I developed the Nutrivore Score to be the most comprehensive and least biased assessment of the nutrient density of individual foods. Why? When I first started developing the foundational content for Nutrivore.com a little over a year ago, I knew that I needed a method to quantify the nutrient density of foods. This is actually a field of research called nutrient profiling, the science of categorizing foods according to their nutritional composition. My initial plan was to comb through the research and choose one of the dozen or so existing nutrient density scores to use. After reading through nearly every nutrient profiling study ever published (which took me about two months!), I reached a disappointing conclusion: Every nutrient density score that had been developed thus far is flawed.

The goal of a  Nutrivore diet is to fully meet the body’s nutritional needs from the foods we eat, see What Is a Nutrivore?. The most efficient way to achieve this goal is by choosing nutrient-dense superfoods as the foundational foods of our diet. But, how do we even identify which foods those are?  My new Nutrivore Score is a measure of much nutrients, relative to the daily value (DV), a food contains per calorie, using 33 nutrients in its calculation.

But, before we dive into how the Nutrivore Score is calculated, let’s first discuss why it’s necessary.

Defining the Term Nutrient-Dense

Scientists have been working towards a standard method for quantifying the nutrient density of foods for about twenty years, but their efforts have been complicated by fuzzy definitions, incomplete nutrient data, lack of clarity on whether certain nutrients (or food groups) should be more or less heavily weighted in a calculation, disagreement on whether a food should be penalized for containing high levels of problematic compounds (like sodium or added sugars), and a misguided desire to retrofit a nutrient density score to align with the USDA dietary guidelines or its proxy, the Healthy Eating Index, rather than analyzing health outcomes or nutrient status test results.

The concept of a nutrient-dense food was first defined in the 1970s as any food that provided “significant amounts of essential nutrients” per serving. Because of a lack of formal criteria for determining whether or not a food met this definition, inconsistent and subjective standards were applied, largely build around broad food groups, and overly focused on fat and sugar content as problematic, rather than vitamins, minerals, and other important nutrients as beneficial. As a result, some foods were labelled as unhealthy, like nuts, olives, and avocadoes, purely because of their fat content—we now recognize all of these foods contain heart-healthy fats that reduce cardiovascular disease risk and they all have medium to high Nutrivore Scores. In addition, the terms “good source” and “excellent source” were defined as providing 10% or 20% DV, respectively, of a specific nutrient per serving—for example, if a food contained 10% DV of vitamin C, it could include the phrase “A good source of vitamin C” on its label. As a result, some foods were labeled as healthy based on being a good source of a single nutrient; for example, whole grains were promoted based on being a good source of fiber—we now know that whole grains have, on average, the lowest Nutrivore Scores of any whole food while also having high energy density, meaning you consume a whole lot of calories but relatively few essential nutrients per serving.

The Science of Nutrient Profiling

Nutrient profiling, defined as the science of categorizing foods according to their nutritional composition, began in the early 2000s with the development of several similar methods to quantify the nutritional value of foods, including (but not limited to): Nutrient for Calorie (NFC), Calorie for Nutrient (CFN), Nutritious Food Index (NFI), Naturally Nutrient Rich (NNR) Score, Nutrient-Rich Foods Index (NRF), Nutrient Adequacy Score (NAS), and Nutrient Density Score (NDS). These scores/indices differ from each other in small but meaningful ways.

Some scores calculate nutrient density as a function of food weight, which is influenced by nonnutritive compounds like water content, but most represent the nutrient density as a function of energy. Given that our food supply is overabundant in calories while being overall depleted in nutrients, the more important information for the average consumer is how to maximize nutrients for each calorie, rather than for each gram or serving of food.

Some of the scores are normalized (so for example, the range is 0 to 100 or 0 to 1000), whereas others are simply totals. The problem with normalization is communication: while it may seem simpler to represent all foods on a scale from 0 to 100, the immense difference between the nutrient density of vegetables versus, say, fast food, is minimized when the scale is smaller. Some scores also include a weighting by food group, so the most nutrient-dense grain gets allocated the score of 100 in the grains group and the most nutrient-dense vegetable gets allocated the score of 100 in the vegetables group. This food group weighting system completely undermines the entire concept of nutrient profiling. For example, the Nutrivore Score of kale is 4150 whereas the Nutrivore Score of oats is 200, but when you apply a correction for food groups, their nutrient density scores are very similar. Studies show their health benefits are not equivalent, why would be normalize their nutrient-density scores to make them appear to be equally nutritious foods when they clearly aren’t?

The other way these scores differ is in the nutrients used to make the calculations. Most include protein and fiber, but the CFN only includes protein and the NFI only includes fiber. Which vitamins are utilized in the calculations ranges from only vitamin C (in the NDS5) all the way to including all of the vitamins except B7 and K (in the NDS15). And which minerals are utilized ranges from just calcium and iron (in the NQI, NRF6, and NDS5) all the way to calcium, iron, zinc, magnesium, copper, iodine, and selenium (in the NDS23). For the NRF and NDS, multiple variations were created, incorporating anywhere from 5 to 23 nutrients into their calculations (hence the number after the acronym; for example, NDS5 uses 5 nutrients and NRF23 uses 23 nutrients) and either with or without penalizing foods for their sodium, added sugars and saturated fat content (in which case, the acronym has a “.3” added at the end, for example the NRF15.3 includes 15 nutrients in its calculation and penalizes for 3). None of these scores incorporate phytonutrients into their calculations (which is sad given how valuable they are, see The Amazing World of Plant Phytochemicals and Polyphenols: Magic Bullet or Health Hype?).

In fact, there has been much discussion among scientists over which nutrients to include in nutrient profiling calculations. This concern originates from the fact that certain nutrients are more strongly correlated with health outcomes than others (typically those that we’re most likely to be deficient in rather than the nutrient itself being less important), such as high consumption of omega-3 fats, fiber and vitamin D. To attempt to hone in on the best sampling of nutrients to include in a nutrient-density score, a couple of studies have compared the NRF calculated with 5 to 16 nutrients (with or without limits for sodium, sugars and saturated fats, and with our without weighting for various food groups) to the Healthy Eating Index (HEI). The HEI is a way to quantify compliance with the USDA dietary guidelines, by assigning an energy adjusted score for servings from 9 food groups or nutrients to encourage (total fruits, whole fruits, total vegetables, greens and beans, whole grains, dairy, total protein foods, seafood and plant protein, and fatty acids ratio) and subtracting servings from 4 food groups or nutrients to discourage (refined grains, sodium, added sugars, and saturated fat). Interestingly, these studies found that an NRF with fewer nutrients in the calculation better aligned with the HEI, with 9 nutrients (protein, fiber, vitamin A, vitamin C, vitamin E, calcium, iron, magnesium and potassium) being optimal.

But, here’s where this line of reasoning is fundamentally flawed. Why would we retrofit a nutrient density score to align with dietary guidelines that were crafted without nutrient density or nutrient sufficiency in mind? This especially makes no sense when you consider that there is also little understanding of how individual nutrient-dense foods fit into healthful dietary patterns. As discussed in Essential Nutrient Deficiency and Autoimmune Disease, Natural Approaches to Cold & Flu Season (and Covid-19!), The Importance of Nutrient Density and Introduction to Nutritional Sciences, the prevalence of nutrient deficiencies is extremely high, even when people follow the USDA dietary guidelines, and these deficiencies increase risk of chronic and infectious disease. To advance the public’s understanding of what constitutes a nutrient-dense food, nutrient profiling must necessarily be algorithmically independent from the Healthy Eating Index and USDA dietary guidelines. Only then can we use nutrient profiling to improve dietary guidelines. And, the fact that the NRF calculation that best aligns with the HEI is the one that uses only nine nutrients reveals that following the USDA dietary guidelines will not result in nutrient sufficiency.

How Nutrient Profiling Could Inform Dietary Guidelines

It makes vastly more sense to devise a nutrient profiling method that simply reflects the nutritive value of a food, and then to study how eating more nutrient-dense foods impacts disease risk. In fact, there was a 2104 study of people over the age of 55 that showed that the higher the NRF9 of their diet as a whole, the lower their risk of all-cause mortality—the highest NRF9 quartile had a 16% lower chance of dying than the lowest NRF9 quartile. This study helps to prove that potentially huge health benefit of a diet replete with nutrient-dense foods, but more studies like this that incorporate even more nutrients into the calculus are necessary to advance this field of research.

To illustrate how important it is to take a comprehensive approach to nutrient profiling, take a look at how ten whole foods rank, when using 9, 15, 20 or 33 nutrients to quantify their nutrient density (in the NRF9, NRF15, NRF20 and Nutrivore Score, respectively). The more nutrients that are included in a calculation, when following the NRF model which does not cap a nutrient at 100% DV, the higher the score can be—that’s why every food has a higher score when more nutrients are taken into account. However, look not only at the order of the foods, and how including more nutrients provides a more complete picture of how nutrient-dense a food is, but also the spread between the scores. The more nutrients used in the calculus, the easier it is to differentiate between the most nutrient-dense foods and the least. Given what a nutrient powerhouse liver is, it just makes sense that its score would be vastly higher than, say, chicken breast.

