Exploring the Evidence on Dietary Patterns: The Interplay of What We Eat and Health

Transcription

1 NUTRI-BITES Webinar Series Exploring the Evidence on Dietary Patterns: The Interplay of What We Eat and Health January 25, 2018 Presenter: Kellie O. Casavale, PhD, RD Nutrition Advisor, Division of Prevention Science HHS, Office of Disease Prevention and Health Promotion Moderator: James M. Rippe, MD Leading cardiologist, Founder and Director; Rippe Lifestyle Institute Approved for 1 CPE (Level 2) by the Commission on Dietetic Registration, credentialing agency for the Academy of Nutrition and Dietetics.

2 Conagra Nutrition With a mission of: We believe that everyone deserves easy access to understandable, credible, and science-based nutrition information. We aim to provide cutting edge knowledge that will enable health professionals to more effectively help their clients.

3 Webinar logistics CEUs a link to obtain your Continuing Education Credit certificate will be available on this webinar s page at and ed to you within 2 days. A recording of today s webinar and slides as a PDF will be available to download within 2 days at: The presenter will answer questions at the end of this webinar. Please submit questions by using the Chat dialogue box on your computer screen.

4 Today s Faculty Kellie O. Casavale, PhD, RD Nutrition Advisor, Division of Prevention Science HHS, Office of Disease Prevention and Health Promotion Moderator: James M. Rippe, MD Leading cardiologist. Founder and Director, Rippe Lifestyle Institute

5 Exploring the Evidence on Dietary Patterns: The Interplay of What We Eat and Health NUTRI-BITES Webinar Series Learning Objectives Increase awareness of the how evidence on the importance of healthy eating patterns has advanced and now forms an underpinning of the Dietary Guidelines for Americans. Describe healthy eating patterns that align with the Dietary Guidelines for Americans. Advance proficiency with applying healthy eating patterns in practice. Become familiar with resources to enable adapting healthy eating patterns to clients sociocultural and personal preferences.

6 Exploring the Evidence on Dietary Patterns: the Interplay of What We Eat and Health Kellie O. Casavale, PhD, RD Nutrition Advisor Office of Disease Prevention and Health Promotion Office of the Assistant Secretary for Health U.S. Department of Health and Human Services

7 Disclosures Sister currently employed by Conagra 8

8 Objectives Increase awareness of the how evidence on the importance of healthy eating patterns has advanced and now forms an underpinning of the Dietary Guidelines for Americans Describe healthy eating patterns that align with the Dietary Guidelines for Americans Advance proficiency with applying healthy eating patterns in practice Become familiar with resources to enable adapting healthy eating patterns to clients sociocultural and personal preferences 9

9 Background 10

10 Introduction to the Dietary Guidelines for Americans Food-based recommendations Help promote health and prevent chronic disease For implementation through Federal nutrition and health programs For use by health professionals and the community Healthy eating patterns are a central tenant of edition 11

11 Developing the Dietary Guidelines for Americans An overview, based on the Dietary Guidelines process 12

12 Developing the Dietary Guidelines for Americans 13

13 Developing the Dietary Guidelines for Americans 14

14 Developing the Dietary Guidelines for Americans 15

15 Eating Patterns and the Dietary Guidelines for Americans 16

16 Eating Patterns and the Dietary Guidelines for Americans People do not eat foods and nutrients in isolation but in combination, and this combination forms an overall dietary pattern or eating pattern. Since 1995 edition, DGA has recommended amounts to eat o o By food group By calorie levels 2010 and editions o Systematic reviews on dietary patterns USDA Nutrition Evidence Library Dietary Patterns Systematic Review Project 17

17 Eating Patterns and the Dietary Guidelines for Americans People do not eat foods and nutrients in isolation but in combination, and this combination forms an overall dietary pattern or eating pattern Dietary Guidelines Advisory Committee Strong evidence to characterize eating patterns associated with reduced risk of CVD Moderate evidence to characterize eating patterns associated with reduced risk of type 2 DM, certain cancers, overweight, and obesity Eating patterns and their food and nutrient characteristics are a primary emphasis of DGAs 18

18 Principles of Healthy Eating Patterns An eating pattern represents the totality of all foods and beverages consumed o More than the sum of its parts o Totality of what individuals habitually eat and drink act synergistically in relation to health Nutritional needs should be met primarily from foods o Aim to meet nutrient needs through foods and beverages in nutrient-dense forms Healthy eating patterns are adaptable o Any eating pattern can be tailored to the individual s socio-cultural and personal preferences Recommendations for healthy eating patterns are adaptable frameworks 19

19 Characterizing Eating Patterns Dietary Guidelines for Americans Focuses on what is consumed o Quantities, proportions, variety, or combinations of foods and beverages o Frequency of consumption Not included o When and where foods and beverages are consumed o Lifestyle factors 20

