Dietary Guidelines For Americans Recommendations Research Articles

Abstract P480: Digesting Detention: Investigating Eating Patterns in Jails

Background: Over 12 million people cycle through jails every year in the US. People incarcerated experience significant health inequities compared to the general population, including higher rates of hypertension, diabetes, and cardiovascular disease. Despite widespread acceptance of the association between diet and cardiovascular-related outcomes, research documenting dietary intake and nutritional status of individuals incarcerated in jail is limited. Food intake is notoriously difficult to measure, and current measurement tools are not designed for the jail setting. Objectives and Hypotheses: The objectives of this study were to 1) develop a food intake questionnaire for incarcerated adults; 2) document participants’ perceived accuracy of the instrument and 3) compare calorie, macronutrient, and micronutrient intake of people incarcerated in jail to the Acceptable Macronutrient Distribution Range (AMDR) and the 2020-2025 Dietary Guidelines for Americans (DGA). We hypothesized that participants would consume more sodium, added sugar, and saturated fat while incarcerated compared to the DGA and macronutrient consumption patterns of people incarcerated in jail would not meet the AMDR. Methods: Cycle menus were obtained from the jail administration to design a questionnaire that would allow study participants to accurately document the consumption of foods provided by the jail and purchased through commissary each day. Sixty-five (65) incarcerated adults (24 women and 41 men) were recruited from a northern Arizona county jail to complete the 4-day cross-sectional food intake questionnaire. Participants were asked to fill out the questionnaires in real time. Following the study period, questionnaires were collected, and participants provided feedback on the appropriateness and feasibility of the questionnaire via a group listening session. Daily total and mean calorie, macro- and micronutrient intake were calculated using the ASA24 and compared to the AMDR and the DGA. Results: Of 65 people recruited, 64 completed the questionnaire. Participants reported enjoying reflecting on their diets but indicated that institutional menu modifications during the study period led to confusion as the food items listed did not always match what was served. Average percent saturated fat of total calories (11.7%, 95% CI: 10.9, 12.4) and sodium (3723 mg, 95% CI: 3048, 4399) exceeded DGA recommendations. Macronutrient consumption was within recommended ranges. Conclusions: The results of this study can inform efforts to improve the food intake tracking tool which can be used in future research assessing nutritional status in jails and prisons, as well as other controlled food environments. These results will also provide the first observational evidence of nutritional status in jail settings, informing future institutional policy change and interventions.

Pregnancy-specific dietary guidelines for Americans are not met: Findings from a pilot study.

To assess maternal dietary intake during pregnancy and adherence to the 2020-2025 pregnancy-specific Dietary Guidelines for Americans (DGA). This was a retrospective observational study. The study population consisted of women who gave birth to term infants (>37 weeks of gestation). Participants were given the Dietary Screener Questionnaire (DSQ) after birth and asked to recall their dietary intake in the last month of pregnancy. Participants' estimated dietary intakes were then compared to the 2020-2025 DGA which includes specific recommendations for pregnant women. Out of 51women who completed the DSQ, none consumed the recommended amounts of all surveyed dietary factors. Specifically, only one woman (2%) met the recommended intake of fruits, 11 women (22%) met the recommended intake of calcium, 25 women (49%) exceeded the recommended upper limit for added sugar intake,and none of the women (0%) met the intake of vegetables, whole grains, dairyand fiber. Women in our study did not adhere to the pregnancy-specific DGA recommendations in the last month of pregnancy. Our findings underscore the need to increase maternal nutritional awareness and education to improve adherence to the DGA.

Women Who Give Birth Preterm Do Not Meet Dietary Guidelines During Pregnancy.

