Fortification: new findings and implications.

This article reviews the current landscape regarding food fortification in the United States; the content is based on a workshop sponsored by the North American Branch of the International Life Sciences Institute. Fortification of the food supply with vitamins and minerals is a public health strategy to enhance nutrient intakes of the population without increasing caloric intake. Many individuals in the United States would not achieve recommended micronutrient intakes without fortification of the food supply. The achievement and maintenance of a desirable level of nutritional quality in the nation's food supply is, thus, an important public health objective. While the addition of nutrients to foods can help maintain and improve the overall nutritional quality of diets, indiscriminate fortification of foods could result in overfortification or underfortification in the food supply and nutrient imbalances in the diets of individuals. Any changes in food fortification policy for micronutrients must be considered within the context of the impact they will have on all segments of the population and of food technology and safety applications and their limitations. This article discusses and evaluates the value of fortification, the success of current fortification efforts, and the future role of fortification in preventing or reversing nutrient inadequacies.

Updated US Department of Agriculture Food Patterns meet goals of the 2010 dietary guidelines.

The US Department of Agriculture Food Patterns were updated for the 2010 Dietary Guidelines for Americans to meet new nutrition goals and incorporate results of food pattern modeling requested by the Dietary Guidelines Advisory Committee. The purpose of this article is to describe the process used and changes in the updated patterns. Changes include renaming the Meat and Beans and Milk Groups to the Protein Foods and Dairy Groups, respectively, to be more encompassing of foods in each. Vegetable subgroups now provide more achievable intake recommendations. Calcium-fortified soymilk is now included in the Dairy Group because of its similarity to foods in that group. Increased amounts of seafoods are recommended in the Protein Foods Group, balanced by decreased amounts of meat and poultry. A limit on calories from solid fats and added sugars is included, replacing the previous discretionary calorie allowance and emphasizing the need to choose nutrient-dense forms of foods. Lacto-ovo vegetarian and vegan patterns that meet nutrition goals were created by making substitutions in the Protein Foods Group, and for vegan patterns, in the Dairy Group. Patterns identify food choices that meet nutritional needs within energy allowances and encourage choosing a variety of foods. They rely on foods in nutrient-dense forms, including a limited amount of calories from solid fats and added sugars. The Food Patterns provide a useful template for educating consumers about healthful food choices while highlighting a large gap between choices many Americans make and healthy eating patterns.

Impact of typical rather than nutrient-dense food choices in the US Department of Agriculture Food Patterns.

BACKGROUND: The US Department of Agriculture (USDA) Food Patterns, released as part of the 2010 Dietary Guidelines for Americans, are designed to meet nutrient needs without exceeding energy requirements. They identify amounts to consume from each food group and recommend that nutrient-dense forms-lean or low-fat, without added sugars or salt-be consumed. Americans fall short of most food group intake targets and do not consume foods in nutrient-dense forms. Intake of calories from solid fats and added sugars exceed maximum limits by large margins. OBJECTIVE: Our aim was to determine the potential effect on meeting USDA Food Pattern nutrient adequacy and moderation goals if Americans consumed the recommended quantities from each food group, but did not implement the advice to select nutrient-dense forms of food and instead made more typical food choices. DESIGN: Food-pattern modeling analysis using the USDA Food Patterns, which are structured to allow modifications in one or more aspects of the patterns, was used. Nutrient profiles for each food group were modified by replacing each nutrient-dense representative food with a similar but typical choice. Typical nutrient profiles were used to determine the energy and nutrient content of the food patterns. RESULTS: Moderation goals are not met when amounts of food in the USDA Food Patterns are followed and typical rather than nutrient-dense food choices are made. Energy, total fat, saturated fat, and sodium exceed limits in all patterns, often by substantial margins. With typical choices, calories were 15% to 30% (ie, 350 to 450 kcal) above the target calorie level for each pattern. Adequacy goals were not substantially affected by the use of typical food choices. CONCLUSIONS: If consumers consume the recommended quantities from each food group and subgroup, but fail to choose foods in low-fat, no-added-sugars, and low-sodium forms, they will not meet the USDA Food Patterns moderation goals or the 2010 Dietary Guidelines for Americans.

Consumer research for development of educational messages for the MyPyramid Food Guidance System.

OBJECTIVE: To assess consumer understanding and use of messages from the original Food Guide Pyramid and potential concepts for a revised Food Guidance System. DESIGN: Focus groups conducted in two phases, in 2002 and 2004. SETTING: Market research facilities in Baltimore, Chicago, and Houston. PARTICIPANTS: Phase I, 178 participants in 18 groups: 6 of general adult consumers, 4 of adults over 60 years of age, 4 of food stamp recipients, and 4 of overweight adults. Phase II, 75 participants in 8 groups: 4 of younger adults and 4 of older adults. PHENOMENON OF INTEREST: Understanding and use of original Pyramid symbol and messages and potential concepts for a revised food guidance system. ANALYSIS: Focus group sessions were audiotaped and transcribed. Content analysis summarized comments into meaningful themes. RESULTS: Key concepts of the original Pyramid were widely understood, but specific knowledge was limited and misunderstandings common, especially related to servings and food group placement. Detailed information about whole grains, types of fats, vegetable subgroups, and physical activity was lacking. CONCLUSIONS AND IMPLICATIONS: While consumers are aware of general concepts about healthy eating, they lack specific knowledge to help them implement recommendations. Educators can help by providing consumers with concrete examples and specific information.

Impact of using updated food consumption and composition data on selected MyPyramid Food Group nutrient profiles.

