Empty calories? Nutrient intake in relation to sugar intake in English adolescents

The relation between the intake of added sugars and other nutrients was examined by analysing the diet of 405 English children aged 11–14 years. For each sex, the nutrient intake of the 30 subjects with the highest intake of added sugars in proportion to energy intake (g/MJ) was compared with the nutrient intake of the 30 subjects with the lowest intake of added sugars in proportion to energy intake. Those eating the highest amount of added sugars consumed less protein and vitamin D compared with those who ate the lowest amounts of added sugars.
Some differences in the nutrient intakes of the high and low added sugar groups were observed for girls only, and non-significant trends were observed in both sexes, tending to suggest that those consuming diets containing low levels of added sugars in proportion to energy (a low preference for sugar) ate a more nutrient-dense diet and, to some extent, supported the concept of 'empty calories'. However, when sugars intake was expressed as g weight (and not in proportion to energy), energy intake and consumption of most nutrients were considerably higher in those eating high levels of added sugars, probably because of their higher intake of foods in general.     

Fortified Foods Are Major Contributors to Nutrient Intakes in Diets of US Children and Adolescents

BackgroundEven in an era of obesity and dietary excess, numerous shortfall micronutrients have been identified in the diets of US children and adolescents. To help tailor strategies for meeting recommendations, it is important to know what foods contribute greatly to micronutrient intakes. Data are lacking on specific contributions made by added nutrients.ObjectiveOur aims were to examine the impact of fortification on nutrient adequacy and excess among US children and adolescents and to rank food sources of added nutrient intake and compare rankings with those based on total nutrient intake from foods.Design and statistical analysesData were from 7,250 respondents 2 to 18 years old in the National Health and Nutrition Examination Survey 2003-2006. Datasets were developed that distinguished nutrient sources: intrinsic nutrients in foods; added nutrients in foods; foods (intrinsic plus added nutrients); and total diet (foods plus supplements). The National Cancer Institute method was used to determine usual intakes of micronutrients by source. The impact of fortification on the percentages of children having intakes less than the Estimated Average Requirement and more than the Upper Tolerable Intake Level was assessed by comparing intakes from intrinsic nutrients to intakes from intrinsic plus added nutrients. Specific food sources of micronutrients were determined as sample-weighted mean intakes of total and added nutrients contributed from 56 food groupings. The percentage of intake from each grouping was determined separately for total and added nutrients.ResultsWithout added nutrients, a high percentage of all children/adolescents had inadequate intakes of numerous micronutrients, with the greatest inadequacy among older girls. Fortification reduced the percentage less than the Estimated Average Requirement for many, although not all, micronutrients without resulting in excessive intakes. Data demonstrated the powerful influence of fortification on food-source rankings.ConclusionsKnowledge about nutrient intakes and sources can help put dietary advice into a practical context. Continued monitoring of top food sources of nutrients and nutrient contributions from fortification will be important.     

Modelling the Impact of Reducing Ultra-Processed Foods Based on the NOVA Classification in Australian Women of Reproductive Age

Women of reproductive age have a high proportion of overweight/obesity and an overall poor nutritional intake and diet quality. Nutritional modelling is a method to forecast potential changes in nutrition composition that may offer feasible and realistic changes to dietary intake. This study uses simulation modelling to estimate feasible population improvements in dietary profile by reducing ultra-processed food (UPF) consumption in Australian women of reproductive age. The simulation used weighted data from the most recent 2011–2012 National Nutrition and Physical Activity Survey. A total of 2749 women aged 19–50 years was included, and 5740 foods were examined. The highest daily energy, saturated fat, and added sugar and sodium came from UPF. Reducing UPF by 50% decreased energy intake by 22%, and saturated fat, added sugar, sodium, and alcohol by 10–39%. Reducing UPF by 50% and increasing unprocessed or minimally processed foods by 25% led to a lower estimated reduction in energy and greater estimated reductions in saturated fat and sodium. Replacement of 50% UPF with 75% of unprocessed or minimally processed foods led to smaller estimated reductions in energy and nutrients. Our results provide insight as to the potential impact of population reductions in UPF, but also increasing intake of unprocessed or minimally processed foods, which may be the most feasible strategy for improved nutritional intake.     

