Dietary Fat Guidance from The Role of Lean Beef in Achieving Current Dietary Recommendations

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Dietary Fat Guidance from 1980-2006 The Role of Lean Beef in Achieving Current Dietary Recommendations Penny Kris-Etherton, Ph.D., R.D. Department of Nutritional Sciences Pennsylvania State University

Outline Health Statistics in the U.S. Dietary Guidelines for Americans, 2005 Food-based Dietary Recommendations Other Dietary Recommendations Role of Beef in a Healthy Diet Historical Perspective, Dietary Guidance Summary

Leading Causes of Death for All Males and Females United States: 2003* 500 400 427 Deaths in Thousands 484 300 200 287 268 Males Females 100 68 60 35 66 45 39 0 A B C D E A B D F E A Total CVD B Cancer C Accidents D Chronic Lower Respiratory Diseases E Diabetes Mellitus F Alzheimer s Disease Source: CDC/NCHS and NHLBI. *Preliminary

Obesity Trends* Among U.S. Adults BRFSS, 1990, 1995, 2005 (*BMI 30, or about 30 lbs overweight for 5 4 person) 1990 1995 2005 No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%

Obesity Trends* Among U.S. Adults BRFSS, 2005 (*BMI 30, or ~ 30 lbs overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%

Dietary Guidelines for Americans, 2005

Nine Focus Areas Adequate Nutrients Within Calorie Needs Weight Management Physical Activity Food Groups To Encourage Fats Carbohydrates Sodium and Potassium Alcoholic Beverages Food Safety

Key Scientific Recommendations 1. Consume a variety of foods within and among the basic food groups while staying within energy needs 2. Control calorie intake to manage body weight 3. Be physically active every day 4. Increase daily intake of fruits and vegetables, whole grains, and reduced-fat milk and milk products 5. Choose fats wisely for good health 6. Choose carbohydrates wisely for good health 7. Choose and prepare foods with little salt 8. If you drink alcoholic beverages, do so in moderation 9. Keep food safe to eat

Adequate Nutrients Within Calorie Needs Consume a variety of nutrient-dense foods and beverages within and among the basic food groups while choosing foods that limit intake of saturated and trans fat, cholesterol, added sugars, salt, and alcohol DASH and Food Guide system examples of healthy eating patterns

New for 2005 Specific, detailed eating patterns DASH/USDA Food Guide 2000 calorie example Foods groups identified with disease prevention Specific recommendations for: people over 50, women who may become pregnant and those in first trimester, older adults, dark skinned people, and people exposed to insufficient UVB radiation

USDA Food Guide - Food Group Recommendations 1600 kcals 2000 kcals 2400 kcals Fruits Vegetables dark green orange legumes starchy other 1.5 c (3 serv) 2 c (4 serv) 2 c/wk 1.5 c/wk 2.5 c/wk 2.5 c/wk 5.5 c/wk 2 c (4 serv) 2.5 c (5 serv) 3 c/wk 2 c/wk 3 c/wk 3 c/wk 6.5 c/wk 2 c (4 serv) 3 c (6 serv) 3 c/wk 2 c/wk 3 c/wk 6 c/wk 7 c/wk Grains 5 oz. equivalent 6 oz. equivalent 8 oz. equivalent whole grains other grains 3 oz. 2 oz. 3 oz. 3 oz. 4 oz. 4 oz. Lean meat & beans 5 oz. equivalent 5.5 oz. equivalent 6.5 oz. equivalent Milk 3 c 3 c 3 c Oils 22 g 24 g 31 g Discretionary kcal 132 267 362

DASH PYRAMID

Percent Increase or Decrease from Current Consumption (zero line) to Recommended Intakes

Nutrient Adequacy Committee Recommendation: Consume a variety of foods within and among the basic food groups, while staying within energy needs. Basic food groups are: Fruits Vegetables Grains Milk, yogurt and cheese Meat, poultry, fish, dry beans, eggs, and nuts

Nutrient Density Nutrient Adequacy Nutrient-dense foods are those that provide substantial amounts vitamins and minerals and relatively fewer calories. Foods that are low in nutrient density are foods that supply calories but relatively small amounts of micronutrients (sometimes none at all). The greater the consumption of foods or beverages that are low in nutrient density, the more difficult it is to consume enough nutrients without gaining weight, especially for sedentary individuals. The consumption of added sugars, solid fats, and alcohol provides calories while providing little, if any, of the essential nutrients.

