New scoring system rates quality of carbohydrate foods

In a recent study published in the journal Nutrients, researchers presented the feasibility of carbohydrate food quality score (CFQS) modeling to improve understanding of the value of and variations in carbohydrate food (CF) quality among various diets.

Study: Application of a New Carbohydrate Food Quality Scoring System: An Expert Panel Report. Image Credit: Tatjana Baibakova /

Study: Application of a New Carbohydrate Food Quality Scoring System: An Expert Panel Report. Image Credit: Tatjana Baibakova /


To date, dietary guidelines (DGA) on carbohydrate intake are primarily based on quantitative measures such as fiber content and added sugars, with limited guidance on carbohydrate-comprising food group qualities. Data on selecting vegetables by their starch levels or color, as well as grains and fruits by their wholeness, are limited.

Many daily consumed CFs have low whole grains and fiber content but high sodium, saturated fat, and added sugar content. Since CFs are more cost-effective sources of nutrients as compared to fat- or protein-rich foods, new methods for identifying and selecting higher-quality food items could improve diet-associated health outcomes during times of economic uncertainty and increasing inflation.

About the study

In the present study, researchers assess the applicability of a CF quality scoring system in improving food selection to consume diets high in nutrients and fiber and low in sugar content.

CFQS-4 and CFQS-5 models were developed for assessing CF quality. These CFQS models were based on DGA guidelines linked to beneficial health outcomes to national dietary recommendations.

CFQS-4 included four sodium, free sugars, potassium, and fiber to assess non-grain CF quality. In addition to these nutrients, CFQS-5 included whole grains to assess grain food quality.

Both CFQS models were applied to different diets, including healthy vegetarian, healthy United States-style, thrifty diet plan, and the healthy Mediterranean diet, each of which was represented by 20 CFs.

The thrifty diet plan provided budget-friendly dietary choices and informed the supplemental nutrition assistance program (SNAP) advantages for four-member households. In addition, four food tables were included that represented culturally inclusive diet patterns for African Americans, Latin Americans, Asian Americans, and Native Americans.

CFQS models were applied to current DGA health diet plans, the 2020-2025 DGA healthy diet plans, the United States Department of Agriculture (USDA) thrifty diet plan, and culturally inclusive diet patterns. Nutritional and calorie requirements were aligned with age, sex, and activity levels.

For the analysis, diets were modeled for 19- to 50-year-old females consuming 2,000 kcal daily. Data were sourced from the FoodData Central, Food Patterns Equivalents Database (FPED), and the Food and Nutrient Database for Dietary Studies (FNDDS) database.

Nutritional criteria were developed to meet 90% of the recommended daily intake for all food groups. Only food items with over 40% of their energy derived from carbohydrates were listed on the food menus.

CFs were validated using the Oldways common foods and flavors lists, as well as the dietetics and nutrition academy members, representing the Latinos and Hispanics in Dietetics and Nutrition (LAHIDAN), the National Organization of Blacks in Dietetics and Nutrition (NOBIDAN), and African Women and Girls Advancing Nutrition Dietetics and Agriculture (WANDA).

Single-day food menus were modeled, including two snacks and three meals, such as breakfast, lunch, dinner, and snacks in the morning and evening. The diets aimed at 45% to 65% kcal from carbohydrates and equivalent proportions of regular fruit, vegetable, and grain servings.

Study findings

In the healthy U.S.-style diet, the one-day food menu comprised 2,082 kcal that were derived from carbohydrates (53%, 278 g), protein (19%, 101 g), and fat (29%, 68 g). The menu provided fiber (26.0 g), added sugars (5.0 g), potassium (3,935 mg), and sodium (1,136 mg).

The healthy vegetarian diet menu comprised 2,096 kcal from carbohydrates (45%, 34.0 g), protein (19%, 102.0 g), and fat (40%, 92.0 g). This menu provided 23.0 g, 7.0 g, 3,203 mg, and 2,228 mg of fiber, added sugars, potassium, and sodium, respectively.

The healthy Mediterranean-style diet menu comprised 2,094 kcal, of which 48%, 24%, and 31% were derived from carbohydrates, protein, and fat, respectively. The nutrient content of fiber, added sugars, potassium, and sodium was 31.0 g, 0.0 g, 4,787 mg, and 2,205 mg, respectively.

The USDA thrifty food plan one-day food menu comprised 2,100 kcal from carbohydrates (47%, 246 g), protein (28%, 145.0 g), and fat (28%, 65 g). The nutrient content was 37 g, 5.0 g, 4,801 mg, and 1,809 mg of fiber, added sugars, potassium, and sodium, respectively.

The USDA thrifty menu was based on the average May 2022 food costs of $7.60/person/day for four-member households and $9.20/day for one-member households. In line with the dietary guidelines advisory committee (DGAC) diet pattern of 2020, for individuals aged two years and older, all included nutrients provided more than 90% of the adequate intake (AI) or recommended daily allowance (RDA), except vitamin D.  

The modeled menus showed that several CFs of different types, encompassing all CFQS scores, could be consumed in one day, thereby meeting DGA recommendations.

Overall, the study findings showed the feasibility of the CFQS system in assessing CF quality, guiding decision-making, informing policy-makers, healthcare professionals, stakeholders, and consumers, and enhancing food selection concordant with DGA recommendations.

Journal reference:
  • Comerford, K. B., Drewnowski, A., Papanikolaou, Y., et al. (2023). Application of a New Carbohydrate Food Quality Scoring System: An Expert Panel Report. Nutrients 15(1288). doi:10.3390/nu15051288
Pooja Toshniwal Paharia

Written by

Pooja Toshniwal Paharia

Pooja Toshniwal Paharia is an oral and maxillofacial physician and radiologist based in Pune, India. Her academic background is in Oral Medicine and Radiology. She has extensive experience in research and evidence-based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.


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