Associations between added sugars and micronutrient intakes and status: further analysis of data from the National Diet and Nutrition Survey of Young People aged 4 to 18 years

Added sugars are often viewed as 'empty calories', negatively impacting micronutrient intakes, yet reviews consider the evidence inconclusive. This study aimed to quantify associations between dietary added sugars (as a percentage of energy) and micronutrient intake and biochemical status in the National Diet and Nutrition Survey. Using data from 1688 British children aged 4-18 years who completed 7 d weighed dietary records in 1997, micronutrient intakes were examined across quintiles of added sugars. After excluding low energy reporters, mean dietary intakes of most nutrients exceeded the reference nutrient intake, except for zinc. Compared with quintile 1 (9% added sugars), high consumers in quintile 5 (23% added sugars) had micronutrient intakes ranging from 24% lower to 6% higher (mean 14% lower). Zinc intakes in quintile 1 v. quintile 5 averaged 93% v. 78% of reference nutrient intake; magnesium 114% v. 94%; iron 115% v. 100%; and vitamin A 111% v. 92%, respectively. Plasma levels of magnesium, zinc and carotenoids did not vary across quintiles, but weak negative correlations were observed with serum ferritin and transferrin saturation. Plasma selenium was inversely correlated with added sugars (r -0.17; P < 0.0001) but there was no association with glutathione peroxidase. The impact of added sugars on micronutrient intakes appears modest overall but may have relevance for children consuming inadequate amounts of nutrient-rich foods coupled with a diet high in added sugars (approximately 23%). Further work is needed to explore the impact of different sources of added sugars and to refine assessments of inadequate intakes and status.     

The impact of salt, fat and sugar levels on toddler food intake

Understanding the early determinants of food intake, in particular the role of food sensory quality, is a necessary step to improve the prevention of unhealthy food habits. However, the extent to which food intake varies according to salt, fat and sugar content is imperfectly known. The present study aimed at evaluating whether toddler food intake varied during lunches or snacks in which salt, fat or sugar contents had been modified in common foods. Seventy-four children (30 (se 0·5) months old) participated in the study in their usual day-care centres. Every other week, they were served lunches composed, among other items, of green beans and pasta with varying salt (0, 0·6 and 1·2?% added salt) or fat (0, 2·5 and 5?% added butter) levels and afternoon snacks composed of fruit purée varying in sugar level (0, 5 and 10?% added sugar). During each meal, children could eat as much as they wanted from the target foods. Each food was weighed before and after the meal. Salt level had a positive impact on the intake of the target foods. On the contrary, no impact of added fat or added sugar levels was observed. This implies that fat and sugar addition could be avoided in foods for children without having an impact on palatability, allowing the energy density of children's diet to be limited. Salt addition should be limited, but its suppression in vegetables, whose intake is to be promoted, should be considered cautiously.     

Processed Food Contributions to Energy and Nutrient Intake Differ among US Children by Race/Ethnicity

This study determined and compared the mean daily intake of energy and nutrients from processed foods by level of processing (minimally processed; processed for preservation, nutrient enhancement, and freshness; mixtures of combined ingredients; ready-to-eat processed foods; and prepared foods/meals) among non-Hispanic white, non-Hispanic black, and Mexican American US children. Data from participants 2–18 years old (n = 10,298) of the nationally representative cross-sectional National Health and Nutrition Examination Survey 2003–2008 with a complete one day, 24-h dietary recall were used to determine mean intake of energy and nutrients recommended for increase and decrease, as per the 2010 Dietary Guidelines for Americans, among child race/ethnic groups by category of food processing. Regression analysis was used to estimate and compare covariate-adjusted (gender, age, and poverty-income-level) least square means (p < 0.05/3 race/ethnic groups). All children, regardless of race or ethnicity consumed processed foods. Approximately 66% to 84% of total daily energy, saturated fat, cholesterol, fiber, total sugar, added sugars, calcium, vitamin D, potassium, and sodium intake are contributed by one of the five categories of processed foods. Clinicians and policy should primarily advise consideration of the energy and nutrient composition of foods, rather than the processing level, when selecting a healthy diet for children.     