Nutrient Contribution of Beef to the Diet Food Group Major Contribution(s) Substantial Contribution(s) (>10% of total) Meat Group (meat, poultry, fish, eggs, nuts) Niacin Vitamin B6 Zinc Protein Vitamin E Thiamin Riboflavin Vitamin B12 Phosphorus Magnesium Iron Copper Potassium Linoleic Acid

Dietary Guidelines for Americans 2005 Nutrients of Concern: Beef is a source of these nutrients (underlined) Adults: calcium, potassium, fiber, magnesium and vitamin A (as carotenoids), C and E Children and adolescents: calcium, potassium, fiber, magnesium and vitamin E Specific population groups: vitamin B12, iron, folic acid, vitamins E and D

Beef contributes substantially Percentage of School-aged Children Whose Daily Nutrient Intake was Below the Estimated Average Requirement (EAR) for all Children, 1994-1996 (Nutrients considered shortfall nutrients indicated highlight) Suitor & Gleason, 2002 Dietary Component Vitamin A Vitamin C Vitamin E Thiamin Riboflavin Niacin Vitamin B6 Folate Vitamin B12 Phosphorus Magnesium Iron Zinc Sample Size All (M&F, 6-18 yrs) 10.1 10.5 78.9 1.9 2.1 1.9 1.3 50.6 1.3 19.9 36.5 2.9 8.2 2692

Probabilities of Adequacy for Selected Nutrients on the 1 st 24-hour Recall among Adults (CSFII 1994-96) (Nutrients considered shortfall nutrients indicated in highlighted area) Nutrient Vitamin A Vitamin C Vitamin E Thiamin Riboflavin Niacin Folate Vitamin B-6 Vitamin B12 Phosphorus Magnesium Iron Copper Zinc Calcium Men, % Probability 47.0 49.3 14.1 83.9 85.8 90.5 33.9 78.3 80.5 94.3 36.1 95.5 87.4 65.7 58.6 Women, % Probability 48.1 52.3 6.8 72.2 80.9 80.4 20.9 60.7 64.2 85.1 34.3 79.4 73.3 62 45.7 Foote et al., 2004 Beef contributes substantially

Women s Nutrient Intake Percent of Women Over 20 NOT Meeting Recommended Dietary Allowances (RDAs) Analysis of CSFII 1994-96, Final Report prepared by Bermudez Consultenos International

Food Sources of Iron as Consumed by Americans (% total consumption, CSFII, 1994-96) Food Ready-to-eat cereal Yeast bread Beef Cakes/cookies Pasta Flour Dried beans Poultry % of total 16.9 13.1 8.5 4.2 3.7 3.2 3.1 3.0 **Beef provides 2.01 mg iron/3 oz serving

Food Sources of Magnesium as Consumed by Americans (% total consumption, CSFII, 1994-96) Food Milk Yeast bread Coffee Ready-to-eat cereal Potatoes (white) Beef Poultry Dried beans/lentils % of total 8.3 7.7 6.5 4.9 4.7 4.3 3.4 3.4 **Beef provides 16 mg magnesium/3 oz serving

Food Sources of Potassium as Consumed by Americans (% total consumption, CSFII, 1994-96) Food Milk Potatoes (white) Coffee Beef Tomatoes Orange juice Yeast bread Poultry % of total 10.2 8.9 6.7 6.2 6.2 4.1 3.6 3.3 **Beef provides 200 mg potassium/3 oz serving

Beef s Nutrient Contribution According to a study published in the Journal of the American Dietetic Association, Beef was the #1 source of PROTEIN, ZINC, VITAMIN B 12 #2 Source of Selenium #3 source of IRON, VITAMIN B 6, PHOSPHOROUS, NIACIN and POTASSIUM #4 source of RIBOFLAVIN Source: Cotton et al., JADA, Volume 104 Number 6, June 2004

