Nutrition and Your Health: |
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*See report on increasing fish consumption for new fish item groups now being used in analyses. †Equal to approximately 0.27 ounces of nuts, or 0.38 tbsp of peanut butter. A separate nutrient profile had been previously developed for each subgroup in the MPFEN group and for legumes. Addendum A shows these nutrient profiles. To determine appropriate amounts of eggs, nuts, and legumes to use in the vegetarian pattern, nutrient differences among these foods were examined. Nuts and legumes contain more calories per ounce equivalent than meat, poultry, or fish. The weighted average number of calories in each is 210 per 1-oz. eq. of nuts, 113 per 1-oz. eq. of legumes, 51 per oz. of meat, 53 per oz. of poultry, and 39 per oz. of fish. To develop isocaloric food intake patterns, the differences in energy levels were compensated for by decreasing overall amounts, including fewer ounce equivalents than are in the original MPFEN patterns. Amounts were decreased iteratively to lower caloric levels, using varying proportions from eggs, nuts, and legumes, until a nutrient intake level became marginal in at least one pattern. Because so many nutrients are provided in amounts above the recommended standards, it was possible to meet most nutrient needs with lower intakes of eggs, nuts, and legumes, and come close to an isocaloric food pattern. Also, iron, a limiting nutrient, is provided in high amounts by legumes. (See # 4 below for a discussion of absorbed iron intakes.) The percentages and amounts below represent the amounts of eggs, nuts, and legumes substituted for the MPFEN pattern. Since amounts of each were decreased to maintain isocaloric food patterns, the total percentages (seen in Table G2-2) do not total to 100 percent, and the amounts in the 5-oz. eq. daily food pattern do not total to 5 ounces. This was done so that the percentages and ounce equivalents in this table could be directly compared with Table G2-1.
*Equal to approximately 1.2 ounces of nuts or 1.6 tbsp. of peanut butter. †Equals about 0.58 cups of cooked legumes. Total legumes, including amounts recommended in the vegetable group, are about 1 cup. The proposed vegetarian ENL group differs somewhat from the original MPFEN group in nutrient content. Table G2-3 summarizes the differences in the ENL group from the original MPFEN group in absolute terms, based on an assumed intake level of 5-oz eq. per day. Actual nutrient levels in the original MPFEN group and in the ENL group are found in Addendum A.
*Does not account for differences in absorption (see # 4). As illustrated in Table G2-3, there was a 36-calorie-per-day increase in the energy content of the vegetarian ENL group, compared with the original MPFEN group, in food patterns, including 5-oz. eq. from the group per day. This was due to the amounts of nuts and legumes, which have higher calorie-to-protein ratios than animal-based protein sources. (Addendum A provides a comparison of all nutrients in per oz. eq. of these foods.) To maintain isocaloric patterns, vegetarian food patterns could be modified by slightly adjusting the amounts of added sugars, solid fats, and oils. This modification was not completed since the difference was small (from about 14 calories in the 1,000 calorie pattern to about 50 calories in the 3,200 calorie pattern). Differences in the amounts of protein, niacin, zinc, and vitamin B12 that could have an impact on nutrient adequacy were also noted. Adequacy of these nutrients was evaluated in all patterns, as reported below.
*Based on energy-adjusted standards for potassium. In addition to iron, the other nutrient that became limiting as amounts of eggs, nuts, and legumes were adjusted was niacin. Poultry and fish are especially rich in niacin, and nuts are also a rich source but at a higher calorie "cost". Amounts in all patterns decreased substantially, with amounts in the 1,600-calorie pattern just above the RDA in the final iteration.Amounts of vitamin B12 also dropped dramatically, but all levels remained above the RDA. For vitamin E, the higher levels found in nuts made a substantial increase in the amounts in each pattern. Patterns at or above 2,800 calories met the RDA for vitamin E. Other interesting changes in the patterns included the following:
DiscussionThe nutrient profile for legumes includes tofu, though in relatively small amounts. If vegetarians select more tofu and other soy-based meat analogs as part of their legume choices, the fiber content of the diet could be slightly lower, and other nutrients could be altered as well. ADDENDUM A: NUTRIENT PROFILES OF THE MPFEN AND ENL GROUPS AND THEIR COMPONENT FOODS ADDENDUM B: PROTEIN IN VEGETARIAN DIETSSeveral points regarding protein and amino acids in vegetarian diets follow:
PROTEIN
ESSENTIAL AMINO ACIDS
COMPLEMENTARY PROTEINS
REFERENCESPosition of the American Dietetic Association and the Dietitians of Canada: Vegetarian diets. J Am Diet Assoc. 2003;103:748-765.IOM. Dietary Reference Intakes: Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC. 2002. Vegetarian Resource Group. Protein in the vegan diet. http://www.vrg.org/nutrition/protein.htm. Accessed May 4, 2004 ALTERNATIVES FOR ENRICHED GRAINS IN FOOD INTAKE
PATTERNS
|
Folate | 25 percent |
Iron | 24 percent |
Calcium | 9 percent |
Magnesium | 8 percent |
Copper | 12 percent |
Dietary Fiber | 10 percent |
Enriched grains also supply 27 percent of the thiamin, 16 percent of the riboflavin, and 20 percent of the niacin in the food pattern, although these nutrients are provided in the overall pattern at levels well above requirements. Enriched grains also supply 17 percent of the calories and 22 percent of the carbohydrate in this food pattern.
Shortfalls If Enriched Grains (But Not Whole Grains) Are Omitted From the Food Patterns: Some of the nutrients mentioned above are supplied in amounts well above the nutrient's goal level. However, there are some nutrient shortfalls if enriched grains are not included in the patterns (while keeping the whole grains recommendations as proposed).
The food subgroups that would provide the most similar mix of nutrients to make up these shortfalls are additional whole grains, legumes, and dark green vegetables. For these groups, recommendations in the food patterns are already much higher than reported consumption (see attached Table G2-9). Further increases in the recommendations for these food subgroups would move the food patterns even farther away from what Americans now eat. Potential substitution of these foods for enriched grains in the patterns is discussed further in item 3 below.
The specific shortfalls due to removal of enriched grains from the patterns (keeping whole grains), without replacement from other food groups, are listed below. Resulting amounts that are <95 percent of the nutritional goal are included.
Nutrient | Food Pattern | Age-Sex Group (sedentary) | Existing Proposed Patterns—Amount in Pattern as % of Nutritional Goal | Without Enriched Grains—Amount in Pattern as % of Nutritional Goal |
---|---|---|---|---|
Folate | 1600 (3m) | F 51+ | 103% | 79% |
1800 (2m) | F31-50 | 117% | 89% | |
1800 (3m) | F14-18 | 120% | 92% | |
Calcium | 1600 (3m) | F 9-13 | 93% | 87% |
1800 (2m) | F31-50 | 97% | 88% | |
1800 (3m) | M 9-13, F 14-18 | 98% | 91% | |
2000 (2m) | F19-30 | 101% | 91% | |
2200 (2m) | M 31-50 | 104% | 92% | |
2200 (3m) | M14-18 | 103% | 94% | |
Magnesium | 2000 (3m) | M 51+ | 97% | 90% |
2200 (2m) | M31-50 | 95% | 87% | |
Iron | 1000 (2m) | M/F 2-3 | 103% | 78% |
1200 (2m) | F 4-8 | 100% | 76% | |
1400 (2m) | M 4-8 | 121% | 91% | |
1800 (2m) | F31-50 | 97% | 74% | |
1800 (3m) | F 14-18 | 117% | 90% | |
2000 (2m) | F19-30 | 108% | 82% | |
Fiber | 1000 (2m) | M/F 2-3 | 88% | 81% |
1200 (2m) | F 4-8 | 100% | 91% | |
1400 (2m) | M 4-8 | 100% | 91% | |
2200 (2m) | M31-50 | 102% | 93% | |
2200 (3m) | M 14-18 | 102% | 93% |
Separation of Whole Grains From Enriched Grains Within Foods: The process of assigning food group and subgroup servings to individual foods "decomposes" mixed foods into their various parts. This approach helps to accurately assign servings from each food group and subgroup to the many mixed dishes that are eaten. Food items that contain grains are assigned to either or both the whole grain and enriched grain subgroups. This means that the many grain products made of both whole and enriched grains—including many breads and ready-to-eat cereals—are calculated as part whole and part enriched grain.
