The Newly Developed Elderly Nutrient-Rich Food Score Is a Useful Tool to Assess Nutrient Density in European Older Adults

Abstract

Objective: To develop a nutrient-rich food (NRF) score that captures dietary reference values for older adults and to validate this against a diet index that was specifically designed to assess adherence to dietary guidelines for the older population. Design: A cross-sectional study within the Dutch National Food Consumption Survey (DNFCS, n = 735 men and women aged 70–94 years, enrolled between October 2010 and February 2012) and within the NU-AGE study ( n = 250 men and women aged 65–79 years, enrolled between April 2012 and March 2013). Dietary intake was assessed by means of two non-consecutive dietary record assisted 24-h recalls and 7-day food records, respectively. Structured questionnaires collected data on lifestyle and socio-economic information. Anthropometrics were measured by trained dieticians or research assistants. We evaluated Elderly NRF (E-NRF) scores against the NU-AGE index, a measure of adherence to European dietary guidelines for the aging population. The E-NRF scores were composed of nutrients that: ( 1 ) have been shown to be of inadequate intake in the aging population (>20%), ( 2 ) were defined as nutrients of public health relevance, and ( 3 ) were associated with relevant health outcomes. Results: The E-NRF score that best predicted the NU-AGE index included seven nutrients to encourage (protein, dietary fiber, folate, vitamin D, calcium, magnesium, potassium) and three nutrients to limit (saturated fat, sodium and mono- and disaccharides) on a 100-kcal basis, the E-NRF7.3 score (model R 2 0.27 in DNFCS and 0.41 in NU-AGE). Food groups contributing the most to the individual E-NRF7.3 scores were vegetables, bread, potatoes and milk and milk products. Conclusion: The E-NRF7.3 score is a useful tool for assessing nutrient density of diets within the older population. No index has previously been developed with the aim of evaluating nutrient density of diets and foods specifically capturing dietary reference values for older adults.

The Use of a Nutrient Quality Score is Effective to Assess the Overall Nutritional Value of Three Brassica Microgreens

“…By using a NQS, it is possible to go beyond the evaluation of a food product on the basis of one nutrient at a time, while avoiding defining any food as 'good' or not, in absolute terms. The setup of our NQS was derived from the well-known concept of nutrient density, which is the basis of several indexes and scores in the literature [2,[45][46][47][48]. On the other hand, although the nutrient density indexes and scores are usually calculated for each food item per 100 kcal, we established the NQS 11.1 in relation to the summative contribution of nutrients in a serving size, according to Ghoora et al [14].…”

“…It is well known that an inadequate intake of some nutrients can be associated with hidden hunger [ 1 ], although the signs of this form of undernutrition may not be obvious in people affected by it. For both young people and older adults, hidden hunger can be due to an inadequate intake of one or more nutrients, including macro- and micro-nutrients [ 2 ]. For example, an adequate intake of dietary fiber may be useful for preventing constipation and reducing the risk of colon cancer and diseases associated with glucose metabolism [ 3 ].…”

The Elderly-Nutrient Rich Food Score Is Associated With Biochemical Markers of Nutritional Status in European Older Adults

“…However, including vitamin B12 to the E-NRF7.3 reduced the validity instead of improving it. Therefore, vitamin B12 was omitted from the E-NRF7.3 (15). This approach is in line with the extensively studied NRF9.3, for which a threshold for the useful number of nutrients exists, after which the ranking of products or prediction of healthy diet index declined (49, 50).…”

“…Nutrients to limit (LIM3) comprise saturated fat, sodium, and total mono- and disaccharides. The development of the E-NRF7.3 score has been described in detail elsewhere (15).…”

“…The newly developed nutrient rich food score was composed of nutrients that: (1) have been shown to be of inadequate intake in the older aged population (>20%) (11), (2) were defined as nutrients of public health relevance for older adults, and (3) were associated with relevant health outcomes (12). The nutrient rich food score that best predicted adherence to the NU-AGE index, an index assessing adherence to a healthful diet for the aging population (13, 14), was called the E-NRF7.3 score and included protein, dietary fiber, vitamin D, folate, calcium, potassium, magnesium as nutrients to encourage, and saturated fat, total mono- and disaccharides, and sodium as nutrients to limit (15).…”