A Nutrient‑Density–Based Food Rating System for Noncommunicable Disease Prevention

Fig 1. Dried okra scores a perfect NVS 100—its nutrients get super‑charged once the water is removed

🔑 Key Takeaways

• Top‑scoring foods: organ meats, dark green leafy vegetables, fish, and seafood.
• Lowest‑scoring foods: soft drinks, grain‑based sweets, instant noodles, packaged ultraprocessed snacks, and refined grains.
• Better discrimination: NVS separates nutritional quality within fruits, vegetables, animal‑source foods, and starchy staples more effectively than Nutri‑Score or Health Star Rating.^[7,8]
• Moderate alignment with Nutri‑Score (r = 0.58) and HSR (r = 0.63), but very weak alignment for ultraprocessed foods (r < 0.15).
• Rankings shift depending on whether foods are evaluated per gram (mass‑based) or per calorie (energy‑based).
• NVS provides clearer nutritional distinctions than existing systems and supports more meaningful environmental and affordability comparisons.
• Further validation is needed, but NVS shows strong potential to guide global nutrition policies and programs.

Fig 2. Nutritional Value Score (NVS)

Most people assume they know which foods are truly nutritious—but the numbers often tell a different story. The Nutritional Value Score (NVS)cuts through the guesswork by measuring how much real nutrition a food delivers per calorie, and the side‑by‑side comparisons can be eye‑opening.^[1]

This matters even more in low‑ and middle‑income countries, where undernutrition and rising noncommunicable diseases create a double burden. Existing nutrient profiling systems help, but many overlook bioavailability and the realities of diverse global diets. To fill these gaps, Beal and Ortenzi developed the NVS—a tool built to identify genuinely high‑value foods across different contexts.

By combining multiple nutrient dimensions into one metric, the NVS offers a holistic, globally relevant way to assess nutrient density and public‑health value. While further validation and local data will strengthen it, the NVS already provides a solid foundation for policy, programming, environmental assessments, and identifying high‑impact foods.

Figure 1. Nutritional Value System (NVS) Scoring. A visualization of the NVS algorithm (scaled 1–100) comparing nutrient weights and sample food profiles.

📊 Nutrient Density Snapshot

Which foods score highest — and lowest — across key nutrient components?

Overall NDS (Nutrient Density Score)

High: Fish & shellfish (especially dried), dried okra, organ meats, dark leafy greens, deer
Low: Soft drinks, starchy staples, ultraprocessed foods, watermelon, apple

Vitamins

High: Organ meats, dark leafy greens (spinach, moringa)
Low: Soft drinks, white rice noodles, refined pasta, coconut, watermelon, oncom, tofu

Minerals

High: Dried vegetables (dried okra), dark leafy greens, dried fish/shellfish, sunflower seeds
Low: Soft drinks, instant noodles, white rice, rice noodles, watermelon, apple, tree fern, eggplant

Protein

High: Dried fish/shellfish, nonfat Greek yogurt, lean meats (boar, deer), other animal foods, tempeh
Low: Soft drinks, fufu, cassava, ultraprocessed foods

n‑3 Fatty Acids (Omega-3s)

High: Fatty fish, shellfish
Low: Most other foods

Fiber

High: Non‑starchy vegetables (especially dried), corn, passion fruit, legumes, nuts, seeds (pumpkin seeds)
Low: Soft drinks, animal‑source foods, plant‑based milks, refined starchy staples, ultraprocessed foods, watermelon

Calorie Density

High (desirable): Most foods (below 1.3 Cal/g)

• These foods provide more nutrients per gram without being overly calorie‑dense.

Low (less desirable): Nuts, seeds, ultraprocessed foods

• Nuts and seeds receive a low score on the calorie component of the Nutritional Value Score (NVS) because they are very energy-dense (5–7+ kcal/g due to high fat content), and the NVS heavily rewards foods with low calorie density (<1.3 kcal/g). Their healthy fatty acids (mostly unsaturated) are rewarded separately in the nutrient ratios component, which penalizes saturated-to-unsaturated fat ratios. Overall, nuts and seeds still rank moderately well thanks to strong nutrient density, fiber, and healthy fat profiles, but the strict calorie-density penalty prevents them from scoring as highly as low-energy foods like dried okra or spinach.