In practice, when a person selects a mixed grain bread or cereal, he gets
both a whole grain portion and an enriched grain portion. Because of the desirable
baking properties of enriched flour, these mixed grain products are often appealing
to consumers who do not choose to eat 100 percent whole grains. For example,
the most commonly eaten foods containing "whole grains" and the whole grains
and enriched grains servings contained in 100 grams of the food are listed
below. These food items make up about 70 percent of all the whole grains consumed
by Americans according to the CSFII 1994–1996 food consumption survey.
Food (in order of the number of individuals reporting it in the CSFII 1994–1996 survey) | Approx. Whole Grain Servings per 100 g* |
Approx. Enriched Grain Servings per 100 g* |
---|---|---|
100% whole wheat bread | 3.4 | 0.1 |
Tortilla chips and corn chips | 4.8 | 0.0 |
Popcorn | 4.0 | 0.0 |
Pancakes | 0.3 | 2.2 |
Oatmeal | 0.8 | 0.0 |
Wheat bread/cracked wheat bread | 1.3 | 2.7 |
Whole wheat bread (not 100%) | 1.2 | 2.6 |
Multigrain/mixed grain breads | 2.2 | 1.6 |
Rye and pumpernickel breads | 1.4 | 2.4 |
Cheerios | 3.3 | 0.1 |
Oatmeal cookies | 0.9 | 0.3 |
Raisin bran cereal | 1.8 | 0.8 |
Graham crackers | 0.9 | 3.5 |
Granola bars | 2.9 | 0.0 |
Bagels—not 100% whole wheat | 0.9 | 2.6 |
Wheat crackers | 2.5 | 2.6 |
Wheat/cracked wheat rolls | 1.2 | 2.3 |
*Note: Whole and enriched grain servings per 100 grams are from the ARS Pyramid Servings Database that was developed for and is used in analysis of national food consumption surveys.
These sample choices demonstrate the types of foods that consumers most often select that include at least some whole grains. While many are not entirely whole grains, they provide some whole grains in the diets of those who might not otherwise select any. The proposed Pyramid food patterns suggest that half of all grain servings be whole grains. This approach allows these mixed products to fit readily into a person's food choices.
Pyramid food patterns are designed to meet nutritional goals with the minimum necessary change from typical American food choices. All nutritional goals (with the exception of vitamin E) can be met with the amounts of enriched grains in the proposed patterns, which are approximately 40 to 75 percent of average enriched grain consumption. Replacement of the enriched grains in the food patterns with whole grains does not compromise the nutritional integrity of the patterns. However, it does violate the premise that changes from typical consumption patterns will be made only if needed to meet nutritional goals and makes the Pyramid less practical for many to follow, given the popularity of many mixed grain food products.
Some consumers, though, may not want to consume as many enriched grains
as are included in the food patterns. We want to provide flexibility of choice
where possible. A sensible approach to increase choice within grains might
be to state that "at least half of the total amount of grains selected should
be whole grains." This statement would allow consumers to select only whole
grains if they wished and still follow the Pyramid food patterns. In educational
materials, examples of food products that are whole grains, mixed whole and
enriched grains, and enriched grains could help clarify how consumers can
follow the Pyramid while selecting foods of their choice.
Is it possible to offer more flexibility in food patterns for those who do not want to consume legumes by identifying alternative foods that will make up for nutrient shortfalls in the proposed patterns with no legumes?
Legumes provide a broad array of vitamins, minerals, and macronutrients. The most commonly consumed legumes are pinto beans, white beans, kidney beans, tofu, black beans, lentils, chickpeas, cowpeas, split peas, and lima beans. Because of their rich mix of nutrients, the amounts of legumes recommended in the proposed food intake patterns were increased above current consumption. However, recommended intakes are still fairly small in relation to other food groups. Therefore, for any given nutrient, the percent of total intake provided by legumes is modest. Table G2-10 provides information on current consumption levels and proposed recommendations for legume intake as background for this analysis.
Note that the recommended increase in legume intake is large when expressed as a percentage of current consumption but modest in actual amount. For adults, the increase ranges from about ¼ cup (0.56 servings) to less than ½ cup (0.92 servings) per day.
*Note: 0.43 cups per day, or 3 cups per week, is the recommended amount of legumes in the proposed 1,800-calorie food intake pattern for sedentary adult women age 31 to 50 years.
Impact of Removing Legumes From Food Patterns: Some of the nutrients provided by legumes are supplied in amounts well above the nutrient's goal level. However, there are some nutrient shortfalls if legumes are not included in the patterns. The specific shortfalls due to removal of legumes from the patterns, without replacement from other food groups, are listed in Table G2-12. Resulting amounts that are <95 percent of the nutritional goal are included.
Note: Vitamin E and potassium are not included in the table. Vitamin E levels are below the RDA for all patterns; without legumes the levels of vitamin E decreased an additional 3 to 4 percent of the RDA. Potassium levels in almost all patterns are also below the AI; without legumes, the levels of potassium in all patterns decreased an additional 5 to 6 percent of the AI.
Table G2-12. Nutrient Shortfalls Without Legumes in Food Patterns
The most widespread impact was on fiber, with decreases to less than the AI for almost all food intake patterns. Magnesium also decreases to less than the RDA for teens and adult men and women. Iron was less than the RDA for all premenopausal women and young children.
Options for Modifying Patterns To Make Up for Shortfalls If Legumes Are Omitted: The nutrients of concern with no legumes in the patterns are dietary fiber, magnesium, iron, calcium, vitamin E, and potassium. Other food groups and subgroups that provide substantial amounts of these nutrients and nutrient content in an amount approximating the calories in ½ cup of legumes were identified. In addition to the nutrients of concern, folate is included in Table G2-13 because legumes provide such a high percentage of the overall folate in the food patterns.
Dark green vegetables, whole grains, and other vegetables appear to provide the closest match with the nutrients provided by legumes. Orange vegetables do not provide sufficient iron or magnesium; starchy vegetables do not provide sufficient fiber or magnesium; and fruits do not provide enough fiber, iron, or magnesium. Whole grains provide sufficient fiber and other nutrients but at a slightly higher calorie level. Therefore, the amount of enriched grains was adjusted downward to compensate.
Table G2-13. Comparison of Nutrients in Other Foods to Amounts in Legumes
The results of the food pattern analysis with the following substitutions for legumes follow:Increased amounts of whole grains and decreased amounts of enriched grains. For each ½ cup of legumes in a food pattern, whole grains were increased by 2 ounces and enriched grains decreased by 0.5 ounces. Overall, recommended amounts of grains increased by about ½ to 1½ ounces. Shortfalls of magnesium, iron, and calcium were totally replaced. Shortfalls of fiber were almost completely eliminated, with the exception of young children, whose intake levels were slightly below those in the original patterns (83 percent for age 2 to 3 years and 93 percent for age 4 to 8 years). Amounts of potassium in all food patterns decreased by 3 to 4 percent of the RDA and of vitamin E by 2 to 3 percent of the RDA from amounts in the original proposed patterns. Resulting food intake patterns would recommend about fourfold to sixfold increases in the amounts of whole grains over what is now consumed.
Increased amounts of dark green vegetables. For each ½ cup of legumes in a food pattern, dark green vegetables were increased by 1½ cups. Daily amounts of all vegetables recommended increased by ¼ to 1 cup, and amounts of dark green vegetables recommended increased by about ¼ to 1½ cups per day. For example, the proposed 1,800-calorie pattern (for adult women age 31 to 50 years) recommended 2 cups of vegetables, of which ½ cup would be dark green vegetables. A revised pattern with no legumes would recommend almost 3 cups of vegetables a day, with more than 1½ cups of that as dark green vegetables. With these changes to the intake patterns, shortfalls of magnesium, iron, calcium, and dietary fiber were totally replaced. Amounts of potassium in all food patterns increased by about 6 to 7 percent of the RDA and of vitamin E by about 14 to 18 percent of the RDA. However, the resulting food intake patterns would recommend about tenfold to fortyfold increases in the amounts of dark green vegetables over what is now consumed.
