scholarly journals The Role of Fortified and Enriched Refined Grains in the US Dietary Pattern: A NHANES 2009–2016 Modeling Analysis to Examine Nutrient Adequacy

2021 ◽  
Vol 8 ◽  
Author(s):  
Yanni Papanikolaou ◽  
Victor L. III Fulgoni
Keyword(s):  
Older Adults ◽  
Dietary Fiber ◽  
Dietary Pattern ◽  
Daily Intake ◽  
Dietary Guidelines ◽  
Refined Grains ◽  
Old Adults ◽  
Nutrient Adequacy ◽  
Modeling Analysis ◽  
The Us

Background: While dietary recommendations call for greater whole-grain intake and reduced refined grain consumption, there are limited peer-reviewed studies examining the influence of fortified/enriched refined grains on nutrient adequacy.Methods: A modeling analysis using data from National Health and Nutrition Examination Survey (NHANES) 2009–2016 estimated usual daily intake of shortfall nutrients for Dietary Guidelines for Americans (DGA) in the current dietary pattern and when specific percentages of fortified/enriched refined grain foods (bread, ready-to-eat cereals, and all-grained foods) were removed from the diet (19–50-year-old adults, N = 11,169; 51–99-year-old adults, N = 9,641).Results: While American adults are currently falling short of nutrient recommendations, eliminating 25, 50, and 100% of all grains consumed in the US dietary pattern resulted in a greater percentage of adults not meeting recommendations for several shortfall nutrients, including dietary fiber, folate DFE, iron, and magnesium. Removal of all grains led to a reduced energy intake by ~10% in both age groups examined. Currently, ~3.8% of 19–50-year-old adults meet the adequate intake (AI) for dietary fiber. Removal of 25, 50, and 100% of grains from the diet resulted in 2.6 ± 0.3, 1.8 ± 0.2, and 0.7 ± 0.1% of adults exceeded the AI for dietary fiber, respectively. Similarly, 11.0 and 13.8% of younger and older adults, respectively, fall short of folate, DFE recommendations with the current diet. Following the removal of 100% of grains from the diet, 43.4 ± 1.1 and 56.2 ± 1.0%, respectively, were below the estimated average requirement (EAR) for folate DFE. For iron, current dietary pattern consumption shows 8.4% and 0.8% of younger and older adults, respectively, are not meeting iron recommendations, however, removal of 100% of grains from the diet results in nearly 10 and 22% falling short of the EAR. Currently, about 51 and 54% of younger and older adults are below the EAR for magnesium; however, with the removal of 100% of grains, 68 and 73%, respectively, fall below the EAR.Conclusion: Removal of specific refined grains led to an increased percentage of Americans not meeting recommendations for several shortfall nutrients, including dietary fiber, folate, iron, and magnesium.

scholarly journals Grain Foods in US Infants Are Associated with Greater Nutrient Intakes, Improved Diet Quality and Increased Consumption of Recommended Food Groups

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2840
Author(s):  
Yanni Papanikolaou ◽  
Victor L. Fulgoni
Keyword(s):  
Dietary Fiber ◽  
Diet Quality ◽  
Dietary Pattern ◽  
Vitamin B6 ◽  
Daily Intake ◽  
Food Group ◽  
Dietary Guidelines ◽  
Committee Report ◽  
Food Groups ◽  
Grain Foods

