scholarly journals Integration of various dimensions in food-based dietary guidelines via mathematical approaches Report of a DGE/FENS Workshop in Bonn, Germany, 23-24 September 2019

2020 ◽  
pp. 1-18
Author(s):  
Anne Carolin Schäfer ◽  
Annemarie Schmidt ◽  
Angela Bechthold ◽  
Heiner Boeing ◽  
Bernhard Watzl ◽  
...  

Abstract In the past, food-based dietary guidelines (FBDGs) were derived nearly exclusively by using systematic reviews on diet-health-relationships and translating dietary reference values for nutrient intake into foods. This approach neglects many other implications that dietary recommendations have on society, the economy and environment. In view of pressing challenges, such as climate change and the rising burden of diet-related diseases, the simultaneous integration of evidence-based findings from different dimensions into FBDGs is required. Consequently, mathematical methods and data processing are evolving as powerful tools in nutritional sciences. The possibilities and reasons for the derivation of FBDGs via mathematical approaches were the subject of a joint workshop hosted by the German Nutrition Society (DGE) and the Federation of European Nutrition Societies (FENS) in September 2019 in Bonn, Germany. European scientists were invited to discuss and exchange on the topics of mathematical optimisation for the development of FBDGs and different approaches to integrate various dimensions into FBDGs. We concluded that mathematical optimisation is a suitable tool to formulate FBDGs finding trade-offs between conflicting goals and taking several dimensions into account. We identified a lack of evidence for the extent to which constraints and weights for different dimensions are set and the challenge to compile diverse data that suit the demands of optimisation models. We also found that individualisation via mathematical optimisation is one perspective of FBDGs to increase consumer acceptance, but the application of mathematical optimisation for population-based and individual FBDGs requires more experience and evaluation for further improvements.

2004 ◽  
Vol 7 (3) ◽  
pp. 443-452 ◽  
Author(s):  
Kylie Ball ◽  
Gita D Mishra ◽  
Christopher W Thane ◽  
Allison Hodge

AbstractObjective:To investigate the proportion of middle-aged Australian women meeting national dietary recommendations and its variation according to selected sociodemographic and behavioural characteristics.Design:This cross-sectional population-based study used a food-frequency questionnaire to investigate dietary patterns and compliance with 13 commonly promoted dietary guidelines among a cohort of middle-aged women participating in the Australian Longitudinal Study on Women's Health.Setting:Nation-wide community-based survey.Subjects:A total of 10 561 women aged 50–55 years at the time of the survey in 2001.Results:Only about one-third of women complied with more than half of the guidelines, and only two women in the entire sample met all 13 guidelines examined. While guidelines for meat/fish/poultry/eggs/nuts/legumes and ‘extra’ foods (e.g. ice cream, chocolate, cakes, potatoes, pizza, hamburgers and wine) were met well, large percentages of women (68–88%) did not meet guidelines relating to the consumption of breads, cereal-based foods and dairy products, and intakes of total and saturated fat and iron. Women working in lower socio-economic status occupations, and women living alone or with people other than a partner and/or children, were at significantly increased risk of not meeting guidelines.Conclusions:The present results indicate that a large proportion of middle-aged Australian women are not meeting dietary guidelines. Without substantial changes in their diets, and help in making these changes, current national guidelines appear unachievable for many women.


2018 ◽  
Vol 120 (8) ◽  
pp. 946-957 ◽  
Author(s):  
Maria Persson ◽  
Sisse Fagt ◽  
Maarten J. Nauta

AbstractNational dietary guidelines are directed at the general population. However, these guidelines may be perceived as unrealistic by a substantial part of the population, as they differ considerably from individual consumption patterns and preferences. Personalised dietary recommendations will probably improve adherence, and it has been shown that these recommendations can be derived by mathematical optimisation methods. However, to better account for risks and benefits of specific foods, the background exposure to nutrients and contaminants needs to be considered as well. This background exposure may come from other foods and supplements, and also from environmental sources like the air and the sun. The objective of this study was therefore to analyse the effect of including individual variation in background exposure when modelling personalised dietary recommendations for fish. We used a quadratic programming model to generate recommended fish intake accounting for personal preference by deviating as little as possible from observed individual intake. Model constraints ensure that the modelled intake meets recommendations for EPA, DHA and vitamin D without violating tolerable exposure to methyl mercury, dioxins and dioxin-like polychlorinated biphenyls. Several background exposures were analysed for 3016 Danish adults, whose food intakes and body weights were reported in a national dietary survey. We found that the lower nutrient constraints were critical for the largest part of the study population, and that a total of 55% should be advised to increase their fish intake. The modelled fish intake recommendations were particularly sensitive to the vitamin D background exposure.


Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1517
Author(s):  
Juyeon Lee ◽  
Kook-Hwan Oh ◽  
Sue-Kyung Park

We investigated the association between dietary micronutrient intakes and the risk of chronic kidney disease (CKD) in the Ansan-Ansung study of the Korean Genome and Epidemiologic Study (KoGES), a population-based prospective cohort study. Of 9079 cohort participants with a baseline estimate glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 and a urine albumin to creatinine ratio (UACR) <300 mg/g and who were not diagnosed with CKD, we ascertained 1392 new CKD cases over 12 year follow-up periods. The risk of CKD according to dietary micronutrient intakes was presented using hazard ratios (HRs) and 95% confidence intervals (95% CIs) in a full multivariable Cox proportional hazard models, adjusted for multiple micronutrients and important clinico-epidemiological risk factors. Low dietary intakes of phosphorus (<400 mg/day), vitamin B2 (<0.7 mg/day) and high dietary intake of vitamin B6 (≥1.6 mg/day) and C (≥100 mg/day) were associated with an increased risk of CKD stage 3B and over, compared with the intake at recommended levels (HR = 6.78 [95%CI = 2.18–21.11]; HR = 2.90 [95%CI = 1.01–8.33]; HR = 2.71 [95%CI = 1.26–5.81]; HR = 1.83 [95%CI = 1.00–3.33], respectively). In the restricted population, excluding new CKD cases defined within 2 years, an additional association with low folate levels (<100 µg/day) in higher risk of CKD stage 3B and over was observed (HR = 6.72 [95%CI = 1.40–32.16]). None of the micronutrients showed a significant association with the risk of developing CKD stage 3A. Adequate intake of micronutrients may lower the risk of CKD stage 3B and over, suggesting that dietary guidelines are needed in the general population to prevent CKD.


2020 ◽  
pp. 140349482097149
Author(s):  
Hanna Lagström ◽  
Jaana I. Halonen ◽  
Sakari Suominen ◽  
Jaana Pentti ◽  
Sari Stenholm ◽  
...  

Aims: To investigate the association of six-year cumulative level of socioeconomic neighbourhood disadvantage and population density with subsequent adherence to dietary recommendations, controlling for preceding dietary adherence, in adults in Finland. Methods: Population-based Health and Social Support (HeSSup) study participants from four age groups (20–24, 30–34, 40–44 and 50–54 years at baseline in 1998). Data on diet and alcohol consumption were obtained from the 2003 and 2012 surveys and information on neighbourhoods from Statistics Finland Grid database ( n = 10,414 men and women). Participants diet was measured as adherence to Nordic Nutrition recommendation (score range 0–100). Neighbourhood disadvantage was measured by median household income, proportion of those with primary education only and unemployment rate, and population density by the number of adult population between years 2007 and 2012. Linear models were used to assess the associations of neighbourhood characteristics with the score for adherence to dietary recommendations in 2012. Results: Cumulative neighbourhood socioeconomic disadvantage was associated with slightly weaker (1.49 (95% confidence interval (CI) −1.89 to −1.09) point decrease in dietary score) adherence while higher population density was associated with better (0.70 (95% CI 0.38−1.01) point increase in dietary score) adherence to dietary recommendations. These associations remained after controlling for prior dietary habits, sociodemographic, chronic cardio-metabolic diseases, and severe life events. Conclusions: These longitudinal findings support the hypothesis that neighbourhood characteristics affect dietary habits.


2021 ◽  
Vol 13 (7) ◽  
pp. 3621
Author(s):  
Anna Strid ◽  
Elinor Hallström ◽  
Ulf Sonesson ◽  
Josefin Sjons ◽  
Anna Winkvist ◽  
...  

New methods for combined evaluation of nutritional and environmental aspects of food products are needed to enable a transformation of dietary guidelines integrating both health and environmental perspectives. We evaluated two sustainability aspects; nutrition and climate impact, of foods commonly consumed in Sweden and the implications of using parallel or integrated assessments of these two aspects, also discussing the usability and suitability of these food sustainability indicators in relation to Swedish dietary guidelines, industry food product development, and consumer communication. There were large differences in both nutrient density and climate impact among the different foods. The parallel assessment easily visualized synergies and trade-offs between these two sustainability aspects for the different foods. Coherence with dietary guidelines was good, and suitability and usability deemed satisfying. The integrated indicator showed better coherence with dietary guidelines than indicators based solely on nutrient density or climate impact; however, the difficulty to interpret the score limits its usability in product development and consumer communication. With both methods, advantageous as well as less advantageous plant-based and animal-based food alternatives were suggested. The two alternative methods evaluated could serve as useful tools to drive individual and societal development towards more sustainable food production and consumption.


