title: The Nutrient Balance Concept: A New Quality Metric for Composite Meals and Diets.
abstract: BACKGROUND
  Combinations of foods that provide suitable levels of nutrients and energy are required for optimum health. Currently, however, it is difficult to define numerically what are 'suitable levels'.
  
  
  OBJECTIVE
  To develop new metrics based on energy considerations-the Nutrient Balance Concept (NBC)-for assessing overall nutrition quality when combining foods and meals.
  
  
  METHODS
  The NBC was developed using the USDA Food Composition Database (Release 27) and illustrated with their MyPlate 7-day sample menus for a 2000 calorie food pattern. The NBC concept is centered on three specific metrics for a given food, meal or diet-a Qualifying Index (QI), a Disqualifying Index (DI) and a Nutrient Balance (NB). The QI and DI were determined, respectively, from the content of 27 essential nutrients and 6 nutrients associated with negative health outcomes. The third metric, the Nutrient Balance (NB), was derived from the Qualifying Index (QI) and provided key information on the relative content of qualifying nutrients in the food. Because the Qualifying and Disqualifying Indices (QI and DI) were standardized to energy content, both become constants for a given food/meal/diet and a particular consumer age group, making it possible to develop algorithms for predicting nutrition quality when combining different foods.
  
  
  RESULTS
  Combining different foods into composite meals and daily diets led to improved nutrition quality as seen by QI values closer to unity (indicating nutrient density was better equilibrated with energy density), DI values below 1.0 (denoting an acceptable level of consumption of disqualifying nutrients) and increased NB values (signifying complementarity of foods and better provision of qualifying nutrients).
  
  
  CONCLUSIONS
  The Nutrient Balance Concept (NBC) represents a new approach to nutrient profiling and the first step in the progression from the nutrient evaluation of individual foods to that of multiple foods in the context of meals and total diets.
authors.affiliation: Nestec SA, International Headquarters, Avenue Nestlé 55, Vevey, Switzerland.
authors.forename: Edward B
authors.initials: EB
authors.lastname: Fern
authors.affiliation: Nestec SA, International Headquarters, Avenue Nestlé 55, Vevey, Switzerland.
authors.forename: Heribert
authors.initials: H
authors.lastname: Watzke
authors.affiliation: Nestec SA, International Headquarters, Avenue Nestlé 55, Vevey, Switzerland.
authors.forename: Denis V
authors.initials: DV
authors.lastname: Barclay
authors.affiliation: Nestec SA, International Headquarters, Avenue Nestlé 55, Vevey, Switzerland.
authors.forename: Anne
authors.initials: A
authors.lastname: Roulin
authors.affiliation: Center for Public Health Nutrition, University of Washington, Seattle, Washington, United States of America.
authors.forename: Adam
authors.initials: A
authors.lastname: Drewnowski
mesh_terms: D016208:Databases, Factual; D004032:Diet; D004734:Energy Metabolism; D062407:Meals; D009753:Nutritive Value