There are limited data providing guidance on grain foods as part of a healthy dietary pattern in infants and may represent a gap in knowledge for the development of the 2020–2025 Dietary Guidelines for Americans Scientific Advisory Committee report currently in progress. An analysis using infant data from the National Health and Nutrition Examination Survey was conducted to assess grain food relationships with nutrient and energy intakes, diet quality, and food group consumption in infant consumers relative to non-consumers. Grain consumers were defined as infants consuming foods from the main grain food group, as defined by the US Department of Agriculture, and included whole and refined/enriched grains. All infants consuming grain foods had greater energy (kcal) vs. grain non-consumers (p’s < 0.0047). While infant grain consumers 6- to 12-months-old (N = 942) had higher daily intakes of sodium and added and total sugars, these infants also had significantly higher dietary fiber, calcium, folate, potassium, magnesium, zinc, phosphorus, choline, thiamin, riboflavin, and vitamin B6 compared to non-consumers. In 13- to 23-month-olds (N = 1668), grain consumption was associated with greater daily dietary fiber, iron, zinc, magnesium, phosphorus, folate, riboflavin, niacin, thiamin, vitamin A, vitamin B6, and vitamin B12 relative to non-consumers. Diet quality scores were significantly higher in all infant grain consumers examined in comparison to non-consumers (p’s < 0.0065). Grain intake was also linked with greater daily intake of several recommended food groups in both younger and older infants versus non-consumption of grains. The current analysis provides evidence to substantiate the inclusion of whole and enriched grain foods as part of the infant dietary pattern as beneficial associations between grain food consumption and dietary quality are apparent. Eliminating and/or reducing grain foods in infant dietary patterns may lead to unintended nutrient and health consequences.

scholarly journals Diet Quality of Congregate and Home-delivered Meal Recipients in the United States (P04-076-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Fayrouz Sakr Ashour ◽  
Edwina Wambogo ◽  
Nadine Sahyoun
Keyword(s):  
Older Adults ◽  
Diet Quality ◽  
Daily Intake ◽  
The United States ◽  
Whole Grains ◽  
Dietary Guidelines ◽  
Ratio Method ◽  
Added Sugar ◽  
Refined Grains

Abstract Objectives 1) Examine diet quality of OAANSP meals, 2) examine diet quality of complementary food consumed in addition to the CM/HDM meal, and 3) examine diet quality of daily intake by individuals who did versus did not consume a CM/HDM meal. Background: Older adults are becoming a larger proportion of the US population, a phenomenon that will continue over the next few decades. Congregate (CM) and home-delivered meals (HDM) of the Older Americans Act Nutrition Program (OAANP) have beneficial effects on the lives of older adults. Yet, data demonstrating value remains relatively limited, arguably leading to underfunding. Methods Data from the Administration for Community Living (ACL) Outcomes Evaluation Study was collected using a multistage clustered sample design. Data collection tools comprised a survey (including information on respondent's sociodemographics, health status, self-reported weight and height, social relationships, dietary self-reliance, participation in other nutrition assistance programs, and food security) and two 24-hour recalls. HEI-2010 was used to calculate individual and mean scores using the simple HEI scoring algorithm and the population ratio method, respectively. Radar plots were used to visualize HEI comparisons, and multiple logistic regression models were built to examine associations between diet quality and OAANSP. Results OAANSP participation was associated with HEI (P < 0.0001 and P = 0.04 for CM and HDM, respectively) and so was number of meals/day (P = 0.007 and P = 0.03 for CM and HDM, respectively). Compared to the complementary diet, OAANSP meals had better scores for total vegetables (P < 0.0001), and greens and beans (P < 0.001). The complementing diet quality for CM participants had better scores than the meal for total fruit, whole grains, seafood and plant proteins; and whole grains for HDM participant. Meals and complementing foods exceeded the dietary guidelines for sodium, refined grains, saturated fat, added sugar and total protein. HDM participants’ mean HEI score was lower on no meal-day compared to meal-day (P < 0.0001). Conclusions CM/HDM meals may need to be revised, especially for sodium, added sugar and refined grains. Adding another meal daily and expanding nutrition education may be important for a healthier diet. Funding Sources None.

Diet

2015 ◽  
Author(s):  
Elizabeth G Nabel
Keyword(s):  
Dietary Fiber ◽  
Daily Intake ◽  
Blood Lipid ◽  
Dietary Guidelines ◽  
Food Sources ◽  
Healthy Weight ◽  
Dietary Recommendations ◽  
Animal Products ◽  
Vegetable Foods ◽  
Fiber Proteins

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.

scholarly journals Optimizing Complementary Diets to Provide Nutrient Adequacy for Infants 6 to 12 Months Old: A Dietary Modelling Study (P11-090-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Lynda O'Neill ◽  
Anne Dattilo ◽  
Matthieu Maillot ◽  
Florent Vieux ◽  
Jose Saavedra
Keyword(s):  
Vitamin D ◽  
Breast Milk ◽  
Daily Intake ◽  
Dietary Guidelines ◽  
Food Groups ◽  
University Of Minnesota ◽  
Data Set ◽  
Nutrient Adequacy ◽  
Developmental Appropriateness ◽  
Breast Fed

