Molly Miller, M.S., R.D., Thomas Boileau, Ph.D.,

Transcription

1 WHAT EFFECT THE ANTICIPATED DIETARY GUIDELINES ADVISORY COMMITTEE CONSUMPTION RECOMMENDATIONS MAY HAVE ON THE MEAT AND POULTRY INDUSTRY? Molly Miller, M.S., R.D., Nutrition Manager-Regulatory Services R&D, Tyson Foods, Inc. Thomas Boileau, Ph.D., Scientific, Nutrition and Regulatory Affairs, Kraft Foods Group Inc./Oscar Mayer

2 FROM NUTRITION SCIENCE TO NUTRITION POLICY: CHALLENGES AND OPPORTUNITIES FOR THE MEAT INDUSTRY Thomas Boileau, Ph.D., Scientific, Nutrition and Regulatory Affairs, Kraft Foods Group Inc./Oscar Mayer

3 A Little About Me: New to the meat industry 12 years in the food industry Ph.D. in Nutritional Sciences I believe in meat and poultry

4 Outline Overview of the relationship between meat intake and health DGAC 2010 evidence review process Limitations of the current evidence Challenges in assessing the nutritional benefits of meats Dietary assessment of nutritional contribution of meats Meat components associated with nutritional value of meats Future opportunities

5 From Nutrition Science to Consumer Food Products Nutrition Science Nutrition Policy (Dietary Guidelines For Americans) Product Development

6 External Nutrition Policy Environment Dietary Guidelines 2015 Advisory Committee General anti-meat, pro plant-based diet sentiment Active Federal regulatory agencies (PHO / Sodium) Sustainability / Animal welfare Emerging nutrition science 6

7 OVERVIEW OF THE RELATIONSHIP BETWEEN MEAT INTAKE AND HEALTH Dietary Guidelines 2010

8 Nutrition Science Influences Federal Nutrition Policy Dietary Guidelines Advisory Committee 2015 Nutrition Evidence Library Dietary Guidelines Advisory Committee 2015 Report US Dept. of Agriculture (USDA) US Dept. of Health & Human Services (HHS) Dietary Guidelines for Americans 2015 Policy Document Appointed by USDA & HHS Public Comment Translation by USDA & HHS Nutritionists

9 Assessing Strength of Science in Nutrition Randomized controlled trials Blinding Generalizable population Appropriateness of control Meta- analyses Observational studies Adjustment for confounders Methods of diet assessment Increasing Strength Animal studies Physiological differences Nutritional differences In vitro studies Bioavailability Expert Opinions

10 Strengths and Weaknesses of Epidemiological Studies Strengths: Assess diet and disease associations Large number of participants Hypothesis generating Able to address some research questions RCTs cannot Weaknesses: Cannot determine cause and effect Regardless of the number of studies Diet and lifestyle confounders Inaccurate diet assessments Inaccurate nutrient assessments

11 USDA Nutrition Evidence Library (NEL) USDA s Nutrition Evidence Library (NEL) specializes in conducting systematic reviews to inform Federal nutrition policy and programs. NEL staff collaborate with stakeholders and leading scientists using state-of-the-art methodology to objectively review, evaluate, and synthesize research to answer important diet-related questions. The NEL Process Step 1: Develop systematic review questions Step 2: Search, screen, and select studies to review Step 3: Extract data and assess the risk of bias of the research Step 4: Describe and synthesize the evidence Step 5: Develop conclusion statements and grade the evidence Step 6: Identify research recommendations

12 Nutrition Evidence Library: Evaluation Criteria

13 DG2010 NEL Findings for Meat and Health Outcomes What is the relationship between animal protein intake and? Question Blood Pressure Breast Cancer Body Weight CVD Colon Cancer Prostate Cancer Type II Diabetes Conclusion No association No association Inconsistent evidence Limited inconsistent evidence suggests a link, somewhat more positive for processed meats Inconsistent positive associations Limited evidence shows association Limited inconsistent evidence suggests a link Grade Evidence Moderate Limited Limited Limited Moderate Limited Limited 1. No independent relationship between intake of meat and body weight. p Epi 6 Epi 1 RCT, 2 Epi 7 Epi 13 Epi 6 Epi 7 Epi 2. Moderate evidence suggests an association between the increased intake of processed meats (e.g., franks, sausage, and bacon) and increased risk of colorectal cancer and cardiovascular disease. p. 27

14 Limitations of Epidemiological Studies Example: Red Meat Intake and Breast Cancer Baseline Differences by Quintile: BMI Smoking Status Total energy intake (30% more) Parity Red Meat Intake Age- adjusted model not signixicant Multivariable RR=1.22, P=0.01 No effect when women divided by menopausal status BMJ, 2014

15 Limitations of Epidemiological Studies Example: Red Meat Intake and Mortality Baseline Differences by Quartile: BMI Smoking Status Diabetes Physical activity High cholesterol Family history of heart attack History of cancer Alcohol intake Total energy intake Arch Intern Med, 2012

