Impact of Adopting Lower-Fat Food Choices on Energy and Nutrient Intakes of American Adults

Objective To evaluate the energy and nutrient intake of free-living men and women who choose foods consistent with different fat-reduction strategies.Design For each year of the Continuing Survey of Food Intake by Individuals from 1989 through 1991, food codes were used to sort respondents by type of milk; type of meats; and type of cheese, yogurt, salad dressing, cake, and pudding (ie, full-fat or fat-modified products) consumed.Subjects A nationally representative sample of 3,313 men and 3,763 women who completed 3-day intake records and consumed either a reduced-fat or full-fat food from at least 1 of the 3 fat-reduction strategy categories.Statistical analysis performed Analysis of variance with the Scheffé test was used to analyze differences in energy and nutrient intake between exclusive users, mixed users, and nonusers of each strategy or combined strategies.Results Regardless of fat-reduction strategy, men and women who used them reported significantly lower intakes of total fat (up to 18 g lower), saturated fat (up to 12 g lower), cholesterol (up to 75 ing lower) and energy compared with nonusers. Exclusive users of single strategies met or approached recommendations of the National Cholesterol Education Program for total fat, saturated fat, and cholesterol intake; micronutrient intake varied depending on the strategy used. Skim milk users had the most favorable micronutrient intake, whereas lean meat users reported inadequate intake of zinc (men 6396 and women 59% of the Recommended Dietary Allowances [RDAs]) and female users of fat-modified products reported inadequate intakes of vitamin E (64% of RDA) and zinc (65% of RDA). Multiple-strategy users achieved National Cholesterol Education Program goals and reported adequate micronutrient intakes and significantly lower energy intake. Mixed users of fat-modified products compared with nonusers of any fat-modified products had adequate micronutrient intake and lower intakes of total fat (32% vs 36% of energy for men and 32% vs 35% of energy for women) and saturated fat (11% vs 13% of energy for men and 11% vs 12% of energy for women). In addition, nonusers of any fat-modified strategy had the highest cholesterol and energy intake and the lowest intake of. many micrbnutrients.Applications A variety of fat-reduction strategies can be implemented to reduce energy, total fat, saturated fat, and cholesterol intake. Some of the strategies were associated with an inadequate micronutrient intake, so additional dietary guidance is needed to ensure that all nutrient requirements are met. Furthermore, people who do not use any fat-reduction strategy or those who exclusively use lean meats or fat-modified products would benefit from understanding how to balance their food choices. J Am Diet Assoc. 1999;99:177–183.     

The nutritional impact of dairy product consumption on dietary intakes of adults (1995-1996): the Bogalusa Heart Study

OBJECTIVE: To examine the nutritional impact of dairy product consumption on the dietary intakes of adults. DESIGN: Dietary intakes of adults who participated in a cross-sectional survey (1995-1996) in Bogalusa, LA. SUBJECTS: Dietary intake data were collected on 1,266 adults (61% women, 39% men; 74% white, 26% African American) in Bogalusa, LA. STATISTICAL ANALYSIS: Analysis of covariance was used to examine the mean nutrient intake differences among four dairy consumption groups. Significance tests in multiple comparisons between any two groups were conducted using Tukey's procedure. RESULTS: Forty-eight percent of adults consumed one serving or less of dairy products, 32% consumed two servings, 12% consumed three servings, and 8% consumed four or more servings. Overall mean intake of dairy was higher in whites (mean=1.63) compared with African Americans (mean=1.22) (P<.0001), especially the consumption of milk and cheese. No differences were found in overall mean intake of dairy servings by sex after adjusting for energy intake. However, women consumed significantly more servings of cheese (P<.0001) and yogurt (P<.01) than men. There were higher intakes of total energy, saturated fat, total protein, animal protein, and lactose (P<.0001), with greater number of servings of dairy products consumed. There were lower intakes of monounsaturated and polyunsaturated fatty acids (P<.0001), vegetable protein (P<.0001), total carbohydrates (P<.01), sucrose (P<.001), fructose (P<.0001), and fiber (P<.001). The percentage of energy from saturated fat (P<.0001) and protein (P<.001) increased with increasing number of dairy servings consumed. Intakes of calcium; magnesium; potassium; zinc; sodium; folate; thiamin; riboflavin; and vitamins B-6, B-12, A, D, and E were higher with greater number of dairy servings consumed. There was lower consumption of sweetened beverages (P<.001), specifically regular soft drinks (P<.0001), with greater consumption of milk products. CONCLUSIONS: Dairy product consumption by adults has a major influence on their vitamin and mineral intakes. The higher intakes of saturated fat, total energy, and animal protein and lower intake of fiber suggest that it may be useful to consume lower-fat dairy products and/or modify eating patterns to optimize the nutritional contributions of dairy products. Public health organizations and dietetics professionals need to educate adults on practical strategies for increasing dairy product consumption for improving the nutritional quality of adults' diets.     