To evaluate maternal dietary intake during pregnancy compared with the 2015-2020 and 2020-2025 Dietary Guidelines for Americans (DGA). A retrospective observational study design was used. The cohort included women who gave birth to preterm infants between 25 1/7 weeks and 33 6/7 weeks of gestation. Within 2 weeks of birth, participants were asked to recall their diet in the last month of pregnancy using the Dietary Screener Questionnaire. Participants' dietary intakes were compared to current 2020-2025 DGA that include specific recommendations for pregnant women and prior 2015-2020 DGA that were in place during the study period but were not pregnancy-specific. Forty-five women participated in the study. None met the 2015-2020 or 2020-2025 DGA recommended intake of all seven dietary components. When compared to both DGAs, 2.2% of participants met the recommended dairy intake, 26.7% met the calcium intake, 15.6% were below the threshold for added sugar, and none met the vegetable or whole grain intake. When compared to the 2015-2020 DGA, 28.9% met the fruit intake and 2.2% met the fiber intake. However, when compared to the 2020-2025 DGA, only 2.2% met the fruit intake and none met the fiber intake. Women who gave birth preterm did not adhere to the 2015-2020 or 2020-2025 DGA recommendations in the last month of pregnancy. Nurses are uniquely positioned to provide pregnant women with nutritional screening and counseling as part of routine prenatal care.

Comparison of foods and beverages served and consumed in Child and Adult Care Food Program-participating childcare centres to national guidelines.

The federal Child and Adult Care Food Program (CACFP) sets minimum nutrition and portion size standards for meals served in participating childcare programs. CACFP has been associated with more nutritious meals served. It is unclear, however, whether CACFP results in children's dietary intake being aligned with national recommendations. We assess whether children's dietary intake in CACFP-participating childcare centres meets benchmarks set by the Dietary Guidelines for Americans (DGA). This is a cross-sectional study. We used direct observation to estimate quantities of foods/beverages served and consumed per child. Mean amounts served per child per day were compared with CACFP portion size requirements for each component (fruits, vegetables, milk and meat/meat alternate). Mean amounts of foods/beverages consumed were compared with DGA recommendations (energy content, fruits, vegetables, whole/refined grains, dairy, protein and added sugars). One sample t-tests evaluated if quantities served and consumed were different from CACFP and DGA standards, respectively. Six CACFP-participating childcare centres. 2-5 year-old children attending childcare. We observed forty-six children across 166 child meals. Most meals served met CACFP nutrition standards. Compared with CACFP portion size standards, children were served more grains at breakfast and lunch; more fruits/vegetables at lunch but less at breakfast and snack and less dairy at all eating occasions. Compared with DGA recommendations, children under-consumed every food/beverage category except grains during at least one eating occasion. Children were served quantities of foods/beverages mostly consistent with CACFP portion size requirements, but had sub-optimal intake relative to DGA. More research is needed to help children consume healthy diets in childcare.

Meeting the Healthy People 2030 Added Sugars Target

Many Americans exceed the dietary recommendations for added sugars. Healthy People 2030 set a population target mean of 11.5% calories from added sugars for persons aged ≥2 years. This paper describes the reductions needed in population groups with varying added sugars intake to meet this target using four different public health approaches. Data from the 2015-2018 National Health and Nutrition Examination Survey (n=15,038) and the National Cancer Institute method were used to estimate the usual percentage calories from added sugars. Four approaches investigated lowering intake among (1) the general U.S. population, (2) people exceeding the 2020-2025 Dietary Guidelines for Americans recommendation for added sugars (≥10% calories/day), (3) high consumers of added sugars (≥15% calories/day), or (4) people exceeding the Dietary Guidelines for Americans recommendation for added sugars with two different reductions on the basis of added sugars intake. Added sugars intake was examined before and after reduction by sociodemographic characteristics. To meet the Healthy People 2030 target using the 4 approaches, added sugars intake needs to decrease by an average of (1) 13.7 calories/day for the general population; (2) 22.0 calories/day for people exceeding the Dietary Guidelines for Americans recommendation; (3) 56.6 calories/day for high consumers; or (4) 13.9 and 32.3 calories/day for people consuming 10 to <15% and ≥15% calories from added sugars, respectively. Differences in added sugars intake were observed before and after reduction by race/ethnicity, age, and income. The Healthy People 2030 added sugars target is achievable with modest reductions in added sugars intake, ranging from 14 to 57 calories/day depending on the approach.

How Well Do Low-PRAL Diets Fare in Comparison to the 2020-2025 Dietary Guidelines for Americans?