Fat intake, diet variety and health promotion

Different epidemiological studies indicated that the optimization of diet and nutrition combined with healthy life style can decrease the risk and even lead to amelioration of various noncommunicable diseases. Promising food-based dietary guidelines have been recommended in order to improve the nutritional and health status. One of the most popular recommendations is related to the amount (less fat and fat-rich foods) and type of the dietary fat component (less saturated, more polyunsaturated fatty acids, lower n-6:n-3 ratio). An overview on the nutrient intake among different age groups in Austria shows that the general consumption of some food groups--especially those rich in carbohydrates--is too low and that the intake of fat is far beyond the recommended amount of 30% of total energy (E%). The results of the 24-hour recall made among Austrian adults (n = 2,585) showed that about 18% of this population group had a fat intake of 30-35 E%, whereas 60% had an intake higher than 35 E%. Only 24% of the female and male adults had a fat intake lower than 30 E%. A result of this high proportion of fat--in the form of foods rich in fat--in the average total energy consumption is a too low intake of carbohydrates, and foods rich in carbohydrates, respectively. An increasing fat intake is associated with an increasing intake of some nutrients such as vitamin A, E, calcium and zinc, but a decreasing intake of other nutrients like vitamin C, folate, carotenoids and others. The diversity of foods consumed during a day increases with decreasing amount of fat in the diet of adults. People with a high amount of fat in their daily diet show a lower intake of vegetables and fruit, cereal products, carotenoids, folates and dietary fibers, but a higher intake of meat and meat products, milk and milk products, sweets and flummeries as well as saturated fatty acids (SFA) and cholesterol. Of course, a higher variety of food items in the daily diet should not be associated with a higher energy intake. Thus, foods with a high nutrient density (vegetables, fruits, low-fat milk products, whole grain cereals, legumes etc.) are recommended. Finally, it has to be annotated that a high diversity in the daily diet with reduced fat and SFA intake allows a sufficient nutrient intake and is an important approach for health promotion.     

Sources of Vitamin A in the Diets of Pre-School Children in the Avon Longitudinal Study of Parents and Children (ALSPAC)

Vitamin A is essential for growth and development. We investigated whether high consumption of energy-dense nutrient-poor foods in the diets of pre-school children is detrimental to diet quality with respect to vitamin A. Data were collected from 755 children at 18-months and 3½-years, from the Avon Longitudinal Study of Parents and Children, using 3-day unweighed dietary records completed by parents in 1994 and 1996, respectively. Energy, carotene and retinol intakes were calculated. The quality of the diet declined from 18-months to 3½-years with respect to vitamin A. Preformed retinol intakes decreased by −54 μg/day on average (p = 0.003). Carotene intakes were similar at each age although there was a 23% increase in energy intake by 3½-years. Longitudinally those in the highest quartile of intake at 18-months were twice as likely to remain in the highest quartile at 3½-years for retinol (OR 2.21 (95% CI 1.48–3.28)) and carotene (OR 1.66 (95% CI 1.11–2.50)) than to change quartiles. Nutrient-rich core foods provided decreasing amounts of carotene and preformed retinol over time (both p < 0.001). Vegetables and milk contributed the highest proportion of carotene at both ages, but milk’s contribution decreased over time. Milk and liver were the largest sources of retinol. Nutrient-poor foods provided an increased proportion of energy (p < 0.001) with low proportions of both nutrients; however fat spreads made an important contribution. It is recommended that pre-school children should take vitamin supplements; only 19% at 18-months did this, falling to 11% at 3½-years. Care should be taken to choose nutrient-rich foods and avoid energy-dense, nutrient-poor foods when feeding pre-school children.     