Increase amounts of other vegetables (tomatoes, lettuce, green beans, cabbage, onions, etc.) in the patterns. For each ½ cup of legumes in a food pattern, the amount of other vegetables was increased by 2 cups. Daily amounts of all vegetables recommended increased by 3/4 to 2 3/4 cups, amounts of other vegetables recommended increased by about 1 to 3½ cups per day. For example, the 1,800-calorie pattern (for adult women age 31 to 50 years) originally recommended 2 cups of vegetables, of which ½ cup would be other vegetables. A revised pattern with no legumes would recommend more than 4 cups of vegetables a day, with more than 3 cups of that as other vegetables. With these changes to the intake patterns, shortfalls of magnesium, iron, calcium, and dietary fiber were totally replaced. Amounts of potassium in all food patterns increased by 10 to 14 percent of the RDA and of vitamin E by 9 to 11 percent of the RDA. The resulting food intake patterns would recommend about threefold to fivefold increases in the amounts of other vegetables over what is now consumed and a doubling to tripling of overall vegetable consumption.
The proposed food intake patterns meet all nutritional goals, with the exception of vitamin E and potassium. Flexibility in the patterns is suggested through choices made within food groups or subgroups. However, some individuals may not choose to eat any foods from a particular group. For these individuals, nutrient adequacy will not be met unless compensating changes are made in other food choices. To maintain energy balance, the alternative foods selected should not increase calorie intake.
For those who choose not to eat any legumes, several alternative approaches will meet nutrient needs. Individuals who do not consume legumes can be encouraged to increase whole grain consumption, while decreasing enriched grain consumption slightly to balance energy intake. However, vitamin E and potassium intake are slightly decreased with this approach. Alternatively, they can substantially increase their intake of other vegetables, such as tomatoes, lettuce, green beans, and cabbage. The latter approach requires intake of a large quantity of these vegetables, about 3 or more cups each day for many adults, and a total vegetable intake of 4 or more cups per day. The third option, to increase dark green vegetable consumption, does not seem realistic, as increases of tenfold to fortyfold in dark green vegetable consumption would be required.
(Updated May 24, 2004 to Include Changes To Increase Potassium in Patterns)
PURPOSE: To determine the nutrient contributions of each food group and subgroup in the proposed food intake patterns.
Food Group | Major Contribution(s) | Substantial Contribution(s) (>10% of total) |
---|---|---|
Fruit group | Vitamin C | Thiamin Vitamin B6 Folate Magnesium Copper Potassium Fiber Carbohydrates |
Vegetable group | Vitamin A Vitamin B6 (tie) Potassium Copper Fiber |
Vitamin E Vitamin C Thiamin Niacin Vitamin B6 Folate Calcium Potassium Phosphorus Magnesium Iron Zinc Copper Carbohydrate Protein Fiber Alpha-linolenic acid |
Vegetable subgroups: | ||
–Dark green vegetables | Vitamin A Vitamin C | |
–Orange vegetables | Vitamin A | |
–Legumes | Folate Copper Fiber | |
–Starchy vegetables | Vitamin B6 Copper | |
–Other vegetables | Vitamin C | |
Grain group | Thiamin Folate Magnesium Iron Carbohydrate |
Vitamin A Riboflavin Niacin Vitamin B6 Vitamin B12 Calcium Phosphorus Copper Zinc Protein Fiber Linoleic acid Alpha-linolenic acid |
Grain subgroups: | ||
–Whole grains | Folate (tie) Magnesium Iron Carbohydrate (tie) |
Thiamin Riboflavin Niacin Vitamin B6 Vitamin B12 Phosphorus Copper Zinc Fiber |
–Enriched grains | Thiamin Folate (tie) Carbohydrate (tie) |
Folate Riboflavin Niacin Iron Copper |
Meat, poultry, fish, eggs, and nuts group |
Niacin Vitamin B6(tie) Zinc Protein |
Vitamin E Thiamin Riboflavin Vitamin B12 Phosphorus Magnesium Iron Copper Potassium Linoleic acid |
Milk group | Riboflavin Vitamin B12 Calcium Phosphorus |
Vitamin A Thiamin Vitamin B6 Magnesium Zinc Potassium Carbohydrate Protein |
Oils and soft margarines | Vitamin E Linoleic acid Alpha-linolenic acid |
What is the impact of removing fruit juice from the food patterns?
Note: All items considered "fruit juice" in this analysis are 100 percent fruit juice. Fruit drinks and "ades" are not included.
Total fruit juice intake was about 37 percent of all fruit intake, across all ages, with the majority of the juice intake as citrus juice. While not assessed separately in this analysis, previous analysis (CSFII 1989–1991) has shown that young children's intakes of fruit and fruit juice were approximately 47 percent juice (23 percent citrus and 24 percent other) and 53 percent fruits.
Nutrient | Original Nutrient Profile (Fruit Plus Juice) | Modified Nutrient Profile With Fruit Replacing Juices | Percentage Change |
---|---|---|---|
Vitamin A (mcg RAE) | 18.7 | 33.38 | +78.2% |
Vitamin C (mg) | 29.76 | 21.88 | -26.5% |
Folate (mcg) | 28.30 | 14.02 | -50.5% |
Thiamin (mg) | 0.066 | 0.040 | -39.6% |
Magnesium (mg) | 14.559 | 13.289 | -8.7% |
Potassium (mg) | 252.93 | 210.87 | -16.6% |
Calories | 69.75 | 54.77 | -21.5% |
Fiber (g) | 1.339 | 1.828 | +36.6% |
Alpha-linolenic acid (mg) | 0.015 | 0.022 | +43.5% |
The impacts on overall dietary patterns of removing the juices and then replacing the juices with fruit are detailed below.
Age/Sex Group (food pattern) | Vitamin C in Original Food Pattern(% RDA) | Vitamin C in Pattern Without Fruit Juice(% RDA) | Vitamin C in Pattern With Fruit Replacing Juice (%RDA) |
---|---|---|---|
Females 51–70 (1600 calories) | 123% | 74% | 102% |
Females 31–50 (1800 calories) | 141% | 92% | 120% |
Males 51–70 (2000 calories) | 151% | 89% | 125% |
Males 31–50 (2200 calories) | 151% | 90% | 125% |
Potassium: The removal of juices exacerbated the shortfalls in potassium in all patterns. Amounts in each pattern were decreased about 5 percent of the RDA, and all patterns, except 3,200 calories, decreased to less than 100 percent of the RDA. With fruit replacing juice, in comparison to fruit and juice, potassium levels were about 2 percent of the RDA less. For example, for females age 31 to 50 years, the original 1,800-calorie food pattern contained 66 percent of the RDA for potassium. Without fruit juice, the pattern contained 61 percent of the RDA, and with fruit replacing juice, 64 percent of the RDA.
Age/Sex Group (food pattern) | Magnesium in Original Pattern (%RDA) | Magnesium in Pattern Without Fruit Juice (%RDA) | Magnesium in Pattern With Fruit Replacing Juice (%RDA) |
---|---|---|---|
Females 51-70 (1600 calories) | 100% | 97% | 100% |
Females 14-18 (1600 calories) | 100% | 96% | 99% |
Males 51-70 (2000 calories) | 94% | 90% | 93% |
Males 31-50 (2200 calories) | 93% | 88% | 92% |
Males 14-18 (2200 calories) | 101% | 97% | 100% |
Age/Sex Group(food pattern) | Fiber in Original Pattern(%AI) | Fiber in Pattern Without Fruit Juice (%AI) | Fiber in Pattern With Fruit Replacing Juice (%AI) |
---|---|---|---|
Children 1-3 (1000 calories) | 86% | 85% | 91% |
Females 4-8 (1200 calories) | 97% | 96% | 101% |
Males 4-8(1400 calories) | 97% | 96% | 102% |
Fruit juices provide substantial contributions of several vitamins and minerals in higher amounts than do whole fruits. These include vitamin C, folate, and potassium. However, replacement of fruit juice with fruit does not result in shortfalls, with the exception of nutrients that are already in shortfall amounts in the food intake patterns.