The above table also helps to illustrate how a single nutrient can dramatically shift the nutrient profiling score of a specific food. For example, zinc is not included in the NRF9 but is included in the other scores. Oysters are the top food source of zinc, insufficiency of which affects an estimated 73% of Americans in large part because zinc-rich foods are few and far between and those that are, like oysters, are not a common food on the Standard American Diet. In fact, a single serving of oysters contains 174% DV of zinc! As soon as zinc is added to the score, oysters rank much more highly, which makes sense since they’re such a valuable source of vitamins, minerals and healthy fats while being an invaluable source of zinc!

The insight gleaned from nutrient profiling is profound. It emphasizes the value of certain families of plant foods (especially cruciferous vegetables, mushrooms, leafy greens, and fresh herbs) while also elevating the value of fish, shellfish and organ meat. At the same time, it emphasizes the high caloric density and low nutrient density of grains and dairy products.  This information would be super useful were it incorporated into the USDA dietary guidelines, helping people to identify the most nutritious foods to eat!

The Problem with Penalizing, Capping and Emphasizing

Some scores penalize for the presence of nutrients whose excess consumption have been (even loosely) linked to health problems, like sodium, saturated fat, added sugars, and cholesterol.

As I discussed in detail in Eggs: Nutritious Protein or Cholesterol Bomb?, dietary cholesterol does not increase serum lipids for most people and is the backbone of vitamin D and other steroid hormones. Dietary saturated fat is only problematic when intake exceeds about 15% of total calories (although this does depend on genetic predisposition, see Saturated Fat: Healthful, Harmful, or Somewhere In Between? and Genes to Know About: ApoE). Sodium is only problematic when intake exceeds about 7 grams per day, and there are studies showing that even this level is only worrisome when potassium intake is concomitantly low, see Is Salt Paleo?. Added sugars become problematic above about 10% of total calories (and 25% of total carbohydrates), see How Does Sugar Fit into a Healthy Diet? and TWV Podcast Episode 467: Can Eating Sugar Daily Be Healthy?. Most importantly, all of these nutrients are healthy in moderate amounts, and only unhealthy when the whole diet includes excess. And, all of these potentially problematic nutrients are abundant in fast food, junk food and other hyperpalatable manufactured foods that are also low in essential nutrients and very high in calories—this is why scores that penalize for these nutrients give these types of foods scores less than zero!

Penalizing individual foods for the presence of these nutrients does not reflect the diet as a whole, and has the capacity to undervalue otherwise nutrient-dense whole foods which can fit into a health-promoting diet, while not being necessary to show that fast food and junk food are unhealthy (they’re nutritionally void enough to already have low scores!).

Some of these scores (like the NDS) cap a nutrient’s contribution at 100% DV, whereas others recognize that a food having more than a 100% DV of a specific nutrient per serving makes that food a very valuable source of that nutrient! There’s no such thing as a nutritionally complete food, so the goal is nutrient sufficiency of the entire diet, not of any one particular food. Thus, it’s important to understand how to combine foods that are good sources of different nutrients in order to achieve dietary nutrient sufficiency. Capping a nutrient’s contribution to the nutrient density score at 100% hinders our ability to understand the importance of food combining for nutrient sufficiency. For example, Brazil nuts are the most nutrient-dense nut attributable to their very high selenium content—a 1-ounce serving delivers nearly 1000% DV of selenium! But, if you capped the contribution of selenium to the calculation of Brazil nut nutrient density, they would erroneously appear to be one of the lowest nutrient-density nuts. It just makes sense to fully value the awesome selenium content of Brazil nuts and have that reflected in its nutrient density score!

Another topic for discussion is whether to weight certain nutrients more in nutrient profiling.

It makes sense on the surface to count those nutrients for which a larger proportion of the population are deficient more than those nutrients for which very few people are deficient. But, here’s the challenge with that logic: the potential for overcorrection and simply shifting towards different common nutrient deficiencies. If those foods that are particularly good sources of the nutrients that, for example, an estimated 70% or more of Americans routinely don’t consume enough of (vitamin B9, vitamin D, vitamin E, choline, calcium, potassium, zinc, omega-3 fats, and polyphenols) had inflated scores as a result of weighting these nutrients more heavily in nutrient profiling, food sources of other nutrients end up being undervalued. This approach has the capacity to shift food choices in a way that could help address some population level nutrient deficiencies over the short term, but that’s not the same thing as moving towards nutrient sufficiency, especially over the long term.

When we look at nutrient profiling methods described in the scientific literature, it becomes abundantly clear that a nutrient-density score best describes a food when it includes as many nutrients as possible, when the contribution of nutrients are not capped at 100% DV, when they are presented relative to calories, when they are not weighted by food groups, and when they are not normalized to a fixed scale.

Consumer-Focused Nutrient Profiling

Several other nutrient profiling methods have been devised by non-researchers with the goal of educating consumers, such as the ANDI Score, NuVal (based on ONQI), Guiding Stars, and Nutrition IQ.

The ANDI score may be one of the most comprehensive nutrient profiling systems, but the score overemphasizes nutrients inherent to plant foods while deemphasizing nutrients inherent to animal foods, creating a biased result. For example, the ANDI score incorporates separately into its calculation: beta carotene, alpha carotene, lycopene, lutein and zeaxanthin (all carotenoids); fiber and resistant starch (both fiber); glucosinolates and organosulfides (both organosulfur compounds); phytosterols, angiogenesis inhibitors, aromatase inhibitors, resveratrol and ORAC score (most plant phytonutrients are antioxidants as are vitamin C and E). On the other hand, the score omits protein, functional amino acids and peptides (like anserine, creatine, carnosine, carnitine, and taurine) and all types of health-promoting fats (like omega-3s, monounsaturated fats, CLA and MCTs).

The ONQI is calculated based on 16 nutrients, with penalties for 5 nutrients and corrections for fat and protein quality and for glycemic load. Most notably, only 5 minerals are included, only three of the B vitamins are included, and only two types of phytonutrients (flavonoids and carotenoids) are included, while vitamin K and choline are excluded. In addition, because both cholesterol and saturated fat are penalized (despite the fact that whether these are problematic is entirely context-dependent), animal foods are penalized unnecessarily.

The Guiding Stars system rewards whole grains (despite their low nutrient-density compared to vegetables, fruits, legumes, nuts and seeds), and penalizes for total fat, sodium, sugar and cholesterol  And, the Nutrition IQ system also rewards whole grains, uses only a few nutrients in its determination, and also penalizes for saturated fat and sodium. The net result for both of these scores is to overemphasize grains, which are not nutrient-dense by any objective measure, and deemphasize animal foods.

The Problem of Incomplete Data

There’s one final challenge to nutrient profiling: incomplete data.

The United States Department of Agriculture maintains arguably the most comprehensive nutrient database in the world, called Food Central, with expanded nutrient data compiled for over 7,000 basic foods and partial nutrient data (at least what is required on food label) for nearly 360,000 different branded foods. But, even this amazing database is missing some key information. Many of the main entries are missing measurements for some nutrients (commonly vitamin D, vitamin B5, manganese, vitamin K2, and phytosterols) and certain nutrients aren’t included in the database at all (including vitamin B7, iodine, polyphenols, CoQ10, and other functional compounds, including most phytonutrients). Fiber is not differentiated between soluble and insoluble, and the method used to measure fiber is known to undercount resistant starch and oligosaccharides.

In addition, the entries generally provide average measurements for common quality food products, so it’s not possible to differentiate the nutrient content of higher quality options. And, while many of these gaps can be filled in from measurements presented in scientific studies, it’s surprising to discover how incomplete human knowledge is about the nutrient content of common foods.

There’s really no good solution, other than to scour the scientific literature and other databases for as many nutrients as possible missing from the USDA Food Central database (which my team and I are doing), label when a nutrient-density score is calculated based on incomplete data, and advocate for continued measurements of the nutrient content of foods.

How the Nutrivore Score Is Calculated

The Nutrivore Score is currently the most comprehensive, and least bias, method for representing the inherent nutrient content of foods, borne out of a confusing array of similar, yet all flawed, nutrient density scores, while recognizing the current limitations posed by incomplete data.

The Nutrivore Score is calculated based on 32+1 nutrients. The 32 primary nutrients that go into the score are:

The score is calculated as the sum of each nutrient relative to its RDA or AI present in 100 grams of the food, divided by the amount of calories per 100 grams. Data that’s not included in the Food Central Database are obtained from scientific papers and other databases like Phenol Explorer whenever possible. When multiple papers report the amount of a nutrient for a particular food, the highest value is utilized, unless there’s a clear methodological advantage to one specific measurement, and provided it is no more than one standard deviation from the mean of all available data (in which case, the second highest value is utilized following the same statistical test). Also, periodically two entries from the Food Data Central database are amalgamated to calculate the Nutrivore Score when two highly-related foods (for example, sockeye salmon and Coho salmon) have incomplete data. This is noted wherever it’s the case.

Further, the Nutrivore Score adds the highest value of available data for one bonus nutrient (that’s the +1), relative to a threshold set using epidemiological studies for that nutrient, similar to a %DV. The bonus nutrient currently can be any of: glucosinolates (the precursor for isothiocyanates and indoles), thiosulfinates, CoQ10, CLA, betaine, betalains, myo-inositol, ergothioneine, taurine and medium-chain triglycerides. The reason why only one bonus nutrient is included in the Nutrivore Score is because incomplete data would mean less common or understudied foods are unnecessarily penalized. Where the level of multiple nutrients in a food remain unknown, the Nutrivore Score is marked with an asterisk to denote that the score is likely underestimated for that food and should be thought of as a minimum.

