What are the patterns of dietary intake across the lifespan and the opportunities to support healthy aging?

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What are the patterns of dietary intake across the lifespan and the opportunities to support healthy aging? Eve Stoody, PhD Lead Nutritionist U.S. DEPARTMENT OF AGRICULTURE CENTER FOR NUTRITION POLICY & PROMOTION United States Department of Agriculture

TODAY S TOPICS 2015-2020 Dietary Guidelines for Americans Dietary intake across the lifespan Opportunities for the future

2015-2020 DIETARY GUIDELINES FOR AMERICANS DietaryGuidelines.gov The Dietary Guidelines make recommendations about the components of a healthy and nutritionally adequate diet to help promote health and prevent chronic disease for current and future generations.

2015-2020 DIETARY GUIDELINES FOR AMERICANS The goal of the Dietary Guidelines is for individuals throughout all stages of the lifespan to have eating patterns that promote overall health and help prevent chronic disease. Chapter 1, page 14

2015-2020 DIETARY GUIDELINES FOR AMERICANS Guidelines 1 2 3 4 5 Follow a healthy eating pattern across the lifespan Focus on variety, nutrient density, and amount Limit calories from added sugars and saturated fats and reduce sodium intake Shift to healthier food and beverage choices Support healthy eating patterns for all

KEY RECOMMENDATIONS The Dietary Guidelines describes adaptable eating patterns Consume a healthy eating pattern that accounts for all food 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 and trans fats, added sugars, and sodium

KEY RECOMMENDATIONS Quantitative Limits Quantitative recommendations are provided for components of the diet that should be limited. These components are of particular public health concern, and the specified limits can help individuals achieve healthy eating patterns within calorie limits: Consume less than 10% of calories per day from ADDED SUGARS Consume less than 10% of calories per day from SATURATED FATS Consume less than 2,300 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

Americans are not consuming healthy eating patterns Measured by Average Total Healthy Eating Index-2010 (HEI-2010) Scores of the U.S. Population Ages 2 Years and Older (Figure I-1) Data Source: Analyses of What We Eat in America, National Health and Nutrition Examination Survey (NHANES) data from 1999-2000 through 2009-2010. Note: HEI-2010 total scores are out of 100 possible points. A score of 100 indicates that recommendations on average were met or exceeded. A higher total score indicates a higher quality diet.

Americans are not consuming healthy eating patterns Measured by Average Total Healthy Eating Index-2010 (HEI-2010) Scores of the U.S. Population Across Age Groups Data Source: Analyses of What We Eat in America, National Health and Nutrition Examination Survey (NHANES) data from 1999-2000 through 2009-2010. Note: HEI-2010 total scores are out of 100 possible points. A score of 100 indicates that recommendations on average were met or exceeded. A higher total score indicates a higher quality diet.

Current eating patterns in the United States need improvement Percent of the U.S. Population Ages 1 Year and Older Who are Below, At, or Above Each Dietary Goal or Limit (Figure 2-1) Note: The center (0) line is the goal or limit. For most, those represented by the blue sections of the bars, shifting toward the center line will improve their eating pattern. Data Source: What We Eat in America, NHANES 2007-2010 for average intakes by agesex group. Healthy U.S.-Style Food Patterns, which vary based on age, sex, and activity level, for recommended intakes and limits.

Vegetables: Intakes and Recommendations Average Daily Intakes by Age-Sex Groups, Compared to Ranges of Recommended Intake (from Figure 2-3) Data Sources: What We Eat in America, NHANES 2007-2010 for average intakes by age-sex group. Healthy U.S.-Style Food Patterns, which vary based on age, sex, and activity level, for recommended intake ranges.

Dietary intake across the lifespan Most Americans need to shift intakes to achieve healthy eating patterns. Some needed shifts are minor and can be accomplished by making simple substitutions, while others will require greater effort to accomplish. Young children and older Americans generally are closer to the recommendations than are adolescents and young adults.

OPPORTUNITIES FOR THE FUTURE

Improving the intakes of young children and maintaining those intakes as they grow into adolescence and adulthood could result in health eating patterns across the lifespan and improved health over time Data Source: Analyses of What We Eat in America, National Health and Nutrition Examination Survey (NHANES) data from 1999-2000 through 2009-2010. Note: HEI-2010 total scores are out of 100 possible points. A score of 100 indicates that recommendations on average were met or exceeded. A higher total score indicates a higher quality diet.

2015-2020 DIETARY GUIDELINES FOR AMERICANS 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. Guideline 5

Creating and Supporting Healthy Choices (Figure 3-1) Data Source: Adapted from: (1) Centers for Disease Control and Prevention. Division of Nutrition, Physical Activity, and Obesity. National Center for Chronic Disease Prevention and Health Promotion. Addressing Obesity Disparities: Social Ecological Model. Available at: http://www.cdc.gov/obes ity/health_equity/addres singtheissue.html. Accessed October 19, 2015. (2) Institute of Medicine. Preventing Childhood Obesity: Health in the Balance, Washington (DC): The National Academies Press; 2005, page 85. (3) Story M, Kaphingst KM, Robinson-O Brien R, Glanz K. Creating healthy food and eating environments: Policy and environmental approaches. Annu Rev Public Health 2008; 29:253-272.

FROM THE DIETARY GUIDELINES TO MYPLATE Reaching Consumers

MATERIALS FROM CHOOSEMYPLATE.GOV Posters and other print materials Toolkits Spanish language resources Audience-specific resources Preschoolers Kids Older individuals Healthy eating on a budget NIH National Institute on Aging

2020-2025 DIETARY GUIDELINES FOR AMERICANS Agricultural Act of 2014 Will include dietary guidance for women who are pregnant and children from birth to 24 months of age a focus on other stages of the lifespan in the future?

A FOCUS ON OLDER INDIVIDUALS Specific Guidance in the Dietary Guidelines Healthy Weight Physical Activity Food Safety Alcohol Dietary Fiber Sodium Potassium Calcium Vitamin B 12 Vitamin D Supplements (General) 2015-2020 2010 * * * 2005 2000 * * 1995 1990 1985 1980 The recommendations of the Dietary Guidelines apply to older individuals, but there are cases when specific statements have focused on this population. * These topics are covered for adults ages 50/51y+

FUTURE RESEARCH Dietary patterns & various health outcomes: Cardiovascular disease, body weight, type 2 diabetes, certain types of cancer, bone health, depression, & dementia/cognitive impairment/alzheimer s disease Most of the dietary patterns studies included subjects who were 50y+ (mean age) at baseline and followed them for ~10y There is still a gap of understanding how dietary patterns across the entire lifespan contribute to healthy aging

FUTURE RESEARCH Improve methods for assessing dietary patterns more comprehensively, precisely, and with standardization so that investigators can better define habitual food intake in populations Examine dietary patterns and associations with health in studies with strong methodological design (i.e., longer duration of follow-up and assessment of dietary intake at various time points over the course of the study) Establish cohort studies that start earlier in life in order to capture dietary patterns contributing to health outcomes later in life

ACKNOWLEDGEMENTS Liz Rahavi Julie Obbagy Carol Dreibelbis Kellie Casavale Colette Rihane Hannah Mitchell

THANK YOU! USDA Center for Nutrition Policy and Promotion cnpp.usda.gov DietaryGuidelines.gov NEL.gov ChooseMyPlate.gov SuperTracker.usda.gov