2012 ◽  
Vol 16 (3) ◽  
pp. 468-478 ◽  
Author(s):  
Isabel Drake ◽  
Bo Gullberg ◽  
Emily Sonestedt ◽  
Peter Wallström ◽  
Margaretha Persson ◽  
...  

AbstractObjectiveTo examine how different scoring models for a diet quality index influence associations with mortality outcomes.DesignA study within the Malmö Diet and Cancer cohort. Food and nutrient intakes were estimated using a diet history method. The index included six components: SFA, PUFA, fish and shellfish, fibre, fruit and vegetables, and sucrose. Component scores were assigned using predefined (based on dietary recommendations) and population-based cut-offs (based on median or quintile intakes). Multivariate Cox regression was used to model associations between index scores (low, medium, high) and all-cause and cause-specific mortality by sex.SettingMalmö, the third largest city in Sweden.SubjectsMen (n 6940) and women (n 10 186) aged 44–73 years. During a mean follow-up of 14·2 years, 2450 deaths occurred, 1221 from cancer and 709 from CVD.ResultsThe predictive capability of the index for mortality outcomes varied with type of scoring model and by sex. Stronger associations were seen among men using predefined cut-offs. In contrast, the quintile-based scoring model showed greater predictability for mortality outcomes among women. The scoring model using median-based cut-offs showed low predictability for mortality among both men and women.ConclusionsThe scoring model used for dietary indices may have a significant impact on observed associations with disease outcomes. The rationale for selection of scoring model should be included in studies investigating the association between dietary indices and disease. Adherence to the current dietary recommendations was in the present study associated with decreased risk of all-cause and cause-specific mortality, particularly among men.


2018 ◽  
Vol 21 (8) ◽  
pp. 1503-1514 ◽  
Author(s):  
Anna K Farmery ◽  
Gabrielle O’Kane ◽  
Alexandra McManus ◽  
Bridget S Green

AbstractObjectiveEncouraging people to eat more seafood can offer a direct, cost-effective way of improving overall health outcomes. However, dietary recommendations to increase seafood consumption have been criticised following concern over the capacity of the seafood industry to meet increased demand, while maintaining sustainable fish stocks. The current research sought to investigate Australian accredited practising dietitians’ (APD) and public health nutritionists’ (PHN) views on seafood sustainability and their dietary recommendations, to identify ways to better align nutrition and sustainability goals.DesignA self-administered online questionnaire exploring seafood consumption advice, perceptions of seafood sustainability and information sources of APD and PHN. Qualitative and quantitative data were collected via open and closed questions. Quantitative data were analysed with χ2 tests and reported using descriptive statistics. Content analysis was used for qualitative data.SettingAustralia.SubjectsAPD and PHN were targeted to participate; the sample includes respondents from urban and regional areas throughout Australia.ResultsResults indicate confusion around the concept of seafood sustainability and where to obtain information, which may limit health professionals’ ability to recommend the best types of seafood to maximise health and sustainability outcomes. Respondents demonstrated limited understanding of seafood sustainability, with 7·5 % (n 6/80) satisfied with their level of understanding.ConclusionsNutrition and sustainability goals can be better aligned by increasing awareness on seafood that is healthy and sustainable. For health professionals to confidently make recommendations, or identify trade-offs, more evidence-based information needs to be made accessible through forums such as dietetic organisations, industry groups and nutrition programmes.


2015 ◽  
Author(s):  
Elizabeth G Nabel

An unhealthy diet is a major risk factor for chronic diseases such as cardiovascular diseases, cancer, diabetes, and conditions related to obesity. In the 20th century, the average American diet shifted from one based on fresh, minimally processed vegetable foods to one based on animal products and highly refined, processed foods, leading to an increased consumption of calories, fat, cholesterol, refined sugar, animal protein, sodium, and alcohol and far less fiber and starch than was healthful. As a result, more than one third of US adults are obese, with an estimated medical cost of $147 billion. Physicians have an important role in educating patients about healthful nutrition and in providing dietary guidelines. This module discusses the role of energy in weight loss; the structure of fat and cholesterol, their effects on blood lipid levels and cardiovascular risk, and related dietary recommendations; carbohydrates; dietary fiber; proteins; vitamin and mineral consumption; water and food consumption; and the relationship between diet and health. Tables review the principles of a healthy diet; recommended daily intake of fat and other nutrients; types of dietary fiber and representative food sources; types of vitamins; essential minerals and trace elements; and dietary guidelines for healthy people. Figures include a graph showing the percentage of adults who are healthy weight, overweight, and obese and the structure of fat and cholesterol. This review contains 2 highly rendered figures, 6 tables, and 37 references.


