An integrative analytical framework to identify healthy, impactful, and equitable foods: a case study on 100% orange juice

To identify healthy, impactful, and equitable foods, we combined health scores from six diverse nutrient profiling systems (NPS) into a meta-framework (meta-NPS) and paired this with dietary guideline adherence assessment via multilevel regression and poststratification. In a case-study format, a commonly debated beverage formulation – 100% orange juice (OJ) – was chosen to showcase the utility and depth of our framework, systematically scoring high across multiple food systems (i.e. a Meta-Score percentile = 93rd and Stability percentile = 75th) and leading to an expected increase of US dietary fruit guideline adherence by ∼10%. Moreover, the increased adherence varies across the 300 sociodemographic strata, with the benefit patterns being sensitive to absolute or relative quantification of the difference of adherence affected by OJ. In sum, the adaptable, integrative framework we established deepens the science of nutrient profiling and dietary guideline adherence assessment while shedding light on the nuances of defining equitable health effects. We developed a meta-nutrient profiling system (meta-NPS) to establish a consensus healthfulness evaluation and paired these assessments with quantification of dietary impact and equity. Integrating individual NPS, the meta-NPS has two novel features – Meta Score (the average rank) and Stability (the relative rank certainty), shown via empirical cumulative distribution function curves. In terms of impact and equity, multiple modelling approaches were utilised to estimate fruit guideline adherence impacted by orange juice for 300 subpopulations. While the framework applies to any food, 100% orange juice was highlighted to advertise salient utility.为甄别健康、兼具影响力与公平性的食品，我们将六种不同的营养成分分析系统（nutrient profiling systems, NPS）的健康评分整合为一套元框架（meta-NPS），并将该框架与通过多层回归与后分层法开展的膳食指南依从性评估相结合。我们以案例研究形式选取了一款广受讨论的饮品配方——100%橙汁（100% orange juice, OJ），以此展示本框架的实用性与应用深度。该饮品在多个食品系统中获得系统性高分（即元评分百分位为第93位，稳定性百分位为第75位），预计可使美国膳食水果指南依从性提升约10%。此外，依从性的提升幅度在300个社会人口学分层中存在差异，且该收益模式对橙汁所影响的依从性差异的绝对量化与相对量化均较为敏感。综上，我们构建的这套兼具适应性与整合性的框架，不仅深化了营养成分分析与膳食指南依从性评估的相关研究，同时也为界定公平健康效应的细微差异提供了新的视角。我们构建了一套元营养成分分析系统（meta-nutrient profiling system, meta-NPS），以形成统一的健康性评价标准，并将此类评估与膳食影响及公平性量化分析相结合。元营养成分分析系统整合了各独立NPS，具备两项创新特性——元评分（Meta Score，即平均排名）与稳定性（Stability，即相对排名确定性），相关特性可通过经验累积分布函数曲线进行展示。在膳食影响与公平性层面，我们采用多种建模方法，对300个亚群体受橙汁影响的水果指南依从性进行了估算。尽管本框架可适用于任意食品，但我们仍以100%橙汁为例，以凸显其显著的应用价值。