” Wilson adds Price Chopper’s vice president of produce and owner both champion health and they support having tools such as NuVal in the produce department.

Coborn’s, headquartered in St. Cloud, MN, actively integrates NuVal into its produce marketing. “Our coupon table offers NuVal scavenger hunts for kids and NuVal brochures, we have NuVal displays with a monthly “trade-up” theme for shoppers, and “Healthy Checklanes” feature items, including produce, with high NuVal scores,” explains Kim Kockler, RD, LD, food safety and nutrition manager, Coborn’s.

Scoring Systems Bridge Store With Community

Supermarket outreach at schools, community events, and hospitals both educates shoppers and provides a bridge to the in-store shopper experience. NuVal is particularly active in schools, where “students learn how the NuVal Scoring System works through grade-appropriate posters, handouts, interactive games, challenges, and prizes,” says Bernier. “The NuVal message is simple — the higher the score, the better the nutrition. Students receive informational materials for their parents and are encouraged to talk to their parents about NuVal. This is a good opportunity for students to use what they learn at school to shop with their parents like an expert.” One lesson teaches the difference in nutrition and NuVal score between processed fruit snacks (made primarily with added sugar) and fresh berries.

“We give free presentations in the community that show how to use NuVal to make better choices,” says Brittany Nikolich, RDN, CD, Fox Valley regional

food scoring system like NuVal

NuVal assigns individual foods a score from 1-100 based on the food’s content of more than 30 nutrients.

dietitian, Skogen’s Festival Foods, De Pere, WI. “Our store tours for community groups (scouts, seniors, families, weight loss programs) generate

interest in how to use various items in the produce department. Materials for kids on the tour might include produce-themed coloring sheets and recipes that include NuVal scores.”

“I work NuVal into every one of my presentations,” says Ashley Kibutha, RD, LD, supermarket registered dietitian, Coborn’s. “I include NuVal in kids’ day events, community education classes, lunch and learns with NuVal scores on the menu, and community health fairs. I teach NuVal classes, and conduct cooking demos on trading up to ingredients with higher NuVal scores like fresh fruit instead of canned or frozen with added sugars.”

Both Guiding Stars and NuVal partner with area health insurers to encourage healthful living through better food choices — including more fruits and vegetables. The Healthy Savings program (a consortium of insurers, grocers and food companies) ranks the healthier one-third of grocery items using Guiding Stars and preloads savings on those foods onto the shopper’s smartphone or insurance card. The program is offered at Cub Foods, Hornbacher’s, Rainbow Foods, and Lunds & Byerlys grocery stores.

Impact On Sales Is Unclear

The impact of scoring systems on produce departments is unclear. It is possible that they could negatively impact the produce department’s bottomline if shoppers avoid lower scoring items such as salad kits, prepared items, and condiments. “A Caesar salad kit might get just one star because it loses points for the fat in the cheese and dressing,” explains Guiding Stars’ Broihier. “Likewise, dried cranberries score lower because of their added sugar.”


“I include NuVal in kids’ day events, community education classes, lunch and learns with NuVal scores on the menu, and community health fairs.”

— Ashley Kibutha, RD, LD, Coborn’s

Research on whether scores affect purchases is not consistent. A 2014 article in the journal Public Health Nutrition reported that use of the Guiding Stars system did not increase sales of nutritious foods; the authors suggested that such programs might lead to lower profits. However, fruits and vegetables were not among the items evaluated by the authors. In a response to the article, consultants to Hannaford point out that, in fact, the company’s data shows that Guiding Stars has not reduced food sales.

The Future of Scoring Systems in Produce

Scoring systems may be less useful in the produce department than they are in the center of the store, where products differ nutritionally and a shopper might want to compare, say, one packaged pasta side dish to another. In produce, every fresh fruit or vegetable has numerous nutrition merits, so differentiating one from another matters less.

Where scoring systems do have value in produce is in the items sold as companions to fruits and vegetables such as salad dressing, trail mix, croutons, and other salad toppings. Here, nutrition and therefore scores vary. Value-added produce such as salad kits will score lower if they contain foods and condiments that are high in fat, sugar, and/or salt.

