Global Review of Dairy Recommendations in Food-Based Dietary Guidelines

At present, there are ~100 countries with national food-based dietary guidelines. While the intent of these guidelines is to inform national-level dietary recommendations, they also tie into global health and sustainable development initiatives, since diet and nutrition are linked to outcomes for all 17 United Nations Sustainable Development Goals. Therefore, key messaging in food-based dietary guidelines plays an important role in both national and global health efforts. However, this type of national-level dietary guidance is not standardized and varies considerably from country to country, and from food group to food group. The main objective of this review is to provide a novel look at dairy food group messaging within global food-based dietary guidelines, focusing specifically on nutrient-based and health-based messaging. Dairy-based messaging from 94 national food-based dietary guidelines was reviewed and grouped by region, with an emphasis on messaging regarding dairy's contribution to nutrients of public health concern for both underconsumption and overconsumption. The results showed that most nutrient-based dairy messaging relating to underconsumption was focused on calcium, followed by vitamin D, iodine, potassium, and protein; whereas messaging related to overconsumption was focused on saturated fat, added sugars, and salt. Health-based messaging specific to dairy food intake typically coalesced around three types of health outcomes: (1) bone, teeth, and muscle, (2) cardiometabolic, and (3) gut and immune. Although a fundamental concept of food-based dietary guidelines is to provide dietary guidance in a manner that is both “food-based,” and in the context of “dietary” patterns, most food-based dietary guidelines still express the health value of dairy foods (and potentially other foods groups) solely in terms of their nutrient content – and often times only in the context of a single nutrient (e.g., calcium).

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Menu Descriptions and Nutrient Content of Food Items in U.S. Restaurants (FS02-01-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz051.fs02-01-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Danielle Krobath ◽

William Masters ◽

Megan Mueller

Keyword(s):

Saturated Fat ◽

Nutrient Content ◽

The United States ◽

Dietary Guidelines ◽

Health Claims ◽

Trans Fat ◽

Dietary Recommendations ◽

Food Items ◽

Significant Difference ◽

Nutrient Data

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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The healthiness and sustainability of national and global food based dietary guidelines: modelling study

BMJ ◽

10.1136/bmj.m2322 ◽

2020 ◽

pp. m2322 ◽

Cited By ~ 7

Author(s):

Marco Springmann ◽

Luke Spajic ◽

Michael A Clark ◽

Joseph Poore ◽

Anna Herforth ◽

...

Keyword(s):

Global Health ◽

Greenhouse Gas Emissions ◽

Greenhouse Gas ◽

National Level ◽

Premature Mortality ◽

Dietary Guidelines ◽

National Guidelines ◽

Gas Emissions ◽

Paris Climate Agreement ◽

The Uk

AbstractObjectiveTo analyse the health and environmental implications of adopting national food based dietary guidelines (FBDGs) at a national level and compared with global health and environmental targets.DesignModelling study.Setting85 countries.ParticipantsPopulation of 85 countries.Main outcome measuresA graded coding method was developed and used to extract quantitative recommendations from 85 FBDGs. The health and environmental impacts of these guidelines were assessed by using a comparative risk assessment of deaths from chronic diseases and a set of country specific environmental footprints for greenhouse gas emissions, freshwater use, cropland use, and fertiliser application. For comparison, the impacts of adopting the global dietary recommendations of the World Health Organization and the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems were also analysed. Each guideline’s health and sustainability implications were assessed by modelling its adoption at both the national level and globally, and comparing the impacts to global health and environmental targets, including the Action Agenda on Non-Communicable Diseases, the Paris Climate Agreement, the Aichi biodiversity targets related to land use, and the sustainable development goals and planetary boundaries related to freshwater use and fertiliser application.ResultsAdoption of national FBDGs was associated with reductions in premature mortality of 15% on average (95% uncertainty interval 13% to 16%) and mixed changes in environmental resource demand, including a reduction in greenhouse gas emissions of 13% on average (regional range −34% to 35%). When universally adopted globally, most of the national guidelines (83, 98%) were not compatible with at least one of the global health and environmental targets. About a third of the FBDGs (29, 34%) were incompatible with the agenda on non-communicable diseases, and most (57 to 74, 67% to 87%) were incompatible with the Paris Climate Agreement and other environmental targets. In comparison, adoption of the WHO recommendations was associated with similar health and environmental changes, whereas adoption of the EAT-Lancet recommendations was associated with 34% greater reductions in premature mortality, more than three times greater reductions in greenhouse gas emissions, and general attainment of the global health and environmental targets. As an example, the FBDGs of the UK, US, and China were incompatible with the climate change, land use, freshwater, and nitrogen targets, and adopting guidelines in line with the EAT-Lancet recommendation could increase the number of avoided deaths from 78 000 (74 000 to 81 000) to 104 000 (96 000 to 112 000) in the UK, from 480 000 (445 000 to 516 000) to 585 000 (523 000 to 646 000) in the USA, and from 1 149 000 (1 095 000 to 1 204 000) to 1 802 000 (1 664 000 to 1 941 000) in China.ConclusionsThis analysis suggests that national guidelines could be both healthier and more sustainable. Providing clearer advice on limiting in most contexts the consumption of animal source foods, in particular beef and dairy, was found to have the greatest potential for increasing the environmental sustainability of dietary guidelines, whereas increasing the intake of whole grains, fruits and vegetables, nuts and seeds, and legumes, reducing the intake of red and processed meat, and highlighting the importance of attaining balanced energy intake and weight levels were associated with most of the additional health benefits. The health results were based on observational data and assuming a causal relation between dietary risk factors and health outcomes. The certainty of evidence for these relations is mostly graded as moderate in existing meta-analyses.