Abstract Objectives The purpose of this study was to determine the optimal composition of complementary diets for infants 6 to 12 months old (m.o), in terms of daily intake of food groups to ensure nutrient adequacy. A secondary goal was to determine differences in these optimized diets with fortified versus unfortified foods. Methods Dietary modelling using linear programming was applied to the Feeding Infants and Toddlers Study 2016 data set to develop theoretical diets that satisfy nutrient requirements, while meeting median energy needs, for 6 to 8 m.o. and 9 to 12 m.o. breast-fed, formula-fed, and mixed-fed infants. The food data set was adjusted to ensure, among other criteria, developmental appropriateness and safety. Using the Nutrition Data System for Research (NDSR, version 2015: University of Minnesota, Minneapolis, MN), the current US fortification for grains was included, and analyses were then performed without fortification. Results Among modelled diets for 6 to 8 m.o., a greater amount of total food, particularly vegetables, was required to achieve nutrient adequacy in the absence of fortification. The quantity of vegetables ranged from 54 g/day (3.5% of total energy (E)) in the formula based fortified diet up to 206 g/day (15% of E) in the breast milk unfortified diet. The modelling showed that inclusion of starches and grains was negligible in the unfortified diets, being primarily replaced by vegetables and pulses. For 9 to 12 m.o., daily intake of vegetables were particularly high at 222 g/day (12% of E), in the breast-fed, unfortified group. Pulses, nuts and seeds were featured in the unfortified diets at a level of 61 g/day (10% of E) in both the breast milk diet and the mixed diet. In terms of nutrient adequacy, all requirements were met apart from iron in the breast fed unfortified diet for 6 to 8 m.o.. Meeting Vitamin D was unachievable in all but the formula based diets for 6 to 8 m.o. Conclusions Fortification or supplementation is required to provide adequate iron to breast-fed infants, particularly in the early months of complementary feeding, and vitamin D to most infants. The diet optimization, which could be the basis for food based dietary guidelines, showed that complementary diets should be adapted according to the milk source in the infant diet. Funding Sources Nestlé Nutrition, Vevey, Switzerland.

scholarly journals Added Sugar Intake is Associated with Blood Pressure in Older Females

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2060 ◽  
Author(s):  
Safiyah Mansoori ◽  
Nicole Kushner ◽  
Richard R. Suminski ◽  
William B. Farquhar ◽  
Sheau C. Chai
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Daily Intake ◽  
Dietary Factors ◽  
Dietary Guidelines ◽  
Calorie Intake ◽  
Activity Levels ◽  
Fruit Consumption ◽  
Cross Sectional ◽  
Added Sugar

Hypertension or high blood pressure (BP) is highly prevalent in the aging population. Notably, diet and lifestyle have a strong influence on BP. We investigated the association between dietary factors and BP in older adults. This cross-sectional study included 128 participants, aged 65–80 years. Multiple linear regressions were conducted to examine the associations between diet, including meats, vegetables, grains, fruits, dairy, fats, and added sugar, and BP. There was a significant association between intake of added sugar and systolic BP and diastolic BP in females after controlling for age, income, body mass index, physical activity levels, daily calorie intake, and BP medication use. The model predicted that a decrease of 2.3 teaspoons (0.5 standard deviation) of added sugar would result in a 8.4 mmHg drop in systolic BP and a 3.7 mmHg drop in diastolic BP. Whole fruit was associated with a reduction in diastolic BP in both males and females, and the model predicted that, for every 0.71 cup increase in whole fruit consumption, there would be a decrease in diastolic BP of 2.8 mmHg. Our findings support the dietary guidelines of limiting daily intake of added sugar and increasing fruit consumption to promote overall cardiovascular health in older adults.