Food mixture or ingredient sources for dietary calcium: shifts in food group contributions using four grouping protocols

Identifying dietary sources of nutrients by assigning survey foods to food groups can under- or overestimate the contribution a group makes to the intake of specific nutrients. Using calcium and food intakes from USDA's 1994-1996, 1998 Continuing Survey of Food Intakes by Individuals, the authors determined the proportion of dietary calcium from the dairy, grains, meats, fruits, and vegetables groups using four grouping protocols. Calcium contributions from milk and cheese were higher as more ingredient sources and fewer survey food items were represented in the dairy group. Milk, cheese, and yogurt reported as separate survey food items contributed 42% of total calcium intake. An additional 21% of dietary calcium came from dairy ingredients in mixed foods such as macaroni and cheese, pizza, sandwiches, and desserts. The remaining dietary calcium sources were single grains (16%); vegetable (7%); meat, poultry, and fish (5%); fruit (3%); and miscellaneous foods (7%). Data quantifying the nutrient contributions from dairy ingredients could affect dietary guidance messages or research using dairy foods as variables.     

Dairy food intake is positively associated with cardiovascular health: findings from Observation of Cardiovascular Risk Factors in Luxembourg study

Conflicting findings have been reported about dairy food consumption and risk for cardiovascular disease. Furthermore, few studies have examined dairy food intake in relation to cardiovascular health and the incorporation of lifestyle factors such as diet and physical activity. This study examined whether dairy food consumption was associated with cardiovascular health, recently defined by the American Heart Association. Data were analyzed from 1352 participants from the Observation of Cardiovascular Risk Factors in Luxembourg survey. A validated food frequency questionnaire was used to measure intakes of milk, yogurt, cheese, dairy desserts, ice cream, and butter. Seven cardiovascular health metrics were assessed: smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting plasma glucose. A total cardiovascular health score (CHS) was determined by summing the total number of health metrics at ideal levels. It was hypothesized that greater dairy food consumption (both low fat and whole fat) would be associated with better global cardiovascular health, as indicated by a higher CHS. Total dairy food intake was positively associated with the CHS. Higher intakes of whole fat milk, yogurt, and cheese were associated with better cardiovascular health. Even when controlling for demographic and dietary variables, those who consumed at least 5 servings per week of these dairy products had a significantly higher CHS than those who consumed these products less frequently. Higher total whole fat dairy food intake was also associated with other positive health behaviors, including being a nonsmoker, consuming the suggested dietary intakes of recommended foods, and having a normal body mass index. Increased dairy food consumption was associated with better cardiovascular health.     

Dietary sources of fats and cholesterol in US children aged 2 through 5 years.

OBJECTIVES. This study of lipid intakes among preschool children (1) analyzed the contributions of 38 food groups to fat, saturated fat, and cholesterol intakes; (2) estimated the effects of food substitutions on intakes; and (3) examined demographic differences in food group intake and food group sources of these lipids. METHODS. The sample consisted of 547 children, aged 2 to 5 years, from the US Department of Agriculture''s 1985 and 1986 Continuing Surveys of Food Intakes by Individuals. Dietary information for 4 nonconsecutive days throughout a year was used. All foods were classified into groups and the lipids contributed from each group were computed. RESULTS. Over 80% of the children consumed more total fat, saturated fats, and cholesterol than is recommended. The major source of total fat and saturated fats was whole milk; the major sources of dietary cholesterol were eggs and whole milk. Children''s food consumption patterns differed by region of the country and race/ethnicity, providing opportunities to refine nutrition education interventions and evaluations. CONCLUSIONS. By substituting lower-fat foods for the major sources of saturated fats, significant reductions in preschool children''s intakes of saturated fats, fat, and dietary cholesterol could be achieved.     

