Microbiome HEALTH
POWERED by
natural FOOD ratios
like CARB-to-FIBER
Microbiome-Powered
FOOD QUALITY APP
Scan Barcodes while Shopping & Cooking
Nutrient Consume Score (NCS)
Introducing NCS, an online food quality calculator, where the latest nutrition and microbiome research is integrated into a 100-point scale. It emphasizes options with optimal carb-to-fiber and other natural ratios present in whole foods. Avoid carb & calorie counting and easily choose balanced nutrition that supports a healthy microbiome. Your gut will naturally do the rest, positively impacting mood, immunity, metabolism, and appetite. Coming soon: a smartphone app to make gut healthy food choices convenient. Cheers to our gut microbiome & health!
Chris Damman, MD, MA
UWMC Gastroenterologist
Chief Editor GutBites MD
The Calculator
► Type Favorite Food, What is the score?
► Combine 2 Foods, +, How do they mix?
► Add Some Fiber, ≡, Does score change?
► Type a Wild Card, *, What foods return?
► Sort the Results, 🔘, How do they rank?
► Scores At-a-Glance, Rank by category?
The Score
Maximize green, moderate yellow, and minimize red scoring food combinations in both amount and frequency. Use subscores to provide insights on how to synergize & supplement foods. Don’t fret about small point differences between foods or achieving the highest possible green score. Do embrace a wide variety of green scoring foods and listen carefully to your body’s personalized response to specific foods.
►Green (100-70): Maximize
►Yellow (69-60): Moderate
►Red (59-0): Minimize
The App
Gut Nutrition’s North Star
Microbiome-supportive food choice with NCS’s simple 1-100 score.
- SCAN product barcodes
- CHOOSE healthy foods
- CREATE healthy meals
- FEEL the health benefits
Complimentary & Compatible with any diet. Pre-release sign up open.
The Design
The NCS algorithm iteratively integrates the latest literature on nutrient ratios and bioactives to inform an overall food quality score. It references the USDA’s FoodData Central for nutrient values of individual foods. Quality scores of 70-100 and ratio subscores of less than 2 correlate with whole foods and better-for-you processed foods.
The Evidence
Food processing in its current form has disrupted the natural ratios present in whole food matrixes, concentrating for simple carbohydrates, saturated fats, sodium, and additives while limiting fiber, unsaturated fats, potassium, and bioactives. Some of the latest research is suggesting that disrupted ratios that involve both concentrated and insufficient nutrients are important contributors to the rising rates of gut, metabolic, cardiovascular & neurologic disease.[1,2]
Nutrient ratios that provide a composite score of carb, fat, and micronutrient quality have been associated with a lower odds ratio for metabolic syndrome, diabetes, cardiovascular disease, cancer, and lung disease as well as higher odds ratio for optimal cardiometabolic health.[3,4]
Carb-to-Fiber Ratio (i.e. Carb Quality) is associated with better health[5]: lower depression[6], smaller waist[7], lower diabetes rates[8–10], and less heart disease[11,12]. Fiber slows the absorption of carbs and is converted by the microbiome to factors like butyrate that help to efficiently process them once absorbed. For more information on fiber please follow this link.
Total Fat-to-Unsaturated Fat Ratio (i.e. Fat Quality) is also associated with health: improved blood lipids and glycemic control.[13] For more information on fats please follow this link.
Sodium-to-Potassium Ratio (i.e. Salt Quality) has been associated with lower blood pressure[14] and interventions have lead to decreased blood pressure and stroke.[15] For more information on sodium and potassium please follow this link.
Additives & Bioactive Some unnatural additives like certain sugar alternatives[16], trans fats[17], and some emulsifiers[18] have been linked to poor health markers or outcomes while other natural bioactives like polyphenols[19] and short chain fatty acids (e.g. acetic acid[20], butyrate[21]) have been linked to better health outcomes. For more information on polyphenols follow this link.
Microbiome-Powered
FOOD QUALITY APP
Scan Barcodes while Shopping & Cooking
MD-authored gut health literature digests & first-in-class food quality calculator to power your microbiome.
This resource is intended to provide dietary guidance. Please consult your physician for any questions pertaining to medical advice.