scholarly journals A Food Group Based Approach to Satisfy Nutrient Recommendations in Toddlers (12-24 Months) Using Dietary Modelling (P11-091-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Lynda O'Neill ◽  
Anne Dattilo ◽  
Matthieu Maillot ◽  
Florent Vieux ◽  
Jose Saavedra
Keyword(s):  
Vitamin D ◽  
Daily Intake ◽  
Food Group ◽  
Dietary Guidelines ◽  
Food Groups ◽  
University Of Minnesota ◽  
Dietary Recommendations ◽  
Data Set ◽  
Food Component ◽  
Nutrient Adequacy

Abstract Objectives The aim of this study was to optimize the quantity of daily intake of food groups to meet energy, nutrient needs, and to assess differences in diets using fortified versus unfortified foods to provide nutrient adequacy in the second year of life. Methods Mathematical modeling was applied to the Feeding Infants and Toddlers Study 2016 (observed diet) data set to develop optimized theoretical toddler (12 – 24 months old) diets. The model was constrained to meet median energy requirements and appropriate nutrient reference values and minimize the deviation from the average observed diet. Only the complementary food component of the diet was modelled. Using the Nutrition Data System for Research (NDSR, version 2015: University of Minnesota, Minneapolis, MN), the current US fortification of grains and dairy were accounted for and the analysis was repeated without fortification. Results The mathematically modeled diets revealed a lower quantity of food (613 to 732 g/day less) and energy (449.3 kcal/per day) were needed to meet nutrient recommendations, compared to the observed diet. The modelled diets contained less meat and fish and less starches and grains, compared to the observed diet. However, the modelled diets contained greater quantities of vegetables and fruit than the observed diet. Additional fruit and vegetables were required when the modelled diet was unfortified rather than when it was fortified. However, the fortified diet allowed for greater variety, and inclusion of other dairy (yogurt and cheese), and starches and grains compared with the unfortified diet. In terms of nutrient adequacy, the modelled fortifed diet met all recommendations, whereas the unfortified diet met all but vitamin D. Conclusions Our results indicate that with the exception of Vitamin D, nutrient needs of young toddler age children can be satisfied with lower and more appropriate energy intake than currently observed. These findings can assist with dietary recommendations based on a food group approach, for meal planning, or for the development of food based dietary guidelines. Funding Sources Nestlé Nutrition, Vevey, Switzerland.

scholarly journals Fruit Juices: Are They Helpful or Harmful? An Evidence Review

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1815
Author(s):  
Carrie H. S. Ruxton ◽  
Madeleine Myers
Keyword(s):  
Vascular Function ◽  
Health Benefit ◽  
Dietary Guidelines ◽  
Potential Health ◽  
Nutrient Adequacy ◽  
Balanced Diet ◽  
Regular Consumption ◽  
The Us ◽  
Evidence Review

Dietary guidelines often deal with 100% fruit juice (FJ) inconsistently because it represents a source of free sugars. However, FJ also provides bioavailable micronutrients and plant bioactives at levels similar to those found in whole fruits. The present review weighs up the evidence from high-quality studies investigating a potential health harm for FJ against evidence from studies which indicate a potential health benefit. The findings reveal that FJ consumption, at moderate intakes consistent with the dietary guidelines for the US and some European countries (75–224 mL daily), does not increase the risk of obesity, type 2 diabetes, cardiovascular disease or poor glycaemic control. In contrast, regular consumption of FJ—even up to 500 mL per day in short-to-medium-term studies—appears to confer a health benefit in terms of vascular function and reduced blood pressure. Emerging evidence for cognitive health benefits requires further investigation in human trials. Observational studies report associations between FJ and nutrient adequacy and suggest that FJ consumption is associated with reduced risk of stroke. In conclusion, FJ appears to offer more benefit than risk and there appears to be no justification for discouraging FJ within a balanced diet for children and adults.

scholarly journals Dietary protein requirements and adaptive advantages in athletes

2012 ◽  
Vol 108 (S2) ◽  
pp. S158-S167 ◽  
Author(s):  
Stuart M. Phillips
Keyword(s):  
G Protein ◽  
Nitrogen Balance ◽  
Dietary Protein ◽  
Daily Intake ◽  
Dietary Guidelines ◽  
Protein Requirements ◽  
Dietary Reference Intakes ◽  
The Us ◽  
Nitrogen Intake ◽  
Practical Recommendations