Some types of fruit have more potassium than others. Since potassium is low in almost all food patterns, suggestions for selecting at least some fruit or juice rich in potassium could help to increase overall intakes. Of the subcategories created for this analysis of juice and fruit intake, citrus juices have the highest level of potassium. A table of rich sources of potassium is being prepared and could be included in the report.
The current analysis assumes that intake from the fruit group is approximately 1/3 juice and 2/3 fruit when averaged across all age groups. Previous analysis suggests that young children may, in fact, consume relatively more juice and less fruit. They also may consume relatively more apple and grape juice, and less citrus juice than other age groups. For children who consume mostly juice and little fruit, shortfalls in fiber would be increased. For children age 8 and younger, replacing some juice with fruit could help meet the fiber recommendations. Recommending intake of no more than 1/3 juice and no less than 2/3 fruit would promote adequate fiber intakes.
A recommendation to select at least 2/3 fruits and no more than
1/3 juice is consistent with current overall consumption. This recommendation
for total juice intake is also consistent with the recommendation
from the American Academy of Pediatrics to limit fruit juice to
no more than 4 to 6 ounces per day for children age 1 to 6 years
and 8 to 12 ounces per day for children age 7 to 18 years.
What are the nutrient shortfalls in the food intake patterns if milk and milk products are not consumed?
Milk and milk products provide more than 70 percent of the calcium consumed by Americans, based on food supply data. This contribution has remained relatively constant over time, with a gradual decrease from about 75 percent in the early 1970s to about 72 percent in 2000. (Note that the percent contributions of calcium by food groups from NHANES 1999–2000 is not yet available.) Foods included in the milk group include all fluid milks, cheeses, yogurt, and other dairy products such as puddings, flavored milks, milk shakes, milk-based meal replacements, and frozen desserts. Items excluded are those that are primarily fat (butter, cream, sour cream, and cream cheese).
Because they provide so much of the overall calcium in American diets, milk products have been traditionally identified as a separate food group to highlight their importance for meeting calcium needs. This analysis identifies calcium and other nutrients for which milk products make a substantial contribution and nutrient shortfalls if milk products are not consumed. Reported intakes from the milk group, intake recommendations, and the percentage of calcium provided by this food group in the proposed food patterns are presented in Table G2-19.
Food Pattern (calories) | Age/Sex Groups | Milk Group Recommendation (1 cup eq. servings) |
Reported Consumption (CSFII 94-96) (1 cup eq. servings) | Calcium Provided by Milk Group in Food Patterns (% of total calcium) |
---|---|---|---|---|
1000 | Child 2-3 | 2 | 1.85 | 79 |
1200 | F 4-8 | 2 | 1.84 | 73 |
1400 | M 4-8 | 2 | 2.02 | 70 |
1600 | F 9-13 | 3 | 1.86 | 73 |
F 51+ | 3 | 1.01 | 73 | |
1800 | F 31-50 | 2 | 1.11 | 61 |
M 9-13 | 3 | 2.27 | 70 | |
F 14-18 | 3 | 1.38 | 70 | |
2000 | F 19-30 | 2 | 1.26 | 58 |
M 51+ | 3 | 1.32 | 68 | |
2200 | M 14-18 | 3 | 2.34 | 66 |
M 31-50 | 2 | 1.55 | 56 | |
2400 | M 19-30 | 2 | 1.73 | 53 |
2600 | M 19-30 | 2 | 1.73 | 52 |
2800 | M 14-18 | 3 | 2.34 | 61 |
3000 | M 19-30 | 2 | 1.73 | 49 |
3200 | M 14-18 | 3 | 2.34 | 59 |
Nutrients Provided by Recommended Amounts From the Milk Group in Food Patterns: On average, the milk group provides 10 percent of the calories in the food intake patterns. The percentage varies from 16 percent of calories at 1,000 calories to 5 percent at 3,200 calories, because the intake amounts recommended from the milk group do not increase with increasing calorie intakes. The milk group also provides more than 10 percent of the following nutrients in the patterns (on average): riboflavin, vitamin B12, vitamin A, thiamin, vitamin B6, calcium, phosphorus, magnesium, zinc, potassium, protein, and carbohydrate
Impact of Removing Milk Products From Food Patterns: Some of the nutrients provided by milk products are supplied in amounts well above the nutrient's goal level. For example, even though milk products and the major contributor of riboflavin to the food patterns, intake levels are still above the RDA when milk products are excluded. Amounts of riboflavin drop from about 200 to 250 percent of the RDA to about 111 to 170 percent of the RDA. However, there are some other nutrient shortfalls in addition to calcium if milk products are not included in the patterns.
The specific shortfalls due to removal of milk products from the patterns, without replacement from other food groups, are listed in Table G2-20. Nutrients are included if the resulting amount is <95 percent of the nutritional goal. Note that vitamin E is not included in the table. Vitamin E levels are below the RDA for all patterns, and without milk products, the levels of vitamin E in the patterns decrease by 1 percent or less of the RDA.
Nutrient | Food Pattern | Age-Sex Group (sedentary) | Existing Proposed Pattern—Amount in Pattern as % of Nutritional Goal |
Without Milk Products—Amounts in Pattern as % of Nutritional Goal |
---|---|---|---|---|
Calcium | 1000 (2m) | M/F 2-3 | 155% | 32% |
1200 (2m) | F 4-8 | 104% | 28% | |
1400 (2m) | M 4-8 | 110% | 33% | |
1600 (3m) | F 9-13 | 96% | 26% | |
1600 (3m) | F 51 to 70 | 104% | 28% | |
1800 (2m) | F 31-50 | 101% | 40% | |
1800 (3m) | M 9-13, F 14-18 | 101% | 30% | |
2000 (2m) | F19-30 | 105% | 44% | |
2000 (3m) | M 51+ | 113% | 37% | |
2200 (2m) | M 31-50 | 109% | 48% | |
2200 (3m) | M 14-18 | 107% | 37% | |
2400 (2m) | M 19-30 | 115% | 53% | |
2600 (2m) | M 19-30 | 118% | 57% | |
2800 (3m) | M 14-18 | 117% | 46% | |
3000 (2m) | M 19-30 | 125% | 64% | |
3200 (3m) | M 14-18 | 120% | 49% | |
Potassium | 1000 (2m) | M/F 2-3 | 58% | 33% |
1200 (2m) | F 4-8 | 56% | 36% | |
1400 (2m) | M 4-8 | 64% | 43% | |
1600 (3m) | F 9-13 | 71% | 45% | |
1600 (3m) | F 51+ | 68% | 43% | |
1800 (2m) | F31-50 | 66% | 49% | |
1800 (3m) | M 9-13 | 77% | 52% | |
1800 (3m) | F 14-18 | 74% | 49% | |
2000 (2m) | F19-30 | 73% | 57% | |
2000 (3m) | M 51+ | 81% | 57% | |
2200 (2m) | M31-50 | 75% | 59% | |
2200 (3m) | M 14-18 | 84% | 59% | |
2400 (2m) | M 19-30 | 83% | 66% | |
2600 (2m) | M 19-30 | 92% | 76% | |
2800 (3m) | M 14-18 | 103% | 78% | |
3000 (2m) | M 19-30 | 104% | 88% | |
3200 (3m) | M 14-18 | 112% | 88% | |
Magnesium | 1600 (3m) | F 51 to 70 | 100% | 75% |
1800 (2m) | F 31-50 | 104% | 87% | |
1800 (3m) | F 14-18 | 100% | 77% | |
2000 (3m) | M 51+ | 94% | 75% | |
2200 (2m) | M 31-50 | 93% | 80% | |
2200 (3m) | M 14-18 | 101% | 82% | |
2400 (2m) | M 19-30 | 107% | 94% | |
Vitamin A | 1600 (3m) | F 51 to 70 | 122% | 92% |
The most widespread impacts were on calcium and potassium, with decreases to less than the AI for almost all food intake patterns. Intakes of magnesium, phosphorus, and vitamin A were also affected. Magnesium levels were low for all teen and adult men, and for many teen and adult women. Phosphorus levels were low for teen and preteen males and females, and for children age 2 to 3 years. Vitamin A levels were low for women age 50 and older.
