Curbside Consult with Dr. Jayne 4/24/23

As a primary care physician at heart, I know how important it is for patients to learn how to make better food choices. A friend clued me in to the Plateful app, which helps consumers make better choices by providing information that may be more understandable than the typical “Nutrition Facts” label. Once a user scans the UPC found on a packaged food, or uses the PLU code on a fruit or vegetable, the app displays a Nutrition Value and an Eco Value, each of which ranges from 0 to 100. In addition to the numbers, star values also display to help users understand the relative value of a food choice.

The Nutrition Value is based on the Tufts Food Compass Score, which was validated over nearly two decades. I wasn’t familiar with it before seeing the Plateful app. This isn’t surprising given the huge lack of nutrition education at medical schools when I was in training. I think we had a four-hour block to cover the entire topic, and you can bet that people paid less attention to it than they did to competing educational priorities like the surgical skills lab or cramming for the USMLE licensing exams. If I remember correctly, it was tacked on to the end of second year almost as an afterthought.

Although medical education has become more well-rounded since then, I’d bet that nutrition still gets less coverage than it probably should. Some of the most damaging chronic health conditions, including coronary artery disease, stroke, diabetes, and certain cancers can be impacted by nutrition, but it seems that our society would much rather spend its healthcare dollars on pills and injections rather than addressing the root causes of the diseases.

The Tufts Food Compass looks at 54 attributes across nine categories, including: ingredients, nutrient ratios, vitamins, minerals, fiber/protein, lipids, phytochemicals, additives, and processing. Foods with a higher Food Compass Score are associated with more favorable Body Mass Index, blood pressures, lipid profiles, and fasting blood glucose values as well as being associated with lower all-cause mortality rates. The validation studies were performed with a nationally representative sample of nearly 48,000 adults aged 20-85 in the US.

As you may guess, whole foods get higher scores, where heavily processed or additive-laden options get lower scores. Consumers are encouraged to use the app to scan similar foods and compare them. One of the use cases mentioned on the app’s website is comparing two loaves of bread to see which one has a higher Nutrition Value. The Eco Value looks at a food’s relative level of environmental friendliness, with a nod to climate, land, and water impacts. Foods with an Eco Value of more than 50 are more associated with a sustainable food system. While reading the website, I was surprised to learn that some foods that are conventionally thought of as healthy are actually less great for the environment due to water and climate impacts.

According to the website, parent company Opsis Health has more cool tools on the horizon, including the ability to take a picture of a plateful of food and have it converted to detailed nutrient information. That’s going to be a lot more accessible to most people than weighing or measuring food, which is often the first step in trying to take control of your eating habits. We’ve had so much portion inflation in the US that people often have no idea what a realistic serving of anything is any more. (I had to guess the weight of the amazing bone-in pork chop I had in Chicago, so I’m among the masses who might benefit from this innovation.) Turning your phone into essentially what is a 3D food scanner sounds a lot cooler than logging things into Nutritionix or MyFitnessPal or any of the other tools that are out there.

In learning more about Plateful and the company, I liked the website’s clean look and bright colors, and the amazing food photos as well. I also liked the fact that I had to dig pretty deep before I saw mention of AI as being part of the upcoming solution. It seems like many other companies are entirely in-your-face with AI-this and AI-that, so it was refreshing to find that it’s part of the solution but they’re not leading with it. I’m looking forward to following them over the coming months to see how the solution evolves and will definitely have fun doing some food comparisons in the coming months.

For the chocoholics out there who may be wondering, my go-to “survival chocolate” vendors were pretty much neck and neck, with the Hu Kitchen Salty Dark Chocolate (vegan, paleo) leading with a slightly higher Nutrition Value while the Ghirardelli Intense Dark Sea Salt Almond squares squeaked by with a higher Eco Value. I give them both five stars for their mental health boosting properties, so it would be a toss-up to choose one over the other. As the Plateful website says, “Lower NV foods, eaten on occasion, can fit into a healthy eating pattern if the majority of foods you eat over time are nutritious.” Sometimes you just need a little bit of dark chocolate to get you through the day.

It would be interesting to learn about the business model for the coming solution and whether it will be presented as a consumer-driven offering or whether it will be made available as part of an employee benefits plan or as part of a payer-based offering. The latter two would be smart as potential enhancements to reduce overall healthcare costs. I don’t have a frame of reference for what kind of databases are out there to create the library of UPC codes, PLU codes, and nutritional values, let alone what the R&D lift looks like for the “scan your plate” app that will be coming. I always enjoy learning about something that’s not in my usual lanes of EHR, HIE, and patient portal, so learning about this was a welcome diversion. Knowing that it may be able to help patients with healthy food choices, which is one of the solutions to healthcare crisis of our times, was a bonus.

Is your organization doing anything to promote nutrition education or healthy eating? Leave a comment or email me.

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