20 Assessing the Evidence on Eating Patterns Systematic reviews o To examine relationships between Overall eating pattern (foods, beverages, and nutrients) and health outcomes Food pattern modeling o To assess how well various Combinations and amounts of foods from all food groups would result in healthy eating patterns Meet nutrient needs Accommodate limits (e.g., saturated fats, added sugars, sodium, etc.) Analyses of current intakes o To identify areas of potential public health concern 21

21 Describing Healthy Eating Patterns Labels vs. Characteristics Labels Characteristics Vegetarian Prudent Traditional Mediterranean Western Low-Carbohydrate Low-Fat Published evidence Labels not uniformly defined Some research based on what is not eaten without reporting what was eaten Published evidence Variability in how components are defined 22

22 Examples of Variability in How Studies Report Components of Eating Patterns DGA Food Group Examples of how available literature on dietary patterns described dietary components.. Total meat Meat, sausage, fish, and eggs Red meat, processed meat, and poultry Potatoes Studies most often excluded potatoes Some studies included potatoes But rarely reported preparation method (e.g., fried versus baked) Other studies didn t report how they handled potatoes 23

23 Eating Patterns in the Dietary Guidelines for Americans Despite this variability, many associations between eating patterns and various health outcomes were remarkably consistent Characteristics consistently linked to health outcomes Basis for overarching Guidelines and Key Recommendations 24

24 The Guidelines 1. Follow a healthy eating pattern across the lifespan. All food and beverage choices matter. Choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease. 2. Focus on variety, nutrient density, and amount. To meet nutrient needs within calorie limits, choose a variety of nutrient-dense foods across and within all food groups in recommended amounts. 3. Limit calories from added sugars and saturated fats and reduce sodium intake. Consume an eating pattern low in added sugars, saturated fats, and sodium. Cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns. 25

25 The Guidelines (continued) 4. Shift to healthier food and beverage choices. Choose nutrientdense foods and beverages across and within all food groups in place of less healthy choices. Consider cultural and personal preferences to make these shifts easier to accomplish and maintain. 5. Support healthy eating patterns for all. Everyone has a role in helping to create and support healthy eating patterns in multiple settings nationwide, from home to school to work to communities 26

26 Key Recommendations Consume a healthy eating pattern that accounts for all foods and beverages within an appropriate calorie level. A healthy eating pattern includes: A variety of vegetables from all of the subgroups dark green, red and orange, legumes (beans and peas), starchy, and other Fruits, especially whole fruits Grains, at least half of which are whole grains Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products Oils A healthy eating pattern limits: Saturated fats and trans fats, added sugars, and sodium 27

27 Key Recommendations (continued) Key Recommendations that are quantitative are provided for several components of the diet that should be limited. These components are of particular public health concern in the United States, and the specified limits can help individuals achieve healthy eating patterns within calorie limits: Consume less than 10 percent of calories per day from added sugars Consume less than 10 percent of calories per day from saturated fats Consume less than 2,300 milligrams (mg) per day of sodium If alcohol is consumed, it should be consumed in moderation up to one drink per day for women and up to two drinks per day for men and only by adults of legal drinking age. Meet the Physical Activity Guidelines for Americans 28

28 Inside Healthy Eating Patterns: Food Groups Eating an appropriate mix of foods from the food groups and subgroups within an appropriate calorie level is important to promote health. Each food group and subgroup provides an array of nutrients. Recommended amounts reflect eating patterns associated with positive health outcomes. Foods from all of the food groups should be eaten in nutrientdense forms. 29

29 Inside Healthy Eating Patterns: Other Components In addition to the food groups, it is important to consider other food components when making food and beverage choices. Added sugars Saturated fats Trans fats Dietary cholesterol Sodium Alcohol Caffeine 30

30 Examples of Other Components Cholesterol Individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern. The Healthy U.S.-Style Eating Pattern contains approximately 100 to 300 mg of cholesterol across the 12 calorie levels. Caffeine Much of the available evidence on caffeine focuses on coffee intake. Three to five 8-oz cups of coffee per day can be incorporated into healthy eating patterns. Individuals who do not consume caffeinated coffee or other caffeinated beverages are not encouraged to incorporate them into their eating pattern. In addition, caffeinated beverages may contain added calories from cream, whole or 2% milk, creamer, and added sugars, which should be limited. 31

31 Healthy Eating Patterns that Align with the Dietary Guidelines for Americans 32

32 Examples of Healthy Eating Patterns Developed using systematic reviews, analysis of current intake, and food pattern modeling analyses Aim to meet RDAs, AIs, and AMDRs Three examples provided in the Dietary Guidelines for Americans: o Healthy U.S.-Style Eating Pattern o Healthy Mediterranean-Style Eating Pattern o Healthy Vegetarian Eating Pattern There are many other possible healthy eating patterns 33