Consumption of bakery products,sweetened soft drinks and yogurt among children aged 6-7 years: association with nutrient intake and overall diet quality

The present study tests the hypothesis that higher consumption of bakery products, sweetened soft drinks and yogurt is associated with higher intake of energy, saturated fats, sugars and worse overall diet quality among Spanish children. This is a cross-sectional study covering 1112 children aged 6.0-7.0 years in four Spanish cities. Nutrient and food intake were obtained through a food-frequency questionnaire, and overall diet quality calculated using the healthy-eating index (HEI) developed by Kennedy et al. (1995). Standardized methods were used to measure anthropometric variables. Associations of interest were summarized as the difference in nutrient and food consumption between the value of the fifth and the first quintile of consumption (dq) of bakery products, sweetened soft drinks or yogurt, adjusted for energy intake and BMI. Bakery products, sweetened soft drinks and yogurt supplied 15.5, 1.0 and 5.6 % energy intake respectively. Higher consumption of these three foods was associated with greater energy intake (P<0.001), but not with higher BMI. Consumption of bakery products was associated with the proportion of energy derived from intake of total carbohydrates (dq 4.5 %, P<0.001) and sugars (dq 2 %, P<0.001), but did not show association with the HEI. Consumption of sweetened soft drinks was associated with a lower consumption of milk (dq -88 ml, P<0.001) and Ca (dq -175 mg/d, P<0.001), and worse HEI (dq -2, P<0.01). Consumption of yogurt, while associated with higher energy intake from saturated fats (dq 1.77 %, P<0.001) and sugars (dq 2.02 %, P<0.001), showed no association with the HEI. Differences in the intake of nutrients and foods across quintiles of consumption of bakery products, sweetened soft drinks and yogurt were usually very small. We conclude that the impact of the consumption of bakery products, sweetened soft drinks and yogurt on the quality of the diet of Spanish children is only modest, although it may contribute to aggravating certain unhealthy characteristics of their diet, particularly excess energy, saturated fats and sugars. Therefore, consumption of bakery products and sweetened soft drinks should be moderated, and priority given to consumption of low-fat, low-sugar yogurt.     

Nutrient intake variability and number of days needed to assess intake in preschool children

The duration of the period of time during which diet should be recorded for sufficiently accurate results on the usual intake of an individual is an especially challenging issue in prospective studies among children. We set out to describe nutrient intake variability in preschoolers and to determine the number of record days required (D) to estimate intake of energy and thirty-two nutrients. The diet and the use of dietary supplements were assessed with three consecutive daily food records including one weekend day in 1639 children participating in the population-based birth cohort of the Type 1 Diabetes Prediction and Prevention Project (DIPP) in Finland. Variance ratios and D stratified by sex and age groups were calculated for 455 (1-year-old), 471 (3-year-old) and 713 (6-year-old) children (born between 1998 and 2003). Within:between variance ratios and D increase with increasing age, and are slightly higher for girls. Vitamin A, cholesterol, n-3 and n-6 fatty acids, β-carotene and folate intakes require the most replicates. Including supplemental intake has an impact on the variance estimates according to the proportion of supplement users. In the DIPP Nutrition Study with 3?d food records, the correlation coefficients between observed and true intakes of energy and thirty-two nutrients averaged 0·91 in 1-year-old children, 0·79 in 3-year-old children and 0·74 in 6-year-old children. For providing accurate nutrient intake estimates, three replicates of food records are reasonable in 1-year-old children but must be questioned for several nutrients in 3- and 6-year-old children. The accuracy of ranking boys is greater than that for girls.     

