An integrative analytical framework to identify healthy, impactful, and equitable foods: a case study on 100% orange juice

Abstract

To identify healthy, impactful, and equitable foods, we combined health scores from six diverse nutrient profiling systems (NPS) into a meta-framework (meta-NPS) and paired this with dietary guideline adherence assessment via multilevel regression and poststratification. In a case-study format, a commonly debated beverage formulation – 100% orange juice (OJ) – was chosen to showcase the utility and depth of our framework, systematically scoring high across multiple food systems (i.e. a Meta-Score percentile = 93rd and Stability percentile = 75th) and leading to an expected increase of US dietary fruit guideline adherence by ∼10%. Moreover, the increased adherence varies across the 300 sociodemographic strata, with the benefit patterns being sensitive to absolute or relative quantification of the difference of adherence affected by OJ. In sum, the adaptable, integrative framework we established deepens the science of nutrient profiling and dietary guideline adherence assessment while shedding light on the nuances of defining equitable health effects.

Graphical abstract

We developed a meta-nutrient profiling system (meta-NPS) to establish a consensus healthfulness evaluation and paired these assessments with quantification of dietary impact and equity. Integrating individual NPS, the meta-NPS has two novel features – Meta Score (the average rank) and Stability (the relative rank certainty), shown via empirical cumulative distribution function curves. In terms of impact and equity, multiple modelling approaches were utilised to estimate fruit guideline adherence impacted by orange juice for 300 subpopulations. While the framework applies to any food, 100% orange juice was highlighted to advertise salient utility.

Keywords:

• Meta nutrient profiling system
• dietary guidelines
• fruit juice
• equity
• integrative statistics

Acknowledgment

The authors thank Dr. Dariush Mozaffarian for his critical insight and review of the manuscript, including high-level structural comments.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Food scores and the subpopulation estimates from the models are included.

References

Additional information

Funding

This work was supported in part by a research contract between the Florida Department of Citrus and Bespoke Analytics, LLC. The funders did not provide input into the study design, analysis, interpretation, or writing. Part of the framework of this study is involved in a patent related to food recommendation (JEM).