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How well do Australian women comply with dietary guidelines?

Public Health Nutrition ◽

10.1079/phn2003538 ◽

2004 ◽

Vol 7 (3) ◽

pp. 443-452 ◽

Cited By ~ 64

Author(s):

Kylie Ball ◽

Gita D Mishra ◽

Christopher W Thane ◽

Allison Hodge

Keyword(s):

Economic Status ◽

Saturated Fat ◽

Population Based ◽

Dietary Guidelines ◽

Dietary Recommendations ◽

Middle Aged ◽

National Guidelines ◽

Cross Sectional ◽

Behavioural Characteristics ◽

Increased Risk

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.

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The Warning on Saturated Fat: From Defective Experiments to Defective Guidelines

KIMIKA ◽

10.26534/kimika.v28i2.42-47 ◽

2017 ◽

Vol 28 (2) ◽

pp. 42-47

Author(s):

Fabian M. Dayrit

Keyword(s):

Heart Disease ◽

Inflammatory Diseases ◽

Saturated Fat ◽

Coconut Oil ◽

Heart Association ◽

Dietary Guidelines ◽

Omega 3 ◽

Dietary Recommendations ◽

International Agencies ◽

Omega 6

Coconut oil has been adversely affected by the current dietary guidelines that advocate a lowering of total fat and the replacement of saturated fat with polyunsaturated fat. This recommendation has its origins in the saturated fat-cholesterol-heart disease hypothesis that Ancel Keys first proposed in 1957. This hypothesis became an official recommendation with the publication of the Dietary Guidelines for Americans in 1980 and has been adopted by many other countries and international agencies. The dietary recommendations also warn against coconut oil. Recently, the American Heart Association re-issued this warning in its 2017 Presidential Advisory. However, a critical review of the experiments that Keys conducted has revealed experimental errors and biases that cast serious doubt on the correctness of his hypothesis and the warnings against coconut oil. Further, the recommendation to decrease saturated fat recommendation effectively means an increase in unsaturated fat in the diet. The actual result has been an increase in omega-6 fats and a high omega-6 to omega-3 fat ratio. This unhealthy ratio has been linked to heart disease, the very disease that the AHA wants to target, as well as cancer and inflammatory diseases. Defective experiments have led to defective guidelines. This first paper in this series of papers will present these errors and biases and address the points raised by the AHA.

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Energy and Nutrient Intake of Americans according to Meeting Current Dairy Recommendations

Nutrients ◽

10.3390/nu12103006 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3006 ◽

Cited By ~ 1

Author(s):

Julie M. Hess ◽

Christopher J. Cifelli ◽

Victor L. Fulgoni III

Keyword(s):