The Nutrivore Score is not corrected for nutrient bioavailability, nutrient absorption capacity, or metabolic conversion inefficiencies. It’s true that specific isoforms of nutrients are more easily absorbed and/or used by the body. For example, while vitamin K1 accounts for approximate 90% of the total vitamin K in the diet, only 10 to 15% of it is absorbed in the digestive tract, the net effect being that vitamin K1 accounts for about half of the total absorbed vitamin K, whereas vitamin K2 is highly absorbable and represents the remaining 50% (see TWV Podcast Episode 417: Vitamin K2, Hype, or Essential?).  While vitamin K isoform data is available for some foods in the USDA Food Central database, as a general rule, nutrient isoform data is rarely available, making correcting for absorption or utilization efficiency of different nutrient forms impossible. It’s also true that certain combinations of nutrients can either enhance or hinder absorption. For example, vitamin C can increase iron absorption, fats can increase carotenoid and vitamin K absorption, but zinc and copper compete for absorption as do calcium and magnesium. However, this can’t be accounted for in a nutrient density score for an individual food because all nutrients present in an entire meal interact. And sometimes, absorption is influenced by factors independent of food. For example, vitamin D status influences calcium absorption; a functioning gallbladder is necessary for efficient fat and fat-soluble vitamin absorption; and while folic acid is much more readily absorbed in the digestive tract than the active form of vitamin B9, L-methylfolate, those with MTHFR gene variants can’t covert folic acid efficiently (see Paleo for Pregnancy and Lactation and Genes to Know About: MTHFR). So, because nutrient absorption competition or facilitation goes beyond an individual food and is instead related to all of the foods consumed at a meal as well as other factors such as genetics, it makes no sense to correct for these in a nutrient profiling method. The Nutrivore Score also does not incorporate a satiety index, again because satiety is related to macronutrient and water combinations from an entire meal rather than an individual food.

Rather than penalizing for the presence of nutrients whose excess is associated with health problems (like saturated fats, sodium and sugars), these nutrients are simply not included in the Nutrivore Score calculation. It is helpful to note that foods high in fats and sugars have a higher energy density, meaning more calories per gram or per serving of food, which does lower the Nutrivore Score. In addition, the presence of antinutrients such as phytates or oxalates are not taken into account. This is because the impact of antinutrients on nutrient absorption is also extremely context dependent. For example, our gut bacteria can liberate a substantial amount of the calcium, magnesium, iron, potassium and zinc bound to phytates for us, thereby releasing the bound minerals as well as phosphorus and thereby enhancing their bioavailability. A healthy, diverse gut microbiome can typically degrade about half (about 500 to 600 mg daily) of the phytate consumed in the average American diet. Other factors influencing bioavailability include health of the gastrointestinal tracts, nutrient status, competitive binding with other nutrients, meal composition, various drugs and supplements, time of day and biorhythms, age and gender. It doesn’t make sense to try to reflect nutrient digestibility and absorption in the Nutrivore Score when the system is so complex and varies from individual to individual.

You can think of the Nutrivore Score as a simple yet comprehensive representation of the inherent nutrients within a food, and acknowledge that a variety of factors will determine whether or not your body absorbs and uses all of those nutrients.

Because nutrients can be lost, formed and transformed by cooking, the Nutrivore Score is calculated based on the nutrients within the raw whole food, unless noted otherwise. Also, it is unusual for there to be nutrient data for different quality levels of a food. For example, the Food Central database contains only one entry for olive oil, but research has shown that the polyphenol content of virgin olive oil can range from anywhere between 50 to 5000 mg/kg, and the vitamin E content can range from 100 to over 1000 mg/kg. Another example: even though locally-grown, in-season organic vegetables and fruit and known to have higher nutrient density (due to being grown in higher quality soil, picked ripe, and eaten much sooner after harvest), there are no separate entries in the Food Central database for organic versus conventionally-grown produce. For this reason, we can think of Nutrivore Scores as a minimum or average value and feel confident that the effort to seek out higher quality options (grass-fed meat, wild-caught fish, fresh cold-pressed extra-virgin olive oil, and local in-season vegetables and fruit) is still nutritionally valuable if currently not quantifiable.

As more nutrient data become available, the Nutrivore Score will be updated to reflect more complete nutritional information. This obviously applies to missing nutrition information from the Food Central database, but there’s also the likelihood of adding nutrients to the Nutrivore Score calculation in the future. For example, a protein digestibility score, soluble versus insoluble fiber, trace minerals, functional nonproteinogenic amino acids and peptides, functional fatty acids, and vitamin-like compounds that aren’t currently utilized to calculate the Nutrivore Score could all be added once there is sufficient data to rationalize their inclusion. For now, extremely sparse data makes this prohibitive, and similarly would reward foods simply for being better studied, not necessarily for inherently higher nutritional value, relative to less common foods.

Using the Nutrivore Score

It is time for a positive approach to dietary guidance using nutrient density as a basic principle.  The Nutrivore Score is a necessary foundational step towards achieving this goal! By understanding the nutrients per calorie offered by individual foods via the Nutrivore Score, in addition to recognition that certain nutrients are exclusive to specific food groups, we can achieve nutrient sufficiency by choose a variety of nutrient-dense superfoods as well as the highest Nutrivore Score options from the various foundational food groups.

As I build Nutrivore.com, the Nutrivore Score is one of several tools that I am using to communicate which foods have the most to offer us. As you can see with the sample nutrient card above, I’m also highlighting the nutrients per serving (rather than only considering nutrients per calorie), including which are excellent sources (more than 20%DV) and which are good sources (10-20%DV). I’m combining this nutritional information with a review of the scientific literature on the specific health impacts of eating a food, and detailed information on what nutrients do in the body and how much of them we need. And, I’m creating educational resources on how to select various foods with complementary nutrition to achieve nutrient sufficiency!

I’m building this website outside of any dietary dogma. Being a Nutrivore is about the overall quality of the whole diet, and not about a list of yes-foods and no-foods. Even though eliminating empty calorie foods helps to achieve nutrient sufficiency without overeating, no food is strictly off-limits. In this way, being a Nutrivore is a diet modifier rather than a diet itself—a Nutrivore approach can be layered atop of other dietary structures and priorities in order to meet an individual’s specific health needs and goals.

I see Nutrivore as the natural extension of my science-grounded approach, and one that will allow me to both level up the depth of my resources for my long-time readers who love my science deep dives, but also meet people where they are and embrace the idea that even a small first step is worth celebrating. (See also What Is a Nutrivore?, Ditching Diet Dogma, My Personal Journey with the Autoimmune Protocol and My Personal Journey as a Blogger).

My vision for Nutrivore.com is extremely ambitious: A detailed educational resource devoid of dietary dogma and instead purely based on scientific studies and nutrient profiling to quantify nutrient density, all with the goal of helping people achieve dietary nutrient sufficiency (a.k.a. Nutrivore) through informed day-to-day choices.

The Nutrivore Score is a measure of much nutrients, relative to the daily value (DV), a food contains per calorie. A nutrient-dense powerhouse superfood is any food with a Nutrivore Score higher than 800. High nutrient-density foods have a Nutrivore Score between 400 and 800. Medium nutrient-density foods have a Nutrivore Score between 150 and 400. And, low nutrient-density empty-calorie foods have a nutrivore score less than 150. Remember, there are no yes-foods and no-foods on a Nutrivore approach, but instead what matters is whether the diet as a whole meets the body’s nutritional needs. Overall dietary nutrient sufficiency is easy to achieve by selecting a variety of the highest Nutrivore Score foods within each food category.

So far, I have calculated the Nutrivore Score of about over 7,500 different foods, and boy there have been some surprises!  Did you know that golden kiwis are a little more nutrient-dense than green kiwis? Or that dark meat turkey is more nutrient-dense than light meat turkey? Or that maple syrup and molasses have a medium nutrient-density score and that molasses is more nutrient-dense than cheese or pears?! Or that Asian pears are the most nutrient-dense Rosaceae family fruit (the apple and stone fruit family). Or that blackberries, strawberries and raspberries are all more nutrient-dense than blueberries? You’ll be able to find all of this information in my new e-book, Guide to Nutrivore!

Introducing the Guide to Nutrivore E-Book!

Guide to Nutrivore lays the foundation for Nutrivore as a general health approach, a base dietary philosophy devoid of dogma, on top of which you can layer additional food focus or eliminations to meet individual needs. In this sense, being a Nutrivore is a diet modifier rather than a diet itself.

With this beautifully-designed e-book, you’ll:

• learn how a Nutrivore approach can improve health
• appreciate what essential and nonessential nutrients do in the body
• get practical tips on how to increase nutrient-density
• examine how to use the Nutrivore Score to choose healthier foods
• find detailed nutrition information on the Top 100 Nutrivore Score Foods
• compare the nutrient-density versus energy-density of food groups
• easily implement Nutrivore with handy-dandy visual guides and reference tables!

The Guide to Nutrivore explains how to eat a Nutrivore diet and introduces the Nutrivore Score, the most comprehensive and least-biased method to assess the nutritive value of individual foods.  Detailed nutrition information for the Top 100 Nutrivore Score Foods is summarized with beautiful graphics for each food. And, the Guide to Nutrivore includes analysis of food groups, considerations when preparing Nutrivore meals, practical tips to increase the nutrient density of your diet, and a look-up table for the Nutrivore Score of approximately 300 foods.