Dietary Guidelines for Americans 2005

New for 2005 Focus on reducing trans and saturated fatty acids Increase emphasis on MUFAs and PUFAs Increase in range of total fat 20-35% (recommended by DRIs for Macronutrients, 2002) Specific recommendations for children and adolescents Total fat between 30-35 % calories (2 to 3 yo) Total fat between 25-35% calories (4 to 18 yo) with most fats coming from PUFAs and MUFAs such as fish, nuts and vegetable oils Dietary Guidelines for Americans 2005

Dietary Guidelines for Americans, 2005 KEY RECOMMENDATIONS Consume less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep trans fatty acid consumption as low as possible. Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils. When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free. Limit intake of fats and oils high in saturated and/or trans fatty acids, and choose products low in such fats and oils.

Print materials: Mini Poster

From Inside the Pyramid : Why is it important to make lean or low-fat choices from the Meat and Beans group? Foods in the meat, poultry, fish, eggs, nuts, and seed group provide nutrients that are vital for health and maintenance of your body. However, choosing foods from this group that are high in saturated fat and cholesterol may have health implications. Nutrients Food sources of the nutrients in bold can be found in the Dietary Guidelines for Americans. Click on the nutrient name to link to the food sources table. Meat, poultry, fish, dry beans and peas, eggs, nuts, and seeds supply many nutrients. These include protein, B vitamins (niacin, thiamin, riboflavin, and B6), vitamin E, iron, zinc, and magnesium.

Maximum Daily Intake of SFA to Achieve <10% of Total Calories Total Calorie Intake 1600 2000 2200 2500 2800 Limit of SFA Intake 18 g or less 20 g or less 24 g or less 25 g or less 31 g or less Dietary Guidelines for Americans 2005

Dietary Recommendations for Saturated Fatty Acids, Trans Fatty Acids and Dietary Cholesterol Minimize Saturated and Trans Fatty Acid and Cholesterol Consumption while Consuming a Nutritionally Adequate Diet National Academies, 2002 200-01

Acceptable Macronutrient Distribution Ranges for Fat, Fatty Acids, Carbohydrate and Protein Range (percent of energy) Macronutrient 1-3 yrs 4-18 yrs Adults Fat, % 30-40 25-35 20-35 n-6 linoleic acid 5-10 5-10 5-10 n-3 α-linolenic acid 0.6-1.2 0.6-1.2 0.6-1.2 Carbohydrate 45-65 45-65 45-65 Protein 5-20 10-30 10-35 *Approximately 10% of the total can come from longer-chain n-3 or n-6 fatty acids. National Academies, 2002

UNITED STATES DIETARY GOALS, 1977 1. Increase carbohydrate consumption to account for 55 to 60 percent of the energy (caloric) intake. 2. Reduce overall fat consumption from approximately 40 to 30 percent of energ intake. 3. Reduce saturated fat consumption to account for about 10 percent of total energy intake; and balance that with poly-unsaturated and mono-unsaturated fats, which should account for about 10 percent of energy intake each. 4. Reduce cholesterol consumption to about 300 mg. a day. 5. Reduce sugar consumption by about 40 percent to account for about 15 percent of total energy intake. 6. Reduce salt consumption by about 50 to 85 percent to approximately 3 grams a day.

UNITED STATES DIETARY GOALS, 1977 The Goals Suggest the Following Changes in Food Selection and Preparation 1. Increase consumption of fruits and vegetables and whole grains. 2. Decrease consumption of meat and increase consumption of poultry and fish. 3. Decrease consumption of foods high in fat and partially substitute polyunsaturated fat for saturated fat. 4. Substitute non-fat milk for whole milk. 5. Decrease consumption of butterfat, eggs and other high cholesterol sources. 6. Decrease consumption of sugar and foods high in sugar content.

Dietary Guidelines for Americans, 1980

Dietary Guidelines for Americans, 1985

Dietary Guidelines for Americans, 1990

Dietary Guidelines for Americans, 1995

Dietary Guidelines for Americans, 2000

Dietary Guidelines for Americans, 2005 KEY RECOMMENDATIONS Consume less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep trans fatty acid consumption as low as possible. Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils. When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free. Limit intake of fats and oils high in saturated and/or trans fatty acids, and choose products low in such fats and oils.