Nutrient Intake ◽

Saturated Fat ◽

Dietary Guidelines ◽

Adequate Intake ◽

Dairy Food ◽

Added Sugars ◽

Dairy Foods ◽

Dietary Guidelines For Americans ◽

Calcium Magnesium ◽

Using Data

Most Americans do not meet dairy food recommendations from the 2015 Dietary Guidelines for Americans (DGA). This study assesses differences in nutrient intake between Americans who meet recommendations for dairy intake and those who do not, using data from the National Health and Nutrition Examination Survey from 2013–2014 and 2015–2016 (n = 5670 children ages 2–18 years and n = 10,112 adults ages 19+). Among children and adults, those meeting dairy food recommendations were significantly more likely to have adequate intake (% above Estimated Average Requirement (EAR)) of calcium, magnesium, phosphorus, riboflavin, vitamin A, vitamin B12, and zinc and consume above the Adequate Intake (AI) for potassium and choline than Americans not meeting dairy recommendations, regardless of age, sex, or race/ethnicity. Americans meeting dairy recommendations were also more likely to exceed recommendations for sodium and saturated fat but consume less added sugars. Nearly 60% of Americans 2 years and older not meeting dairy recommendations consumed calcium and magnesium below the EAR. Only about 20% of Americans who did not meet dairy recommendations consumed above the AI for potassium. Dairy foods make important and unique contributions to dietary patterns, and it can be difficult to meet nutrient needs without consuming recommended amounts of dairy foods.

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Food Based Dietary Guidance - Weighing up the recommendations

Proceedings of The Nutrition Society ◽

10.1017/s0029665120003456 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Michael Dolan ◽

Sali Abouhajar ◽

Damian O'Kelly ◽

Elizabeth O'Sullivan ◽

Aileen Kennedy ◽

...

Keyword(s):

Fruits And Vegetables ◽

Food Group ◽

Dietary Guidelines ◽

Food Groups ◽

Automatic Assessment ◽

Dietary Recommendations ◽

Adequate Diet ◽

Group A ◽

Serving Sizes ◽

Serving Size

AbstractFood Based Dietary Guidelines (FBDG) are dietary recommendations described in terms of amounts of foods that should be consumed. They are designed to support healthy eating through simple messaging and indicate how to achieve a nutritionally adequate diet. However, assessing compliance with FBDG targets can be difficult. The quantity of food either being consumed or prescribed and the amount of that food that constitutes a serving are needed to calculate the contribution of the food towards a food group target. The aim of this study was to define the serving weight of foods, guided by definitions from Irish FBDG, to the McCance and Widdowson Composition of Foods Integrated Dataset 2015 (CoFID). This will enable the automatic assessment of compliance to FBDG using Nutritics nutrition analysis software. Foods from CoFID were categorised into six food groups as defined by Ireland's FBDG. Quantified servings from the Irish FBDG were matched to foods. Calculation criteria were developed to establish a serving size for remaining foods within each food group. For fats and oils, as well as raw fruits and vegetables, household measurements were converted to grams, using Food Portion Sizes from the Food Standards Agency. Quantities for cooked fruits and vegetables were calculated using weight-change factors published by Bognar. For the breads, cereals and potatoes group a serving size was calculated using the midpoint for the calorie bands in this group, as defined by the Food Safety Authority of Ireland. For the dairy group, a serving size was determined by calculating the quantity needed to provide 250 mg of calcium. This was in line with achieving the total daily recommended amount of calcium from the dairy group from 3 servings. For meat, fish and alternatives (MFA), serving sizes were developed using the recommended amount of protein per body weight reference value for males and females. For foods high in fat, sugar and salt, serving sizes were defined using 100kcal as the recommended amount of energy provided for snacks. Out of 3,291 foods, 1,980 were grouped into 6 food groups. Quantified servings were available for 694 foods in 3 food groups. Calculated serving sizes were developed for the remaining 1,276 foods. The quantity of each food that constitutes a serving will be integrated into Nutritics to automatically assess compliance to FBDG. This will enable Health Care and Food Industry Professionals to deliver informed advice on meeting population health targets.

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Food and nutrient intakes of Greek (Cretan) adults.Recent data for food-based dietary guidelines in Greece

British Journal Of Nutrition ◽

10.1017/s0007114599000926 ◽

1999 ◽

Vol 81 (S1) ◽

pp. S71-S76 ◽

Cited By ~ 41

Author(s):

Joanna Moschandreas ◽

Anthony Kafatos

Keyword(s):

Nutrient Intake ◽

Potential Benefit ◽

Saturated Fat ◽

Food Group ◽

Dietary Guidelines ◽

Consumption Patterns ◽

Fat Intake ◽

Younger Adults ◽

Dietary Recall ◽

Wide Availability

The present study aimed to estimate current nutrient intake levels and food group consumption patterns in Greece using cut-off levels derived from the results of dietary recall interviews with 470 Cretan adults. It was found that the present-day Greek diet contains, in the main, adequate levels of fibre. In comparison with the traditional diet, however, the levels of saturated fat in the diet have greatly increased, particularly in younger adults. An association was found between low fruit and vegetable and low fibre intake and a fat intake that was mainly in the form of saturated fat, this being particularly evident in female subjects. Given the wide availability of olive oil, fish, fresh fruit and vegetables in Greece, the development of national dietary guidelines would be of great potential benefit, particularly to the younger generations.