Trends in serum total cholesterol and dietary fat intakes in New Zealand between 1989 and 2009

Objective : To describe trends in serum cholesterol and dietary fat intakes for New Zealand adults between 1989 and 2008/09. Methods : Serum total cholesterol concentrations and dietary fat intakes were analysed for 9,346 New Zealanders aged 15–98 years (52% women) who participated in three national surveys in 1989, 1997 and 2008/09. Results : Population mean serum cholesterol decreased from 6.15 mmol/L in 1989 to 5.39 mmol/L in 2008/09. Mean saturated fat intake decreased from 15.9% of energy intake in 1989 to 13.1% in 2008/09. Between 1997 and 2008/09, unsaturated fat intake increased and fat from butter and milk decreased. Older adults had the largest decrease in serum cholesterol (1.35 mmol/L). Conclusions : The decrease in serum cholesterol is substantially larger than reported for many other high‐income countries, and occurred in parallel with changes in dietary fat intakes and, for older adults, increased use of cholesterol‐lowering medications. Implication : Given the demonstrated role of reduced saturated fat intake on lowering serum cholesterol, and as population average serum cholesterol levels and saturated fat intakes exceed recommended levels, initiatives to further encourage reductions in saturated fat are imperative.     

Association of dairy products,lactose, and calcium with the risk of ovarian cancer

Epidemiologic findings have been inconsistent regarding the association of dietary fat, dairy products, and lactose with risk of ovarian cancer. The authors conducted a case-control study in Hawaii and Los Angeles, California, to examine several dietary hypotheses regarding the etiology of ovarian cancer in a population with a broad range of dietary intakes. A total of 558 patients with ovarian cancer diagnosed in 1993-1999 and 607 controls were interviewed regarding their diet. Consumption of all dairy products, all types of milk, and low-fat milk, but not consumption of whole milk, was significantly inversely related to the odds of ovarian cancer. Similar inverse gradients in the odds ratios were obtained for intakes of lactose and calcium, although these nutrients were highly correlated (r = 0.77). The odds ratio for ovarian cancer was 0.46 (95% confidence interval: 0.27, 0.76) among women in the highest quartile of dietary calcium intake versus the lowest (p for trend = 0.0006). The significant dietary association was limited to dairy sources of calcium (p for trend = 0.003), although a nonsignificant inverse gradient in risk was also found in relation to calcium supplement intake. These results suggest that intake of low-fat milk, calcium, or lactose may reduce the risk of ovarian cancer.     

Associations of Dairy Intake with Circulating Biomarkers of Inflammation,Insulin Response,and Dyslipidemia among Postmenopausal Women

BackgroundCardiometabolic diseases are prevalent in aging Americans. Although some studies have implicated greater intake of dairy products, it is not clear how dairy intake is related to biomarkers of cardiometabolic health.ObjectiveOur aim was to test the hypothesis that associations of dairy foods with biomarkers of lipid metabolism, insulin-like growth factor signaling, and chronic inflammation may provide clues to understanding how dairy can influence cardiometabolic health.DesignThis was a cross-sectional study in the Women's Health Initiative using baseline food frequency questionnaire data to calculate dairy intake.Participants/settingParticipants were 35,352 postmenopausal women aged 50 to 79 years at 40 clinical centers in the United States.Main outcome measuresBaseline (1993-1998) concentrations of 20 circulating biomarkers were measured.Statistical analysesMultivariable-adjusted linear regression was used to estimate percent difference in biomarker concentrations per serving of total dairy and individual foods (milk, cheese, yogurt, butter, and low-fat varieties).ResultsLower triglyceride concentrations were associated with greater intake of total dairy (–0.8% [95% CI –1.2% to –0.3%]), mainly driven by full-fat varieties. Individual dairy foods had specific associations with circulating lipid components. For example, greater total milk intake was associated with lower concentrations of total cholesterol (–0.4% [95% CI –0.7% to –0.2%]) and high-density lipoprotein cholesterol (–0.5% [95% CI –0.9% to –0.1%]), whereas greater butter intake was associated with higher total cholesterol (0.6% [95% CI 0.2% to 1.0%]) and high-density lipoprotein cholesterol (1.6% [95% CI 1.1% to 2.0%]) concentrations. In contrast, higher total yogurt intake was associated with lower total cholesterol (–1.1% [95% CI –2.0% to –0.2%]) and higher high-density lipoprotein cholesterol (1.8% [95% CI 0.5% to 3.1%]). Greater total dairy intake (regardless of fat content), total cheese, full-fat cheese, and yogurt were consistently associated with lower concentrations of glucose, insulin, and C-reactive protein. However, milk and butter were not associated with these biomarkers.ConclusionsHigher dairy intake, except butter, was associated with a favorable profile of lipids, insulin response, and inflammatory biomarkers, regardless of fat content. Yet, specific dairy foods might influence these markers uniquely. Findings do not support a putative role of dairy in cardiometabolic diseases observed in some previous studies.     