The DRI report for phosphorus notes that phosphorus is widely used as an additive in processed foods, and assessment of intakes may be difficult to ascertain, but intake data suggest an increase in consumption in the range of 10 to 15 percent over the past 20 years. In light of this, the issue of phosphorus intake is not further considered in this report.
Options for Alternatives to Milk Products in the Food Patterns: Alternatives within the milk group may be the most feasible recommendations for many individuals who avoid milk because of its lactose content. The same mix of nutrients found in regular milk products is also in lactose-reduced or low-lactose milk products.
For those who do not wish to consume any dairy products, several considerations are important. First, the alternative must have high calcium and potassium levels. Second, the calcium must be in a form that is bioavailable. Also, consideration should be given to sources of magnesium and perhaps vitamin A.
A table of potential alternatives for milk products is being prepared. No scenarios for replacement of milk products with other foods were developed, as this would necessitate enormous deviations from typical food choices. In addition, the most viable alternatives for many individuals may be alternative foods within the milk group or fortified foods such as fortified orange juice or fortified soy products.
While milk products are clearly, and correctly, associated with
calcium, no food group, including the milk group, provides only
a single nutrient. Any recommendations to increase flexibility in
the food patterns by suggesting alternatives to milk products need
to consider the impacts on the intake of potassium, magnesium, and
vitamin A.
Examine the adequacy of food patterns with varying levels of fat, from 20 to 35 percent of calories.
To determine if food patterns at varying levels of fat content within the range recommended by the DRI can meet adequacy and moderation goals for other nutrients.
Total vs. Foundation Diet Approach: The Food Guide Pyramid is a total diet system, which means that all calories must be accounted for in some way. This diet system differs fundamentally from a foundation diet, which ensures nutrient adequacy but allows free choice of any additional calories to meet energy needs. The free choice of some calories in a foundation diet approach is not compatible with moderation goals, such as limiting saturated fat intake. The total diet approach is used because some of the nutritional goals for the Pyramid specify ranges or maximum amounts rather than minimums. Also, specific calorie levels have been identified for various age/sex/activity level groups of people.
Within a total diet system, flexibility of choice for the consumer is given where possible through choices within specific food categories. These food categories have similarities in their content of key nutrients, including their macronutrient composition. For example, the proposed food patterns for the Pyramid allow flexibility of choice within each food group or subgroup and within the categories of additional solid fats, additional oils, and added sugars. Choices made within these categories maintain the overall nutritional profile of the diet.
Defining "Optimal" Dietary Choices: The Pyramid does not set nutritional policy—it is an educational tool designed to help Americans implement current policy on what constitutes an "optimal" diet. Operationally, an "optimal" diet is defined as meeting the current Dietary Guidelines and Dietary Reference Intakes. Quantified nutritional goals for the Pyramid's food patterns are set according to these standards. In addition, educational messages are developed to provide additional guidance where qualitative but not quantified goals are available.
Selection of One Set of "Optimal" Choices: There are an immense number of food patterns that could meet current nutritional adequacy and moderation goals. How can one set of food choices be selected over another? The premise used in determining food patterns for the Pyramid has been to start with what is actually consumed by Americans and adjust the amounts of various food categories (which include both "food groups" and "subgroups") into healthful proportions. Alterations are made in the amounts recommended from each category until nutrient goals (for adequacy and moderation) are met. Major shifts from actual consumption patterns may occur, but only if they are needed to meet the stated goals. This approach differs from some other food guidance approaches that use different criteria to identify other "optimal" dietary patterns.
Discretionary Fats in the Food Patterns: Within each food group and subgroup, food items in their lowest fat form are selected for use in determining the nutrient profile of the group or subgroup. However, some amount of fat remains in each group's nutrient profile and is termed "intrinsic" fat. The total amount of all intrinsic fat in the food patterns ranges from about 10 grams in the 1,000-calorie pattern to 35 grams in the 3,200-calorie pattern. To bring the amounts of total fat and essential fatty acids to recommended levels, a separate component—discretionary fats—is added. Discretionary fats represent the mix of fats that individuals may consume as part of their food choices or add to their food choices. For example, individuals may use portions of their discretionary fat "allowance" to select 1 percent milk rather than fat-free milk and to have mayonnaise on a sandwich.
As part of the current revision of the food patterns, discretionary fats were separated into two components—"solid fats" and "oils and soft margarines." The solid fat component includes animal fats (beef, pork, chicken, and dairy fats), as well as hydrogenated vegetable fats (shortening and stick margarine). Because the solid discretionary fat component includes a higher percentage of saturated and trans fats, as well as cholesterol, the amounts in the food patterns have been restricted to 40 percent of total discretionary fats. This contrasts with the 58 percent of discretionary fats, as typically consumed, that are solid fats. The other component of discretionary fats—oils (soybean, cottonseed, and corn oils) and soft margarines—has been increased to 60 percent in the food patterns. As typically consumed, this component represents 42 percent of total discretionary fats.
Solid fats and oils contain many nutrients such as vitamin A, vitamin E, sodium, and calcium, in addition to the nutrients that are fat components (essential fatty acids). However, only vitamin E, linoleic acid, alpha-linolenic acid, and cholesterol were affected substantially by manipulating the fat content of the food intake patterns.
Few of the food patterns with any level of fat met the RDA for vitamin E. The RDA was met only at 35 percent calories from fat, and then only in the highest calorie patterns (3,000 and 3,200 calories). As would be expected, the percentage of the RDA for vitamin E in an intake pattern increased consistently with additional fat in the pattern.
Levels of linoleic acid and alpha-linolenic acid (ALA) were highly sensitive to the overall fat content of the pattern. At 20 percent of calories from fat, few patterns met the AIs or were within the AMDRs for these fatty acids. At 25 percent calories from fat, fewer patterns were below the AIs, and all were within the AMDRs. Patterns at 30 and 35 percent calories from fat all met both the AIs and AMDRs.
Because linoleic acid and ALA are found at higher levels in oils than in solid fats, the intake pattern at 20 percent of calories from fat was modified to use only oils and soft margarines in the patterns (no solid fats) to determine whether linoleic acid and ALA could be provided in sufficient quantities at 20 percent of calories from fat. While the results are an improvement over the original 20 percent patterns, the standards for linoleic acid and ALA were not met at many calorie levels.
For this exercise, calories in the pattern were balanced using added sugars. Tables G2-21–G2-24 show the amounts of added sugars in each pattern, in addition to the information provided on fat-related nutrients. Added sugars ranged from 13 to 46 teaspoons (52 to 184 grams) at 20 percent of calories from fat, to zero to 17 teaspoons (0 to 68 grams) at 35 percent. The amounts of added sugars allowed in the 35 percent pattern are quite limited at most calorie levels.
Additional findings include the following:
Detailed results are presented in the following tables. Note that some of the information in the tables is presented as a range, because several age/sex groups may have the same caloric needs but different RDAs or AIs. The ranges represent the percentages of the goal for different age/sex groups at that calorie level.
Table G2-21 shows the estimation of the shortfalls and percentage of calories from fat and carbohydrates if the amounts of fat in each pattern were set to 20 percent of calories. The table also presents the approximate amounts in each food pattern. Results that are less than (or more than) the goal appear in bold.