Nutrivore Scores of Common Foods

And, while you wait for Guide to Nutrivore and Nutrivore.com, here’s the Nutrivore Scores of some common foods!

And, don’t forget to grab my free Nutrivore Score Guide to Food Groups!

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Drewnowski A, Smith J, Fulgoni VL 3rd. The New Hybrid Nutrient Density Score NRFh 4:3:3 Tested in Relation to Affordable Nutrient Density and Healthy Eating Index 2015: Analyses of NHANES Data 2013-16. Nutrients. 2021 May 20;13(5):1734. doi: 10.3390/nu13051734. PMID: 34065287; PMCID: PMC8160959.

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Drewnowski A. Defining nutrient density: development and validation of the nutrient rich foods index. J Am Coll Nutr. 2009 Aug;28(4):421S-426S. doi: 10.1080/07315724.2009.10718106. PMID: 20368382.

Drewnowski A. The Nutrient Rich Foods Index helps to identify healthy, affordable foods. Am J Clin Nutr. 2010 Apr;91(4):1095S-1101S. doi: 10.3945/ajcn.2010.28450D. Epub 2010 Feb 24. PMID: 20181811.

Fernández-Ríos A, Laso J, Campos C, Ruiz-Salmón I, Hoehn D, Cristóbal J, Batlle-Bayer L, Bala A, Fullana-I-Palmer P, Puig R, Aldaco R, Margallo M. Towards a Water-Energy-Food (WEF) nexus index: A review of nutrient profile models as a fundamental pillar of food and nutrition security. Sci Total Environ. 2021 Oct 1;789:147936. doi: 10.1016/j.scitotenv.2021.147936. Epub 2021 May 21. PMID: 34082212.

Fulgoni VL 3rd, Keast DR, Drewnowski A. Development and validation of the nutrient-rich foods index: a tool to measure nutritional quality of foods. J Nutr. 2009 Aug;139(8):1549-54. doi: 10.3945/jn.108.101360. Epub 2009 Jun 23. PMID: 19549759.

Imai C, Takimoto H, Fudono A, Tarui I, Aoyama T, Yago S, Okamitsu M, Sasaki S, Mizutani S, Miyasaka N, Sato N. Application of the Nutrient-Rich Food Index 9.3 and the Dietary Inflammatory Index for Assessing Maternal Dietary Quality in Japan: A Single-Center Birth Cohort Study. Nutrients. 2021 Aug 19;13(8):2854. doi: 10.3390/nu13082854. PMID: 34445014; PMCID: PMC8400739.

Maillot M, Darmon N, Darmon M, Lafay L, Drewnowski A. Nutrient-dense food groups have high energy costs: an econometric approach to nutrient profiling. J Nutr. 2007 Jul;137(7):1815-20. doi: 10.1093/jn/137.7.1815. PMID: 17585036.

Miller GD, Drewnowski A, Fulgoni V, Heaney RP, King J, Kennedy E. It is time for a positive approach to dietary guidance using nutrient density as a basic principle. J Nutr. 2009 Jun;139(6):1198-202. doi: 10.3945/jn.108.100842. Epub 2009 Apr 1. PMID: 19339707.

Mobley AR, Kraemer D, Nicholls J. Putting the nutrient-rich foods index into practice. J Am Coll Nutr. 2009 Aug;28(4):427S-435S. doi: 10.1080/07315724.2009.10718107. PMID: 20368383.

Murakami K, Livingstone MBE, Fujiwara A, Sasaki S. Application of the Healthy Eating Index-2015 and the Nutrient-Rich Food Index 9.3 for assessing overall diet quality in the Japanese context: Different nutritional concerns from the US. PLoS One. 2020 Jan 30;15(1):e0228318. doi: 10.1371/journal.pone.0228318. PMID: 31999772; PMCID: PMC6992222.

Murakami K, Livingstone MBE, Fujiwara A, Sasaki S. Reproducibility and Relative Validity of the Healthy Eating Index-2015 and Nutrient-Rich Food Index 9.3 Estimated by Comprehensive and Brief Diet History Questionnaires in Japanese Adults. Nutrients. 2019 Oct 21;11(10):2540. doi: 10.3390/nu11102540. PMID: 31640242; PMCID: PMC6836176.

Streppel MT, Sluik D, van Yperen JF, Geelen A, Hofman A, Franco OH, Witteman JC, Feskens EJ. Nutrient-rich foods, cardiovascular diseases and all-cause mortality: the Rotterdam study. Eur J Clin Nutr. 2014 Jun;68(6):741-7. doi: 10.1038/ejcn.2014.35. Epub 2014 Mar 19. PMID: 24642783.

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Today, the average American consumes almost 152 pounds of sugar each year, a staggering amount of refined simple carbohydrates equivalent to 6 cups of white sugar every week. This may be the single biggest dietary contributor to the rise in chronic disease. But, the noncaloric sweeteners recommended in health-conscious communities may be trading one health detriment for another; so this week, let’s talk about sugars and sweeteners, the good, the bad, and the ugly.

How Sugar Is Linked to Health Problems

Let’s start with sugar. Table sugar (cane sugar or beet sugar) is predominantly sucrose, a disaccharide made of one glucose and one fructose molecule. Sucrose is digested and absorbed quickly and the glucose it contains has a rapid impact on blood sugar levels and insulin secretion. Consumption of glucose is associated with increased production of oxygen radicals and markers of inflammation, even in healthy people. However, it is exaggerated in people who are obese or have type 2 diabetes, high cholesterol, or metabolic syndrome.  And, high sugar consumption can lead to nutrient deficiencies. This is discussed in detail in:

• How Does Sugar Fit into a Healthy Diet?
• 5 Nutrients You’re Deficient In… If You Eat Too Much Sugar

And, high fructose consumption (the other half of the sucrose molecule) has been linked to obesity, insulin resistance, hypertension, fatty liver disease, type 2 diabetes, cardiovascular disease, metabolic syndrome and increased cancer risk. In fact, the biological effects of too much fructose is likely the driving force behind the association between high sugar intake and chronic diseases.

This is particularly important not just because of the rise of high-fructose corn syrup but also because many sweet treats marketed to diabetics use fructose-based sweeteners like agave syrup. Just because they don’t cause a rise in blood sugars, doesn’t mean they’re harmless. In fact, the evidence points to fructose-based sweeteners being even worse. This is discussed in detail in:

• Is Fructose a Key Player in the Rise of Chronic Health Problems?
• Fructose and Vitamin D Deficiency: The Perfect Storm?
• Why is High Fructose Corn Syrup Bad For Us?
• Is It Paleo? Fructose and Fructose-Based Sweeteners (I’m looking at you, Agave!) 

It’s important to note that there is good evidence that consuming fructose from whole fruits is not the same as fructose-based sweeteners. In fact, one recent study compared the metabolic effects of consuming 100 grams of fructose from high-fructose corn syrup versus from fresh fruit. While both showed some problematic effects, it was much worse in the HFCS group. And studies show that eating 300 grams of fruit daily (about 4 servings, and up to about 45 grams of fructose) causes the biggest decrease in all-cause mortality (a general marker of health and longevity), so eating fruit is  good!  This is discussed in detail in:

• Why Fruit is a Good Source of Carbohydrates

So, one piece of good news is that we don’t need to count fresh fruit towards sugar intake. And, here’s more good news: the cusp for the negative effects of high-sugar intake really is around 10% of total calories from added sugars. So, we don’t have to give up all sweet foods to be healthy, but rather choose our sugars wisely and moderate our intake. The most important sugars to limit are refined ones (which don’t offer any redeeming nutritional qualities), which you can get lists of here:

• How To Avoid Added and Refined Sugars
• How Does Sugar Fit into a Healthy Diet?

Unfortunately, the sweet taste of sugar is highly addictive, so it can be really tough to reduce our intake or give it up if. Listen to:

• The Whole View Podcast, Episode 323: Cheat or Treat, Let’s Talk Sweets!
• The Whole View Podcast, Episode 300: How Do You Handle Sugar and Salt Cravings?

But Sweeteners Are Not a Good Solution

So, it’s human nature to look for the alternative, some sweet deliciousness not linked to health problems that we don’t need to feel guilty about! Sweet substances that are not sugars are called sweeteners — they are artificial or natural substances that taste sweet but don’t contain caloric sugar molecules like glucose and fructose.  And, while I’m sure you won’t be surprised to learn that the artificial sweetener aspartame causes even more health problems than sugar, you might not know that other nonnutritive sweeteners like sorbitol, mannitol, xylitol, and erythritol cause gut dysbiosis and increased intestinal permeability. This is discussed in detail in:

• Is It Paleo? Splenda, Erythritol, Stevia and other low-calorie sweeteners
• The Whole View Podcast, Episode 309: Aspartame Is Evil

And, here’s where I’m about to be the bearer of bad news. Even the two “natural” sweeteners predominantly used in products marketed to health-conscious communities — yes, I’m talking about stevia and monk fruit — are problematic. There are now high-quality studies proving that stevia is an endocrine disruptor and is also problematic for the gut microbiome. (Yes, this applies to the stevia plant and whole leaf stevia, too.) And monk fruit extract isn’t even approved as a food additive due to toxicity concerns (it’s only approved for use in supplements). These are discussed in:

• The Trouble with Stevia
• What’s the Next Superfood Sweetener?

