title: Performance characteristics of NuVal and the Overall Nutritional Quality Index (ONQI).
abstract: BACKGROUND
  Improving diets has considerable potential to improve health, but progress in this area has been limited, and advice to increase fruit and vegetable intake has largely gone unheeded.
  
  
  OBJECTIVE
  Our objective was to test the performance characteristics of the Overall Nutritional Quality Index (ONQI), a tool designed to help improve dietary patterns one well-informed choice at a time.
  
  
  METHODS
  The ONQI was developed by a multidisciplinary group of nutrition and public health scientists independent of food industry interests and is the basis for the NuVal Nutritional Guidance System. Dietary guidelines, existing nutritional scoring systems, and other pertinent scientific literature were reviewed. An algorithm incorporating >30 entries that represent both micro- and macronutrient properties of foods, as well as weighting coefficients representing epidemiologic associations between nutrients and health outcomes, was developed and subjected to consumer research and testing of performance characteristics.
  
  
  RESULTS
  ONQI and expert panel rankings correlated highly (R = 0.92, P < 0.001). In consumer testing, approximately 80% of >800 study participants indicated that the ONQI would influence their purchase intent. ONQI scoring distinguished the more-healthful DASH (Dietary Approaches to Stop Hypertension) diet (mean score: 46) from the typical American diet according to the National Health and Nutrition Examination Survey (NHANES) 2003-2006 (mean score: 26.5; P < 0.01). In linear regression analysis of the NHANES 2003-2006 populations (n = 15,900), the NuVal system was significantly associated with the Healthy Eating Index 2005 (P < 0.0001). Recently generated data from ongoing studies indicate favorable effects on purchase patterns and significant correlation with health outcomes in large cohorts of men and women followed for decades.
  
  
  CONCLUSIONS
  NuVal offers universally applicable nutrition guidance that is independent of food industry interests and is supported by consumer research and scientific evaluation of its performance characteristics.
authors.affiliation: Yale-Griffin Prevention Research Center, Derby, CT 06418, USA. david.katz@yale.edu
authors.forename: David L
authors.initials: DL
authors.lastname: Katz
authors.forename: Valentine Y
authors.initials: VY
authors.lastname: Njike
authors.forename: Lauren Q
authors.initials: LQ
authors.lastname: Rhee
authors.forename: Arthur
authors.initials: A
authors.lastname: Reingold
authors.forename: Keith T
authors.initials: KT
authors.lastname: Ayoob
mesh_terms: D054626:Consumer Health Information; D004032:Diet / Q000191:economics / Q000592:standards*; D015438:Health Behavior; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D016014:Linear Models; D009749:Nutrition Surveys; D014481:United States