Pattern(20% kcal fat) | Calories From Fat (%) | Calories From CHO (%) | Added Sugars(tsp.) | Vitamin E(% RDA) | Linoleic Acid(% AI) | ALA(% AI) |
---|---|---|---|---|---|---|
1000 | 20 | 65 | 13 | 45 | 72 (4.6%) | 74 (0.4%) |
1200 | 20 | 64 | 13 | 53 | 67 | 74 (0.5%) |
1400 | 20 | 63 | 15 | 59 | 76 (4.9%) | 82 (0.4%) |
1600 | 20 | 62 | 15 | 33-45 | 71-78 (4.6%) | 70-77 (0.5%) |
1800 | 20 | 63 | 18 | 39-54 | 83-90 (4.8%) | 83-91 (0.5%) |
2000 | 20 | 64 | 18 | 43 | 79-92 (4.8%) | 69-100 (0.5%) |
2200 | 20 | 65 | 23 | 46 | 72-76 (4.8%) | 75 (0.5%) |
2400 | 20 | 65 | 24 | 51 | 79 | 82 (0.5%) |
2600 | 20 | 66 | 28 | 58 | 87 | 92 (0.5%) |
2800 | 20 | 66 | 32 | 60 | 99 | 98 (0.5%) |
3000 | 20 | 67 | 36 | 68 | 101 | 108 (0.5%) |
3200 | 20 | 68 | 46 | 71 | 116 | 116 (0.5%) |
*The percentage of calories shown only when less than AMDR. AMDR for linoleic acid is 5-10 percent kcal; AMDR for ALA is 0.6-1.2 percent kcal.
Table G2-22 shows the estimation of the shortfalls and percentage of calories from fat and carbohydrates if the amounts of fat in each pattern were set to 25 percent of calories. The table also presents the approximate amounts in each food pattern.
Pattern(25% kcal fat) | Calories From Fat (%) | Calories From CHO (%) | Added Sugars(tsp.) | Vitamin E(% RDA) | Linoleic Acid(% AI) | ALA(% AI) |
---|---|---|---|---|---|---|
1000 | 25 | 60 | 10 | 53 | 92 | 93 |
1200 | 25 | 59 | 10 | 63 | 87 | 95 |
1400 | 25 | 58 | 10 | 71 | 100 | 107 |
1600 | 25 | 57 | 10 | 39-54 | 94-102 | 92-100 |
1800 | 25 | 59 | 13 | 47-64 | 108-118 | 107-117 |
2000 | 25 | 59 | 12 | 51-52 | 103-120 | 89-129 |
2200 | 25 | 60 | 16 | 55 | 94-100 | 97 |
2400 | 25 | 60 | 17 | 61 | 103 | 106 |
2600 | 25 | 61 | 20 | 68 | 112 | 117 |
2800 | 25 | 61 | 24 | 72 | 129 | 125 |
3000 | 25 | 62 | 27 | 80 | 131 | 137 |
3200 | 25 | 63 | 38 | 84 | 150 | 148 |
Note: No patterns were less than AMDR for linoleic or ALA.
Table G2-23 shows the estimation of the shortfalls and percentage of calories from fat and carbohydrates if the amounts of fat in each pattern were set to 30 percent of calories. The table also presents the approximate amounts in each food pattern.
Pattern(30% kcal fat) | Calories From Fat (%) | Calories From CHO (%) | Added Sugars(tsp.) | Vitamin E(% RDA) | Linoleic Acid(% AI) | ALA(% AI) |
---|---|---|---|---|---|---|
1000 | 30 | 55 | 7 | 62 | 111 | 113 |
1200 | 30 | 54 | 6 | 74 | 108 | 116 |
1400 | 30 | 53 | 6 | 83 | 124 | 131 |
1600 | 30 | 53 | 5 | 46-63 | 116-127 | 131-123 |
1800 | 30 | 54 | 7 | 54-74 | 134-146 | 131-143 |
2000 | 30 | 54 | 6 | 60 | 149-127 | 109-158 |
2200 | 30 | 55 | 9 | 64 | 116-123 | 119 |
2400 | 30 | 55 | 10 | 71 | 126 | 130 |
2600 | 30 | 56 | 12 | 79 | 138 | 143 |
2800 | 30 | 56 | 15 | 83 | 158 | 153 |
3000 | 30 | 57 | 18 | 92 | 161 | 167 |
3200 | 30 | 58 | 27 | 98 | 184 | 179 |
Note: No patterns were less than AMDR for linoleic or ALA.
Table G2-24 shows the estimation of the shortfalls and percentage of calories from fat and carbohydrates if the amounts of fat in each pattern were set to 30 percent of calories. The table also presents the approximate amounts in each food pattern.
Pattern(35% kcal fat) | Calories From Fat (%) | Calories From CHO (%) | Added Sugars(tsp.) | Vitamin E(% RDA) | Linoleic Acid(% AI) | ALA(% AI) |
---|---|---|---|---|---|---|
1000 | 35 | 50* | 4 | 70 | 131 | 132 |
1200 | 35 | 48 | 2 | 84 | 128 | 137 |
1400 | 35 | 48 | 2 | 96 | 147 | 156 |
1600 | 35 | 48 | 0 | 53-72 | 139-152 | 134-146 |
1800 | 35 | 48-49 | 2 | 61-84 | 159-173 | 155-169 |
2000 | 35 | 49 | 0 | 68 | 152-177 | 129-187 |
2200 | 35 | 50 | 3 | 73 | 137-146 | 1140-141 |
2400 | 35 | 50 | 3 | 80 | 150 | 154 |
2600 | 35 | 51 | 4 | 89 | 164 | 169 |
2800† | 35 | 51 | 7 | 95 | 186 | 181 |
3000† | 35 | 52 | 9 | 105 | 191 | 197 |
3200† | 35 | 53 | 17 | 111 | 217 | 211 |
*The 1,000-calorie pattern contained 96 percent of the AI for carbohydrates.
†The 2,800-, 3,000-, and 3,200-calorie patterns contained 310, 314, and 319 mg. of cholesterol, respectively.
A scenario of using oils and soft margarines only in the patterns (no solid fats) was run to determine if linoleic acid and ALA could be provided in sufficient quantities at 20 percent of calories from fat. This analysis was undertaken because the intake patterns with 20 percent of calories from fat, which were split between solid fats (40 percent) and oils/soft margarines (60 percent), were low in both linoleic acid and ALA across almost all calorie levels. Table G2-25 shows the results of this analysis.
Pattern(20% kcal fat) | Calories From Fat (%) | Calories From CHO (%) | Added Sugars(tsp.) | Vitamin E(% RDA) | Linoleic Acid(% AI) | ALA(% AI) |
---|---|---|---|---|---|---|
1000 | 20 | 65 | 13 | 58 | 103 | 95 |
1200 | 20 | 64 | 13 | 60 | 82 | 85 |
1400 | 20 | 63 | 15 | 67 | 92 | 94 (0.5%) |
1600 | 20 | 62 | 15 | 37-50 | 85-92 | 80-87 (0.5%) |
1800 | 20 | 63 | 18 | 44-60 | 99-108 | 94-103 (0.5%) |
2000 | 20 | 64 | 18 | 48-49 | 94-110 | 78-104 (0.5%) |
2200 | 20 | 65 | 23 | 52 | 86-91 | 85 (0.5%) |
2400 | 20 | 65 | 24 | 57 | 94 | 94 (0.5%) |
2600 | 20 | 66 | 28 | 65 | 105 | 105 (0.5%) |
2800 | 20 | 66 | 32 | 68 | 120 | 112 (0.5%) |
3000 | 20 | 67 | 36 | 77 | 123 | 124 |
3200 | 20 | 68 | 46 | 81 | 143 | 134 (0.5%) |
* Percentage of calories shown only when less than AMDR.
The analysis suggests the following advice concerning fat intake:
Examine the adequacy of food patterns with fat at 35 percent of calories and added sugars at 5 percent of calories, with other carbohydrate sources decreased to maintain calorie level.
When calories from fat in the food patterns are increased to 35 percent, the amount of added sugars in many patterns drops to almost zero to compensate and maintain calorie levels. Some evidence suggests that keeping added sugars to at least 5 percent of calories is related to improved dietary nutritional quality. In food patterns with fat at 35 percent and added sugars at 5 percent of calories, would changes in other carbohydrate sources to compensate for the additional calories affect the adequacy of the patterns?