The contribution of yogurt to nutrient intakes across the life course

Yogurt is a nutrient‐dense food within the milk and dairy products food group. The nutritional content of yogurt varies depending on the processing method and ingredients used. Like milk, it is a good source of protein and calcium, and can be a source of iodine, potassium, phosphorus and the B vitamins – riboflavin (B₂) and vitamin B₁₂ (depending on type). Some yogurt products are also fortified with vitamin D. The nutritional value of dairy products (milk, cheese and yogurt) and the importance of the nutrients they provide for bone health are well recognised. These foods are collected together as one of the four main food groups within the UK's eatwell plate model that illustrates a healthy, balanced diet. Studies exploring the nutritional and health attributes of yogurt are limited but some research has suggested benefits in relation to bone mineral content, weight management, type 2 diabetes and metabolic profile. Yogurt consumption has also been associated with diet quality. The aim of this paper is to use national survey data to examine yogurt consumption in the UK and consider its contribution to nutrient intakes at different life stages within the context of nutritional challenges in each age group. The contribution of yogurt to energy and nutrient intakes across the life course was calculated via secondary analysis of data from the Diet and Nutrition Survey of Infants and Young Children (2011) and the National Diet and Nutrition Survey (2008/2009–2010/2011). The products categorised within the ‘yogurt group’ included all yogurt, fromage frais and dairy desserts, and fortified products. Comparisons were also made between specific sub‐categories of yogurt, namely ‘yogurt’, ‘fromage frais’ and ‘dairy desserts’. Nutrients included in the analyses were energy; the macronutrients; micronutrients that yogurt can be defined as a ‘source of’; micronutrients that may be of concern in the UK population; and vitamin D for fortified products. A simple dietary modelling exercise was also undertaken to investigate the potential impact of including an additional pot of yogurt per day on the nutrient intakes of adolescents. Children aged 3 years and under had the highest intakes of yogurt [mean intake 43.8 g/day (SD 39.7 g) in 4–18 month‐olds; 46.7 g/day (SD 39.1 g) in 1.5–3 year‐olds], and adolescents (11–18 years) consumed the least [21 g/day (SD 38.0 g)]. In adults, highest mean consumption [35.7 g/day (SD 55.0 g)] was during middle age (50–64 years), equivalent to less than a third of a standard 125 g pot. Around 80% of young children (aged 3 years and under) but only a third of teenagers and young adults had consumed any yogurt product during the survey period of 4 days. Average yogurt consumption was twice as high in women as men among older adults (65 years and over), while gender differences in consumption were less apparent in children. Fromage frais and fortified yogurt products were most commonly consumed by younger children, as were dairy desserts in those aged 4–18 years. Among adults, yogurt per se was most commonly consumed. Children aged 4–10 years exhibited the most variety in the types of yogurt consumed. Low‐fat yogurt (including those with added fruit, nuts and cereals) was the most commonly consumed yogurt type when all ages were combined. More than a third of all yogurt products consumed by children aged 3 years and under were fortified, compared with 18% in those aged 4–10 years. During adulthood, the consumption of fortified products was negligible. The yogurt group made a useful contribution to micronutrient intakes in children aged 4 months to 10 years, particularly vitamin B₁₂ (4–18 months: 7.6%; 1.5–3 years: 5.3%; 4–10 years: 3.8%), riboflavin (7.8%, 6.9%, and 5.7%, respectively), calcium (9.5%, 8.2%, and 5.9%, respectively), iodine (7.2%, 7.6%, and 7%, respectively) and phosphorus (8.1%, 6.3%, and 4.3%, respectively). It also provided 3.9% of the total intake of vitamin D in those aged 4–18 months and 10.5% in those aged 1.5–3 years. Although the contribution to total dietary energy intake was low (4.9% at 4–18 months and 4.2% at 1.5–3 years), yogurt contributed a high proportion of non‐milk extrinsic sugars (NMES) to the diets of young children (22.7% and 11.1% in 4–18 months and 1.5–3 years, respectively). However, the total NMES intake was comparatively low in children aged 4–18 months (6.7% total energy), and 11.6% in 1.5–3 year‐olds (compared to 15.3% total energy in children aged 11–18 years in this survey). As children aged, the contribution of yogurt (all categories combined) to micronutrient intake, as well as to NMES, decreased, reflecting the increasing amounts and variety of foods in the diet. Yogurt made a small contribution to energy and macronutrient intakes during adulthood, with the greatest proportions mostly in the older age group (65 years and over) (energy: 1.7%; fat: 1.3%; saturated fatty acids: 2.1%; NMES: 4%). As intake was higher among women, yogurt made a greater contribution to their micronutrient intakes compared with men, providing >5% of the reference nutrient intakes (RNIs) for phosphorus, iodine, calcium, vitamin B₁₂ and riboflavin. Simple dietary modelling was carried out to investigate the hypothetical change in mean nutrient intakes among adolescents aged 11–14 and 15–18 years, if they were all to add an extra 125 g pot of low‐fat fruit yogurt to their current diet. This showed an increase in average intake, as a percentage of the RNI, for several micronutrients for which there is some evidence of low intakes in this age group, notably calcium in boys and girls (11–18 years) and iodine in girls (11–18 years). Although some benefits for micronutrient intakes were noted, such advice would impact on energy and macronutrient intakes (including NMES), and would need to be given in the context of the wider diet (e.g. as ‘swaps’ for less nutrient‐dense foods). In conclusion, yogurt makes a small but valuable contribution to nutrient intakes in the UK, particularly in young children. Among adolescents, the addition of a low‐fat yogurt would help meet recommended intakes for several micronutrients, particularly calcium and iodine, which are of concern in some teenage diets. Advice to replace some types of snacks and desserts, particularly those high in fat and sugars and low in micronutrients, with a pot of yogurt or similar dairy product may improve the nutrient density of their diet.     