References
1. Fardet A, Rock E. Chronic diseases are first associated with the degradation and artificialization of food matrices rather than with food composition: calorie quality matters more than calorie quantity. Eur J Nutr. 2022;61: 2239–2253. doi:10.1007/s00394-021-02786-8
2. Mozaffarian D. Dietary and policy priorities to reduce the global crises of obesity and diabetes. Nature Food. 2020;1: 38–50. doi:10.1038/s43016-019-0013-1
3. Mozaffarian D, El-Abbadi NH, O’Hearn M, Erndt-Marino J, Masters WA, Jacques P, et al. Food Compass is a nutrient profiling system using expanded characteristics for assessing healthfulness of foods. Nature Food. 2021;2: 809–818. doi:10.1038/s43016-021-00381-y
4. O’Hearn M, Erndt-Marino J, Gerber S, Lauren BN, Economos C, Wong JB, et al. Validation of Food Compass with a healthy diet, cardiometabolic health, and mortality among U.S. adults, 1999–2018. Nat Commun. 2022;13: 1–14. doi:10.1038/s41467-022-34195-8
5. Mozaffarian RS, Lee RM, Kennedy MA, Ludwig DS, Mozaffarian D, Gortmaker SL. Identifying whole grain foods: a comparison of different approaches for selecting more healthful whole grain products. Public Health Nutr. 2013;16. doi:10.1017/S1368980012005447
6. Makhani SS, Davies C, George KA, Castro G, de la Vega PR, Barengo NC. Carbohydrate-to-Fiber Ratio, a Marker of Dietary Intake, as an Indicator of Depressive Symptoms. Cureus. 2021;13. doi:10.7759/cureus.17996
7. Sawicki CM, Lichtenstein AH, Rogers GT, Jacques PF, Ma J, Saltzman E, et al. Comparison of Indices of Carbohydrate Quality and Food Sources of Dietary Fiber on Longitudinal Changes in Waist Circumference in the Framingham Offspring Cohort. Nutrients. 2021;13: 997. doi:10.3390/nu13030997
8. AlEssa HB, Bhupathiraju SN, Malik VS, Wedick NM, Campos H, Rosner B, et al. Carbohydrate quality and quantity and risk of type 2 diabetes in US women. Am J Clin Nutr. 2015;102: 1543–1553. doi:10.3945/ajcn.115.116558
9. Hashimoto Y, Tanaka M, Miki A, Kobayashi Y, Wada S, Kuwahata M, et al. Intake of Carbohydrate to Fiber Ratio Is a Useful Marker for Metabolic Syndrome in Patients with Type 2 Diabetes: A Cross-Sectional Study. ANM. 2018;72: 329–335. doi:10.1159/000486550
10. AlEssa HB, Ley SH, Rosner B, Malik VS, Willett WC, Campos H, et al. High Fiber and Low Starch Intakes Are Associated with Circulating Intermediate Biomarkers of Type 2 Diabetes among Women. J Nutr. 2016;146: 306–317. doi:10.3945/jn.115.219915
11. Fontanelli M, Sales C, Liu J, Micha R, Mozaffarian D, Fisberg RM. The ≤ 10:1 carbohydrate to fiber ratio to identify healthy grain foods and its association with cardiometabolic risk factors in Brazil. Proc Nutr Soc. 2020;79: E309. doi:10.1017/S0029665120002578
12. AlEssa HB, Cohen R, Malik VS, Adebamowo SN, Rimm EB, Manson JE, et al. Carbohydrate quality and quantity and risk of coronary heart disease among US women and men. Am J Clin Nutr. 2018;107: 257–267. doi:10.1093/ajcn/nqx060
13. Schwingshackl L, Zähringer J, Beyerbach J, Werner SS, Heseker H, Koletzko B, et al. Total Dietary Fat Intake, Fat Quality, and Health Outcomes: A Scoping Review of Systematic Reviews of Prospective Studies. Ann Nutr Metab. 2021;77. doi:10.1159/000515058
14. Binia A, Jaeger J, Hu Y, Singh A, Zimmermann D. Daily potassium intake and sodium-to-potassium ratio in the reduction of blood pressure: a meta-analysis of randomized controlled trials. J Hypertens. 2015;33. doi:10.1097/HJH.0000000000000611
15. Neal B, Wu Y, Feng X, Zhang R, Zhang Y, Shi J, et al. Effect of Salt Substitution on Cardiovascular Events and Death. N Engl J Med. 2021;385. doi:10.1056/NEJMoa2105675
16. Suez J, Cohen Y, Valdés-Mas R, Mor U, Dori-Bachash M, Federici S, et al. Personalized microbiome-driven effects of non-nutritive sweeteners on human glucose tolerance. Cell. 2022;185. doi:10.1016/j.cell.2022.07.016
17. Mozaffarian D, Aro A, Willett WC. Health effects of trans-fatty acids: experimental and observational evidence. Eur J Clin Nutr. 2009;63: S5–S21. doi:10.1038/sj.ejcn.1602973
18. Naimi S, Viennois E, Gewirtz AT, Chassaing B. Direct impact of commonly used dietary emulsifiers on human gut microbiota. Microbiome. 2021;9: 1–19. doi:10.1186/s40168-020-00996-6
19. Del Bo’ C, Bernardi S, Marino M, Porrini M, Tucci M, Guglielmetti S, et al. Systematic Review on Polyphenol Intake and Health Outcomes: Is there Sufficient Evidence to Define a Health-Promoting Polyphenol-Rich Dietary Pattern? Nutrients. 2019;11: 1355. doi:10.3390/nu11061355
20. Valdes DS, So D, Gill PA, Kellow NJ. Effect of Dietary Acetic Acid Supplementation on Plasma Glucose, Lipid Profiles, and Body Mass Index in Human Adults: A Systematic Review and Meta-analysis. J Acad Nutr Diet. 2021;121. doi:10.1016/j.jand.2020.12.002
21. Amiri P, Hosseini SA, Ghaffari S, Tutunchi H, Ghaffari S, Mosharkesh E, et al. Role of Butyrate, a Gut Microbiota Derived Metabolite, in Cardiovascular Diseases: A comprehensive narrative review. Front Pharmacol. 2022;12. doi:10.3389/fphar.2021.837509
56 responses to “Carb-to-Fiber Ratio Calculator for Gut Microbiome Nutrition”
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The above calculator demonstrates the power of the algorithm. The above app will make it practical. Still a work in progress and welcome your feedback.