Dietary Guidelines for Americans, 1980-2005: Focus shifts from total fat to type of fat 1980 1985 1990 1995 2000 2005 Avoid too much fat, saturated fat and cholesterol Select a diet low in fat, saturated fat and cholesterol Select a diet low is saturated fat, cholesterol & moderate in total fat Choose fats wisely: Limit intake of fats and oils high in saturated and/or trans fat Get mono and polyunsaturated fat from fish, nuts and vegetable oils

AHA Diets- 1980 s and 1990 s Step I Diet (Population Diet) < 30 % Total Fat; < 10 % Sat Fat; < 300 mg/day of Dietary Cholesterol Step II Diet (Patient Diet) < 30 % Total Fat; < 7 % Sat Fat; < 200 mg/day of Dietary Cholesterol

AHA 2006 Diet and Lifestyle Recommendations for CVD Risk Reduction Balance calorie intake and physical activity to achieve or maintain a healthy body weight Consume a diet rich in vegetables and fruits Choose whole-grain, high-fiber foods Consume fish, especially oily fish, at least twice a week Limit your intake of saturated fat to <7% of energy, trans fat to <1% of energy and cholesterol to <300mg/day Choosing lean meats and vegetable alternatives Selecting fat-free (skim), 1% fat and low fat dairy products Minimizing intake of partially hydrogenated fats Minimize your intake of beverages and foods with added sugars Choose and prepare foods with little or no salt If you consume alcohol, do so in moderation When you eat food that is prepared outside of the home, follow the AHA Diet and Lifestyle Recommendations Lichtenstein et al., Circulation 114:82-96, 2006

Maximum Daily Intake of SFA to Achieve <10% and < 7% of Total Calories Total Calorie Intake Limit of SFA Intake for <10 % Limit of SFA Intake for <7 % 1600 18 g or less 12.6 g or less 2000 20 g or less 14 g or less 2200 24 g or less 16.8 g or less 2500 25 g or less 17.5 g or less 2800 31 g or less 21.7 g or less Dietary Guidelines for Americans 2005

Fiber Protein Therapeutic Lifestyle Changes: ATP III: Nutrient Composition of TLC Nutrient Saturated fat* Polyunsaturated fat Monounsaturated fat Total fat Carbohydrate** Cholesterol Total calories (energy) * Lower trans fatty acids ** Emphasize complex sources Recommended Intake Diet Less than 7% of total calories Up to 10% of total calories Up to 20% of total calories 25 35% of total calories 50 60% of total calories 20 30 grams per day Approximately 15% of total calories Less than 200 mg/day Balance energy intake and output to maintain expenditure healthy body weight/prevent weight gain

Two Examples of Daily Dietary Patterns That Are Consistent with AHA-Recommended Dietary Goals at 2000 Calories Eating Pattern DASH TLC Serving Size Grains 6-8 sv/day 7 sv/day 1 sl. Bread, 1 oz dry cereal, ½ c cooked rice, pasta Vegetables 4-5 sv/day 5 sv/day 1 c raw leafy vegetables, ½ c cut-up raw or cooked vegetables, ½ c veg. juice Fruits 4-5 sv/day 4 sv/day 1 med. Fruit, ¼ c dried fruit, ½ c fresh, frozen canned fruit, ½ c fruit juice Fat-free or low-fat milk products 2-3 sv/day 2-3 sv/day 1 c milk, 1 c yogurt, 1/5 oz cheese Lean meats, poultry, fish < 6oz. per day < 5 oz per day 1 oz cooked Nuts, seeds, legumes 4-5 sv/day Counted in veg.servings 1/3 c, 2 TBSP peanut butter or seeds, ½ c dry beans or peas Fats and oils 2-3 sv/day Amt. Depends on daily calorie level 1 tsp soft margarine, 1 TBSP mayonnaise, 1 tsp veg. Oil, 2 TBSP salad dressing Sweets and added sugars < 5 sv/week No recommendation 1 TBSP sugar, jelly, jam; ½ c sorbet, 1 c lemonade

Summary Lean beef is a nutrient dense food that is low in calories, total fat, saturated fat and dietary cholesterol Lean beef can be included in a dietary pattern that achieves nutrient adequacy and meets current dietary guidance for health promotion and decreased risk of chronic disease