Diet quality in young children is influenced by beverage consumption

BACKGROUND: Replacement of milk with sugar-containing beverages could affect calcium intake and overall diet quality. OBJECTIVE: To describe dairy food, 100% juice and added sugar beverage intakes, contributions of dairy foods to diet quality, and effects of beverages on diet quality in young children. METHODS: We surveyed participants in the Iowa Fluoride Study (n = 645) at ages 1, 2, 3, 4 and 5 years and calculated intakes for 1-5 years (i.e. weighted averages). Nutrient, dairy food and beverage intakes were obtained from 3-day diaries; nutrient adequacy ratios were calculated as the nutrient intake to Recommended Dietary Allowance/Adequate Intake ratio; and dairy-dependent percentages were calculated as fractions of total diet nutrient adequacy ratios (truncated at 1) not met by non-dairy foods. RESULTS: Milk intakes were inversely associated with intakes of juice drinks (2, 4, 5 and 1-5 years), soda pop (2, 3, 4, 5 and 1-5 years) and added sugar beverages (2, 3, 4, 5 and 1-5 years). Dairy dependent fractions of 1-5 year nutrient adequacy ratios were 68% for calcium and 61% for vitamin D. Higher 1-5 year calcium adequacy was predicted by higher energy, higher other dairy and lower added sugar beverage intakes while higher vitamin D adequacy was predicted by higher energy and higher other dairy intakes. Overall diet quality was predicted by higher energy, higher other dairy, lower 100% juice and lower added sugar beverage intakes. CONCLUSIONS: Dairy foods remain an important source of calcium and vitamin D, while added sugar beverages and, to a lesser extent, 100% juice decrease diet quality of young children.     

The effect of consumption of foods that differ in energy density and/or sodium bicarbonate supplementation on subsequent diet selection in sheep

The short-term consumption of foods that differed in energy density (ED) and/or NaHCO3 supplementation, on subsequent food intake and diet selection in sheep were measured. Thirty sheep weighing 35.9 (sd 2.89) kg were used. Two foods were formulated: H had 11 and L had 8 MJ metabolizable energy/kg fresh matter. Four further foods were formulated by adding either 40 g NaHCO3/kg or 16.5 g NaCl/kg to foods H and L. NaCl was added to give the same Na concentration as with 40 g NaHCO3/kg to control for any effects of Na per se. In a preliminary test, it was found that a 2 h consumption of food H supplemented with NaHCO3 could buffer potential impact on the rumen environment of subsequent consumption of food H alone (as judged by rumen pH and acid-buffering capacity); however, it was not as effective as the consumption of food L alone in doing so. Each food treatment was offered to one of six groups (n 5) for 2 h following 16 h of food deprivation. Sheep were then offered a choice between H and L for a further 6 h. Supplementing H or L with either NaHCO3 or NaCl had no significant effect on either intake or diet selection. ED significantly (P<0.01) affected intake during the 2 h single feeding period, with sheep offered H or L consuming 540 and 663 (sed 37) g respectively, but had no effect on subsequent intake during the choice period. During the choice period all sheep showed a preference for food H, but sheep previously offered L selected significantly more H (0.873 g/g) than sheep previously offered H (0.544 (sed 0.028) g/g; P<0.001). It is concluded that short-term consumption of foods that differ in ED, and hence in their potential impact on the rumen environment, significantly affects subsequent diet selection. This is in agreement with the hypothesis that ruminant animals select a diet to help maintain the rumen environment within a certain physiological range. Food H with 40 g NaHCO3 added/kg may not have been sufficient to affect subsequent diet selection. It is suggested that larger, rather than smaller, changes in the rumen environment achieved through previous feeding should be expected to alter subsequent diet selection.     