Nutrient Ratios

“Nutrient ratios” make up 22.5% of the NVS and reward protective nutrient balances while penalizing those linked to higher NCD (Noncommunicable Disease) risk.

High: Most foods (aligned with dietary guidelines)
Low: Congee, ultraprocessed foods, full‑fat cheese, coconut, dried beef, millet porridge

NVS Value Scoring — Explained

The Nutritional Value Score (NVS) is designed to compare the overall nutritional quality of foods—whether single items, food groups, meals, or entire diets. Because it aggregates multiple nutrient components into one metric, it highlights both strengths and weaknesses that individual foods bring to a diet.

What the scoring reveals

• When foods are grouped, the highest‑scoring categories (average NVS >75) are dark green leafy vegetables and organ meats, reflecting their exceptional micronutrient density.
• Dried okra ranks #1 (NVS 100) because the score heavily rewards nutrient density per calorie, fiber, and healthy nutrient ratios. Fresh okra’s high water content dilutes these benefits.
• No food achieves uniformly high scores across all components. 
• For example, spinach ranks among the top foods overall, yet its n‑3 fatty acid score is only 10, showing how even nutrient‑dense foods have gaps.
• At the other end of the spectrum, congee receives the lowest NVS, followed by many ultraprocessed foods and certain items like full‑fat cheese, coconut, dried beef, and millet porridge.
• Among starchy staples, the NVS consistently places refined grains near the bottom, with an average score around 20, indicating low nutrient density relative to their energy contribution.

Why this matters

The NVS offers a holistic, public‑health–oriented metric that captures:

• overall nutrient density
• key micronutrients
• protein quality
• components relevant to both undernutrition and NCD (Noncommunicable Disease) prevention

Because it integrates multiple nutrient dimensions and uses globally relevant data, the NVS is particularly well‑suited for low‑ and middle‑income country (LMIC) contexts, where diets must balance affordability, nutrient adequacy, and disease prevention.

Further Inspiration & Resources

1. Beal, T., & Ortenzi, F. (2026). Nutritional Value Score rates foods based on nutrient density and noncommunicable disease prevention. The Journal of Nutrition.
2. Poore, J., & Nemecek, T. (2018). Reducing food’s environmental impacts through producers and consumers. Science, 360(6392), 987–992. 
3. Afshin, A., Sur, P. J., Fay, K. A., Cornaby, L., Ferrara, G., Salama, J. S., ... & GBD 2017 Diet Collaborators. (2019). Health effects of dietary risks in 195 countries, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 393(10184), 1958–1972. 
4. Popkin, B. M., Corvalan, C., & Grummer-Strawn, L. M. (2020). Dynamics of the double burden of malnutrition and the changing nutrition reality. The Lancet, 395(10217), 65–74. 
5. Monteiro, C. A., Cannon, G., Lawrence, M., da Costa Louzada, M. L., & Pereira Machado, P. (2019). Ultra-processed foods, diet quality, and health using the NOVA classification system. Food and Agriculture Organization of the United Nations. 
6. Stevens, G. A., Beal, T., Mbuya, M. N. N., Luo, H., Neufeld, L. M., Addo, O. Y., ... & Global Micronutrient Deficiencies Collaborators. (2022). Micronutrient deficiencies among preschool-aged children and women of reproductive age worldwide: A pooled analysis of individual-level data from population-representative surveys. The Lancet Global Health, 10(11), e1590–e1599. 
7. Hercberg, S., Touvier, M., & Julia, C. (2022). The Nutri-Score nutrition label. International Journal for Vitamin and Nutrition Research, 92(3-4), 147–157.
• This paper presents the scientific basis, development, and validation evidence for Nutri-Score.
8. Jones, A., Thow, A. M., Ni Mhurchu, C., Sacks, G., & Neal, B. (2019). The performance and potential of the Australasian Health Star Rating system: A four-year review using the RE-AIM framework. Australian and New Zealand Journal of Public Health, 43(4), 355–365. This is a comprehensive evaluation of implementation, uptake, and impact of the HSR system.