In fact, I get asked All. The. Time about whatever sugar substitute is trending. If whole leaf stevia is off the table (pardon the pun), how about allulose or kabocha extract? Allulose is the molecular mirror image of fructose. While it hasn’t been extensively studied, it’s brought into the body by the same receptor (GLUT5) so we know that it can biologically behave similar to fructose and we’d therefore expect similar problems. Kabocha extract is a pentose (5-carbon) sugar called xylose, which, similar to its derivative xylitol, is known to cause gastrointestinal discomfort and laxative effects when consumed even in moderate quantitates. Neither have been studied in terms of long-term effects, impact on the gut microbiome, or endocrine effects.

Please don’t shoot the messenger! Instead, let’s focus on the best way to enjoy a sweet treat! And, that’s real, natural sugars, in moderation. The best choices are unrefined sugars that offer some nutritional value, like unrefined organic cane sugar, molasses, maple syrup, and honey.

Natural Sugars That Are Actually Healthy

In fact, blackstrap molasses is so nutrient dense that it contains 1.5 times more calcium per calorie than cheese and 5 times more iron per calorie than steak! Plus, it’s rich in copper, selenium, manganese, magnesium, potassium and vitamins B2, B3 and B6. Just one tablespoon contains 20% of the DV of calcium, iron, copper, and manganese, for only 42 calories. Truly, blackstrap molasses is the sugar you can love! I discuss it more in:

• Blackstrap Molasses: The Sugar You Can Love!

And, there are also compelling reasons to choose honey! Honey has known antioxidant and antimicrobial properties and may promote tissue health. Even though it’s a natural sugar, there’s evidence that honey can help regulate blood sugar levels in diabetics (yes, honey is anti-diabetic!) and improve the efficacy of metformin! It’s also been shown to be therapeutic in both chronic constipation and chronic diarrhea because it acts as a selective prebiotic for Lactobacillus and Bifidobacterium, while also inhibiting the growth of undesirable microorganisms that can act as pathogens. There’s even some evidence showing that eating honey can reduce cardiovascular disease risk factors and cancer risk! Plus, honey contains calcium, potassium, magnesium, phosphorus, selenium, copper, iron, manganese, chromium, zinc, and vitamins B1, B2, B3, B5, B6, B9, C and K! In fact, when we examine all of the health problems associated with high-sugar intake, honey seems to reduce their risk, indicating that maybe we shouldn’t count honey towards our sugar intake either!  I discuss this in:

• Honey: The Sweet Truth About a Functional Food!

You Can’t Cheat Sweet, But You Don’t Have to Give It Up Completely

All this to say that there really isn’t a way to cheat sweet (well, honey might be close), but we also don’t need to if we’re conscientious about how often and how much sweet treats we’re indulging in. Natural sugars in moderation absolutely can fit into a healthy diet!

• How Does Sugar Fit into a Healthy Diet?

The post Sugar and Sweetener FAQ appeared first on The Paleo Mom.

In the fall of 2014, a BBC documentary film crew spent most of two days filming in my home. The documentary followed its host, Giles, through a variety of immersive experiences with families following various diets and lifestyles purported to help extend life expectancy, including my family as one of several following the Paleo diet.  In addition to lengthy interviews in my home, they followed me to drop my oldest daughter off at school, Giles worked out with me at my gym (100 slam balls for time, Rx!), they filmed me working at my treadmill desk, and I fed the whole crew a delicious pork roast dinner with baked apple, roasted sweet potatoes, bacon-braised Brussels sprouts, steamed broccoli and salad. I lent Giles a pair of amber-tinted glasses to wear in the evening, and he slept one night in our guest room.  All-in-all, I felt that I represented the Paleo community well, demonstrating my balanced and holistic approach to wellness.

We were completely edited out of the documentary! I was initially disappointed but it turned out to be a great thing because the documentary did not portray any of the diets flatteringly.  I said to my husband at the time, “huh, I guess we were too normal for them.” We didn’t fit the narrative. But, one memory from that experience has been bouncing around my head lately.

As the film crew was packing up and we were saying our goodbyes on the front porch, Giles said to me something to the effect of “You don’t ever say the word Paleo when you talk about what you eat.” Oh. I don’t? Huh. I guess I don’t.

I still don’t.

I realized that I was subconsciously avoiding labeling how we eat as “the Paleo diet”, not to escape the stigma associated with it as a “fad diet”, but rather to sidestep the diet dogma already so entrenched in the Paleo community.

Nutritional Sciences vs. Diet Dogma

Dogma is defined as a set of principles laid down by an authority as incontrovertibly true.  While the Paleo diet has never had a central organizing body, it has always been policed by enthusiasts who follow as unyielding and irrevocable the yes-no food lists presented in any of the early Paleo books, websites or podcasts.  When I posted my recipe for Simple Roasted Green Beans in December 2013, my social media was bombarded with comments all-caps yelling: DON’T YOU KNOW THAT GREEN BEANS ARE A LEGUME?!?! This recipe is sacrilege! (See The Green Bean Controversy and Pea-Gate).

While it may seem laughable now that green beans are commonplace in Paleo recipes, at the time I was rattled.  Because it was the scientific foundation for the Paleo diet that originally attracted me to this way of life (my rapid health improvements inspired me to launch my website and create resources to help others),  I was surprised to confront such a strong desire for a completely static template, unresponsive to new scientific insight, and an unwillingness to consider alternate interpretations of how to best implement the actionable information from scientific studies. Science isn’t static. As more research is performed, we expand human knowledge. Even our understanding of something as fundamental as gravity is continuing to expand. (Hello gravitational waves,  proposed by Henri Poincaré in 1905, predicted mathematically by Albert Einstein in 1916, and finally measured for the first time by the LIGO detector in 2016!!!) A dietary template that follows the science must necessarily iterate and evolve to reflect the ever increasing sum of scientific evidence.

The green bean controversy was merely the first  time of many that I have confronted Paleo diet dogma to the exclusion of science; I’m sure it won’t be the last.

While my ability to write about detailed scientific concepts in an engaging and accessible way is mostly innate, the skill set I use to research the topics I write about is one that I cultivated and refined during my prior career as a medical researcher. For years, I did research in critical care medicine (my two main projects were studying endogenous anti-inflammatory and antioxidant protective enzymes in the liver microvasculature during Systemic Inflammatory Response Syndrome, and stem cell-based gene therapy targeting angiogenic growth factors as a treatment for Acute Respiratory Distress Syndrome) and cell biology (I identified and characterized a new tumor suppressor gene involved in breast and colon cancer that prevents cell transformation via regulation of epithelial tight junctions). I got to use some super cool technologies in my experiments, my research won awards, and I have published in some of the top scientific journals.

But, my health was so bad when my first daughter was born that I took a leave from academia. During that time, I lost 120 pounds, found the Paleo diet, founded the Autoimmune Protocol, and finally regained my health after decades of struggles (see My Personal Journey with the Autoimmune Protocol). Through my blog, podcast, books, workshops and online courses, I found an audience hungry for my scientific explanations, which rely on contemporary biology rather than anthropology, for the why’s behind what to eat and what to avoid.  My resources helped others regain their health too. And, as I earned my place as a thought-leader in the Paleo and community, my scientific approach helped reinforce the legitimacy of the Paleo diet while helping to define its contours. When my leave could no longer be extended after eight years, I decided not to return to medical research after all.  I had found my calling as a science writer, health advocate, and educator. (Learn more about my background in Dr. Sarah Ballantyne, PhD and my story in Dr. Sarah’s Story).

My training as a scientific researcher has always permeated my approach to diet and lifestyle principles. I guess it’s once a scientist, always a scientist. My extensive experience of actually performing scientific research gives me an appreciation for the effort and passion that goes into scientific studies, as well as knowing the academic scientific research community intimately. It also allows me to read scientific papers with a strong knowledge base on the subject matter but also on experimental methodology and on statistical analysis (my B.Sc. is in honors physics so statistics and I go way back). That allows me to weigh the value of individual studies, identify methodological limitations and unanswered questions, and place them in the context of the research field as a whole.

That’s why you’ll never hear me saying BS like “that experiment was performed in mice so it has no relevance to humans” (if it’s a mechanistic study, which most animal experiments are, it’s immensely relevant to us because it explains why an effect happens), or “that human study has a small sample size so we should ignore the data” (statistical power is related to standard deviation and magnitude of effect, so you don’t always need a huge sample size to prove an effect). And, you’ll never hear me spout conspiracy theories, bash scientists as bias (99.9999% of them aren’t), or disregard a study just because it doesn’t confirm my beliefs. I’m completely open to new science challenging my conclusions and I will always let you know when new data changes the landscape with regards to a health topic.

I don’t look for studies that support my assertions, but instead I try to represent the current state of knowledge on that topic, if there’s enough data to reach scientific consensus (something I value immensely), otherwise where the majority of data is currently pointing, the limits of current human knowledge, where results need to be confirmed (and yes, we need more funding for confirmation and replication studies!), and where conflicting data indicates nuance and context.  Despite my blog name, I don’t feel constrained by the term Paleo nor its diet dogma. I know my readers are well-equipped to fathom scientific evidence at odds with traditional Paleo tenets. Whether we collectively incorporate new scientific insight into the Paleo diet, or branch out towards a more inclusive dietary approach, I will always take the time to explain the scientific evidence behind every recommendation, so that your day-to-day choices can be empowered and informed by an appreciation for and understanding of the relevant science.