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Is that app available in the Apple app store?
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Hi Mark, Thanks for the question. Not just yet, but working on it. Will send a note out when it is available. In the meantime, you can try the online calculator as an appetizer. The app will have added the functionality of allowing you to scan grocery store items and combine foods in specific proportions. Stay tuned! Best, Dr. D
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Agree with others this is simple, practical, and helpful.
One technical nit: I have tried the app in both Android and Apple platforms and in both I have the same issue. Some of the food descriptions have indication there is more to the description (… at the end) and neither platform allow me to see the entire food description. E.g., Value of 83 “Lettuce, salad with avocado, tomato, and/o…”
I have been using the app all day to develop menu for the week.
Thanks for the work on your part.
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Thanks for the feedback. Glad you’ve found it useful! Try turning your phone sideways or resizing the window on a computer screen and those longer descriptions should be visible. Please let me know if this doesn’t work, and of course would love to hear about some of those meals you’ve planned.
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Love this, so simple but practical!
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Awesome!
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Very cool tool!
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Interesting and looks easy to use. Also makes you think.
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What a great way to see how healthy you are eating.
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Absolutely outstanding tool. Very well designed infographics. Minor translation and vocabulary issues from American English to Australian English but this will only slightly slow down use.
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Gage, really appreciate your positive feedback! Glad you’ve found the calculator useful.
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Please let us know when the app is available in the app store
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Will absolutely let you know. Thanks for your note.
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Will there be a way for us to be able to input food items with the nutritional facts if it doesn’t show on your list of foods? I’m in Australia so a lot of foods I use don’t show.
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Great question. The app will indeed have the option to input nutritional facts for products not in the database.
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On https://gutbites.org/wp-content/uploads/2023/05/Slides-For-Website.pdf, you give fruit smoothies a score of 84, which may reflect their nutritional content, but isn’t it also true that smoothies are basically sugar bombs because all their sugar is available as free sugar, and are therefore not as healthy as they seem?
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You raise an excellent point. If you type in “fruit smoothie” you’ll see a range of scores (84 to 45) as determined by the algorithm and based on the specific nutrients and their ratios as you surmise. The score of 84 is in part being driving by the high fiber (glycemic index mitigating) content and added protein of that particular smoothie. The algorithm does not currently take into account food structure, which some literature has shown impacts nutrient absorption. There is active debate on the impact of blending food. It is interesting to note that foods that have concentrated components of fiber (i.e. skin or seeds) can actually have an improvement in glycemic index with blending. Below is one of a handful of papers that might support this idea. Thanks for your astute comment! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9657402/
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Thanks for the tool and carb:fiber ratio info.
Question –
1. What is the number right after CARBS?
eg. Avocado, raw – CARBS 1.13, Total Carb 8.53, Fiber 6.7g-
The highlighted numbers next to each of the nutrients represent a nutrients quality scale that’s based on ratios. Generally, the lower the number, the higher quality, but I would focus instead on the colors which mirror those in the composite 1-100 score.
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Thanks Chris,
Is lower COMPOSITE SCORE better than higher?
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Green is generally higher quality for both composite and subscores.
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thank you this looks great.
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Tina, Thanks so much for the positive feedback! Dr D
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What about high fiber versions of common foods such as tortillas, breads and crackers? Will they be listed by brand and not lumped into a category?
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This is a great question. The majority of US products and their bar codes will be covered.
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You mentioned the glycemic index. How does this factor into your algorithm?
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The glycemic index isn’t in the algorithm explicitly but carb to fiber ratio follows glycemic index quite closely. The algorithm also takes into account the benefit of combining simple carbs with protein and high quality fats. Thanks for the question.
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How do I get the app?