Experts question the worth and staying power of rating systems in produce. One Midwest retailer, who declined to be interviewed, stated that because produce stands on its own merit, the company does not use a rating system in that department.

Price Chopper’s Wilson likewise acknowledges the challenge in scoring foods that inherently are good. “With so many fruits and vegetables with a NuVal score of 100, it’s hard to promote one over the other.”

“Rating systems are helpful in the center aisles but not as helpful in produce because all fruits and vegetables are good for people, and our goal is to get people to eat more produce overall,” says Elizabeth Pivonka, Ph.D., RD, president and chief executive, Produce for Better Health Foundation, Hockessin, DE. “Also, these systems might not influence people who don’t pay attention to the ratings, because they are not yet ready to change the way they eat.” Pivonka acknowledges that providing tips in the produce department, including serving suggestions, descriptions, and other information, might be more effective for boosting the appeal of fruits and vegetables.

Produce departments have little say in the decision to use a scoring system for fruits and vegetables because that decision typically is made at the executive level. When chain or store management commits to a program, that program typically is adopted by all departments. Some markets opt to use qualitative information instead of a scoring system, marking foods with claims or icons for such produce features as gluten-free, high fiber, good source of vitamin C, or heart healthy.

Giant Eagle is one such chain. “At Giant Eagle, registered dietitians encourage all individuals to consume a wide variety of fruits and vegetables and call attention to an item’s specific attributes as part of our Health and Wellness attribute identification program. This helps our customers navigate the produce department,” says Dan Donovan, Giant Eagle spokesman, Pittsburgh. “Currently, we are using a third-party vendor for the program, which is only being executed on products that have a UPC.” Fresh fruits and vegetables are not included.

The three major scoring systems differ in their ranking of some fruits and vegetables — potentially confusing shoppers in areas with all three systems. For example, Guiding Stars awards apple, avocado, iceberg lettuce, and kale with a top score of three stars. On NuVal, only kale receives the top score of 100, followed by apple (96), iceberg lettuce (94), and avocado (88). ANDI awards 1000 points to kale but only 127 to iceberg, 53 to apple, and 28 to avocado. While avocado is rich in nutrients, its fat content reduces its NuVal and ANDI scores.

A merger or rebranding could change a store’s relationship with a particular scoring system. Wilson notes that the conversion of Price Chopper to the Market 32 brand is changing the look and feel of the produce department. “Our new look has much less signage. Ads, for example, have been reshaped by the new branding and no longer list NuVal scores.”

In an ideal world, rating systems in produce might not be necessary. “If we were eating mostly real food from plants and including as much produce as we should be, we wouldn’t need scoring systems,” says NuVal scientific advisor Katz. “If our food supply were limited to foods close to nature, we wouldn’t need scoring systems. If most of our foods came packaged in skin, peel, or rind, we wouldn’t need scoring systems. But that’s not how people eat. So we need scoring systems to guide them to the healthiest choices in the market.”


Guiding Stars

The first of the supermarket nutritional scoring systems, Guiding Stars was launched in September 2006 with the goal of helping shoppers quickly spot and select healthful foods. The Guiding Stars mathematical algorithm was developed by nutrition and medical experts from Dartmouth Medical School, Tufts University Human Nutrition Research Center on Aging Research Laboratory, and the University of North Carolina School of Public Health, among others. It incorporates recommendations from the Dietary Guidelines for Americans, U.S. Food and Drug Administration (FDA), U.S. Department of Agriculture (USDA), USDA National Nutrient Database, National Academy of Sciences, World Health Organization, giving foods credits for positive nutrients such as vitamins, minerals, and dietary fiber, and debits for trans fat, saturated fat, cholesterol, added sodium, and added sugars. Final scores then are translated into the Guiding Stars rating system, with one star for good, two stars for better, and three stars for best nutritional value per a standard 100-calorie portion. Guiding Stars is meant to be used to compare foods and beverages in the
same category, for example, frozen meals
or juices. Nearly all fresh produce earns three stars.

