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Anonymous Comment ID #458

Submitted 05/01/2014

DGAC Comments
For Subcommittee 2 – Dietary patterns, foods and nutrients and health outcomes

Making appropriate food choices to improve the nutrient density and quality of the American diet is very complex - many factors impact the choices that people make including their cultural experience with the food, attitudes, family environment, taste, price, packaging, convenience and point-of-purchase nutrition information such as that on food nutrition labels. My work focuses on maternal, child and family health, especially in at risk communities, where all these social and psychological food decision-drivers are inescapable.

In addition, health disparities are real – people living in high poverty areas and ethnic minorities are disproportionately affected by obesity, type 2- diabetes and hypertension. An examination of NHANES data over the past 30-40 years indicates that while there has been a steady increase in caloric intake among all age and racial groups, the 2010 Dietary Guidelines Committee found that the quality of food intake is associated with 10 nutrients that are inadequate - vitamins A, C, D, E and K as well as choline, calcium, magnesium, potassium and dietary fiber. In addition, the malnutrition that the American public experience is associated with the abundance of sodium, sugar and fat in the diet. Together both the food intake and physical inactivity patterns of most Americans have caused us to less than optimal health status.

The cumulative effect of malnutrition across the lifespan makes the focus on vulnerable populations critical. A strong force in improving the multiple facets of the food environment is the US Dietary Guidelines. As a nutrition professional and member of the 2005 DGAC, I know that the dietary guidelines serve as a foundation for government feeding programs. These important federally funded food and nutrition programs play an essential role in the quality of food and nutrition education available to these at-risk populations. Therefore we applaud the fact that WIC has responded to the 2007 IOM report recommendations by greatly expanding the offering of healthy foods. They began by eliminating many fruit juices and made buying fresh fruits and vegetables easier through issuing vouchers. They also reduced the amount of saturated fats allowed in WIC food packages. This process is entering the final phase with the inclusion of whole grain pastas, yogurt and additional types of canned fish. To be consistent, it would be helpful if the recent WIC update that encourages fruits, vegetable and yogurt consumption is reinforced in the 2015 dietary guidelines, thus influencing policy- driven government programs that impact vulnerable populations throughout the lifespan.

Examples of this impact happen when vulnerable populations are in nutrition-sensitive lifespan periods. One example is adolescence - a key time for building bone mineral density – but - unfortunately- many adolescents have poor nutritional intake --- setting them up for significant poor nutrition-related health concerns in later life. 90% of girls and women aged 14 and older consume less than the recommended servings of dairy, and other calcium rich foods creating a community at long term risk for less than optimal bone health. Adolescence is also the time when many people in ethnic groups first experience lactose intolerance further limiting their access to a nutrient dense food group – dairy. Many do not know that they may be able to tolerate a convenient and nutrient dense food from this group – yogurt.

Another example is the rapidly expanding aging population that is living longer. The real impact of the cumulative effect of a lifetime of poor food choices manifest in the high prevalence of chronic diseases as well as concerns for bone health. In addition our older adults are also at risk for decreased muscle health. After age 50, muscle mass decreases by about 1–2% per year and can eventually lead to sarcopenia, the age-associated loss of skeletal muscle mass and function. On average, 5–13% of people aged 60–70 years and 11–50% of those aged 80 and above are affected by sarcopenia. Nutrient dense foods such as whole grain, seeds/nuts, vegetables and dairy including yogurt can make a difference in the health outcomes of these vulnerable populations during these nutrition- sensitive periods.

While we do need to pay attention to price and product information, the bigger opportunity and challenge lies in building understanding of life-stage needs and putting more emphasis on using culture and social insights to come up with creative new ideas that make health and nutrition part of all Americans 21st century lifestyle.

Adapted from a presentation made at the National Food Policy Conference April 23, 2014
By - Yvonne Bronner, ScD, RD
Professor, Behavioral Health Science
Morgan State University
Dannon - Yogurt Everyday Nutrition Advisor

Affiliation: Individual/Professional Organization: Morgan State University, Public Health, Behavioral Health Science
Topic:
  • Behavior
  • Eating Patterns-Diets (USDA Food Patterns, DASH, Vegetarian, Low Carb, Hi-Protein, etc.)
  • Lifespan Needs (Infants, Children, Pregnant Women, Older Adults, etc.)

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