Impact of Typical Rather than Nutrient-Dense Food Choices in the US Department of Agriculture Food Patterns Patricia Britten, PhD Linda E. Cleveland, MS, RD Kristin L. Koegel, MBA, RD Kevin J. Kuczynski, MS, RD Sharon M. Nickols-Richardson, PhD, RD JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS Britten, et al. J Acad Nutr Diet. 2012; 112 (Oct.)

Serum Vitamin C (mg/dl) by Salad Intake Impact of Typical Rather than Nutrient-Dense Food Choices in the US Department of Agriculture Food Patterns Background Serum Vitamin C (mg/dl) by Salad Intake USDA Food Patterns1,2 describe a total diet, at 12 calorie levels, designed to meet nutrient needs without exceeding energy requirements. recommend that nutrient-dense forms of food be consumed – i.e. lean or low-fat, with no added sugars or salt. include a small allowance for energy from solid fats and added sugars. Typical American diets differ from recommendations3-8 intakes from food groups below recommended amounts foods not consumed in nutrient-dense forms intakes of solid fats and added sugars exceed limits for 75% to 95% of population JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS Britten, et al. J Acad Nutr Diet. 2012; 112 (Oct.)

Serum Vitamin C (mg/dl) by Salad Intake Impact of Typical Rather than Nutrient-Dense Food Choices in the US Department of Agriculture Food Patterns Serum Vitamin C (mg/dl) by Salad Intake Key Research Question: What is the impact on energy and nutrient intake if consumers follow USDA Food Pattern advice about quantities to eat from each food group, but select typical rather than nutrient-dense forms of food in each food group? JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS Britten, et al. J Acad Nutr Diet. 2012; 112 (Oct.)

Serum Vitamin C (mg/dl) by Salad Intake Impact of Typical Rather than Nutrient-Dense Food Choices in the US Department of Agriculture Food Patterns Serum Vitamin C (mg/dl) by Salad Intake Methods USDA procedure for developing nutrient profiles was replicated.2 Energy and nutrient content were calculated using nutrient profiles that reflect typical, rather than nutrient-dense, food choices. Data from: National Health and Nutrition Examination Survey (NHANES) 2003-20049 National Nutrient Database for Standard Reference, Release 23 (NDB-SR23)10 MyPyramid Equivalents Database, Version 2.011 Results compared with the established nutritional goals for the Food Patterns.1 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS Britten, et al. J Acad Nutr Diet. 2012; 112 (Oct.)

Results Differences in Food Group Nutrient Profiles Impact of Typical Rather than Nutrient-Dense Food Choices in the US Department of Agriculture Food Patterns Results Differences in Food Group Nutrient Profiles Energy, solid fats, added sugars, saturated fatty acids, and sodium higher in typical compared to nutrient-dense nutrient profiles. Majority of the additional energy is from solid fats and added sugars. Largest calorie increases in Starchy Vegetables, Dairy, Poultry, Red and Orange Vegetables, and Whole Grains. Largest increase in saturated fatty acids content is in Dairy Group. Sodium levels more than double for Vegetables and Whole Grains. JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS Britten, et al. J Acad Nutr Diet. 2012; 112 (Oct.)

Results Differences in Food Pattern Nutrient Levels Impact of Typical Rather than Nutrient-Dense Food Choices in the US Department of Agriculture Food Patterns Results Differences in Food Pattern Nutrient Levels Moderation goals are not met when amounts of food in the USDA Food Patterns are followed but typical rather than nutrient-dense food choices are made. Energy is 350 to 450 calories above the target energy level for each pattern – 15% to 30% higher than the goal. Total fat, saturated fat, and sodium exceed limits in all patterns, often by substantial margins. Adequacy goals are not substantially affected. JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS Britten, et al. J Acad Nutr Diet. 2012; 112 (Oct.)

