Abstract
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.
Highlights
Dietary guidance in the U.S emphasizes adoption of food groupbased dietary patterns to meet nutrient needs and prevent chronic disease risk [1]
Misclassifying processed poultry as processed red meat, i.e., using the broad “red and processed meat” food group, exacerbates these differences. This analysis demonstrated that misclassification of processed meat and how processed meats are defined within meat food groups meaningfully influence population-level intake estimates of red meat and poultry
Different methods of operationalizing red meat and poultry food groups resulted in different population-level intake estimates, because they are distinct and unique food groups
Summary
Dietary guidance in the U.S emphasizes adoption of food groupbased dietary patterns to meet nutrient needs and prevent chronic disease risk [1]. Heterogeneity in research questions, study design, sample populations, and dietary assessment methodologies precludes adoption of standardized food groups or food group lexicons [2] by nutrition researchers. Even with comprehensive data collected at the individual food level, there is a lack of standardized definitions of food groups across public health and research organizations to guide researchers and the public [4, 5]. These two factors contribute heterogeneity to how researchers operationalize food groups across research studies, influencing scientists’ and policy makers’ ability to collate and translate research into food-based dietary pattern recommendations
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