33 Healthy U.S.-Style Eating Pattern Based on types and proportions of foods that Americans typically consume o Nutrient-dense forms o Appropriate amounts Aims to meet nutrient needs without exceeding calorie limits o Marginal or below the RDA or AI for vitamin D, vitamin E, potassium, and choline 34

34 Development of Healthy Eating Patterns Healthy U.S.-Style Eating Pattern 35

35 Development of Healthy Eating Patterns Base patterns Modified to develop the other patterns 36

36 Healthy Mediterranean-Style Eating Pattern Reflects eating patterns associated with health outcomes in studies of Mediterranean-Style diets Compared to Healthy U.S.-Style Eating Pattern o More fruits and seafood o Less dairy o Less calcium and vitamin D 37

37 Healthy Vegetarian Eating Pattern Modified to reflect eating patterns reported by selfidentified vegetarians in NHANES Compared to Healthy U.S.-Style Eating Pattern o Contains more soy products, legumes, nuts and seeds, and whole grains o No meats, poultry, and seafood o Somewhat higher in calcium and fiber and lower in vitamin D 38

38 Limits on Calories for Other Uses Patterns designed to meet food group and nutrient recommendations while staying within calorie needs Based on foods in nutrient-dense forms Limit on Calories for Other Uses o Remaining calories can be used to eat foods that are not in nutrientdense forms or to eat more than the recommended amount of nutrient-dense foods 39

39 Comparison to Typical Eating Patterns U.S. population, across almost every age and sex group, eating patterns are: o Low in vegetables, fruits, whole grains, dairy, seafood, and oil o High in refined grains, added sugars, saturated fats, sodium o For some age-sex groups, high in the meats, poultry, and eggs subgroup Young children and older Americans generally are closer to the recommendations than are adolescents and young adults. Small shifts in food and beverage choices can make a big difference over time. 40

40 Adapting Healthy Eating Patterns Support individuals and families in making choices that align with the Dietary Guidelines Focus on shifts like o Incorporate seafood in meals twice per week in place of meat, poultry, or eggs o Use vegetable oil in place of solid fats when cooking o Choose beverages with no added sugars, such as water Meet people where they are 41

41 Resources for Health Professionals 42

42 Tools & Resources Health.gov/DietaryGuidelines o Tools & Resources Companion Materials o Executive Summary o Recommendations At-A-Glance Toolkit for Professionals o Healthcare provider handout o Patient handouts Available in English and Spanish 43

43 Talk to Your Patients and Clients About Healthy Eating Patterns Conversation starters Tips for encouraging shifts and countering resistance Summary of components of a healthy eating pattern (3 pages) 44

44 Talk to Your Patients and Clients About Healthy Eating Patterns How to Build a Healthy Eating Pattern (3 pages) Shift to Healthier Food & Beverage Choices (2 pages) How-to guides for cutting down on: (2 pages each) o Added Sugars o Sodium o Saturated Fat 45

45 Eat Healthy Be Active Community Workshops One-hour workshops Geared toward adults and families Updated version available in early

46 Thank you! Exploring the Evidence on Dietary Patterns: the Interplay of What We Eat and Health Kellie O. Casavale, PhD, RD Nutrition Advisor Office of Disease Prevention and Health Promotion Office of the Assistant Secretary for Health U.S. Department of Health and Human Services

47 Questions?

48 Exploring the Evidence on Dietary Patterns: The Interplay of What We Eat and Health NUTRI-BITES Webinar Series Based on this webinar the participant should be able to: Increase awareness of the how evidence on the importance of healthy eating patterns has advanced and now forms an underpinning of the Dietary Guidelines for Americans. Describe healthy eating patterns that align with the Dietary Guidelines for Americans. Advance proficiency with applying healthy eating patterns in practice. Become familiar with resources to enable adapting healthy eating patterns to clients sociocultural and personal preferences.

49 Conagra Nutrition Nutri-Bites Webinar details A link to obtain your Continuing Education Credit certificate will be will be available on our website and ed within 2 days Today s webinar will be available to download within 2 days at: For CPE information: acontinelli@rippelifestyle.com Recent CEU webinars archived at the Conagra Nutrition website: The Academy of Nutrition and Dietetics Evidence Analysis Library: Leveraging This Resource to Maximize Your Efficacy Mediterranean Diet Pattern and Health An Update from FDA on the Revised Nutrition Facts Panel

50 Next Conagra Nutrition Nutri-Bites Webinar What's New in Obesity James O. Hill, Ph.D. Professor Departments of Pediatrics & Medicine University of Colorado School of Medicine March 22, pm EDT/1-2pm CDT

51 How are we doing? Stay on the line for a brief survey about today s Conagra Nutrition Nutri-Bites webinar: Exploring the Evidence on Dietary Patterns: The Interplay of What We Eat and Health Thank you!