16 Limitations of Epidemiological Studies Example: Red Meat Intake and Biomarkers Inflammation Baseline Differences by Quartile: BMI Smoking Status Physical activity High cholesterol Total energy intake Healthy eating index After adjustment for BMI, most of these associations with inxlammation and glucose metabolic biomarkers were no longer signixicant. AJCN, 2014

17 Conclusions The evidence linking meat consumption to negative health outcomes is limited in strength Most of the evidence is indirect and associative Future work should seek to establish cause and effect

18 ASSESSMENT OF THE DIETARY CONTRIBUTIONS OF MEATS Challenges and Opportunities

19 Diet Assessment relies on USDA Nutrient Database Federal nutrition policy relies on data provided by USDA nutrient database Limited resources result in lack of frequent updates What We Eat in American (WWEIA) diet survey Much of the data from 2010 and earlier Relies on 24-hr recall for diet assessment

20 Dietary Assessment of the Nutritional Contribution of Meats USDA Nutrient Database Accuracy of nutrient database is key! What dietary patterns are associated with meat intake? What We Eat In America (NHANES III) 2010 What are the most commonly consumed meats? When is meat eaten? Who eats meat? What nutrients do meat provide? 20

21 Food Databases May Not Reflect What People Eat Turkey breast, luncheon meat USDA 07079* Deli Fresh Oven Roasted Turkey Breast Roast Beef, luncheon meat USDA Deli Fresh Roast Beef Bologna, chicken and pork USDA Oscar Mayer Bologna, chicken and pork Serving size (g) Calories (kcal) ( 14%) ( 9%) ( 15%) Fat (g) Saturated fat (g) Sodium (mg) ( 15%) ( 17%) ( 28%) Protein (g) *Number corresponds to food code in USDA nutrient database

22 Opportunity: Branded Food Products Database Improve accuracy and abundance of nutrition data in USDA database Currently limited number of branded products in USDA database Enable data stratification by year Match NHANES data from a given year with nutrition data from same year

23 Nutritional Contribution of Meat: A Balancing Act Calories Sodium Saturated Fat Protein Iron, Zinc, Selenium B- vitamins Meat & Poultry

24 Meat is Guilty By Association Meat Sodium Saturated Fat Calories Disease Endpoints

25 Dietary Contributors to Sodium and Saturated Fat 21% of Sodium from Meats 19% of Saturated Fats from Meats Source: Dietary Guidelines 2010

26 Sodium: Current Science Perspective Current target is <2300 mg/day and as low as <1500 mg/day in certain populations Based primarily on relationship between sodium intake and blood pressure (DASH diet) Current USA intakes 3500 mg/day IOM report from 2013 could not define a healthy intake range based on direct health outcomes New research studies suggest increased risk of cardiovascular disease at low intake levels U-shaped curve What is the best target?

27 Saturated Fat: Current Perspective Saturated fat increases LDL cholesterol, a known risk factor for CVD DGA 2010: Limit intake to <10% of total kcal AHA/ACC 2013: Reduce intake to 5-6% total kcal ADA: Limit to <7% kcal total kcal Saturated fat from different dietary sources behave differently Different saturated fats have different physiological effects DGAC 2010: Moderate evidence that stearic acid is cholesterol neutral 25-30% of saturated fat in meats is stearic acid

28 Meat is a Key Dietary Source of Quality Protein Processed meats provide high quality protein vs. plant sources E.g., legumes limiting in methionine, corn is limiting in lysine Americans get enough protein, but some controversy exists RDA is 0.8 grams / kg body weight (56 grams /day) Most dietary protein is consumed at dinner (42%) Snacking(14%) and Breakfast (17%) are underrepresented Protein has a positive health halo (78% consumers) >50% trying to get more 50% primary grocery shoppers view animal sources as best Protein could be positioned as displacing fat & carbs Carbohydrates are targeted related to obesity 28

29 Advancing Meats with RCTS Example: Protein and Satiety Background: Protein is recognized as the most satiating macronutrient Only 15% of protein is consumed at breakfast Research Findings Randomized controlled trial 35 grams of protein from beef and eggs vs. 13 grams from cereal breakfast increased fullness, reduced snacking 29

30 Conclusions Opportunities exist to build the evidence for the benefits of meat in a balanced diet Contribution of meats to nutrient intakes Benefits associated with meat intake

31 Summary The evidence linking meat consumption to negative health outcomes is limited in strength Most of the evidence is indirect and associative Future work should seek to establish cause and effect Opportunities exist to build the evidence for the benefits of meat in a balanced diet Contribution of meats to nutrient intakes Benefits associated with meat intake

32 Opportunities for the Meat Industry Work towards establishing accurate nutrient databases Continue to demonstrate the benefits of consuming meat Unique nutritional contributions RCTs where possible Consumer benefits Industry Continue to engage together in: Science Policy (e.g., DG2015) Product Development Academia Government

33 Thanks To Our Sponsor

34 AMI Projects Defend Meat Category Menu modelling Demonstrate that meat can be incorporated in to diets that meet dietary guidelines NHANES analysis Healthy Eating Index assessment Understand the importance of meat s contribution to diet Protein, vitamins, minerals USDA database Examine accuracy of USDA database in meat category Most recent NHANES analysis is 2010 In last 3 years, Meat industry has significantly reduced sodium 34