For most food intake patterns, a decrease of 0.5 to 1 serving
of enriched grains was necessary to include both 35 percent of calories
as fat and 5 percent of calories as added sugars at the goal calorie
level. Profiles from the resulting patterns are presented in Table
G2-26:
Pattern | Calories From Fat (% kcal) | Calories From CHO (% kcal) | Added Sugars(% kcal) | Added Sugars(g) | Enriched Grains in Modified Pattern (servings) | Decrease From Original Pattern (servings) |
---|---|---|---|---|---|---|
1000 | 35 | 49 | 5 | 12 | 1.5 | 0 |
1200 | 35 | 48 | 5 | 15 | 1.5 | 0.5 |
1400 | 35 | 49 | 5 | 18 | 2.0 | 0.5 |
1600* | 33 | 48 | 5 | 20 | 2.0 | 1.0 |
1800* | 34-35 | 49 | 5 | 22 | 2.5 | 1.0 |
2000* | 33-35 | 50-51 | 5 | 25 | 3.0 | 1.0 |
2200* | 34-35 | 50 | 5 | 28 | 3.5 | 1.0 |
2400 | 35 | 50 | 5 | 30 | 4.0 | 1.0 |
2600 | 35 | 52 | 5 | 32 | 4.5 | 0.5 |
2800* | 34 | 51 | 5 | 35 | 5.0 | 0.5 |
3000 | 35 | 52 | 5 | 37 | 5.5 | 0 |
3200* | 34 | 53 | 9 | 72 | 5.5 | 0 |
* Percent of calories from fat is less than 35 percent because the pattern with three servings of milk is analyzed at this calorie level. The amount of fat and added sugars in the pattern is based on the pattern with two milk servings.
Enriched grain products contribute important amounts of certain nutrients to the Pyramid food patterns. On average, they provide more than 10 percent of the thiamin, folate, riboflavin, niacin, vitamin B6, calcium, iron, copper, and fiber in a food pattern.
The decreased amounts of enriched grains in most patterns resulted in slightly lower levels of many nutrients. Some of these nutrients are supplied in amounts well above the nutrient's goal level. For these nutrients, then, the 0.5 to 1 serving decrease in enriched grains did not result in shortfalls. However, for a few age/sex groups and for nutrients that were marginal in the original patterns, the decrease did result in or worsen a shortfall. These shortfall nutrients are shown in Table G2-27.
Nutrient | Food Pattern | Age-Sex Group (sedentary) | Original Proposed Patterns—Amount in Pattern as % of Goal | With Less Enriched Grains—Amount in Pattern as % of Goal |
---|---|---|---|---|
Calcium | 1600 (3m) | F 9-13 | 96% | 94% |
1800 (2m) | F31-50 | 101% | 98% | |
1800 (3m) | M 9-13, F 14-18 | 101% | 99% | |
Iron | 1200 (2m) | F 4-8 | 98% | 92% |
1800 (2m) | F31-50 | 96% | 89% | |
Fiber | 1200 (2m) | F 4-8 | 97% | 95% |
1400 (2m) | M 4-8 | 97% | 95% |
The current analysis suggests the following, in addition to the conclusions from the prior analysis of food patterns at 35 percent of calories from fat:
These vulnerable age/sex groups may need advice on selecting a nutrient dense diet, especially for calcium and iron. Increasing the amount of fat in the diet to 35 percent may not be compatible with nutrient adequacy for these groups, especially if they are sedentary.
What is the impact of increasing fish and/or high omega-3 fish consumption to 8 or 9 ounces per week?
In developing the Pyramid food intake patterns, fish have been grouped with red meats, poultry, eggs, nuts, and seeds into a single food group. The nutrient profile of this group has been calculated by assuming a proportionate intake of each category of food equal to the proportion consumed by the population. The meats and poultry selected as representative items have been the leanest choices within each food type. Food items selected in calculating the nutrient profile have been those whose intake represents more than 1 percent of the total intake of the food group. Other foods (with less than 1 percent intake) in each category are grouped with the most similar food in calculating overall percent consumption. For example, since shrimp is the most widely consumed shellfish, all shellfish have been grouped with shrimp to calculate total shellfish consumption, and shrimp nutrient values have been used to represent shellfish in the nutrient profile.
The original food item groups used in developing the proposed food patterns and percent consumption according to NHANES 1999–2000 data are listed in Table G2-28.
Subgroups and Item Groups in Each | Percent of MPFEN Consumption |
---|---|
Meats (beef, ground beef, pork, lamb, ham, luncheon meats, and liver item groups) | 55.7% |
Poultry (chicken and turkey item groups) | 24.5% |
Fish (lean finfish, fatty finfish, tuna, and shellfish item groups) | 8.3% |
Eggs (eggs) | 7.8% |
Nuts and seeds | 3.6% |
In developing the original nutrient profile for fish, finfish were sorted by overall fat content into lean and fatty item groups, and the most consumed fish in each was selected for use in representing the group. Flounder represented lean finfish, and catfish represented fatty finfish. Tuna was considered a separate item group to represent all canned fish, because its consumption was greater than 1 percent of the overall MPFEN group. As stated earlier, shrimp represented all shellfish.
Because the item groups used for fish were separated by overall fat content rather than omega-3 fatty acid content, a re-grouping of fish into new item groups was necessary to complete the requested analysis.
Based on NHANES 1999–2000 consumption data, the majority of fish intake (63 percent) is finfish low in omega-3 fatty acids. The most popular single fish is tuna (22 percent), with shrimp (16 percent), salmon (9 percent), mixed fish (8 percent), and crab (7 percent) also commonly reported. Addendum B lists each type of fish reported in NHANES and also its consumption relative to other fish in its omega-3 group and overall.
Overall tuna intake was split assuming 25 percent was white tuna (albacore) and 75 percent light tuna, according to estimates of light vs. white tuna consumption. Proportionate amounts were added to the two fish subgroups. Proportionate overall fish intake with tuna added is shown in Table G2-29.
Group | Percent of Total Fish Consumption |
---|---|
HI3 fish | 14.35 |
White tuna (est.) | 5.53 |
HI3 fish with tuna | 19.88 |
LO3 fish | 63.53 |
Light tuna (est.) | 16.59 |
LO3 fish with tuna | 80.12 |
Total | 100.00 |
The resulting amounts of EPA and DHA in fish subgroups, including tuna, are shown in Table G2-30. The amounts are weighted averages of the EPA and DHA content of each fish in the group, with weights based on relative consumption of the fish. Values are expressed in grams per ounce of cooked fish, for most fish. For a few fish, only raw values were available and were used.
EPA (g/oz.) | DHA (g/oz.) | EPA Plus DHA (g/oz.) | |
---|---|---|---|
HI3 fish | 0.282 | 0.125 | 0.407 |
LO3 fish | 0.048 | 0.057 | 0.105 |
New MPFEN nutrient profiles were calculated, including either 8 ounces of total fish or 8 ounces of HI3 fish per week. The proportion of foods in the revised MPFEN nutrient profiles is shown in Table G2-31.
Subgroups | Percent of MPFEN Consumption | |
---|---|---|
With 8 ounces total fish per week | With 8 ounces HI3 fish per week | |
Meats | 45.7% | 45.7% |
Poultry | 20.1% | 20.1% |
HI3 fish | 4.6% | 22.9% |
LO3 fish | 18.3% | 0.0% |
Eggs | 7.8% | 7.8% |
Nuts and seeds | 3.5% | 3.5% |
Using the new MPFEN nutrient profiles, amounts of DHA and EPA in each food intake pattern were calculated. Since other sources of EPA and DHA were considered negligible, only the MPFEN values for these fatty acids are reflected in the total amounts in each food intake pattern. These amounts are shown in Table G2-32.