The regular consumption of net acid-producing diets can produce "acid stress" detrimental to human health. Alkalizing diets characterized by a negative potential renal acid load (also called low-PRAL diets (LPD)) enjoy uninterrupted popularity. However, the nutritional adequacy of said diets has rarely been assessed in large populations. Using data from the National Health and Nutrition Examination Surveys, we estimated nutrient intake in individuals consuming an LPD and contrasted the results in an age- and sex-specific manner to individuals on an acidifying diet (high-PRAL diet, HPD). Both groups were compared with the daily nutritional goals (DNG) specified in the 2020-2025 Dietary Guidelines for Americans (DGA). Our analysis included 29,683 individuals, including 7234 participants on an LPD and 22,449 participants on an HPD. Individuals on an LPD numerically met more nutritional goals than individuals on an HPD, yet both failed to meet the goals for several nutrients of public health concern (vitamin D and calcium). As opposed to individuals on an HPD, LPD consumers met the DGA recommendations for saturated fat and potassium. Individuals on an LPD consumed significantly more fiber than individuals on an HPD, as well as yielded a more favorable potassium-to-sodium intake ratio.

Children and Adolescents in the United States with Usual High Added Sugars Intake: Characteristics, Eating Occasions, and Top Sources, 2015-2018.

Background: High consumption of added sugars is related to adverse health consequences. Objective: The objective of this study was to examine characteristics of US youth who report high intakes of added sugars, as well as the eating occasions and top sources of added sugars that contributed to intakes among consumers with high added sugars intake. Design and participants/setting: We conducted a cross-sectional study using 2015−2018 NHANES data among 5280 US youths (2−19 years). Main outcome measures: Outcome measure was usual percent of calories from added sugars using 2 days of dietary recall based on the National Cancer Institute method. High consumers were defined as consuming greater than 15% of total daily calorie intake from added sugars (1.5 times higher than the 2020−2025 Dietary Guidelines for Americans recommendation of <10% of total daily calorie intake). Explanatory measures were selected sociodemographics (e.g., age, sex, race/ethnicity). Eating occasions were breakfast, lunch, dinner, and snack. Statistical analyses performed: We used t-tests to compare mean differences between sociodemographic groups. Results: Overall, 34% of US youths were classified as high consumers of added sugars. The prevalence of high consumers of added sugars significantly varied by some sociodemographics (i.e., age, race/ethnicity, and head of household’s education level). The prevalence of high added sugars consumers was significantly greater among 12−19-year-olds (41%) and 6−11-year-olds (37%) compared to 2−5-year-olds (19%), non-Hispanic Black (42%) and non-Hispanic White (42%) persons compared to Hispanic persons (19%), and those with a head of household’s education level of high school/some college (40%) compared to households with college degree or higher (29%). The prevalence of high consumers did not differ by sex, income, or weight status. Of eating occasions, the amount of added sugars youths consumed was highest during snack occasions among high consumers. Top five sources of added sugars among high consumers on a given day were sweetened beverages, sweet bakery products, candy, other desserts, and ready-to-eat cereals. Conclusion: One in three US youths consumed more than 15% of total calories from added sugars. High added sugars intake was more prevalent among certain subgroups such as 12−19-year-olds and non-Hispanic Black or non-Hispanic White youth. Our findings can provide information for intervention efforts to decrease added sugars intake to promote child health.

Consumption of Foods Away from Home Is Associated with Lower Diet Quality Among Adults Living in Puerto Rico.