中国部分农村地区2～7岁留守儿童膳食营养现况研究

目的 了解中国农村留守儿童膳食营养状况,为农村留守儿童营养干预提供科学依据.方法 采用多阶段分层整群随机抽样方法,随机选择农村2～7岁留守儿童1278名和对照儿童1273名作为调查对象.采用3日膳食称重法和食物摄人频率法进行膳食调查,并以中国营养学会推荐的膳食营养素参考摄入量(DRIs)为依据,评价农村留守儿童膳食能量和各种营养素的摄人状况.结果 农村留守儿童膳食以粮谷类和蔬菜类为主,留守儿童肉禽水产类、水果类及零食类等食物的摄入量低于对照儿童,差异有统计学意义.农村留守儿童能量、三大产热营养素及部分矿物质(钙、锌、硒、钾)和维生素(维生素A、维生素B1、维生素B2)的摄入量均低于推荐摄入量.农村留守儿童能量及主要营养素普遍摄入不足,能量摄入不足率在50%以上,蛋白质摄人不足率达80%以上,而钙、锌等矿物质和维生素B1、维生素B1等维生素的摄入不足率达90%以上.蛋白质来源中,优质蛋白质摄入量仅占总蛋白质摄入量的35%,而植物蛋白质占65%.此外植物性铁的摄入比例明显偏高,达到87%.结论 中国农村留守儿童的膳食结构不尽合理,能量和多种营养素摄入不足,能量、蛋白质及铁的来源不合理,膳食营养状况有待改善.     

The scientific basis of recent US guidance on sugars intake

Most fruits and dairy products are high in sugars, and thus naturally occurring sugars are consumed as part of a healthy diet. Sugars are also added to foods during processing or preparation, primarily to enhance taste. Monosaccharides and disaccharides added to foods are chemically indistinguishable from naturally occurring forms. However, concern has been expressed about the apparent increasing consumption of added sugars and their possible role in displacing or diluting nutrients in the diet and contributing to the epidemic of obesity in developed countries. One of the 2000 Dietary Guidelines for Americans states, "Choose beverages and foods to moderate your intake of sugars." The Dietary Guidelines Advisory Committee discussed whether to specify added sugars rather than the broader term sugars but decided that it was not possible to conclude that added sugars per se play a negative role in the public's health. The Dietary Guidelines Advisory Committee issued a call for more definitive studies of the role of sugars in current diets and the potential effect of a reduction in added sugars on both dietary quality and energy intake. The American Heart Association recently released a statement advising consumers to limit sugars consumption. The macronutrient report for the dietary reference intakes addresses many of these same issues; the expert panel concluded that it was not appropriate to set a tolerable upper intake level for added sugars but suggested a maximal intake level of 25% of energy from added sugars because of concerns about reduced intakes of essential micronutrients.     

Estimating safe maximum levels of vitamins and minerals in fortified foods and food supplements

Purpose

To show how safe maximum levels (SML) of vitamins and minerals in fortified foods and supplements may be estimated in population subgroups.

Methods

SML were estimated for adults and 7- to 10-year-old children for six nutrients (retinol, vitamins B6, D and E, folic acid, iron and calcium) using data on usual daily nutrient intakes from Irish national nutrition surveys.

Results

SML of nutrients in supplements were lower for children than for adults, except for calcium and iron. Daily energy intake from fortified foods in high consumers (95th percentile) varied by nutrient from 138 to 342 kcal in adults and 40–309 kcal in children. SML (/100 kcal) of nutrients in fortified food were lower for children than adults for vitamins B6 and D, higher for vitamin E, with little difference for other nutrients. Including 25 % ‘overage’ for nutrients in fortified foods and supplements had little effect on SML. Nutritionally significant amounts of these nutrients can be added safely to supplements and fortified foods for these population subgroups. The estimated SML of nutrients in fortified foods and supplements may be considered safe for these population subgroups over the long term given the food composition and dietary patterns prevailing in the respective dietary surveys.

Conclusions

This risk assessment approach shows how nutrient intake data may be used to estimate, for population subgroups, the SML for vitamins and minerals in both fortified foods and supplements, separately, each taking into account the intake from other dietary sources.