My Diet Label: Nutrivore

In July 2012, I posted (Re)Defining Paleo, where I discussed the importance of defining a diet based on what we do eat, and not what we eliminate. That’s because it’s not the foods we avoid that make a diet healthy or unhealthy, but rather what we actually consume.  And, the most fundamental property of a health-promoting diet is one that supplies the body with all of the nutrients it needs to function optimally.

Over the years, I’ve come to resonate with a different label for the way I eat. I think of myself as a nutrivore. 

A nutrivorous diet is one in which the goal is to fully meet the body’s physiologic needs for both essential and nonessential nutrients from the foods we eat.  This is also called a nutrient-sufficient diet. 

Every cell, tissue, organ, and system in the human body needs specific amounts of specific nutrients in order to function efficiently and effectively. Nutrients are used not only in the formation the components of our bodies but also in the millions of chemical reactions that occur in our bodies in every moment. We are made of nutrients and our bodies need them to do even basic things like breathing. Every tiny detail of every function of every part of the human body requires nutrients, and it isn’t just macronutrients—protein, fat, and carbohydrates—that supply the energy that fuels the complex functions of life. Micronutrients—vitamins, minerals, plant phytochemicals, and other compounds—are necessary resources that get used up, too, and our micronutrient stores must be continuously topped up from the foods we eat. Being even slightly deficient in a single nutrient can have negative consequences for our health.

Micronutrients can be categorized as essential and nonessential. Essential means that you’ll die without them. Nonessential means that you’ll go on living without them, though you may not be particularly healthy—and indeed, many micronutrients that are considered nonessential are known to improve health. Often, micronutrients are called nonessential simply because we don’t really understand exactly what it does in our bodies to support health—we just know that when we consume more of it, our risk of disease decreases. This is the case for most phytochemicals (like polyphenols) and many vitaminlike compounds (like coenzyme Q10). There are thousands of plant phytochemicals, and our understanding of their roles in health is so rudimentary that the most we can typically say about them is that they have antioxidant activity (that is, they help prevent damage to molecules in our body from oxidation). Yet we know that the more plant phytochemicals in your diet, the lower your risk of chronic disease. When you think about it in these terms, it’s easy to realize that even nonessential nutrients are pretty darned important.

The term nutrient density refers to the concentration of micronutrients (mainly vitamins and minerals, but the term micronutrients also encompasses phytochemicals, essential fatty acids and essential amino acids) per calorie of food. Nutrient-dense foods supply a wide range of vitamins and minerals (or alternatively, high levels of a specific, important vitamin or mineral) relative to the calories they contain, whereas low nutrient density foods supply lots of energy without much in the way of additional nutrition. Thus, a nutrivorous, or nutrient-sufficient, diet is practically achieved by consuming more nutrient-dense foods, in ratios that provide synergistic quantities of every nutrient.

When we consider the foods richest in micronutrients, certain foods come up again and again as powerhouses of nutrition, especially: organ meat, seafood, vegetables, mushrooms, fruit, nuts, seeds, herbs and spices. Yes, that certainly looks a lot like the Paleo diet (at least how I’ve defined and implemented it over the last 8+ years). So, what’s the difference between Paleo and nutrivore? Being a nutrivore is about the overall quality of the whole diet, and not about a list of yes-foods and no-foods.  Even though eliminating empty calorie foods helps to achieve nutrient sufficiency, no food is strictly verboten.

Being a nutrivore is integrated into the Autoimmune Protocol (in addition to eliminations recognizing the importance of removing dietary autoimmune triggers for susceptible individuals, and lifestyle factors important for immune regulation), and you can certainly be a nutrivore while following the Paleo diet (although in Paleo’s case, nutrient-sufficiency is not baked in), which is how my family and I eat in practice.  I think of being a nutrivore as a general health approach, a base dietary philosophy devoid of dogma, on top of which you can layer additional food focus or eliminations to meet individual needs.

The Gut Microbiome Diet

I recently released my new gut microbiome e-book, The Gut Health Guidebook, the culmination of nearly six years of intense research and writing. An even longer, more detailed version is in the works for an upcoming in-print book that was delayed due to covid-19.

When I decided to wade into the scientific literature on the gut microbiome, and specifically the intersection between diet and lifestyle and supporting a healthy and happy our community of gut microbes, I decided the only way to do this right was to leave all of my previously established conclusions about which foods are good or bad at the door. No dogma allowed! Instead, this field of research presented a new opportunity to understand which foods are healthful or harmful in a new light, perhaps finally answering many lingering questions about gray-area foods for which the Paleo community if often criticized for omitting.

As I read and learned and compiled information, I started to see every health-promoting food and behavior through the lens of the microbiome. Everything I already knew was healthy was confirmed, and the benefits largely mediated through the gut microbiome. Everything I already knew was unhealthy was confirmed, and the detriments largely mediated through the gut microbiome. And that world of gray in between solidified into black or white, which is why foods traditionally excluded on the Paleo diet made their way into The Gut Health Guidebook as beneficial for the gut microbiome.

I set out not to make another Paleo book or AIP book, but instead, simply to understand the current state of scientific evidence on optimal diet and lifestyle for the gut microbiome, digging deep into the literature for hidden gems (of which I found many). And, I think this information helps to align the Paleo diet with other scientifically-validated dietary approaches, shedding light on limitations of diets devised without the gut microbiome in mind. This information explains why the Autoimmune Protocol is so powerful (the main takeaways from my gut microbiome research have already been integrated into the AIP over the past few years), but also expands on it in an informed way for people who aren’t challenged with autoimmune disease.

In The Gut Health Guidebook, I’ve build a new diet for general health, from the ground up, based on the gut microbiome, that merges everything the science currently tells us is healthful into one comprehensive approach.

Guess what diet most closely aligns with the gut microbiome diet?  Yep, nutrivore. The Autoimmune Protocol diet and a nutrient-sufficient Paleo diet are close seconds. In fact, in the process of compiling this information, I have come to view AIP and Paleo as two different sub-diets of a nutrivore or a gut microbiome diet, those aforementioned layers on top of a nutrient-sufficient base that help refine a diet to respect bioindividuality and help address personal health needs and goals.

So, I hope you’ll follow me down the rabbit hole of the gut microbiome in The Gut Health Guidebook, being open to new information that challenges diet dogma, and raring to adopt new habits to support optimal health.

I also have a companion e-cookbook coming late this summer, which you can pre-order to get the lowest price as part of The Gut Health Collection.

This companion to The Gut Health Guidebook puts theory into practice with 150+ recipes that each center on at least one of 60 gut health superfood ingredients. The Gut Health Cookbook is organized by gut health superfood, including a summary of each superfood’s benefits to overall health and the gut microbiome, followed by 2 to 4 recipes that highlight that ingredient and pair it with other superfoods. From reimagined decadent desserts to wholesome breakfasts to one-pot meals, this e-book is designed to show you just how easy and delicious eating for your gut microbiome can be! While some of the featured gut microbiome superfoods are not traditionally considered Paleo (like lentils and rice), all of the recipes are gluten-free, approximately 90% are Paleo and more than half are AIP compatible. And, for those of you who have all of my e-books and cookbooks, at least half of the recipes in The Gut Health Cookbook are completely new!

The post Ditching Diet Dogma appeared first on The Paleo Mom.

Nutrivore
no͝ o-trĭ-vôr’
noun

1. 1. A person who chooses foods to supply all the nutrients their body needs to thrive.
   2. A diet predominantly comprised of nutrient-dense whole foods.
   3. A radical yet simple idea: Get all the nutrients we need from the food we eat.

What makes the concept of Nutrivore so revolutionary? Despite the long-established Recommended Daily Intake of essential nutrients and increasing awareness of the importance of non-essential nutrients (like CoQ10 and polyphenols), no mainstream diet has ever integrated the concept of nutrient sufficiency, meaning we get all of the essential and non-essential nutrients our bodies need to thrive from the foods we eat. The notable exception in the Autoimmune Protocol, the dietary tenets of which are based on nutrient-dense foods as the foundation.

As a society, we’re fairly used to thinking about how food is related to weight: eat too much of the wrong things and you become overweight; eat the right amounts of the right things and you lose weight. But health is about so much more than weight, and in actuality how much you weigh is a pretty poor indicator of health (see Can You Really Be Healthy at Any Size?, TWV Podcast Episode 436: What Is Health, and How Do You Measure It?, TWV Podcast Episode 471: The Harm of Weight Discrimination and Stigma – Part 1 and TWV Podcast Episode 472: The Harm of Weight Discrimination and Stigma – Part 2). And food has a much more profound impact on health than whatever the number is on the scale.