Guiding Stars is licensed by more than 1,500 markets in the U.S. and more than 900 in Canada, which include Hannaford Supermarkets, Loblaws, Food Lion, and markets in the Delhaize Group family. The Guiding Stars Licensing Company increases the system’s reach beyond supermarkets to food manufacturers, restaurants, convenience stores, hospitals, and schools.

“Our algorithm has stood the test of time,” says Sue Till, client services manager, Guiding Stars Licensing Company, Scarborough, ME. “Consumers like the simplicity of the one/two/three star program, kids get it, and it crosses language barriers.” Till notes that the Guiding Stars scientific advisory panel frequently “tweaks” the algorithm to align the scoring with evolving science and nutrition guidance.


NuVal

The NuVal Nutritional Scoring System was developed nearly 10 years ago by a team of health and nutrition experts led by David Katz, M.D., director, Yale Griffin Prevention Research Center, New Haven, CT. NuVal is based on an algorithm formerly called the Overall Nutritional Quality Index (ONQI) that assigns individual foods a score from 1-100 based on the food’s content of more than 30 nutrients. The algorithm incorporates data from such respected sources as the Institute of Medicine, U.S. Food and Drug Administration (FDA), Dietary Guidelines for Americans, U.S. Department of Agriculture National Nutrient Database, and the World Health Organization. Vitamins, minerals, antioxidants, fiber, and other food components associated with health add points to the score, while “negative” nutrients such as sugar, sodium, trans fat, and cholesterol bring down the total. A higher score means better nutrition.

A research team at the Harvard School of Public Health looked at thousands of diet records to determine whether eating foods with higher ONQI scores would improve health. They found that people whose diet had the highest ONQI score had less chronic disease (heart disease and diabetes) and lower risk of dying.

In 2007, NuVal became the second nutrition rating system in the marketplace. The numerous grocery chains that license NuVal, including Price Chopper, Coborn’s, Hy-Vee, United Supermarkets, and many others, agreed to post a NuVal score for every item in the market. Most fresh fruits and vegetables received high scores. Squash, peppers, and apples, for example, earned a perfect 100 points; a lower nutrient vegetable such as iceberg lettuce still scored a high 82.

Shoppers can access NuVal scores only at the supermarket or in materials produced by a particular supermarket chain. NuVal does not make its scores available online or in an app.

Proponents of NuVal name five characteristics that appeal to shoppers: simplicity, inclusiveness in covering all foods in the market, convenient location on shelf tags, objectivity, and value-focused in allowing shoppers to seek out the highest score for the money.


Andi

ANDI, the Aggregate Nutrient Density Index, was created by Joel Fuhrman, M.D., Flemington, NJ, to help direct people to make better food purchases and showcase the high nutrient content of vegetables. Dr. Fuhrman notes the ANDI score reflects nutrients in relation to calories, incorporating 35 different nutritional parameters, including vitamins, minerals, phytochemicals and antioxidants, to generate scores that range from 1 to 1000.

“ANDI focuses on the disease-fighting micronutrients in plant foods. Unlike other systems, ANDI does not give points for animal products,” says Dr. Fuhrman. “My goal in creating the scoring system was to encourage people to eat more green and other colorful vegetables. All unprocessed natural plants should be consumed liberally, with special attention to some of the higher scoring veggies and fruits.”

Among the highest scoring foods are dark leafy greens (1000), bok choy (865), spinach (707), arugula (604), and radishes (502). ANDI scores for fruits are lower, for example, 207 for cranberries and 130-180 for most berries. Herbs with the highest ANDI scores include basil (518), cilantro (481), spearmint (457), and oregano (426). Dr. Fuhrman recommends primarily eating foods with an ANDI score greater than 100.

“Keep in mind, however, any scoring system is not a complete evaluation of food,” notes Fuhrman. “Some foods have salient features that make them superfoods irrespective of their overall level of micronutrients. For example, mushrooms may not score high on a scoring system, but contain powerful anticancer phytochemicals.”

ANDI currently is owned and used by select Whole Foods Market stores. According to Dr. Fuhrman, “Whole Foods Market noted a tremendous increase in the consumption of green leafy vegetables after introducing ANDI into their stores.” Dr. Fuhrman cautions that use of ANDI may vary from store to store and region to region.

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