Development of a nutrient profiling scoring system for Thai meals: a prototype for healthier meal choices in Thailand

In Thailand, meals are commonly consumed as combinations of multiple dishes, yet no established nutritional criteria exist to evaluate the healthfulness of meals. This study aimed to develop healthy meal criteria for Thai diets using a nutrient profile model.

The Nutrient Profiling System for Meals (NPS-M) was developed with six nutritional components: energy, protein, vegetables, total fat, added sugar, and sodium. A scoring algorithm was created. Meal combinations were considered healthier if they achieved scores ≥70%, with no zero score in any one component. A total of 72,149 meals were constructed and evaluated. Criterion validity was assessed by comparing NPS-M with the Nutrient-Rich Foods Index 6.3 (NRF6.3), Health Star Rating (HSR), and Thailand's Healthier Choice logo for ready-to-eat foods (HCL-RTE) using Spearman's rank correlation.

The median NPS-M score of all meal combinations was 58 (interquartile range: 45.0-72.0). After excluding meals with zero scores in any component, 10,148 meals (14.1% of total) remained. Among these, 7,252 meals (10.1% of total) achieved scores ≥70%. Sodium was a predominant limiting factor, disqualifying 80% of meals. Criterion validity test-ing showed moderate correlation with NRF6.3 (ρ = 0.566, p <0.001), moderate reverse correlation with HSR (ρ = -0.527, p <0.001), and strong correlation with HCL-RTE (ρ = 0.796, p <0.001).

The NPS-M provides a practical framework for evaluating meal healthfulness in the Thai context. The model has potential for use in restaurants, canteens, and public health programs to improve meal quality and support healthier diets in Thailand.