Scientific Report of the 2015 Dietary Guidelines Advisory Committee

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Part D. Chapter 1: Food and Nutrient Intakes, and Health: Current Status and Trends - Continued

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Chapter Summary

The DGAC conducted data analyses to address a series of questions related to the current status and trends in the Nation’s dietary intake. The questions focused on: intake of specific nutrients and food groups; food categories (i.e., foods as consumed) that contribute to intake; eating behaviors; and the composition of various dietary patterns shown to have health benefits, including Mediterranean-style diets, the Healthy US-style and DASH-style diets. These topics were addressed using data from the WWEIA dietary survey, which is the dietary intake component of the ongoing NHANES. Food pattern modeling using the USDA Food Pattern food groups also was used to address some of the questions of interest. In addition, the DGAC examined the prevalence and trends of health conditions that may have a nutritional origin, or where the course of disease may be influenced by diet.

The DGAC found that several nutrients are underconsumed and the Committee characterized them as shortfall nutrients: vitamin A, vitamin D, vitamin E, vitamin C, folate, calcium, magnesium, fiber, and potassium. For adolescent and premenopausal females, iron also is a shortfall nutrient. Important to note, on the basis of nutrient biomarkers or health outcomes, calcium, vitamin D, fiber, and potassium also are classified as nutrients of public health concern because their underconsumption has been linked in the scientific literature to adverse health outcomes. Iron is included as a shortfall nutrient of public health concern for adolescent females and adult females who are premenopausal due to the increased risk of iron-deficiency in these groups. The DGAC also found that two nutrients—sodium and saturated fat—are overconsumed by the U.S. population and that the overconsumption poses health risks.

The majority of the U.S. population has low intakes of key food groups that are important sources of the shortfall nutrients including vegetables, fruits, whole grains, and dairy. Furthermore, population intake is too high for refined grains and added sugars. The data suggest cautious optimism about dietary intake of the youngest members of the U.S. population because many young children ages 2 to 5 years consume recommended amounts of fruit and dairy. However, a better understanding is needed on how to maintain and encourage the good habits that are started early in life. Analysis of data on food categories, such as burgers, sandwiches, mixed dishes, desserts, and beverages, because they represent such a large proportion of the calories consumed, are prime targets for reformulation to increase population intake of vegetables, whole grains, and other underconsumed food groups and to lower population intake of the nutrients sodium and saturated fat, and the food component refined grains. Dramatically reducing the intake of sugar-sweetened beverages and limiting sweets and desserts would help lower intakes of the food component added sugars.

The U.S. population purchases its food in a variety of locations, including supermarkets, convenience stores, schools, and the workplace, and consumes prepared food outside the home. The DGAC found that while diet quality varies somewhat by the setting where food is obtained, overall, independent of where the food is prepared or obtained, the diet quality of the U.S. population does not meet recommendations for fruit, vegetables, dairy, or whole grains, and exceeds recommendations, leading to overconsumption, for the nutrients sodium and saturated fat, and the food components refined grains, solid fats, and added sugars.

Obesity and chronic diseases with a nutritional origin are very common. The Nation must accelerate progress toward reducing the incidence and prevalence of overweight and obesity and chronic disease risk across the U.S. population throughout the lifespan and reduce the disparities in obesity and chronic disease rates that exist in the United States for certain ethnic and racial groups and for those with lower incomes.

The DGAC identified key aspects of several different dietary patterns that are associated with lower risk of many nutrition-related outcomes such as cardiovascular disease, diabetes, some cancers, psychological health and bone health. These patterns and their associated health benefits are described in greater detail in the next chapter.

The DGAC had enough descriptive information from existing research and data to model three dietary patterns and to examine their nutritional adequacy. These patterns are the Healthy U.S.-style Pattern, the Healthy Mediterranean-style Pattern, and the Healthy Vegetarian Pattern. These patterns include the components of a dietary pattern associated with health benefits.

The findings from this chapter and the remainder of the 2015 DGAC report can be used by individuals, families, communities, schools, local, state and federal agencies and the food industry to address the high prevalence of obesity and other nutrition-related health conditions in the United States and help all sectors of the population consume a diet that is healthful, accessible, and affordable.

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