Dietary Guidelines Meet NOVA: Developing a Menu for A Healthy Dietary Pattern Using Ultra-Processed Foods.

BACKGROUND: A proposed topic for the 2025 Dietary Guidelines for Americans (DGA) Scientific Advisory Committee to address is the relationship between dietary patterns with ultra-processed foods (UPF) and body composition and weight status. Implementing the NOVA system, the most commonly applied framework for determining whether a food is "ultra-processed," in dietary guidance could omit several nutrient-dense foods from recommended healthy diets in the DGA. OBJECTIVE: The purpose of this proof-of-concept study was to determine the feasibility of building a menu that aligns with recommendations for a healthy dietary pattern from the 2020 DGA and includes ≥80% kcal from UPF as defined by NOVA. DESIGN: To accomplish this objective, we first developed a list of foods that fit NOVA criteria for UPF, fit within dietary patterns in the 2020 DGA, and are commonly consumed by Americans. We then used these foods to develop a 7-d, 2000 kcal menu modeled on MyPyramid sample menus and assessed this menu for nutrient content as well as for diet quality using the Healthy Eating Index-2015 (HEI-2015). RESULTS: In the ultra-processed DGA menu that was created, 91% of kcal were from UPF, or NOVA category 4. The HEI-2015 score was 86 out of a possible 100 points. This sample menu did not achieve a perfect score due primarily to excess sodium and an insufficient amount of whole grains. This menu provided adequate amounts of all macro- and micronutrients except vitamin D, vitamin E, and choline. CONCLUSIONS: Healthy dietary patterns can include most of their energy from UPF, still receive a high diet quality score, and contain adequate amounts of most macro- and micronutrients.

Effectively Prescribing Oral Magnesium Therapy for Hypertension: A Categorized Systematic Review of 49 Clinical Trials.

Trials and meta-analyses of oral magnesium for hypertension show promising but conflicting results. An inclusive collection of 49 oral magnesium for blood pressure (BP) trials were categorized into four groups: (1) Untreated Hypertensives; (2) Uncontrolled Hypertensives; (3) Controlled Hypertensives; (4) Normotensive subjects. Each group was tabulated by ascending magnesium dose. Studies reporting statistically significant (p < 0.05) decreases in both systolic BP (SBP) and diastolic BP (DBP) from both baseline and placebo (if reported) were labeled "Decrease"; all others were deemed "No Change." Results: Studies of Untreated Hypertensives (20 studies) showed BP "Decrease" only when Mg dose was >600 mg/day; <50% of the studies at 120-486 mg Mg/day showed SBP or DBP decreases but not both while others at this Mg dosage showed no change in either BP measure. In contrast, all magnesium doses (240-607 mg/day) showed "Decrease" in 10 studies on Uncontrolled Hypertensives. Controlled Hypertensives, Normotensives and "magnesium-replete" studies showed "No Change" even at high magnesium doses (>600 mg/day). Where magnesium did not lower BP, other cardiovascular risk factors showed improvement. Conclusion: Controlled Hypertensives and Normotensives do not show a BP-lowering effect with oral Mg therapy, but oral magnesium (≥240 mg/day) safely lowers BP in Uncontrolled Hypertensive patients taking antihypertensive medications, while >600 mg/day magnesium is required to safely lower BP in Untreated Hypertensives; <600 mg/day for non-medicated hypertensives may not lower both SBP and DBP but may safely achieve other risk factor improvements without antihypertensive medication side effects.

Sodium in the food supply: challenges and opportunities.

This article is based on proceedings from the Symposium on Sodium in the Food Supply: Challenges and Opportunities, sponsored by the North American Branch of the International Life Sciences Institute, at Experimental Biology 2010 in Anaheim, California. The symposium aimed to address the issue of dietary sodium and its consequences for public health. Presenters spoke on a variety of key topics, including salt taste reception mechanisms and preferences, methods and measures to assess sodium in the US food supply, and considerations regarding the reduction of sodium in processed foods. Information from these presentations, as well as literature references, are provided in this article.