Consuming foods away from home (FAFH) is ubiquitous, yet, it is unclear how it influences diet in diverse populations. The study aimed to evaluate the association between frequency and type of consumption of FAFH and diet quality. The study had a cross-sectional design. Participants self-reported the frequency of consuming FAFH as "rarely" (≤1 time per week) vs "frequently" (≥2 times per week) at various commercial establishments or noncommercial FAFH (ie, friends' or relatives' homes). Participants were adults (aged 30 through 75 years) from the PRADLAD (Puerto Rico Assessment of Diet, Lifestyle, and Diseases) study conducted in San Juan, Puerto Rico metro area (n= 239) in2015. A validated food frequency questionnaire captured dietary intake. The Alternate Healthy Eating Index-2010 defined diet quality. Secondary outcomes included whether participants met 2015-2020 Dietary Guidelines for Americans recommendations for sodium, added sugars, saturated fat, dietary fiber, total energy, and alcohol. Linear or logistic regression models adjusted for age, sex, employment, income, education, and food insufficiency tested differences in mean Alternate Healthy Eating Index-2010 scores or odds of meeting (vs not meeting) intake recommendations by FAFH type and frequency. Overall, 54.4% and 37.2% of participants reported consuming commercial FAFH and noncommercial FAFH "frequently," respectively. Consuming FAFH "frequently" (vs "rarely") was associated with lower mean Alternate Healthy Eating Index-2010 scores for both commercial FAFH (57.92 vs 63.58; P= .001) and noncommercial FAFH (56.22 vs 62.32; P < .001). Consuming commercial FAFH "frequently" (vs "rarely") at any type of food establishment was associated with lower odds of meeting the dietary fiber Dietary Reference Intakes (odds ratio 0.43; 95% CI 0.23 to 0.81). Consuming noncommercial FAFH "frequently" was associated with lower odds of meeting recommendations for sodium (odds ratio 0.30; 95% CI 0.11 to 0.79) and added sugars (odds ratio 0.41; 95% CI 0.18 to 0.93). Frequent consumption of FAFH is associated with lower diet quality and lower adherence to dietary recommendations in Puerto Rico. Future studies should explore whether diet quality can be improved by prioritizing healthy at-home meals and reformulating the quality of commercial FAFH.

Nutritional adequacy of meals and commissary items provided to individuals incarcerated in a southwest, rural county jail in the United States

BackgroundPoor diet may contribute to deleterious chronic health among individuals incarcerated. Yet, limited research has evaluated the nutritional content of menus and commissary items provided in jails. Thus, this study assessed the macronutrient distribution, caloric composition, and diet quality of the seven-day cycle menu and commissary items provided in a southwest, rural county jail in the United States.MethodsDaily and mean availability of calories and macronutrients for the seven-day cycle menu and commissary items were estimated using NutritionCalc Plus®. Diet quality (i.e., Healthy Eating Index-2015 [HEI-2015]) was assessed. Macronutrients and calories were compared to the Acceptable Macronutrient Distribution Range (AMDR) and the 2020–2025 Dietary Guidelines for Americans (DGA). Protein and carbohydrate were compared to the Dietary Reference Intake (DRI). HEI-2015 was compared to the average U.S. diet.ResultsDaily caloric provisions exceeded DGA recommendations. Daily available (16.2%-25.2% kcal/day) and mean protein met the AMDR recommendations, yet exceeded the DRI. Mean protein with commissary packs exceeded the AMDR recommendations and DRI. Daily available carbohydrate met AMDR recommendations for all but two days of the seven-day cycle menu, which exceeded recommendations (52.5%-66.4% kcal/day). Mean carbohydrate met the AMDR recommendations and exceeded the DRI, and with the commissary packs, exceeded the AMDR recommendations and DRI. Daily available total fat for the seven-day cycle menu (79.5–146.7 g), mean total fat alone and with the commissary packs exceeded AMDR recommendations. Daily available saturated fat for the seven-day cycle menu (16.7–47.7 g) exceeded AMDR recommendations for all but one day of the seven-day cycle menu, while mean saturated fat alone and with the commissary packs exceeded AMDR recommendations. Daily available added sugars for the seven-day cycle menu (8.4–14.2 g), mean added sugars alone and with the commissary packs all met AMDR recommendations. HEI-2015 scores for the seven-day cycle menu ranged from 49.3–74.5 (mean = 62.2, SD = 9.4), and increased with the commissary packs.ConclusionsExceeding caloric and saturated fat recommendations may contribute to weight gain, regardless of high diet quality. Increasing nutrient-dense foods available in jail may reduce chronic disease among incarcerated populations.