Calorie Level | 8 Ounces Fish per Week EPA+DHA g | 8 Ounces HI3 Fish per Week EPA+DHA g |
---|---|---|
1000 | 0.076 | 0.186 |
1200 | 0.113 | 0.279 |
1400 | 0.151 | 0.372 |
1600* | 0.189 | 0.466 |
1800* | 0.189 | 0.466 |
2000 | 0.208 | 0.512 |
2200 | 0.227 | 0.559 |
2400 | 0.246 | 0.605 |
2600 | 0.250 | 0.615 |
2800 | 0.265 | 0.652 |
3000 | 0.265 | 0.652 |
3200 | 0.265 | 0.652 |
The impact on other nutrients of substituting more fish or HI3 fish for some meat and poultry was quite small. For most nutrients, no change was evident when expressed as a percentage of the RDA or AI. For iron, a decrease of 2 to 4 percent was seen in the patterns with the 8 ounces of HI3 fish but not in the patterns with 8 ounces of all fish. For several nutrients, a change of 1 to 2 percent was seen, but this did not affect the adequacy of the patterns. Changes in total fat, saturated fat, and cholesterol are shown in Table G2-33.
Nutrient/Pattern | Original Amount (g/% kcal) | With 8 Ounces Fish (g/% kcal) | With 8 Ounces HI3 Fish (g/% kcal) | |
---|---|---|---|---|
Total fat | 1800 | 56.2/28% | 55.5/28% | 57.1/29% |
2200 | 68.5/28% | 67.6/28% | 69.6/28% | |
2600 | 77.3/27% | 76.4/27% | 78.6/27% | |
Saturated fat | 1800 | 14.8/7.5% | 14.3/7.3% | 14.7/7.4% |
2200 | 18.1/7.4% | 17.6/7.2% | 18.0/7.3% | |
2600 | 20.2/7.0% | 19.6/6.9% | 20.1/7.0% | |
Cholesterol | (mg) | (mg) | (mg) | |
1800 | 211 | 209 | 203 | |
2200 | 253 | 251 | 244 | |
2600 | 278 | 275 | 267 |
Amounts of fish in the suggested patterns relative to actual consumption also were examined. Since fish with HI3 levels are consumed less than other fish, the suggested increase in intake would be greater if 8 ounces of HI3 fish were recommended. Therefore, a comparison was made of the potential increases over actual consumption for both scenarios. The increases are shown in Table G2-34. The potential increase with an intake of 8 ounces of fish recommended is about 5 ounces, which is about a 1¾ times additional intake on top of current intake levels. The increase with a recommended intake of 8 ounces of HI3 fish is about 7½ ounces, which is more than a twelvefold increase above current intake levels.
Recommendation | Original Intake (oz./wk) | Rec. Intake (oz./wk) | Increase (oz./wk) | Increase (%) |
---|---|---|---|---|
8 oz. fish per week—all fish | 2.92 | 8.00 | 5.08 | 174% |
LO3 fish | 2.34 | 6.40 | 4.06 | 174% |
HI3 fish | 0.58 | 1.60 | 1.02 | 174% |
8 oz. HI3 fish per week | 0.58 | 8.00 | 7.42 | 1270% |
An additional consideration in examining current intake levels is that these are national averages, and there are probably widespread regional differences in overall fish intake and in the type of fish consumed. We were not able to consider these factors in the current analysis.
About 80 percent of current fish intake is from species that are relatively lower in omega-3 fatty acid content. Note that the cutoff level for determining fish that fell into the "HI3" group or the "LO3" group was set at 500 mg per 3-ounce serving, in compliance with a suggestion from the subcommittee.
A recommendation to eat 8 ounces of HI3 fish per week would provide from 186 to 652 mg of EPA and DHA per day combined in food patterns with 1,000 to 3,200 calories, respectively. A recommendation to eat 8 ounces of fish per week would provide from 76 to 265 mg of EPA plus DHA per day over the same calorie range, if intakes followed current consumption patterns. The recommendation for 8 ounces of HI3 fish per week does differ greatly from current consumption.
Fish type | Percent of Subgroup Consumption | Percent of All Fish Consumption | |
---|---|---|---|
High Omega-3 fish | Anchovy | 0.35 | 00.05 |
Mackerel | 0.23 | 0.03 | |
Pompano | 0.22 | 0.03 | |
Salmon | 61.93 | 8.87 | |
Sardines | 4.81 | 0.69 | |
Sea bass | 12.99 | 1.86 | |
Swordfish | 7.85 | 1.13 | |
Trout | 11.61 | 1.67 | |
Total--HI3 fish | 100.00 | 14.35 | |
Low Omega-3 fish | Carp | 0.69 | 0.44 |
Catfish | 6.58 | 4.18 | |
Clams | 3.85 | 2.44 | |
Conch | 0.15 | 0.10 | |
Cod | 8.08 | 5.13 | |
Crab | 11.76 | 7.47 | |
Croaker | 0.39 | 0.25 | |
Flounder | 7.11 | 4.52 | |
Frog | 0.15 | 0.10 | |
Haddock | 2.23 | 1.41 | |
Halibut | 0.16 | 0.10 | |
Lobster | 1.13 | 0.72 | |
Mullet | 0.59 | 0.37 | |
Octopus/squid | 0.97 | 0.61 | |
Oysters | 1.35 | 0.86 | |
Perch | 1.24 | 0.79 | |
Pike | 1.01 | 0.64 | |
Pollock | 1.99 | 1.26 | |
Porgy | 3.67 | 2.33 | |
Scallops | 1.76 | 1.12 | |
Shrimp | 25.37 | 16.12 | |
Snapper | 0.12 | 0.08 | |
Whiting | 1.58 | 1.00 | |
Mix of fish | 12.72 | 8.08 | |
Don't know type | 5.35 | 3.40 | |
Total—LO3 fish | 100.00 | 63.53 | |
Tuna—mixed types | 100 | 22.12 | |
OVERALL TOTAL | 100.00 |
The physical activity data (METs codes) from NHANES 99-00 have not yet been released so that part of the question was not answered.
From the NHANES 99-00 dataset, researchers at USDA/CNPP calculated a variable, based on the self-reported average number of alcoholic drinks per drinking day consumed over the past 12 months and the average number of drinking days per month. The categories used in the tabulations were defined as follows:
<1 drink = 0.1 - 0.49; 1 drink = 0.5 - 1.49; 2 drinks = 1.5 - 2.49; 3 drinks = 2.5 - 3.49; 4 drinks = 3.5 - 4.49.
The NHANES 99-00 dataset has about 50 nutrient intake variables of which 28 were included. They were the nutrients used to develop the new food patterns: energy, protein, carbohydrate, dietary fiber, total fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, linoleic acid, alpha-linolenic acid, cholesterol, vitamin A, vitamin E, vitamin C, thiamin, riboflavin, niacin, vitamin B-6, folate, vitamin B-12, calcium, phosphorus, magnesium, iron, zinc, copper, sodium (excluding salt added at the table), and potassium. Macronutrient intakes are presented in the tables both as a percentage of energy intake and as absolute intakes, and the micronutrient intakes are presented as nutrients densities (per 1,000 kcal) and as absolute intakes.
Among moderate drinkers, age 21 years and older, in the United States in 1999-2000, body mass index generally decreased with increasing amounts of alcohol consumed (Table G2-35). Energy and nutrient intakes generally increased with increasing amounts of alcohol (Table G2-35); while nutrient density of the diet generally decreased with increasing amounts of alcohol (Table 2G-36). Among women, the Healthy Eating Index (HEI) increased with increasing amounts of alcohol (Table G2-35); whereas, among men, the highest HEI was found among men who consumed an average of 2 drinks per day.
Some exceptions to these general conclusions were found. Men who consumed 3 or 4 drinks per day had lower vitamin A intakes than those who drank less, and the highest calcium intakes were by men who had 2 drinks per day. Vitamin C intakes by men decreased with increasing alcohol intake. Among women, carbohydrate intake decreased with increasing alcohol intake. Dietary fiber intakes by women consuming 2 or 3 drinks per day were lower than those who drank less. Total, saturated, monounsaturated, and polyunsaturated fat intakes were highest (in grams) among women who had an average of 1 drink per day. An exception for nutrient density results (Table G2-36) was that magnesium density in the diets of men increased with increasing alcohol intake.
Table G2-37 demonstrates the internal validity of the alcohol data. Mean alcohol intake as measured by 24-hour recalls increased with increasing amounts of alcohol as determined via self-reported frequency of drinking days over the past year and average number of drinks consumed per drinking day.
B. Introduction C. Methodology D. Science Base
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