Effect of dietary linoleic acid on markers of inflammation in healthy persons: a systematic review of randomized controlled trials.

The majority of evidence suggests that n-6 polyunsaturated fatty acids, including linoleic acid (LA), reduce the risk of cardiovascular disease as reflected by current dietary recommendations. However, concern has been expressed that a high intake of dietary n-6 polyunsaturated fatty acid contributes to excess chronic inflammation, primarily by prompting the synthesis of proinflammatory eicosanoids derived from arachidonic acid and/or inhibiting the synthesis of anti-inflammatory eicosanoids from eicosapentaenoic and/or docosahexaenoic acids. A systematic review of randomized controlled trials that permitted the assessment of dietary LA on biologic markers of chronic inflammation among healthy noninfant populations was conducted to examine this concern. A search of the English- and non-English-language literature using MEDLINE, the Cochrane Controlled Trials Register, and EMBASE was conducted to identify relevant articles. Fifteen studies (eight parallel and seven crossover) met inclusion criteria. None of the studies reported significant findings for a wide variety of inflammatory markers, including C-reactive protein, fibrinogen, plasminogen activator inhibitor type 1, cytokines, soluble vascular adhesion molecules, or tumor necrosis factor-α. The only significant outcome measures reported for higher LA intakes were greater excretion of prostaglandin E2 and lower excretion of 2,3-dinor-thromboxane B(2) in one study and higher excretion of tetranorprostanedioic acid in another. However, the authors of those studies both observed that these effects were not an indication of increased inflammation. We conclude that virtually no evidence is available from randomized, controlled intervention studies among healthy, noninfant human beings to show that addition of LA to the diet increases the concentration of inflammatory markers.

Snacking definitions: impact on interpretation of the literature and dietary recommendations.

Snacking is a ubiquitous practice that has increased in recent years. However, the impact of snacking on the diet is difficult to assess because a variety of approaches have been used to define snacking (and snack foods) in the literature. This lack of a universally accepted definition complicates interpretation of the literature and limits the development of science-based recommendations for consumers. The purpose of this review is to illustrate this problem by showing that the conclusions derived from the literature are heavily dependent on the definition used or implied by the authors. It is suggested that the a universally accepted definition for snacking be developed by a coalition of stakeholders to provide a template for future research, guidance for the food industry and to enable the development of well-substantiated dietary recommendations.

Dietary modeling shows that the substitution of canola oil for fats commonly used in the United States would increase compliance with dietary recommendations for fatty acids.

OBJECTIVE: To examine the effect of substituting canola oil for selected vegetable oils and canola oil-based margarine for other spreads on energy, fatty acid, and cholesterol intakes among US adults. DESIGN: Twenty-four-hour food recall data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES) were used to calculate the effect of substituting canola oil for dietary corn, cottonseed, safflower, soybean, and vegetable oils described as "not further specified" and of canola oil-based margarine for other spreads at 25%, 50%, and 100% replacement levels. SUBJECTS: Adult participants aged>or=20 years (n=8,983) of the 1999-2002 NHANES. STATISTICAL ANALYSIS: Sample-weighted mean daily intake values and the percentage of subjects meeting dietary recommendations were estimated at the various replacement levels. Standard errors of the means and percentages were estimated by the linearization method of SUDAAN. RESULTS: Significant (P<0.05) changes compared to estimated actual intakes included: saturated fatty acid intake decreased by 4.7% and 9.4% with 50% and 100% substitution, respectively. Complete substitution increased monounsaturated fatty acid and alpha-linolenic acid intakes by 27.6% and 73.0%, respectively, and decreased n-6 polyunsaturated fatty acid and linoleic acid intakes by 32.4% and 44.9%, respectively. The ratio of n-6 to n-3 fatty acids decreased from 9.8:1 to 3.1:1 with 100% replacement. Energy, total fat, and cholesterol intakes did not change. CONCLUSIONS: Substitution of canola oil and canola oil-based margarine for most other vegetable oils and spreads increases compliance with dietary recommendations for saturated fatty acid, monounsaturated fatty acid, and alpha-linolenic acid, but not for linoleic acid, among US adults.