Association of nut consumption with CVD risk factors in young to middle-aged adults: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Background and aimsFew studies have examined long-term associations of walnut, other nut, and no nut consumption with cardiovascular disease (CVD) risk factors. Results from prospective studies with long-term follow-up can provide further evidence for dietary guideline messaging to consume nuts. Therefore, we examined the associations of walnut, other nut, and no nut consumption with diet quality and CVD risk factors over 30 years of follow-up. Methods and resultsData were analyzed from 3092 young adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Dietary intake, including walnuts and other nuts, was assessed 3 times over 20 years. CVD risk factors were measured at multiple exams. General linear regression evaluated the associations of walnut, other nut, and no nut consumption with CVD risk factors over 30 years (Y30) of follow-up. The 20-year cumulative mean intake of walnuts (0.74 oz/d), other nuts (1.6 oz/d), or no nut consumption was differentially associated with HEI-2015 and CVD risk factors by Y30. Generally, walnut consumers had significantly higher HEI-2015, lower body mass index, waist circumference, blood pressure, and triglyceride concentration, and gained less weight since baseline than other nut consumers (p ≤ 0.05 for all). Further, walnut consumers had lower fasting blood glucose than no nut consumers (p ≤ 0.05). ConclusionStudy findings that walnut and other nut consumption was associated with better CVD risk factors and diet quality aligns with the 2020–2025 US. Dietary Guidelines for Americans recommendation to consume nuts, such as walnuts, within the context of a healthy diet.

What Counts as a Drink? Understanding Standard Drink Equivalence and U.S. Dietary Guidelines for Alcohol

ObjectivesThe Dietary Guidelines for Americans recommends that adults who choose to consume alcohol do so in moderation, defined as up to 2 drinks/day for males and up to 1/day for females. The Dietary Guidelines defines a standard drink as containing 0.6 ounces of pure alcohol (ethanol). Today's beer, wine, and spirits products come in a range of containers with varying alcohol content, making it a challenge for consumers to know how many standard drinks they are consuming. Because food and nutrition communicators (e.g., dieticians, educators, media) are key sources of information for consumers, the objective was to learn about awareness and understanding of these topics among this group and to assess how a brief educational session improved knowledge and intentions.MethodsIn January 2022, participants completed an online survey (N = 29). They included registered dieticians, nutrition experts; food influencers/journalists; and health educators. A week later, they attended a 15-minute, in-person presentation on standard drinks and the Dietary Guidelines for alcohol. A week later, participants completed a follow-up survey (n = 27). Pre/post responses were compared.ResultsPrior to the presentation, 41% of participants considered the alcohol content of a beverage when they purchased or consumed it. After the presentation, that proportion more than doubled, with 93% saying they would think about alcohol content the next time they purchased or consumed it. At baseline, less than one-half (48%) knew that ethanol is the pure alcohol in all beverage alcohol, and slightly more than two-thirds (69%) knew the recommended daily limits of moderate alcohol consumption for males and females. At follow-up, 81% knew that ethanol is in all beverage alcohol, and 81% knew the recommendations for moderate consumption.ConclusionsKnowing the definitions of a standard drink and of moderation are essential aspects of responsible alcohol consumption, yet some food and nutrition experts lack this knowledge – as do many consumers. Given the important role they play in influencing consumer behavior, these findings underscore the importance of ‘educating the educators,’ when it comes to the U.S. Dietary Guidelines for alcohol.Funding SourcesThe authors received no financial support for the research or authorship of this presentation.

Incorporating the Dietary Guidelines for Americans Vegetable Recommendations into the Diet Alters Dietary Intake Patterns of Other Foods and Improves Diet Quality in Adults with Overweight and Obesity