Where Most Diets Fail

As I discussed in The Importance of Nutrient Density, micronutrient deficiencies are so common that some researchers speculate that at least 90% of us of us are deficient in at least one vital nutrient. Our food system is abundant in calories (the U.S. produces about 6,000 calories’ worth of food per person per day), but the Standard American Diet is deficient in most of the essential vitamins and minerals that our bodies need to be healthy. In fact, multiple analyses of food intakes have shown that large percentages of Americans routinely consume inadequate amounts of essential vitamins and minerals. In fact, up to

• 56% of Americans don’t consume enough vitamin A
• 28% of Americans don’t consume enough vitamin B1 (thiamin)
• 22% of Americans don’t consume enough vitamin B2 (riboflavin)
• 24% of Americans don’t consume enough vitamin B3 (niacin)
• 54% of Americans don’t consume enough vitamin B6 (pyridoxine)
• 75% of Americans don’t consume enough vitamin B9 (folate)
• 30% of Americans don’t consume enough vitamin B12 (cobalamin)
• 48% of Americans don’t consume enough vitamin C (ascorbate)
• 94% of Americans don’t consume enough vitamin D
• 89% of Americans don’t consume enough vitamin E
• 92% of Americans don’t consume enough choline
• 73% of Americans don’t consume enough calcium
• 31% of Americans don’t consume enough copper
• 39% of Americans don’t consume enough iron
• 68% of Americans don’t consume enough magnesium
• 21% of Americans don’t consume enough phosphorous
• 100% of Americans don’t consume enough potassium
• 15% of Americans don’t consume enough selenium
• 73% of Americans don’t consume enough zinc
• 70% of Americans don’t consume enough omega-3 fats
• 90% of Americans don’t consume enough fiber
• 90% of Americans don’t consume enough polyphenols

Junk food, white bread, and high-fructose corn syrup aren’t the only culprits here. Even eating what many people believe to be a healthy whole-foods diet can leave our bodies starved for micronutrients. And this falls on the shoulders of dietary guidelines. Analyses of USDA dietary guidelines reveal common micronutrient deficiencies, including: vitamin A, vitamin D, vitamin E, vitamin K, calcium, iodine, magnesium, potassium, zinc and omega-3 fats. And, the biggest reason for these nutrient shortfalls is the promotion of grains as a foundational food, despite the fact that even whole grains don’t contribute much more than calories and fiber to our diets (see also Gluten-Free Diets Can Be Healthy for Kids).

Unfortunately, diet alternatives to the USDA dietary guidelines (whether fad or based in some legit science, see Autoimmune Protocol Clinical Trials and Studies and Paleo Diet Clinical Trials and Studies) aren’t much of an improvement from a nutrient sufficiency standpoint and some have exacerbated the nutrient deficiency problem either through a lack of a nutrient focus and education or by omitting groups of nutritious whole foods, in some cases eliminating all food sources of certain nutrients.

For example, the standard Paleo diet is structured around avoiding grains, legumes and dairy (of course, this is not my approach, see also Ditching Diet Dogma, The Paleo Template e-book, and Paleo Principles). Vegan diets avoid meat and dairy (see also Plant-Based Protein: What is its Role in the Paleo Diet? and TWV Podcast Episode 435: Is Protein from Vegetables Enough?). Low-carb and ketogenic diets limit the amount of carbohydrates you eat (which, I have criticized in Adverse Reactions to Ketogenic Diets: Caution Advised, How Ketogenic Diet Wreaks Havoc on Your Gut, Paleo, Resistant Starch, and TMAO: New Study Warning Worth Heeding, The Case for More Carbs: Insulin’s NonMetabolic Roles in the Human Body and How Many Carbs Should We Eat?). And low-fat diets limit the amount of dietary fat you eat (which I have also criticized in Carbs Vs. Protein Vs. Fat: Insight from Hunter-Gatherers).  And many weight loss diets are centered around caloric restriction.

What do all of these diets have in common? Because they are all focused on what not to eat, they don’t teach how to choose foods based on the nutrients they contain.  In fact, these diets focus on just about everything but nutrients, especially micronutrients but also nonessential (but super important) nutrients, representing a fundamental flaw in each dietary rationale. Instead, these popular diet plans teach an oversimplification of nutritional sciences or even a complete disregard for all scientific research that doesn’t conform to a diet’s preconceived notions. (See also The History of Dietary Guidelines (and How They’ve Steered Us Wrong))

The result is that these popular diets purported to improve health or facilitate weight loss all fall short of the mark because nutritional deficiencies linked with increased chronic disease risk are still common among adopters. For example:

• Vegan and vegetarian diets are commonly deficient in vitamin A, vitamin B3, vitamin B9, vitamin B12, calcium, chromium, copper, iodine, iron, magnesium, manganese, zinc and omega-3 fats.
• Low-carb diets are commonly deficient in vitamin B2, vitamin B5, vitamin B6, vitamin B9, vitamin D, vitamin E, biotin, choline, calcium, chromium, iodine, iron, magnesium, molybdenum, potassium, zinc and fiber.
• Low-fat diets are commonly deficient in vitamin A, vitamin D, vitamin E, vitamin K, calcium and omega-3 fats.
• Calorie-restriction programs are commonly deficient in vitamin A, vitamin B1, vitamin B2, vitamin B3, vitamin C, vitamin E, calcium, iron, magnesium, potassium and zinc.
• Gluten-free diets are commonly deficient in vitamin D, vitamin B3, vitamin B9, vitamin B12, iron, magnesium, calcium, zinc and fiber.
• Paleo and primal diets (at least how you would learn about them from other thought leaders) are commonly deficient in biotin, calcium and chromium.
• Ketogenic diets are commonly deficient in vitamin A, vitamin B2, vitamin B5, vitamin B6, vitamin B9, vitamin E, vitamin D, vitamin K, biotin, choline, calcium, chromium, choline, iodine, iron, magnesium, molybdenum, potassium, selenium zinc and fiber.

In fact, no popular branded or fad diet achieves nutrient sufficiency because nutrient-awareness is not integrated into their dietary frameworks, which is why the concept of Nutrivore is so important. As already mentioned, the two notable exceptions are: 1) the Autoimmune Protocol, which promotes nutrient-dense superfoods—organ meat, seafood, and tons of veggies—as the foundation of the diet with recommendations for nutrient tracking to ensure nutrient sufficiency; and 2) the way I teach the Paleo diet which incorporates Nutrivore tenets (see Paleo Principles, The Paleo Template E-Book, and the Therapeutic Paleo Approach online course). And this could be replicated by other dietary templates.

The good news is that most popular and fad diets are compatible with Nutrivore by overlaying an emphasis on nutrient-sufficiency overtop of the core dietary structure. By carefully selecting a wide variety of foods such that the body’s nutrient requirements are met by the diet, the most basic function of diet is achieved—nourishment!

Choosing Foods Based on Nutrients

Nutrients are those substances within the foods we eat that provides nourishment essential for growth and the maintenance of life. Every cell, tissue, organ, and system in the human body needs specific amounts of select nutrients in order to function efficiently and effectively. Nutrients are used not only in the formation the components of our bodies but also in the millions of chemical reactions that occur in our bodies in every moment. We are made of nutrients and our bodies need them to do even basic things like breathing.

Every tiny detail of every function of every part of the human body requires nutrients, which can be broadly categorized as macronutrients, those we need in large quantities, and micronutrients, those we need in smaller quantities.

• Macronutrients — protein, fat, and carbohydrates — supply the energy that fuels the complex functions of life along with being basic building blocks for cellular structures.
• Micronutrients — vitamins, minerals, plant phytonutrients, and other compounds — can also be incorporated into cellular structures, but more commonly are necessary resources that facilitate or get used up in cellular chemical reactions.

Micronutrients can be categorized as essential and nonessential. Essential nutrients are those that our bodies can’t make– we’ll develop a disease of deficiency and eventually die without them. Because diseases of deficiency can be studied in detail, it is easy to establish Recommended Daily Intake levels of essential nutrients, the minimum amount of that specific nutrient needed to meet the nutritional needs of 97.5% of the population (the remaining 2.5% needing more). Being even slightly deficient in a single essential nutrient can have negative consequences for our health. In contrast, nonessential nutrients are those for which there is no clearly defined disease of deficiency—we’ll go on living without them, perhaps because our body can synthesize them to some degree, though we may not be particularly healthy if we don’t get enough. Indeed, many nutrients that are considered nonessential are known to improve health the more of them we eat.

Often, micronutrients are called nonessential simply because we don’t really understand exactly what it does in our bodies to support health—we just know that when we consume more of it, our risk of disease decreases. This is the case for most phytonutrients (like polyphenols and carotenoids) and many vitaminlike compounds (like coenzyme Q10 and choline). There are thousands of plant phytonutrients, and our understanding of their roles in health is so rudimentary that the most we can typically say about them is that they have antioxidant activity (that is, they help prevent damage to molecules in our body from oxidation). Yet we know that the more plant phytonutrients in our diet, the lower our risk of chronic and infectious disease. When you think about it in these terms, it’s easy to realize that even nonessential nutrients are pretty darned important.

Our macronutrient and micronutrient stores must be continuously topped up from the foods we eat. Unfortunately, getting all of our required nutrients from food is easier said than done. Many of the staple foods of the typical American diet have very little nutritional value. Even worse, the more a food is refined and processed and manufactured, the more the nutrients inherent to the raw ingredients are leached out, removed, or degraded. Processed foods, refined foods, fast food, and junk food all contribute next to no nutrients to our diets (plus, they’re often problematic for our health in other ways). But even foods that many people think are healthy, like whole grains and low-fat dairy, are pretty weak when it comes to essential nutrients. And every time a nutritionally weak food displaces a nutritional powerhouse, the overall nutritional value of the diet suffers.