The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults

OBJECTIVE: To examine, in free-living adults eating self-selected diets, the effects on plasma cholesterol of substituting saturated fat rich foods with either n-6 polyunsaturated or monounsaturated fat rich foods while at the same time adhering to a total fat intake of 30-33% of dietary energy. DESIGN: Two randomised crossover trials. SETTING: General community. SUBJECTS: Volunteer sample of healthy free-living nutrition students at the University of Otago. Trial I, n=29; and trial II, n=42. INTERVENTIONS: In trials I and II participants were asked to follow for 2(1/2) weeks a diet high in saturated fat yet with a total fat content that conformed to nutrition recommendations (30-33% energy). During the 2(1/2) week comparison diet, saturated fat rich foods were replaced with foods rich in n-6 polyunsaturated fats (trial I) whereas in trial II the replacement foods were rich in monounsaturated fats. Participants were asked to maintain a total fat intake of 30-33% of energy on all diets. MAIN OUTCOME MEASURES: Energy and nutrient intakes, plasma triglyceride fatty acids, and plasma cholesterol. RESULTS: When replacing saturated fat with either n-6 polyunsaturated fat or monounsaturated fat, total fat intakes decreased by 2.9% energy and 5.1% energy, respectively. Replacing saturated fat with n-6 polyunsaturated fat (trial I) lowered plasma total cholesterol by 19% [from 4.87 (0.88) to 3.94 (0.92) mmol/l, mean (s.d.)], low density lipoprotein cholesterol by 22% [from 2.87 (0.75) to 2.24 (0.67) mmol/l], and high density lipoprotein cholesterol by 14% [from 1.39 (0.36) to 1.19 (0.34) mmol/l], whereas replacing saturated fat with monounsaturated fat (trial II) decreased total cholesterol by 12%, low density lipoprotein cholesterol by 15%, and high density lipoprotein cholesterol by 4%, respectively. The change in the ratio of total to high density lipoprotein cholesterol was similar during trial I and trial II. CONCLUSIONS: Young adults are very responsive to dietary-induced changes in plasma cholesterol even when an isocaloric replacement of saturated fat with n-6 polyunsaturated or monounsaturated fat is not achieved. Replacing saturated fat with either n-6 polyunsaturated or monounsaturated fat is equally efficacious at reducing the total to high density lipoprotein cholesterol ratio. SPONSORSHIP: University of Otago, Meadow Lea Ltd.     

Replacing cows' with sheep's dairy fat lowers plasma cholesterol concentration in participants consuming dairy fat-rich diets

OBJECTIVE: To determine the effects on plasma cholesterol concentration of replacing cows' dairy fat with sheep's dairy fat. DESIGN: Randomised crossover dietary intervention. SETTING: General community, Dunedin, New Zealand. SUBJECTS: Volunteer sample of 41 healthy adults with initial plasma cholesterol concentration between 4.8 and 7.8 mmol/l. INTERVENTIONS: Participants were asked to follow a self-selected low-fat background diet throughout the study to which, during each of the 2, 3-week dairy diets, they were asked to add sheep's or cows' dairy products. MAIN OUTCOME MEASURES: Energy and nutrient intakes, plasma triacylglycerol fatty acids, and plasma cholesterol. RESULTS: Energy and nutrient intakes on the sheep-dairy and cow-dairy diets were very similar, with total, saturated, monounsaturated and polyunsaturated fat contributing 34, 18-19, 9, and 3% of total energy intake, respectively. Participants consumed approximately 50 g/day of dairy fat on each diet. Replacing cows' with sheep's dairy fat led to a 0.33 (0.11-0.56, 95% CI) mmol/l decrease (6%) in plasma total cholesterol concentration, from 5.53 (0.90, s.d.) to 5.20 (0.90) mmol/l. Plasma low-density lipoprotein (LDL) cholesterol was 0.18 (0.02-0.33) mmol/l lower on the sheep-dairy diet as was the concentration of plasma high-density lipoprotein (HDL) cholesterol, 0.11 (0.02-0.20) mmol/l. The LDL to HDL cholesterol ratio at the end of the sheep-dairy diet, 2.91 (1.10), was not significantly different (P>0.05) from the cow-dairy diet, 2.73 (0.83). CONCLUSIONS: Within the context of a diet high in dairy fat (50 g/day), replacing cows' milk fat with sheep's milk fat leads to a small reduction in plasma cholesterol concentration, but no change in the ratio of LDL to HDL cholesterol.     