BackgroundUnderstanding how vegetables are incorporated into the diet, especially in the types and amounts recommended by the Dietary Guidelines for Americans, and how this alters dietary intake patterns is vital for developing targeted behavior change interventions. ObjectiveTo determine how a provision of vegetables was incorporated into the diet of adults with overweight and obesity; whether or not the provided vegetables displaced other foods; and what, if any, effect this had on diet quality and body weight and composition. DesignThis study investigated secondary outcomes from the Motivating Value of Vegetables Study, a community-based, randomized, parallel, nonblinded controlled trial. Participants were randomly assigned to a provided vegetable intervention or attention control group using a one to one allocation ratio. Participants/settingMen and women with self-reported low vegetable consumption, aged 18 to 65 years, with a body mass index ≥25 were recruited from Grand Forks, ND, between October 2015 and September 2017. Only participants randomized to the provided vegetable intervention group (n = 51; attrition = 8%) were included in this secondary analysis. InterventionDietary Guidelines for Americans recommended types and amounts of vegetables were provided weekly for 8 weeks. Main outcome measuresHow the provided vegetables were incorporated into the diet was measured using daily self-report and 24-hour dietary recalls. Diet quality was assessed via the Healthy Eating Index 2015. Body weight and composition were measured before and after the intervention. Statistical analyses performedData were assessed using generalized linear mixed models where phase (pre, post) was the within-subject factor and subject was the random effect. ResultsParticipants self-reported using 29% of the provided vegetables as substitutes for other foods. With the increase in vegetable consumption, there were decreases in total grains (mean difference ± standard deviation; –0.97 ± 3.23 oz-equivalents; P = 0.02), protein foods (–1.24 ± 3.86 oz-equivalents; P = 0.01), saturated fats (–6.44 ± 19.63 g; P = 0.02), and added sugars (–2.44 ± 6.78 tsp-equivalents; P = 0.02) consumed. Total Healthy Eating Index 2015 scores increased (+4.48 ± 9.63; P = 0.001) and dietary energy density decreased (–0.44 ± 0.52 kcal/g; P < 0.0001). There was no change in total energy intake or body weight and composition. ConclusionsIncreasing vegetable consumption to meet Dietary Guidelines for Americans recommendations alters dietary intake patterns, improving diet quality and energy density. These findings highlight the importance of characterizing how individuals incorporate Dietary Guidelines for Americans recommendations into their diet.

Flax and Sorghum: Multi-Element Contents and Nutritional Values within 210 Varieties and Potential Selection for Future Climates to Sustain Food Security.

The Dietary Guidelines for Americans recommends giving priority to nutrient-dense foods while decreasing energy-dense foods. Although both flax (Linum usitatissimum) and sorghum (Sorghum bicolor) are rich in various essential minerals, their ionomes have yet to be investigated. Furthermore, previous studies have shown that elevated CO2 levels could reduce key nutrients in crops. In this study, we analyzed 102 flax and 108 sorghum varieties to investigate their ionomic variations (N, P, K, Ca, Mg, S, B, Zn, Mn, Fe, Cu, and Mo), elemental level interactions, and nutritional value. The results showed substantial genetic variations and elemental correlations in flax and sorghum. While a serving size of 28 g of flax delivers 37% daily value (DV) of Cu, 31% of Mn, 28% of Mg, and 19% of Zn, sorghum delivers 24% of Mn, 16% of Cu, 11% of Mg, and 10% of Zn of the recommended daily value (DV). We identified a set of promising flax and sorghum varieties with superior seed mineral composition that could complement breeding programs for improving the nutritional quality of flax and sorghum. Overall, we demonstrate additional minerals data and their corresponding health and food security benefits within flax and sorghum that could be considered by consumers and breeding programs to facilitate improving seed nutritional content and to help mitigate human malnutrition as well as the effects of rising CO2 stress.

Trends in Added Sugars Intake and Sources Among US Children, Adolescents, and Teens Using NHANES 2001–2018

BackgroundOver the past 2 decades, there has been an increased emphasis on added sugars intake in the Dietary Guidelines for Americans (DGA), which has been accompanied by policies and interventions aimed at reducing intake, particularly among children, adolescents, and teens. ObjectivesThe present study provides a comprehensive time-trends analysis of added sugars intakes and contributing sources in the diets of US children, adolescents, and teens (2–18 years) from 2001–2018, focusing on variations according to sociodemographic factors (age, sex, race and ethnicity, income), food assistance, and health-related factors (physical activity level, body weight status). MethodsData from 9 consecutive 2-year cycles of the NHANES were combined and regression analyses were conducted to test for trends in added sugars intake and sources from 2001–2018 for the overall age group (2–18 years) and for 2 age subgroups (2–8 and 9–18 years). Trends were also examined on subsamples stratified by sex, race and ethnicity (Hispanic, non-Hispanic Asian, non-Hispanic Black, non-Hispanic White), income (household poverty income ratio), food assistance, physical activity level, and body weight status. ResultsFrom 2001–2018, added sugars intakes decreased significantly (P < 0.01), from 15.6% to 12.6% kcal among children (2–8 years) and from 18.4% to 14.3% kcal among adolescents and teens (9–18 years), mainly due to significant declines in added sugars from sweetened beverages, which remained the top source. Declines in added sugars intakes were observed for all strata, albeit to varying degrees. ConclusionsDeclines in added sugars intakes were observed among children, adolescents, and teens from 2001–2018, regardless of sociodemographic factors, food assistance, physical activity level, or body weight status, but variations in the magnitudes of decline suggest persistent disparities related to race and ethnicity and to income. Despite these declines, intakes remain above the DGA recommendation; thus, continued monitoring is warranted.