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The app is still in development. I will send out a notification as soon as it is available. In the meantime please feel free to use the online calculator to get a sense of how the algorithm works. Thanks for your inquiry.
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My husband has been doing Noom with much success. This Red, Yellow, Green and how it calculates food look a lot like this. What is the difference?
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Congratulations on your husband’s success! Sharing a few thoughts on your good question below.
Methodological and philosophical differences:
-Granular 1-100 score with color gradients vs. red, orange, yellow score
-Algorithm driven by nutrient ratios (see above for rationale) vs. calorie and nutrient density
-Emphasis on overall health with weight, blood sugar, and gut benefits vs. greater emphasis on weight loss
-Pro bono public service vs. paid for profitHope that helps! Happy to answer any follow up questions.
Compare how the scores differ for food categories in the two links below:
-Gut Bites NCS: https://gutbites.org/wp-content/uploads/2023/05/Slides-For-Website.pdf
-NOOM: https://www.goodhousekeeping.com/health/diet-nutrition/a30930989/noom-food-list/
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Would love to try this, but it doesn’t seem to work. Can type in something, but the search bar doesn’t work. Am I doing something wrong?
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Hi D, Sorry it’s not working. I wonder if you’ve tried the site on a different web browser or different computer/phone/device? Please let me know if this doesn’t help. Best, Dr. D.
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This was eye opening. I thought I was getting fiber, but no. I haveve IBS- D. I follow the formal diet, foods listed high I can’t eat at all and done things on the low side I also don’t tolerate. ( gas, diarrhea). I don’t tolerate fiber, and am eating a high carb diet. Would like to change but don’t know how. Any suggestions would be welcome
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Hi April, I’m glad to hear you found it helpful and sorry to hear fiber is tough on your gut. You articulate the experience of many people and I’m grateful for your comment. I might suggest you work with your healthcare provider or registered dietician on finding which of the FODMAPs trigger your symptoms. It’s equally eye opening to some that not all fiber is treated by individual microbiomes in the same way. Here is a GutBites digest that provides a little more background. My best wishes, Dr. D https://gutbites.org/2022/05/01/are-all-fibers-to-be-plated-equal/
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how will i know when the app is available for iPhones?
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Thanks for your good question. I will be sure to send a note out to folks as soon as it’s available. Best, Dr. D
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I love this. Thanks for developing such a useful tool. Can’t wait for the app.
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Thanks so much for positive feedback!
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what the heck is NFS? In my world of retail, it means “not for sale”
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Great question! NFS is an abbreviation for not further specified used in the USDA database referenced by the NCS calculator.
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No, a number of the foods have NFS as part of their description, such as “Syrup, NFS.” I, too, am confused by this.
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Julian, You’re absolutely right. It stands for not further specified and is an abbreviation used by the USDA database that the nutrient consume score calculator references.
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I found calculator to be limited in current form as I add my salad ingredients, I can no longer see the list to add to the total
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Thanks for your good comment. I made the frame a bit bigger to accommodate more items. The app will be able to accommodate unlimited items. Very much appreciate your feedback!
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Any update on the app release
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Thanks Albert for the interest! Still a work in progress, but will be sure to let you know as soon as it’s available.
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No, they mean “NFS”. It shows up at the end of he names of foods. Just search on NFS and you’ll see it. I’m guessing it’s from the original food database you loaded
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NFS=Not Further Specified. Thanks for reiterating the question. : )
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Does it matter whether you consume the high score vegetables cooked or raw?
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It’s a great question. Cooking, like any form of processing (fermenting, ultra-processing), can make the macro and micronutrients more available and have variable effects on the bioactives (fiber, phytonutrients) by breaking down the cellular structure of food. Cooking also often involves introducing other ingredients like salt, and oils/butter. You’ll see differences in scores that account for these added factors in the cooked/prepared version of the vegetables. Type Broccoli for example and then turn “sort” on and you will see the impact of cooking. If you click on the down arrowhead, you’ll see how the nutrients differ. When you prepare meals and snacks it may be best to aim to have composite scores that fall in the 70’s (vs. 80’s and 90’s) as these scores will be the best balance of nutrients to promote health and calories to keep you full.
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What will be the name of the APP when available so I know how to search for it? Can I be on the mailing list?
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The app name is still a work in progress. Please feel free to sign up on the prerelease list and will let you know when it’s available.
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I love the calculator. Been using it for 3weeks and I feel better than I have in years. Plan menus for specific meals, but really enjoy adding breakfast and lunch then looking at good options for dinner to stay in the high 70s and 80s. Curious if we will be able to save meal receipes. By that a combo of foods I have often, so I don’t have to enter all the pieces each time. Can’t wait for the app.
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Allie, Thanks so much for the positive feedback. The save meal recipes idea is an excellent one and will definitely have to consider for future rollout of app. Glad you’ve found the calculator useful. Warm regards, Dr. D
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