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Prospective association between adherence to the 2017 French dietary guidelines and risk of death, CVD and cancer in the NutriNet-Santé cohort

British Journal Of Nutrition ◽

10.1017/s0007114521001367 ◽

2021 ◽

pp. 1-11

Author(s):

Dan Chaltiel ◽

Chantal Julia ◽

Raphaël Chaltiel ◽

Julia Baudry ◽

Mathilde Touvier ◽

...

Keyword(s):

Prostate Cancer Risk ◽

Dietary Guidelines ◽

Health Concern ◽

Dietary Recommendations ◽

Cox Models ◽

Risk Of Death ◽

Adherence Score ◽

Dietary Records ◽

Prospective Association

Abstract Non-communicable diseases, such as cancers and CVD, represent a major public health concern, and diet is an important factor in their development. French dietary recommendations were updated in 2017, and an adherence score, the Programme National Nutrition Santé Guidelines Score (PNNS-GS2), has been developed and validated using a standardised procedure. The present study aimed to analyse the prospective association between PNNS-GS2 and the risk of death, cancer and CVD. Our sample consisted of French adults included in the prospective NutriNet-Santé cohort (n 67 748, 75 634 and 80 269 for the risk of death, cancer and CVD, respectively). PNNS-GS2 (range: –∞ to 14·25) was calculated from the 24-h dietary records of the first 2 years of monitoring. Association between PNNS-GS2 (in quintiles, Q) and the risk of death, cancer and CVD was studied using Cox models adjusted for the main confounding factors. The sample included 78 % of women, aged on average 44·4 years (sd 14·6) with on average 6·6 (sd 2·3) dietary records. Average PNNS-GS2 was 1·5 (sd 3·4) and median follow-up was 6·6 years for cancers and 6·2 years for CVD and deaths. PNNS-GS2 was significantly associated with the risk of death (hazard ratio (HR)Q5vsQ1: 0·77 (95 % CI 0·60, 1·00), 828 cases), cancer (HRQ5vsQ1 = 0·80 (95 % CI 0·69, 0·92), 2577 cases) and CVD (HRQ5vsQ1 0·64 (95 % CI 0·51, 0·81), 964 cases). More specifically, PNNS-GS2 was significantly associated with colorectal and breast cancer risks but not prostate cancer risk. Our results suggest that strong adherence to the 2017 French dietary recommendations is associated with a lower risk of death, cancer or CVD. This reinforces the validity of these new recommendations and will help to promote their dissemination.

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Heterogeneity in Meat Food Groups Can Meaningfully Alter Population-Level Intake Estimates of Red Meat and Poultry

Frontiers in Nutrition ◽

10.3389/fnut.2021.778369 ◽

2021 ◽

Vol 8 ◽

Author(s):

Lauren E. O'Connor ◽

Kirsten A. Herrick ◽

Ruth Parsons ◽

Jill Reedy

Keyword(s):