The Need to Incorporate Diversity, Equity, and Inclusion: Reflections from a National Initiative Measuring Fruit and Vegetable Intake

The Need to Incorporate Diversity, Equity, and Inclusion: Reflections from a National Initiative Measuring Fruit and Vegetable Intake

Diet Quality in the United States Improved during the Great Recession and Deteriorated During Economic Recovery

BackgroundMacroeconomic changes are associated with population health outcomes, such as mortality, accidents, and alcohol use. Diet quality is a risk or protective factor that could be influenced by economic conditions. ObjectiveThis study examined the trajectory of diet quality measured by the Healthy Eating Index 2015 before, during, and after the 2008-2009 Great Recession. DesignRepeated cross-sectional survey data from the National Health and Nutrition Examination Survey were analyzed. Participants/settingThe analytic sample included 48,679 adults who completed at least one dietary recall from National Health and Nutrition Examination Survey 1999-2018. Main outcome measuresDiet quality was assessed with a 24-hour dietary recall to calculate the Healthy Eating Index 2015 total scores, a measure of the conformance with the 2015-2020 Dietary Guidelines for Americans. Statistical analyses performedLeast squares regression was used to adjust for demographic changes across waves. ResultsDiet quality improved noticeably during the Great Recession and deteriorated as economic conditions improved. ConclusionsDeteriorating economic circumstances may constrain choices, but that does not necessarily imply a worsening of dietary quality. During the Great Recession, American diets became more consistent with Dietary Guidelines for Americans recommendations, possibly because of a shift toward food prepared at home instead of prepared food bought away from home.

Implementing the 2020-2025 Dietary Guidelines for Americans: Recommendations for a path forward.

The Dietary Guidelines for Americans (DGA) provide science-based recommendations for healthy dietary patterns to promote health and reduce risk of chronic diseases. Yet, since their inception in 1980 and updates every 5 years, Americans fall short of meeting dietary recommendations and diet-related chronic diseases continue to be a public health concern. In May of 2021, the Institute of Food Technologists and the Department of Food Science at the University of Massachusetts, Amherst, convened a diverse group of thought leaders in health, nutrition, and food science to identify opportunities and approaches to improve consumer adoption of the DGA recommendations. The invited leaders collaborated in roundtable discussions to develop recommendations and strategies to promote adoption of the DGA recommendations after hearing sessions on the latest consumer trends, advances in food science and technology, and effective communications approaches. Participants agreed that changes in consumer behaviors and heightened interest in health due to the novel coronavirus pandemic have created an opportune time to engage consumers about healthy eating. Communications must be simple, tailored to the consumer, and delivered by influencer(s)/spokesperson(s) who are credible sources and share personal values. Innovations in food science and technology have enabled improvements in the safety, health, acceptability, affordability, and availability of foods but opportunities to provide more options to enhance consumption of desired food groups, such as fruits, vegetables, and whole grains, remain. Moving Americans toward healthier dietary patterns aligned with DGA recommendations will require collaborations within the food sector and beyond to achieve broad scale amplification and investment.

Implementing the 2020-2025 Dietary Guidelines for Americans: Recommendations for a Path Forward.