Avicenna ◽  
2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Manish Barman ◽  
Tanweer Hussain ◽  
Hatem Abuswiril ◽  
Memon Noor Illahi ◽  
Muhammad Sharif ◽  
...  

Hospitals and healthcare systems are instrumental in the formulation and delivery of a coordinated response to disaster management especially epidemics. In healthcare policy and strategy formation, there are only trade-offs, which with uncertainty are akin to gambles. National organizations play a key role in pandemics through the expression of physician motivation. Effective strategies can facilitate physician action through economies of scale that lower the costs for physicians to meet both community and patients' needs. Moreover, no matter how well clinicians are motivated and positioned to act, their collective actions are likely to fall short without complementary systems for population-based care that require the operational support of an organization. This review of institutional policy implementation and frameworks intends to highlight how a nodal-designated COVID-19 center in Qatar managed to control the menace by altering its procedural sets and work arrangements to augment an integrated, intrinsic response to a briskly emerging, conceivably complex situation. This outcome was achieved under the guidance of a national leadership team, effectively adapted to its specific challenges by building on current medical evidence, management routines, proficiencies, and health system capacity. This ambitious drive started with the cohesion of services and implementation of evidence-based protocols by assigning a physician-led team to research, strategize and organize improved patient flow and information by arranging analytical compliance and preparedness. Through these service approaches and ongoing efforts, HMGH has realized significant outcome improvements, such as increasing capacity building, reducing healthcare waste, and increasing patient satisfaction rates whilst successfully achieving significantly lower COVID-19 mortality both in terms of absolute numbers and as percent population compared to many developed countries in the world. The strategies outlined in this article might not be all-inclusive or fit other healthcare system models, but they generate a veritable interest to pursue and be subjected to further rigorous study.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Danielle Krobath ◽  
William Masters ◽  
Megan Mueller

Abstract Objectives This study concerns how the description of foods on restaurant menus relates to their nutrient content as disclosed on company websites. We aimed to test halo effects, regarding how claims about some desirable features might be associated with the presence of other attributes. Methods We used item descriptions and nutrient data for food items (n = 92,949) at the top-selling restaurant chains (n = 92) from 2012 through 2017 in the United States, compiled by the MenuStat project. We classified items into 4 types (mains, appetizers, desserts, sides) and claims into 3 groups using 29 search terms based on consumer interests in health (e.g., “nutritious”), product sourcing (e.g., “local” or “organic”), and vegetal items (vegetarian or vegan). Nutrient data focus on 4 dietary recommendations to limit sodium (mg), trans-fat (g) and saturated fats (% of energy), and to increase fiber (g). We also report calories per item (kcal) and its share from carbohydrates, protein and total fat (%). We used multiple regression to test whether nutrient content was associated with menu claims, controlling for year and restaurant brand, the item being marked as “shareable”, on a kid's menu, or regional and limited-time offerings. Methods and hypotheses were preregistered on As-Predicted.com. Results Contrary to our prediction, nutrient content was more often aligned with U.S. dietary guidelines when their description did include claims. With 3 claim types, 4 food types and 4 recommendations we test 48 possible cases. In 25 (52%) we found alignment between claims and nutrient recommendations, e.g., main dishes with health-related claims had 2% less calories from saturated fat (P < 0.01) and 142 mg less sodium (P < 0.01). In 3 of 48 cases (7%), claims were contrary to recommendations, all of which were desserts with sourcing claims which had more sodium, more trans-fat and more saturated fat than other desserts (all P < 0.01). In 20 of 48 cases (42%) there was no significant difference between items with and without claims. Conclusions Items described as vegetarian/vegan or with sourcing and health claims had nutrient contents that were more often aligned with dietary guidelines than other items. Menu labeling that communicates meal content more directly, such as nutrient fact panels, could inform choice and build trust in restaurant meals. Funding Sources None.


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