     

Food consumption trends and nutrition transition in Korea

This review article aims to provide an overview of food consumption trends in relation to the nutritional status of Koreans. Food consumption patterns and nutritional status of Koreans have changed substantially due to economic improvements and the adoption of a western lifestyle. The traditional habit of consuming vegetable foods like cereals, soybeans and potatoes has seen a decline, while consumption of meat, poultry, egg and fruits has increased. Although the proportion of animal foods has increased from 3.0% in 1969 to 19.2% in 1998, the Korean diet is still not sufficient in milk and eggs. The total energy intake has gradually decreased with reduced consumption of cereals, and concomitantly carbohydrates intake has decreased. Fat intake has increased with elevated consumption of animal foods and added fats and oils, but the level of fat intake remains low with a high consumption of vegetables and increased fruit consumption. This food consumption pattern might have contributed to the ideal proportion of energy from carbohydrates, protein and fat at 66%, 15% and 19% respectively in 1998, which is almost close to the composition of 65%, 15%, and 20% that most nutritionists would term as an ideal ratio. It would appear that the Korean food consumption trend is ideal except for the consumption of salty foods which is high.     

Long-term dietary pattern of fecal donor correlates with butyrate production and markers of protein fermentation during in vitro fecal fermentation

Diet influences gut microbiota composition. Therefore, we hypothesized that diet would impact the extent of dietary fiber utilization and the types of metabolic end-products produced by the microbiota during in vitro fecal fermentation. By obtaining long-term dietary records from fecal donors, we aimed to determine the correlations between dietary intake variables and dietary fiber degradation and short-/branched-chain fatty acid (BCFA) and ammonia production during in vitro fecal fermentation. Eighteen subjects completed 1-year diet history questionnaires and provided fecal samples that were used for in vitro fermentation of a whole wheat substrate. The percentage of dietary fiber fermented was not correlated with nutrient intakes; however, butyrate production was correlated with fecal donor intake of many nutrients of which principal component analysis revealed were mostly contributed by grain-, nut-, and vegetable-based foods. Negative correlations were found for propionate with intake of total carbohydrate, added sugar, and sucrose and for ammonia and BCFA production with intake of unsaturated fats. Thus, our analysis did not support our first hypothesis: the percentage of dietary fiber fermented during in vitro fermentation was not correlated with dietary records. However, production of butyrate; BCFA; ammonia; and, to a lesser extent, propionate was correlated with the diet records of fecal donors, thus supporting our second hypothesis. These results suggest that diets high in plant-based foods and high in unsaturated fats are associated with microbial metabolism that is consistent with host health.     

Development of a semiquantitative food frequency questionnaire to assess food, energy and nutrient intake in Denmark.

Foods to be included in a Danish self-administered semiquantitative food frequency questionnaire were identified from food tables developed, together with data collected, for the survey 'Dietary habits in Denmark, 1985'. The questionnaire was to be used in a prospective study on diet, cancer and health, and the aim was to rank individuals with regard to intake of 19 different nutrients considered of prime importance in human carcinogenesis. The questionnaire for the dietary survey included 247 foods and recipes. From stepwise multiple regression analyses with the intake of each of the 19 nutrients as the dependent variable and the intake of the 247 foods and recipes as independent variables, the foods in the models explaining 90% of the between-person variability were considered for the final questionnaire. All relevant analyses were performed for the study group as a whole, for men and women separately, and in each gender for subgroups of energy intake. Taken together, the models explaining 90% of the between-person variability identified a total of 74 foods or recipes, which were important predictors of the intake of one or more of the nutrients considered. A few foods were excluded and a few foods were added to the final questionnaire based on common biological background information, and on information on foods providing important amounts of given nutrients, but which failed to contribute to regression analyses. The 92 foods and recipes, which were included in the final questionnaire provided altogether 81% of the average total supply of the nutrients.(ABSTRACT TRUNCATED AT 250 WORDS)     