Disease Risk ◽

Reference Method ◽

Population Level ◽

Food Group ◽

Red Meat ◽

Dietary Guidelines ◽

Food Groups ◽

Dietary Recommendations ◽

Hispanic Origin ◽

Percentile Method

Heterogeneity in meat food groups hinders interpretation of research regarding meat intake and chronic disease risk. Our objective was to investigate how heterogeneity in red meat (RM) and poultry food groups influences US population intake estimates. Based on a prior systematic review, we created an ontology of methods used to estimate RM [1= unprocessed RM; 2 (reference)= unprocessed RM + processed RM; 3= unprocessed RM + processed RM + processed poultry; and 4=unprocessed RM + processed RM + processed poultry + chicken patties/nuggets/tenders (PNT)] and three for poultry [A=unprocessed poultry; B= unprocessed poultry + PNT; C (reference)= unprocessed poultry + processed poultry + PNT). We applied methods to 2015–18 National Health and Nutrition Examination Survey data to estimate RM and poultry intake prevalence and amount. We estimated and compared intakes within RM and within poultry methods via the NCI Method for individuals ≥2 years old (n = 15,038), adjusted for age, sex, and race/Hispanic origin. We compared the population percentage that exceeded age- and sex-specific RM and poultry allotments from the Dietary Guidelines for Americans recommended eating patterns. The percent that consumed RM ranged from 47 ± 1.2% to 75 ± 0.8% across methods and mean amount ranged from 10.5 ± 0.28 to 18.2 ± 0.35 lean oz-equivalents/week; 38 ± 1.2% to 71 ± 0.7% and 9.8 ± 0.35 to 13.3 ± 0.35 lean oz-equivalents/week across poultry methods. Estimates for higher, but not lower, intake percentiles differed across RM methods. Compared to the reference, Method 1 was ≥3.0 oz-equivalents/week lower from 20th-70th percentiles, ≥6.0 oz-equivalents/week lower from 75th-90th percentiles, and ≥9.0 oz-equivalents/week lower for the 95th percentile. Method 4, but not Method 3, was ≥3.0 oz-equivalents/week higher than the reference from 50 to 95th percentiles. The population percentage that exceeded allotments was 27 ± 1.8% lower for Method 1, 9 ± 0.8% higher for Method 3, and 14 ± 0.9% higher for Method 4 compared to the reference. Differences were less pronounced for poultry. Our analysis quantifies the magnitude of bias introduced by heterogeneous meat food group methodology. Explicit descriptions of meat food groups are important for development of dietary recommendations to ensure that research studies are compared appropriately.

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Evaluating the Consistency of the French Nutri-Score Front-of-Pack Scoring System with Canadian Dietary Guidelines

Current Developments in Nutrition ◽

10.1093/cdn/nzaa064_001 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1711-1711

Author(s):

Mavra Ahmed ◽

Kacie Dickinson ◽

Laura Vergeer ◽

Christine Mulligan ◽

Beatriz Franco-Arellano ◽

...

Keyword(s):

Nutritional Quality ◽

Saturated Fat ◽

Dietary Guidelines ◽

Food Groups ◽

Food Label ◽

Dietary Recommendations ◽

University Of Toronto ◽

High Consistency

Abstract Objectives Nutrient profiling (NP) models, underpinning front-of-pack (FOP) labelling, can guide consumers towards healthier food choices and should be aligned with food-based dietary guidelines. In France, [the FSAm/HCSP NP model], underpinning the Nutri-Score (NS) FOP, ranks foods on both nutrients-to-limit (saturated fat, sodium, sugar) and nutrients-to-encourage (e.g., protein, fibre, fruits, vegetables, legumes and nuts) and was found to adequately align with dietary recommendations in Europe. However, investigations on the comparable ranking of foods by the FSAm/HCSP NP model with the new Canadian dietary guidelines is lacking. The objective was to assess the ability of the NS to discriminate the nutritional quality of foods and beverages in the Canadian food supply and their consistency with nutritional recommendations according to the Canada's 2019 Food Guidelines (CFG). Methods Using the University of Toronto Food Label Information Program 2017 database (n = 17,360), the nutritional scores for prepackaged foods and beverages were derived using the NS. These scores correspond to five grades of nutritional quality, ranging from green (A; highest quality) to red (E; lowest quality). Scores were assessed as binary where A/B were considered ‘in alignment’ with CFG recommendations while C/D/E were considered ‘not in alignment’. Results The NS system classified 21% of products as A, ranging from 99% of legumes to 0.45% of the sugars/sweets. The NS was able to discriminate the nutritional quality of foods within the same food groups (based on display of three grades represented within the Nutri-Score). Overall, there was 73% agreement between NS and CFG, ranging from 48% for combination dishes to 95% for eggs/egg substitute categories. The classification of foods according to the NS was consistent with the CFG; foods for which consumption is recommended were more favourably classified (e.g., 76% of vegetables were classified as A or B) than foods for which consumption should be limited (e.g., 79% of snacks were classified as C/D/E). Conclusions The NS FOP system is an effective tool to discriminate products across and within food categories. The classification of different food groups in the NS displayed a high consistency with the new Canadian dietary guidelines. Funding Sources Sanofi-Pasteur University of Toronto Université Paris-Descartes Collaborative Grant.

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