Food and nutrient intakes and their associations with lower BMI in middle-aged US adults: the International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP)

BACKGROUND: Clinical trial data show that reduction in total energy intake enhances weight loss regardless of the macronutrient composition of the diet. Few studies have documented dietary patterns or nutrient intakes that favor leanness [BMI (in kg/m(2)) ≤25] in free-living populations. OBJECTIVE: This investigation examined associations of usual energy, food, and nutrient intakes with BMI among US participants of the International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP). DESIGN: The INTERMAP is an international cross-sectional study of dietary factors and blood pressure in men and women (ages 40-59 y) that includes 8 US population samples. The present study included data from 1794 Americans who were not consuming a special diet and who provided four 24-h dietary recalls and 2 timed 24-h urine collections. Multivariable linear regression with the residual method was used to adjust for energy intake; sex-specific associations were assessed for dietary intakes and urinary excretions with BMI adjusted for potential confounders including physical activity. RESULTS: Lower energy intake was associated with lower BMI in both sexes. Univariately, higher intakes of fresh fruit, pasta, and rice and lower intakes of meat were associated with lower BMI; these associations were attenuated in multivariable analyses. Lower urinary sodium and intakes of total and animal protein, dietary cholesterol, saturated fats, and heme iron and higher urinary potassium and intakes of carbohydrates, dietary fiber, and magnesium were associated with lower BMI in both sexes. CONCLUSION: The consumption of foods higher in nutrient-dense carbohydrate and lower in animal protein and saturated fat is associated with lower total energy intakes, more favorable micronutrient intakes, and lower BMI.     

Food sources of energy, macronutrients, cholesterol, and fiber in diets of women.

Data from the 1985 Continuing Survey of Food Intakes by individuals were used to calculate the contributions of individual foods to women's intakes of energy, protein, carbohydrate, fat, saturated fatty acids, cholesterol, and fiber. We separated nearly all food mixtures into their constituent ingredients, grouped the ingredients together with similar foods, and examined the contributions of those foods. Yeast breads that were neither whole grain nor higher fiber contributed about 7% of the energy to the diets, which made them the leading source of energy of the foods we examined. The leading sources of protein were animal products: poultry contributed approximately 12%, beef contributed about 19%, cheese contributed about 8%, and pork contributed about 6%. The various fats and oils were the greatest contributors to fat, and cheese was the chief source of saturated fatty acids. Eggs were the major source of cholesterol; they provided around 36% of the total. Two of the top three sources of carbohydrate--regular soft drinks and sugar--are composed entirely of simple sugars. Potatoes provided around 11% of the fiber, which made them the leading source of fiber. This article shows that the relative ranking of foods and the contribution of each food depend on the way food codes are combined. Therefore, citing one food as the major source of a particular food component without including documentation of how foods are combined can be misleading.     

Trends in nutrient intake of 10-year-old children over two decades (1973-1994) : the Bogalusa Heart Study

Dietary intakes of 10-year-old children were examined in seven cross-sectional surveys to observe secular trends in nutrient intake and food consumption patterns over 2 decades (1973-1994). Total energy intake remained unchanged from 1973 to 1994. However, when expressed as energy per kilogram body weight, intake decreased from 65.5 kcal in 1973 to 55.4 kcal in 1994 because children's weight increased. A significant trend was noted in ponderal index, which increased from 12.31 (1973-1974) to 13.71 (1992-1994), with an actual weight gain of 1.45 kg from 1973 to 1979 and 2.71 kg from 1981 to 1994. Linear trends also were noted for total fat (negative), saturated fat (negative), dietary cholesterol (negative), polyunsaturated fat (positive), and total carbohydrate (positive). There was a significant increase in percent energy from protein and carbohydrate and a significant decrease in percent energy from fat, primarily saturated and monounsaturated fat. Trends in nutrient intakes of children reflected trends in food consumption. The percentage of total fat from fats/oils, mixed meats, eggs, milk, pork, and desserts decreased, while that from poultry, cheese, and snacks increased. Although more children met dietary recommendations for total fat, saturated fat, and dietary cholesterol, the vast majority continued to exceed prudent diet recommendations.     