OBJECTIVE: To examine the changes observed in 5 nutrients of selected USDA food subgroups by partitioning the overall changes into those caused by consumption changes over time, and those caused by nutrient database revisions. DESIGN: Population-weighted estimates of food group intakes (composites) were developed using 24-hour recall data from CSFII 1994-96 and NHANES 1999-2000. Nutrient profiles of these composites were developed using Standard Reference (SR) data (SR11 and SR16-1). SUBJECTS: A total of 14,262 and 8070 individuals over the age of 2 years from CSFII and NHANES, respectively, composed the study sample. OUTCOME MEASURES: Absolute and percent change in food group nutrient content caused by food consumption changes and nutrient database updates. ANALYSIS: Changes due to consumption differences were determined by comparing nutrient profiles created with CSFII and NHANES using SR11. Changes due to nutrient database differences were determined by comparing nutrient profiles created from NHANES data using SR11 and SR16-1 nutrient values. RESULTS: Consumption differences resulted in some variations in the food group nutrient content, but a majority of the changes were associated with use of the updated nutrient database. For example, vitamin A level in the orange vegetable subgroup was increased by 2.4% owing to consumption (from CSFII to NHANES), whereas the level was decreased by 38% due to nutrient updates (from SR11 to SR16-1). CONCLUSION AND IMPLICATIONS: Consideration of the changes in nutrient databases, as well as in food consumption, is essential in monitoring both the trends in the food choices Americans make and the adequacy of their diets.

MyPyramid food intake pattern modeling for the Dietary Guidelines Advisory Committee.

Modeling analyses using the MyPyramid intake patterns were conducted in collaboration with the 2005 Dietary Guidelines Advisory Committee in response to their research questions and to determine likely effects of possible recommendations on overall dietary adequacy. Scenarios modeled included the feasibility of using the food patterns for lacto-ovo-vegetarian diets, of varying fat levels within the patterns, and of increasing dietary flexibility through food group substitutions. Food pattern modeling was a useful tool to identify possible impacts on diet quality of potential Dietary Guidelines recommendations. Modeling analyses can help researchers explore the overall effect of specific dietary recommendations on intake patterns.

Development of food intake patterns for the MyPyramid Food Guidance System.

OBJECTIVE: The purpose of this research was to design food intake patterns based on typical American food selections that would meet Dietary Guidelines and Dietary Reference Intake recommendations. DESIGN: Analytic process to identify appropriate amounts from each food group that together will meet nutritional goals for various age/gender groups. VARIABLES MEASURED: Projected intake of energy, 9 vitamins, 8 minerals, 8 macronutrients, and dietary fiber in each food intake pattern. ANALYSIS: Iterative comparison of nutrients in each food intake pattern to Dietary Reference Intakes and Dietary Guidelines recommendations set as goals for that pattern. RESULTS: Food intake patterns were established that met almost all nutrient goals within estimated energy needs. Intakes of vitamin E at all energy levels, potassium at lower energy levels, and sodium at higher energy levels did not meet goals. CONCLUSIONS AND IMPLICATIONS: The food intake patterns provide a foundation of food choices that will meet nutritional recommendations. They form the scientific basis for the MyPyramid Food Guidance System and can also be used as a starting point for developing other educational programs or materials.

Development of food group composites and nutrient profiles for the MyPyramid Food Guidance System.

OBJECTIVE: To identify food selections in each MyPyramid food group or subgroup reflective of typical consumption patterns by Americans, and the nutrient intake that can be expected from consuming a specified amount of these foods from each group, in a low-fat and no-added-sugars form. DESIGN: An analytical process to identify food consumption choices within each food group and subgroup using national food consumption surveys, and to identify the expected nutrient content of each group using food composition databases. VARIABLES MEASURED: Relative consumption of foods within each food group; nutrient content for each food group and subgroup (energy plus 27 nutrients). ANALYSIS: Disaggregated foods from consumption surveys into component ingredients. Combined similar ingredients into "item clusters" and determined relative consumption of each. Calculated a consumption-weighted nutrient profile for each food group. RESULTS: Consumption-weighted food intake selections and nutrient profiles were developed for all MyPyramid food groups and subgroups. CONCLUSIONS AND IMPLICATIONS: This analytical process derived food group and subgroup composites which estimate typical food choices within each MyPyramid food group. These were used to assess the adequacy of the MyPyramid food intake patterns as they were being iteratively developed.

Developing the consumer interface for the MyPyramid Food Guidance System.

OBJECTIVE: To assess consumer response to potential graphics, slogans, and messages for the consumer interface of the MyPyramid Food Guidance System. DESIGN: Qualitative research conducted in two phases, composed of focus groups and Web-TV testing. SETTING: Professional market research facilities in Baltimore, MD, and Chicago, IL, and Web-TV. PARTICIPANTS: Phase 1,77 adults in 10 groups; Phase 2,407 adults via Web-TV. PHENOMENON OF INTEREST: Consumer response to potential graphic images, slogans, and messages for the Food Guidance System. ANALYSIS: A content analysis was used to summarize comments from focus groups and Web-TV tests into meaningful themes. Frequencies were calculated for responses. RESULTS: Respondents preferred the familiarity of the pyramid shape and found graphics and slogans that were personal, active, and positive to be appealing. CONCLUSIONS AND IMPLICATIONS: The consumer interface for the MyPyramid Food Guidance System was shaped by consumer feedback that identified appealing and useful elements and avoided elements that were potentially confusing or less meaningful. Consumers preferred images and messages that were perceived as new, personal, and active, but they desired some continuity with the original Pyramid shape.

The 2005 Dietary Guidelines Advisory Committee: developing a key message.

The 2005 Dietary Guidelines Advisory Committee used an evidence-based approach to evaluate the science base for the relationships of diet and physical activity and health. Nine key messages and corresponding conclusions were included in the 2005 Dietary Guidelines Advisory Committee report. This article describes the development process, scientific basis, and specific recommendations for one of the key messages.