Diet and Health Implications for Reducing Chronic Disease Risk (1989) / Chapter Skim
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3 Dietary Intake and Nutritional Status: Trends and Assessment
3 Dietary Intake and Nutritional Status: Trends and Assessment
Pages 41-84
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From page 41... ...
The high-meat diet resulted in a high protein intake, but dietary fat was relatively low and contained more polyunsaturated fats than saturated fats. The intake of cholesterol, dietary fiber, calcium, and ascorbic acid is believed tO have been high, but sodium intake was remarkably low.
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From page 42... ...
NATIONAL SURVEYS OF DIETARY INTAKE AND NUTRITIONAL STATUS Surveys Conducted by the U.S. Department of Agriculture {USDA} The Food Supply: Histonca]
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From page 43... ...
Revisions to the list of food items have been described by Pennington (1983~. An example of findings from the Total Diet Study was the observation that iodine was present in the food supply in larger than-recommended amounts, chiefly because of a higher-than-usual iodine content of milk and cereal grain products (Park et al., 1981~.
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From page 44... ...
Weighting factors were applied to make the sample more representative; however, in the absence of studies to determine the bias of nonresponders, the extent to which the 1977 The Centers for Disease Control (CDC) contribute to nutrition monitoring through CSSS, in which the nutritional status of the high-risk pediamc population and pregnant women is monitored on the basis of information obtained from service delivery programs operated by selected state and metropolitan health jurisdictions.
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From page 45... ...
These differ ences lie chiefly, but not exclusively, in methods of a estimating dietary intake, food composition data used to estimate nutrient intake, and standards used for determining dietary adequacy. Methods of Estimating Dietary Intake The 1-day (,4-hour)
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From page 46... ...
The nutrients and dietary fiber reported by the major national surveys are shown in Table 3-~. The major repository of nutrient composition data for individual foods in the United States is USDA's Nutrient Data Bank (NDB)
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From page 47... ...
'Nationwide Food Consumption Survey (USDA, 19841. ~Continuing Survey of Food Intakes of Individuals (USDA, 1985, 1986b)
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From page 48... ...
. Because data were inadequate in 1980 to set RDAs for other nutrients, ranges of Estimated Safe and Adequate Daily Dietary Intakes (ESADDI)
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From page 49... ...
. In theory, optimal nutritional status should be attained by consuming sufficient, but not excessive, sources of energy, essential nutrients, and other food components (such as dietary fiber)
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From page 50... ...
The success of this method will depend on development of more accurate estimates of the mean requirement for each nutrient and its variability in the population, as well as the improvement of methods of assessing dietary intakes. Analogous conceptual approaches may be used for biochemical assess' ment of nutritional status (Beaton, 1986~.
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From page 51... ...
Assessment NHANES is the only national survey providing information on the nutritional status of the popu' ration. Four types of NHANES data are of importance in studies of diet and health: dietary intake, to determine kind and amount of food consumed and its nutrient quality; anthropometry, to describe growth and body weight pattems; biochemical tests, to determine nutrient levels in blood and urine; and clinical examinations, to detect signs of nutritional problems.
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From page 52... ...
A discussion of these changes, below, is based on historical food supply data, results from NFCS and NHANES, and other sources. Food Energy Total caloric intake is of interest in epidemiologic studies not only because of its association with body weight, but also because of implications that it may be involved in the relationship between nutrients and chronic diseases.
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From page 53... ...
Another possible explanation of the observed difference in caloric intake is that ponion sizes were underestimated on the records or that the requirement to record intake resulted in mocliEcation of usual eating patterns (see Chapter 2~. In the 1977-1978 NFCS, the average daily food energy intake for all survey participants was estimated to be 1,826 kcal based on a 3-day intake.
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From page 54... ...
In 1985' linoleic acid in the food supply accounted for 7% of total calories, oleic acid for 17%, and saturated fatty acids for 15% (Figure 3~. Changes since 1909 resulted in a large increase in the percentage of total fat calories from linoleic acid and a decline in the percentage of fat calories from saturated fatty acids (Figure 3-7~.
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From page 55... ...