The New Hybrid Nutrient Density Score NRFh 4:3:3 Tested in Relation to Affordable Nutrient Density and Healthy Eating Index 2015: Analyses of NHANES Data 2013–16

Background: Hybrid nutrient density scores are based on both nutrients and selected food groups. Objective: To compare the new hybrid nutrient-rich food NRFh 4:3:3 score to other nutrient-rich food (NRF) scores, energy density, and energy cost and to model the impact on the Healthy Eating Index (HEI-2015) of partially replacing less nutrient-rich with more nutrient-rich foods. Methods: Analyses were based on 5870 foods and beverages in the Food and Nutrient Database for Dietary Studies and on 24 h dietary recalls from the National Health and Nutrition Examination Survey (NHANES 2013–16). The NRFh 4:3:3 model was based on four nutrients to encourage (protein fiber, potassium, MUFA + PUFA); three food groups to encourage (dairy, fruit, whole grains); and three nutrients to limit (saturated fat, added sugar, sodium). Ratings generated by NRFh 4:3:3 and by other NRF models were correlated with score components, energy density (kcal/100 g), and energy cost (USD/100 kcal). The impact on HEI-2015 of replacing foods in the lowest nutrient density tertile (T1) with top tertile (T3) foods at 10%, 20%, 30%, and 100% equicaloric replacement was modeled using NHANES 2013–16 dietary data by population subgroups. Results: The NRFh 4:3:3 model awarded higher scores to foods containing dairy, fruit, and whole grains and proportionately lower scores to vegetables when compared to the NRF 9.3 model. Higher NRF and NRFh nutrient density scores were linked to lower energy density and higher energy cost; however, both correlations were lower for the NRFh 4:3:3. Isocaloric replacement of bottom tertile with top tertile foods as rated by both models led to significantly higher HEI-2105 values, based on complete (100%) and on partial (10–30%) replacement. Conclusion: The new NRFh 4:3:3 model provides the basis for developing new metrics of affordable nutrient density. The model identified “best value” food categories that were both affordable and nutrient-rich. Total and partial replacement of low nutrient density with high nutrient density foods was associated with higher HEI-2015 scores, suggesting that even partial inclusion of more nutrient dense foods in the diet may have an important impact on total diet quality.     

Dietary recommendations for people with diabetes: an update for the 1990s Nutrition Subcommittee of the British Diabetic Association's Professional Advisory Committee

The broad principles of the 1982 British Diabetic Association recommendations remain valid. For the overweight, reduction in energy intake remains the most important aim.
Carbohydrate should make up about 50–55% of the dietary energy intake, the majority of this coming from complex sources. preferably foods naturally high in dietary fibre or hydrolysis resistant starch. Up to 25 g of added sucrose may be allowed, provided it is part of a diet low in fat, high in fibre and that it substitutes for an isocaloric amount of fat or a high, glycaemic index food or other nutritive sweeteners. Some high carbohydrate diets have been shown to worsen glucose control and serum lipid abnormalities. Some previous recommendations for fibre intake have proved unrealistically high and of limited value. A modest increase to 30 g/d, concentrating on soluble fibre is recommended.
Reduction of fat intake to 30–35% of energy intake remains an important goal which should help to reduce the incidence of cardiovascular disease in people with diabetes and aid weight loss. Of this, only 10% of total energy should be saturated, 10% polyunsaturated and 10–15% may be mono-unsaturated fat. The latter has been shown to provide a useful alternative energy source which may have beneficial effects on glucose control and serum lipids. Cholesterol intake should not exceed 300 mg/day.
Protein should comprise about 10–15% of energy intake. Reduction in protein intake and associated nutrients may help to slow down progression of nephropathy. Limitation of salt intake to 6 g/d is recommended Reduction in fat intake may be relatively more important in Type 2 diabetic patients, whereas limitation in protein intake more so in Type 1 diabetes.