ABSTRACTThe Dietary Guidelines for Americans (DGA) provide science-based recommendations for healthy dietary patterns to promote health and reduce risk of chronic diseases. Yet, since their inception in 1980 and updates every 5 y, Americans fall short of meeting dietary recommendations and diet-related chronic diseases continue to be a public health concern. In May of 2021, the Institute of Food Technologists and the Department of Food Science at the University of Massachusetts, Amherst, convened a diverse group of thought leaders in health, nutrition, and food science to identify opportunities and approaches to improve consumer adoption of the DGA recommendations. The invited leaders collaborated in roundtable discussions to develop recommendations and strategies to promote adoption of the DGA recommendations after hearing sessions on the latest consumer trends, advances in food science and technology, and effective communications approaches. Participants agreed that changes in consumer behaviors and heightened interest in health due to the novel coronavirus pandemic have created an opportune time to engage consumers about healthy eating. Communications must be simple, tailored to the consumer, and delivered by influencer(s)/spokesperson(s) who are credible sources and share personal values. Innovations in food science and technology have enabled improvements in the safety, health, acceptability, affordability, and availability of foods, but opportunities to provide more options to enhance consumption of desired food groups, such as fruits, vegetables, and whole grains, remain. Moving Americans toward healthier dietary patterns aligned with DGA recommendations will require collaborations within the food sector and beyond to achieve broad-scale amplification and investment.

Consumption of Dietary Guidelines for Americans Types and Amounts of Vegetables Increases Mean Subjective Happiness Scale Scores: A Randomized Controlled Trial

BackgroundThe health benefits of diets rich in fruits and vegetables (FV) are well established. Recent observational and intervention research suggests that FV consumption may also exert a positive effect on psychological well-being. ObjectiveThis study aimed to assess changes in mean Subjective Happiness Scale (SHS) scores in response to consuming 2010-2015 Dietary Guidelines for Americans (DGA) recommended types and amounts of vegetables. It was hypothesized that increased vegetable consumption would increase mean SHS scores. DesignThis study investigated a secondary outcome of a randomized, parallel, nonblinded controlled trial with a 1:1 allocation ratio to a provided vegetable intervention or attention control group. Participants/settingMen and women (n = 75) aged 18 to 65 years, body mass index ≥ 25, with low habitual vegetable consumption were recruited from Grand Forks, North Dakota, December 2016 to January 2018, for this community-based study. InterventionThe vegetable intervention consisted of an 8-week feeding phase during which participants were provided with vegetables in DGA-recommended types and amounts. The attention control group was not provided vegetables but completed the same testing schedule as the vegetable intervention group. Main outcome measureMean SHS scores were assessed before and after the intervention. Statistical analysesMean SHS scores were analyzed using a 2-way factorial mixed linear model analysis of variance. ResultsA significant interaction between treatment and visit (P = .015) revealed greater mean SHS scores at week 8 than at baseline in the vegetable intervention group (+0.23 ± 0.11) (mean difference ± SE of the difference) but no change in the attention control group (−0.15 ± 0.11). ConclusionsGreater mean SHS scores were observed after increasing vegetable consumption to meet DGA recommendations, suggesting that adhering to DGA vegetable guidance may help promote psychological well-being.

Physiological Limitations of Protein Foods Ounce Equivalents and the Underappreciated Role of Essential Amino Acid Density in Healthy Dietary Patterns

Protein quality is an important component of protein intake to support growth, development, and maintenance of essential body tissues and functions. Therefore, protein quality should be emphasized as a key characteristic during protein food selection within the larger context of healthy dietary patterns, especially when considering the wide variance of protein quality across animal- and plant-based foods. However, the USDA Dietary Guidelines for Americans (DGA) do not address specific protein quality recommendations within their protein foods ounce equivalents guidance or as a component of Healthy U.S. Style, Healthy Vegetarian, and Healthy Mediterranean Style dietary patterns. In addition, the protein foods ounce equivalents within the DGA are not established on any obvious metabolic equivalency characteristic [i.e., energy, protein, or essential amino acid (EAA) content], which creates misleading messaging of equivalent functional and metabolic benefit across protein foods. EAA content is a key characteristic of protein quality and can be a practical focal point for protein intake recommendations and achieving healthy dietary patterns. This review discusses the importance of protein quality, the state of messaging within DGA recommendations, and proposes EAA density (i.e., EAA content relative to total energy) as one practical approach to improve current dietary recommendations. Two recent publications that evaluated the DGA protein foods ounce equivalents based on metabolic effect and their application within DGA recommended dietary patterns are discussed.