Dietary Food Sources of Fat Changes in levels of specific fatty acids in the food supply can be attributed to several changes in the availability of foods. The increase in linoleic acid supplies was due chiefly to the remarkable increase in the use of salad and cooking oils from 2 to 25 Ib per capita from 1909 to 1985 (Table 3-5~.
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From page 56... ...
10 _ ~ _ I I 1 1 ~1 , 1 190 ~193~ 1~7- 1957- 1~7- 1980 19 1913 1939 1949 1959 1~9 YEARS FIGURE `5 Trends in per-capita intake of oleic acid, saturated fatty acids, and linoleic acid in the U.S. food supply from 1909-1913 to 1985.
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From page 57... ...
. 1909-1967- 1909-1967 Foods191319691985 Foods191319691985 Meat, poultry, and fish Vegetables Beef548179 Tomatoes463638 Pork626162 Dark green and342531 Poultry184670 yellow" Fish121519 Other Totals171221224 Fresh1368796 Eggs374032 Processed113529 Total227183194 Dairy products Whole milk223232122 Potatoes, white Low-fat milk6444112 Fresh1826155 Cheese'51526 Processed01528 Others2810086 Totals1828283 Total'339440450 Dry beans, peas,161618 Fats and oils nuts, and soybeans Butter1865 Grain products Margarine11011 Wheat products216116122 Shortening81623 Com products56157 Lard and beef tallow1254 Other grains191326 Salad and cooking oil21625 Total291144155 Totalf415467 Sugar and sweeteners Fruits Refined sugar7710063 Citrus176072 Syrups and other142290 Noncitrus sweeteners Fresh1547387 Total91122153 Processed83534 Total179168193 Miscellaneousi101714 aBased on unpublished data from R
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From page 58... ...
The average daily consumption of bans fatty acids was estimated to be 3.1 g (6.~% of total fatty acids)
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From page 59... ...
Dietary Sources of Carbohydrates The 1977-1978 NFCS data indicate that grain products provide more carbohydrates than other food groups. Grain products include cereals and
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From page 60... ...
The sweets group contributed only half the amount of carbohydrates supplied by either fruits or vegetables, but sugars are added to foQ6s in the grain products, fruit, and beverage groups (Figure 3~. Beverages and fnJits contribute similar proportions to carbohydrate intake.
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From page 61... ...
On the other hand, N HAN ES I! data indicated that on the day surveyed, a higher proportion of the population consumed alcohol and in larger amounts than were reported by the 1977-1978 NFCS.
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From page 62... ...
The chief difficulty in relating dietary fiber to the occurrence of chronic diseases in populations is the paucity of data on the amount and kinds of dietary fiber in foods. Until the recent past, data were available in food composition tables only for "crude fiber" the residue resulting after foods are treated with acids and alkalies.
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From page 63... ...
The Total Diet Study is the only national study at present that includes all those pills iodine, manganese, selenium, and chromium. Table 3-10 summarizes information about minerals, including the 1980 RDAs, major food sources, availability in the food supply, intakes by survey populations, and nutritional status.
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From page 64... ...
Intakes were highest in the western intake; milk and region and lowest in the South.e grain products ~NMEC concluded that the vitamin A furnished about intake and nutritional status of the U.S. 15% each.e population appear to be adequate but that public health monitoring should continue.
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From page 65... ...
Health indicators of thiamin status were not available from national surveys.f Me availability of riboflavin in the food supply has increased since 1909-1913 chiefly because of the enrichment of grain products (Table 3-3~. In the 1985 CSFII, the mean intake for children 1 to 5 years old was I
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From page 66... ...
Health indicators of nutritional status have not been obtained in national surveys.f Preformed niacin: meats, poultry, fish; whole and enriched grain products; legumes; nuts. In addition, some of the tryptophan present in meats, poultry, fish, cheese, legumes, and seeds can be converted in the body to niacin.
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From page 67... ...
Dietary intakes were positively associated with economic status and were highest in the northeastern region.8 In the 1977-1978 NFCS, among all age and sex groups, 67% consumed 100% or more of the RDA. Intakes were higher for males than for females and were higher generally for young adults than for older people.e JNMEC concluded that vitamin BY intake is adequate.