Here is where becoming a Nutrivore comes in.

What Is Nutrivore?

A Nutrivore diet is one in which the goal is to fully meet the body’s physiologic needs for both essential and nonessential nutrients from the foods we eat, also called nutrient sufficiency, but without consuming excess energy (i.e., staying within daily caloric requirements). By including not only the full cadre of essential nutrients but also fiber, phytonutrients, nonessential and conditionally-essential amino acids (like glutamine and arginine), nonessential health-promoting fatty acids (like DHA, EPA and CLA), and nonessential vitaminlike compounds into the nutrition calculus, we are ensuring both nutrient synergy as well as prioritizing the full complement of nutrients our bodies need to thrive.

Being a Nutrivore is about the overall quality of the whole diet, and not about a list of yes-foods and no-foods. Even though eliminating empty calorie foods helps to achieve nutrient sufficiency without overeating, no food is strictly verboten. In this way, being a Nutrivore is a diet modifier rather than a diet itself—a nutrivorous approach can be layered atop of other dietary structures and priorities in order to meet an individual’s specific health needs and goals.

For example, you can follow a Nutrivore Paleo diet (as I teach in see Paleo Principles, The Paleo Template E-Book, and the Therapeutic Paleo Approach online course), or a Nutrivore Mediterranean diet, or a Nutrivore whole-foods diet, or a Nutrivore plant-based diet, or a Nutrivore Autoimmune Protocol (well, that last one should be a given). You can also apply the Nutrivore philosophy to anti-diet culture, and in fact, it’s completely aligned with the body positivity movement (see also TPV Podcast Episode 358: How Intuitive Eating Has It Wrong).

Even though some individuals may still need to eliminate food sensitivities that trigger reactions or chronic disease symptoms (as in the AIP), or may choose to eliminate certain foods to conform to a specific dietary structure (as in Paleo), this in no way prevents us from achieving nutrient sufficiency, although it may necessitate thoughtful selection from the included foods. Only extreme diets that eliminate all sources of specific nutrients—such as a carnivore diet, fruitarian diet, and some implementations of a ketogenic diet—are incompatible with being a Nutrivore.

Rule #1 of Nutrivore: Choose a Variety of Nutrient-Dense Foods

Because there’s no such thing as a nutritionally complete food or food group, there’s no single food that provides all of the nutrients we need to thrive. (As an aside, very few animals survive exclusively or almost exclusively on a single food. And, for example, giant pandas have to eat about 83 pounds of bamboo shoots, leaves and stems every day to meet their nutritional needs!) As an extreme example, what if you decided to only eat watercress because its the single most nutrient-dense food? Well, you’d get crazy amounts of vitamin C, vitamin K, carotenoids and glucosinolates, and if you ate enough of it (285 cups of watercress would get you to 2000 calories), you could reach the RDA of most vitamins and minerals. But, you’d still be lacking in vitamin D, vitamin B12, choline, omega-3 fats, and some essential amino acids, especially methionine and tryptophan. You’d also miss out on the full diversity of polyphenols as well as some functional compounds that just aren’t available in watercress, like taurine, carnitine, carnosine, creatine, ergothioneine and thiosulfinates.

Ultimately, there are nutrients we can get only from plant foods and nutrients we can get only from animal foods: We need both to obtain the full complement of nutrients that our bodies need to be healthy. See The Diet We’re Meant to Eat, Part 3: How Much Meat versus Veggies?

The most straightforward way to ensure that our diet is abounding in nutrients is to choose nutrient-dense superfoods more often. That means that the more we can fill our plates with vegetables, fruits, and mushrooms and choose fish, shellfish or organ meat for our proteins, seasoning liberally with herbs and spices, and use superfoods like nuts and seeds as condiments, the higher the nutritive quality of our overall diet, which makes room for some lower nutrient-density foods without sacrificing the goal of achieving nutrient sufficiency!

It’s important thing to emphasize that following a Nutrivore approach isn’t about perfection. With there being no foods that are strictly off-limits (unless you have an allergy or intolerance, of course), we can take a step back from diet dogma. In fact, because we are able to store at least a modest amount of most nutrients, the goal isn’t even nutrient sufficiency for the whole diet on a daily basis, but rather nutrient sufficiency on average. It’s okay if you don’t reach the RDA for zinc one day; but, it’s a good idea to troubleshoot and find a way to incorporate more zinc-rich foods into your diet if you find yourself falling short most days. Apps like Cron-o-meter can help you easily see if you’re meeting the RDA of essential vitamins and minerals, eating enough fiber, and getting enough omega-3 fats. Try keeping a food journal for a few days to identify if there are any nutrients you’re routinely falling short on, then figure out what foods you can add to your diet to better meet your nutritional needs.

Introducing Nutrivore.com

I’m so excited to start sharing details about the new website I’ve been building for about a year and a half: Nutrivore.com!  I’m building this website outside of any dietary dogma. Being a Nutrivore is about the overall quality of the whole diet, and not about a list of yes-foods and no-foods. Even though eliminating empty calorie foods helps to achieve nutrient sufficiency without overeating, no food is strictly off-limits. In this way, being a Nutrivore is a diet modifier rather than a diet itself—a Nutrivore approach can be layered atop of other dietary structures and priorities in order to meet an individual’s specific health needs and goals.

I see Nutrivore as the natural extension of my science-grounded approach, and one that will allow me to both level up the depth of my resources for my long-time readers who love my science deep dives, but also meet people where they are and embrace the idea that even a small first step is worth celebrating. (See also Ditching Diet Dogma, My Personal Journey with the Autoimmune Protocol and My Personal Journey as a Blogger).

My vision for Nutrivore.com is extremely ambitious: A detailed educational resource devoid of dietary dogma and instead purely based on scientific studies and nutrient profiling to quantify nutrient density, all with the goal of helping people achieve dietary nutrient sufficiency (a.k.a. Nutrivore) through informed day-to-day choices.

I’ll be launching Nutrivore.com in November (fittingly enough, my 10-year blogging anniversary plus my birthday month!) with a ton of content, and then continuing to add articles regularly afterwards to build the most comprehensive nutrition- and health-focused website ever created.

Last year, I released my gut microbiome e-books, The Gut Health Guidebook and The Gut Health Cookbook, the culmination of over six years of intense research and writing. Even longer, more detailed versions of both of these books are still in the works for upcoming in-print books that were delayed due to covid-19.

When I decided to wade into the scientific literature on the gut microbiome, and specifically the intersection between diet and lifestyle and supporting a healthy and happy community of gut microbes, I decided the only way to do this right was to leave all of my previously established conclusions about which foods are good or bad at the door. No diet dogma allowed! As I read and learned and compiled information, maintaining an open mind to follow the science wherever it led, I realized that a very important tool was missing, a way to define and quantify nutrient density. It’s one thing to say “eat more nutrient-dense foods”, but how do we even identify what foods qualify?

When I completed The Gut Health e-books, my next project was to start developing the foundational content for Nutrivore.com.  I knew that I needed a method to quantify the nutrient density of foods, meaning a score that represents how much nutrients a food contains — the higher the number, the more nutrients per calorie. This is actually a field of research called nutrient profiling, the science of categorizing foods according to their nutritional composition.

My initial plan was to comb through the research and choose one of the dozen or so existing nutrient density scores to use.  After reading through nearly every nutrient profiling study ever published (which took me about two months!), I reached a disappointing conclusion: Every nutrient density score that had been developed thus far was flawed. How flawed? Just one example is scores that utilize just a few select nutrients in the calculations in order to best align with the USDA dietary guidelines. The rationale is that some nutrients are more strongly correlated with health outcomes than others, but ignores the fact that these “important” nutrients are typically the ones we’re most deficient in, rather than any special property of the nutrient itself.  The biggest problem with this approach is the idea of retrofitting to guidelines that were not crafted with nutrient density or sufficiency in mind! This is backwards! We should be aligning dietary guidelines with insight from nutrient profiling, not the other way around!

So, I did the only logical thing I could do. I spent the next six months developing my own nutrient profiling method, which I call the Nutrivore Score!  It’s currently (IMO) the most comprehensive, and least bias, method for representing the inherent nutrient content of foods, borne out of a confusing array of similar, yet all flawed, nutrient density scores, while recognizing the current limitations posed by incomplete data. To date, I have calculated the Nutrivore Score for nearly 300 foods. And wow, were there ever some surprises! Some foods scored way lower than I expected, others much higher, and I’ve realized that the Nutrivore Score is a critically important tool for informing day-to-day food choices. Combining the insight I gleaned from my gut microbiome research with nutrient profiling via the Nutrivore Score has led me to see many foods in a new light. I’ve made changes to my family’s and my diet as a result.

It is time for a positive approach to dietary guidance using nutrient density as a basic principle. The Nutrivore Score is a necessary foundational step towards achieving this goal! By understanding the nutrients per calorie offered by individual foods via the Nutrivore Score, in addition to recognition that certain nutrients are exclusive to specific food groups, we can achieve nutrient sufficiency by choose a variety of nutrient-dense superfoods as well as the highest Nutrivore Score options from the various foundational food groups.

Grab My Nutrivore Score Guide to Food Groups

I’ll be sharing more details on the Nutrivore Score in an upcoming article, but right now, you can get my Nutrivore Score Guide to Food Groups in your inbox for free! Simply sign up below!

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