Dietary guidelines from a variety of sources are generally congruent that an adequate dietary protein intake for persons over the age of 19 is between 0·8–0·9 g protein/kg body weight/d. According to the US/Canadian Dietary Reference Intakes, the RDA for protein of 0·8 g protein/kg/d is “…the average daily intake level that is sufficient to meet the nutrient requirement of nearly all [~98 %]… healthy individuals…” The panel also states that “…no additional dietary protein is suggested for healthy adults undertaking resistance or endurance exercise.” These recommendations are in contrast to recommendations from the US and Canadian Dietetic Association: “Protein recommendations for endurance and strength trained athletes range from 1·2 to 1·7 g/kg/d.” The disparity between those setting dietary protein requirements and those who might be considered to be making practical recommendations for athletes is substantial. This may reflect a situation where an adaptive advantage of protein intakes higher than recommended protein requirements exists. That population protein requirements are still based on nitrogen balance may also be a point of contention since achieving balanced nitrogen intake and excretion likely means little to an athlete who has the primary goal of exercise performance. The goal of the present review is to critically analyse evidence from both acute and chronic dietary protein-based studies in which athletic performance, or correlates thereof, have been measured. An attempt will be made to distinguish between protein requirements set by data from nitrogen balance studies, and a potential adaptive ‘advantage’ for athletes of dietary protein in excess of the RDA.

Diet

2015 ◽  
Author(s):  
Elizabeth G Nabel
Keyword(s):  
Dietary Fiber ◽  
Daily Intake ◽  
Blood Lipid ◽  
Dietary Guidelines ◽  
Food Sources ◽  
Healthy Weight ◽  
Dietary Recommendations ◽  
Animal Products ◽  
Vegetable Foods ◽  
Fiber Proteins

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.

scholarly journals Forget the Fad Diets: Use of the USDA's MyPlate Plan Is Associated with Better Dietary Intake in Adults over Age 50 (OR14-06-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Jacqueline Vernarelli ◽  
Rebecca DiSarro
Keyword(s):  
Older Adults ◽  
Weight Gain ◽  
Energy Density ◽  
Dietary Intake ◽  
Survey Design ◽  
Smoking Status ◽  
Dietary Guidelines ◽  
Added Sugars ◽  
The Us ◽  
The Impact

Abstract Objectives Adults over age 50 have different nutritional and metabolic needs than younger adults. During the aging process, metabolism slows, increasing risk for weight gain. Concurrently, as age increases, risk for cardiovascular disease increases. Adults over age 50 may benefit from guidance that provides nutritional guidance that encourages sufficient nutrient intake without caloric excess. Current recommendations in the US Dietary Guidelines for Americans encourage adults to consume a diet low in energy density, and limit intake of solid fats, added sugars and sodium The USDA's MyPlate Plan is available online and provides free, individualized nutrition plans for individuals of all ages, including specific guidelines for adults over age 50. The objective of this study was to evaluate the association between use of the online MyPlate Plan and dietary intake in adults >50. Methods Using data from 2014–2016 NHANES, the impact of the MyPlate plan on dietary intake was evaluated in a nationally representative sample of older adults (>50y). During the NHANES, participants were asked to report whether or not they had tried the MyPlate plan. All data were analyzed using SAS 9.4 survey procedures to account for the unequal sampling probability and complex survey design of the NHANES. Results Adults over age 50 who reported using the MyPlate Plan online had diets lower in energy density (1.74 vs 1.95, P = 0.0009), total calories (1846 vs 2105, P < 0.002); reported fewer calories from beverages (128 vs. 234, P = 0.01), fewer added sugars (11 vs. 15 tsp, P = 0.003), and consumed more grains (7 vs 6 servings) and over double the amount of intact fruits, after adjusting for sex, race/ethnicity, BMI, food security status, education, physical activity and smoking status. Conclusions These findings expand on previous work from our group evaluating the impact of DGA on diet quality. Promotion of the MyPlate plan, particularly among older adults, may be an effective strategy to combat weight gain and risk for hypertension in the US. Funding Sources None. Supporting Tables, Images and/or Graphs

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