Food-based dietary guidelines--the Austrian perspective

Presently, no national dietary guidelines--neither food- nor nutrient-based--exist for Austria. Usually, the recommendations of the German Society of Nutrition are used instead. The determination of national characteristics of nutritional behaviour and food consumption can reveal starting-points for the improvement of nutritional status in Austria. Seven-day weighed records (children and adolescents, n = 2.173) and 24-h-recalls (adults, n = 2.488) were used for the evaluation of nutrient intake and food consumption. For a sub-sample of children and adolescents, results from laboratory assessment of biomarkers were also available (n = 1.400). Based on fat intake, the age groups were divided into low fat intake (less than 25th percentile = 28-34% fat energy) and high-fat eaters (greater than 75th percentile = 38-45% fat energy). Approximately 75% of the Austrian population have fat intakes above 30% of energy intake, older age groups having a higher prevalence of high fat intakes. Intakes of saturated fatty acids reach 40-46% of total fat. The usual intake of dietary fibre in the Austrian population is between 17-21 g/d; some individuals are able to achieve the recommended intakes for dietary fibre, but do not represent a significant majority of the population. The mean intakes of fruits are clearly higher in children and adolescents (10% of total food intake) than in adults (2-6%). Differences in the intake of selected nutrients in foods between low and high fat consumers, unexpectedly, did not result in different plasma concentrations of cholesterol, nor did it result in differences in fat soluble vitamins. Therefore, one of the primary dietary guidelines for Austria should be the reduction of fat consumption, which is also associated with increasing intakes of fruits and vegetables, increasing intakes of dietary fibre and decreasing intakes of cholesterol.     

Intake of Dairy Products in Relation to Periodontitis in Older Danish Adults

This cross-sectional study investigates whether calcium intakes from dairy and non-dairy sources, and absolute intakes of various dairy products, are associated with periodontitis. The calcium intake (mg/day) of 135 older Danish adults was estimated by a diet history interview and divided into dairy and non-dairy calcium. Dairy food intake (g/day) was classified into four groups: milk, cheese, fermented foods and other foods. Periodontitis was defined as the number of teeth with attachment loss ≥3 mm. Intakes of total dairy calcium (Incidence-rate ratio (IRR) = 0.97; p = 0.021), calcium from milk (IRR = 0.97; p = 0.025) and fermented foods (IRR = 0.96; p = 0.03) were inversely and significantly associated with periodontitis after adjustment for age, gender, education, sucrose intake, alcohol consumption, smoking, physical activity, vitamin D intake, heart disease, visits to the dentist, use of dental floss and bleeding on probing, but non-dairy calcium, calcium from cheese and other types of dairy food intakes were not. Total dairy foods (IRR = 0.96; p = 0.003), milk (IRR = 0.96; p = 0.028) and fermented foods intakes (IRR = 0.97; p = 0.029) were associated with reduced risk of periodontitis, but cheese and other dairy foods intakes were not. These results suggest that dairy calcium, particularly from milk and fermented products, may protect against periodontitis. Prospective studies are required to confirm these findings.     

Association between dairy food consumption and weight change over 9 y in 19,352 perimenopausal women

BACKGROUND: Dairy foods may play a role in the regulation of body weight. OBJECTIVE: We examined the association between changes in dairy product consumption and weight change over 9 y. DESIGN: The study was conducted in 19 352 Swedish women aged 40-55 y at baseline. Data on dietary intake, body weight, height, age, education, and parity were collected in 1987-1990 and 1997. The intake frequencies of whole milk and sour milk (3% fat), medium-fat milk (1.5% fat), low-fat milk and sour milk (or=1 serving/d; 3) constant, >or=1 serving/d; and 4) decreased from >or=1 serving/d to <1 serving/d. Odds ratios (ORs) with 95% CIs for an average weight gain of >or=1 kg/y were calculated by using multivariable logistic regression analyses, with group 1 as the reference. RESULTS: Mean (+/-SD) body mass index (in kg/m2) at baseline was 23.7 +/- 3.5. The constant (>or=1 serving/d) intakes of whole milk and sour milk and of cheese were inversely associated with weight gain; ORs for group 3 were 0.85 (95% CI: 0.73, 0.99) and 0.70 (95% CI: 0.59, 0.84) respectively. No significant associations were seen for the other 3 intake groups. When stratified by BMI, the findings remained significant for cheese and, for normal-weight women only, for whole milk and sour milk. CONCLUSION: The association between the intake of dairy products and weight change differed according to type of dairy product and body mass status. The mechanism behind these findings warrants further investigation.     