Comparison of Calories from Typical versus Nutrient-Dense Food Choices Impact of Typical Rather than Nutrient-Dense Food Choices in the US Department of Agriculture Food Patterns Comparison of Calories from Typical versus Nutrient-Dense Food Choices Comparison of calories from each food group in the USDA 2000 calorie Food Pattern with typical and nutrient-dense food choices. Typical food choices within each food group contain additional calories from solid fats and added sugars (SoFAS), as shown. In a few cases, the nutrient-dense representative foods also contain a small amount of SoFAS, not shown in the figure. JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS Britten, et al. J Acad Nutr Diet. 2012; 112 (Oct.)

Impact of Typical Rather than Nutrient-Dense Food Choices in the US Department of Agriculture Food Patterns Conclusions If consumers eat recommended quantities from each food group, but fail to choose foods in low-fat, no-added-sugars, and low-sodium forms, they will not meet the important moderation goals for the 2010 Dietary Guidelines for Americans. Typical food choices result in a diet that is too high in calories, total fat, saturated fat, solid fats, added sugars, and sodium. Registered Dietitians and other health and nutrition educators can help Americans achieve nutritional goals by teaching principles for selection of nutrient-dense foods. JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS Britten, et al. J Acad Nutr Diet. 2012; 112 (Oct.)

Impact of Typical Rather than Nutrient-Dense Food Choices in the US Department of Agriculture Food Patterns Citations 1. US Department of Agriculture and US Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th ed. Washington, DC: US Government Printing Office; December 2010. 2. Britten P, Cleveland LE, Koegel KL, Kuczynski KJ, Nickols-Richardson SM. Updated USDA food patterns meet goals of the 2010 Dietary Guidelines. [published online ahead of print July 31, 2012] J Acad Nutr Diet. 2012; doi:10.1016/j.jand.2012.05.021. 3. Dietary Guidelines Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010. Washington, DC: US Department of Agriculture, Agricultural Research Service; May 2010. 4. Guenther PM, Juan WY, Lino M, Hiza HA, Fungwe T, Lucas R. Diet quality of low-income and higher income Americans in 2003-04 as measured by the Healthy Eating Index-2005. December 2008. Nutrition Insight 42. Center for Nutrition Policy and Promotion Web site. Available at: http://www.cnpp.usda.gov/Publications/NutritionInsights/Insight42.pdf. Accessed May 23,2012. 5. Bachman JL, Reedy J, Subar AF, Krebs-Smith SM. Sources of food group intakes among the US population, 2001-2002. J Am Diet Assoc. 2008;108(5):804-814. 6. Sources of calories from solid fats among the US population, 2005–06. Risk Factor Monitoring and Methods Branch Web site. Applied Research Program. National Cancer Institute. Available at: http://riskfactor.cancer.gov/diet/foodsources/solid_fats/. Updated December 21, 2010. Accessed May 23, 2012. 7. Sources of calories from added sugars among the US population, 2005–06. Risk Factor Monitoring and Methods Branch Web site. Applied Research Program. National Cancer Institute. Available at: http://riskfactor.cancer.gov/diet/foodsources/added_sugars/ . Updated December 21, 2010. Accessed May 23, 2012. 8. Reedy J, Krebs-Smith SM. Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States. J Am Diet Assoc. 2010;110(10):1477-84. 9. NHANES 2003-2004 Dietary Files. Public-use data files and documentation. National Center for Health Statistics Web site. Available at: http://www.cdc.gov/nchs/nhanes/nhanes2003-2004/diet03_04.htm. Accessed May 23, 2012. 10. U.S. Department of Agriculture, Agricultural Research Service. USDA National Nutrient Database for Standard Reference, Release 23. Nutrient Data Laboratory Home Page. 2010. Available at: http://www.ars.usda.gov/Services/docs.htm?docid=8964. Accessed May 23, 2012. 11. Bowman SA, Friday JE, Moshfegh A. MyPyramid Equivalents Database, 2.0 for USDA Survey Foods, 2003-2004. USDA Agricultural Research Service, Food Surveys Research Group Web site. 2008. Available at: http://www.ars.usda.gov/Services/docs.htm?docid=17563. Accessed May 23, 2012. JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS Britten, et al. J Acad Nutr Diet. 2012; 112 (Oct.)