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From page 68... ...
DIET AND HEALTH Major Food Sources Food Supply, Intakes, and Nutritional Status Pregnant women, +20 mg Lactating women, +40 mg NFCS indicated men 19 to 50 years old, 104 mg.& In the that 73% of the 1977-1978 NFCS, the mean intake (82 vitamin C intake mg/day) for the entire survey population was came from Suits above the RDA.
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From page 69... ...
In the 1977-1918 NFCS, 50% of the calcium intake came from milk and milk products, and 22% from grain products (which contain milk and milk products)
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From page 70... ...
In the 1977-1978 NFCS, milk products and meat, poultry, and fish each contributed 29% of the intake; grain products contributed 20%. Infants, 5~70 mg Children 1-10 years, 15~250 me Males 11-14 years, 350 me Males 1~18 years, 400 mg Males 19->51 years, 350 mg Females 11->51 years, 300 mg Pregnant women, + 150 mg Lactating women, + 150 mg infants, I~15 me Children 1-3 years, 15 me Children 010 years, 10 me Children 11-18 years, 18 me Green vegetables (chlorophyll contains magnesium)
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From page 71... ...
The biologic availability of zinc depends on the food source and the presence of other food components in the diet. Zinc from animal foods is more Food Supply, Intakes, and Nutritional Status In the 1985 CSFII, the mean daily intake for children 1 to 5 years old was 9.
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From page 72... ...
In the Total Diet Study, highest daily intakes were 1.18 me for boys 14 to 15 years old, 1. 24 me for men 25 to 30 years old, and 1.17 mg for men 60 to 65 years old.
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From page 73... ...
This survey underestimated sodium intake for the same reason as did the CSFII (above) .' JNMEC found that dietary intakes of sodium appeared to be high, particularly since surveys underestimate intakes.
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From page 74... ...
The iodine content of foods purchased in grocery stores between 1982 and 1984 was sufficient to provide dietary intakes markedly higher than the iodine RDA for all ag~sex groups. For example, infants 6 to 11 months of age consumed 400%, 2-year-olds, 657%, and boys 14 to 16 years old, 473% of the RDA for iodine.
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From page 75... ...
used food consumption data from the 1977-1978 NFCS to study the effect of enriched and fortified grain products on nutrient intake. Enrichment and fortification of grain products were found to provide 32, IS, 20, and 19% of the total intakes of thiamin, riboflavin, niacin, and iron, respectively (Cook and Welsh, 1987~.
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From page 76... ...
whole-grain products, wholewheat bread, fresh vegetables and fruits, raw nuts, wheat germ, brown rice, honey, yogurt, dried Emit, brewer's yeast, and seeds (Wolfs, 1973~. Their chief reason for adhering to their alternative diet was that they believed it to be healthier.
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From page 77... ...
thiamin. Nonvegetarians had higher mean intakes of protein and preformed niacin, but these nutrients still met or exceeded the RDA in vegetarian diets.
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From page 78... ...
78 1 rat :` Ct C)
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From page 80... ...
Saturated and monounsaturated fatty acids provide the highest percentage of calories from fat in the food supply, although the availability of polyunsaturated fatty acids greatly increased over the years due to wider use of on's and margarines. Compared to 1909-1913, the food supply in 1985 famished larger amounts of beef, poultry, fish, dairy products, fats, on's, fruits, sugars, and sweet
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From page 81... ...
The first report, issued in 1986, provides food intake data from the 1977-1978 NFCS and information on nutritional status based on biochemical analyses from NHANES II (1976-1980~. ~NMEC concluded that food components deserving high-prioriry monitoring status because of high consumption by a considerable portion of the population include food energy, total fats, saturated fat, cholesterol, sodium, and alcohol.
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From page 82... ...
1986. Toward harmonization of dietary, biochemical, and clinical assessments: the meanings of nutritional status and requirements.
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From page 83... ...
1984b. Assessment of the Iron Nutritional Status of the U S
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From page 84... ...
85~3. Nutrition Monitoring Division, Human Nutrition Information Service, Hyattsville, Md.
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