Influence of dairy product and milk fat consumption on cardiovascular disease risk: a review of the evidence

Although evidence has linked the consumption of saturated fat (SF) to increased LDL levels and an increased risk of the development of cardiovascular disease (CVD), recent findings have indicated that the link between CVD and SF may be less straightforward than originally thought. This may be due to the fact that some food sources high in SF contain an array of saturated and unsaturated fatty acids, each of which may differentially affect lipoprotein metabolism, as well as contribute significant amounts of other nutrients, which may alter CVD risk. The purpose of this review is to examine the published research on the relationship between milk fat containing dairy foods and cardiovascular health. The findings indicate that the majority of observational studies have failed to find an association between the intake of dairy products and increased risk of CVD, coronary heart disease, and stroke, regardless of milk fat levels. Results from short-term intervention studies on CVD biomarkers have indicated that a diet higher in SF from whole milk and butter increases LDL cholesterol when substituted for carbohydrates or unsaturated fatty acids; however, they may also increase HDL and therefore might not affect or even lower the total cholesterol:HDL cholesterol ratio. The results from the review also indicate that cheese intake lowers LDL cholesterol compared with butter of equal milk fat content. In addition, the review highlights some significant gaps in the research surrounding the effects of full-fat dairy on CVD outcomes, pointing to the need for long-term intervention studies.     

No differences in growth or body composition from age 12 to 24 months between toddlers consuming 2% milk and toddlers consuming whole milk

OBJECTIVE: To determine whether consumption of 2% milk during the second year of life leads to reduced growth or lower percentage body fat compared with consumption of whole milk. SUBJECTS: Subjects were healthy toddlers who participated in a larger trial examining the effects of the timing of introduction of solid foods on growth. DESIGN: Three-day diet diaries, anthropometric measurements, and body composition determined by dual-energy x-ray absorptiometry were assessed at 12, 18, and 24 months of age. At age 12 months, the toddlers were similar in length, weight, percentage body fat, and total energy intake. From 12 to 24 months of age, milk consumption consisted of whole milk exclusively in one group (n = 23) and 2% milk exclusively in another group (n = 28). STATISTICAL ANALYSES: Differences between the 2 groups in anthropometric measurements, changes in anthropometric measurements, and dietary intakes were determined by Student t tests. Mean differences were considered significant at the P = .05 level. Data are presented as mean +/- standard deviation. RESULTS: Despite lower intakes of total fat and saturated fat in the 2% milk group, there were no differences in height, weight, and percentage body fat. Total energy intake was not reduced in the 2% milk group. APPLICATIONS: Reductions in total fat and saturated fat intake in toddlers can be achieved through the use of 2% milk without compromising growth.     

Whole-fat dairy food intake is inversely associated with obesity prevalence: findings from the Observation of Cardiovascular Risk Factors in Luxembourg study

Because research focusing on dairy food consumption and the risk for obesity is inconsistent and only a few studies have even examined specific dairy products, in regard to type of food and fat content, in relation to obesity risk, this cross-sectional study investigated whether dairy food consumption is associated with the prevalence of global and abdominal obesity. Data were analyzed from 1352 participants in the Observation of Cardiovascular Risk Factors in Luxembourg survey. We hypothesized that higher total dairy food consumption would be independently associated with reduced prevalence of obesity. A validated food frequency questionnaire was used to measure intakes of dairy foods. Odds for global obesity (body mass index ≥30 kg/m²) and abdominal obesity (waist circumference >102 cm for men and >88 cm for women) were determined based on total dairy food intake as well as intakes of individual low- and whole-fat dairy products (milk, yogurt, and cheese). Total dairy food intake was inversely associated with the likelihood of global obesity (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.30-0.89; P < .05) and abdominal obesity (OR, 0.51; 95% CI, 0.32-0.83; P < .01). Participants in the highest tertile of whole-fat dairy intakes (milk, cheese, yogurt) had significantly lower odds for being obese (global obesity: OR, 0.45; 95% CI, 0.29-0.72; P < .01; abdominal obesity: OR, 0.35; 95% CI, 0.23-0.54; P < .001), compared with those in the lowest intake tertile, after full adjustment for demographic, lifestyle, dietary, and cardiovascular risk factor variables. Increasing consumption of dairy foods may have the potential to lower the prevalence of global and abdominal obesity.