Dietary Guidelines Offers Practitioners Insight On Obesity Epidemic

22 October 2010 Elsevier

In an insightful Commentary in the November issue of the Journal of the American Dietetic Association, Linda Van Horn, PhD, RD, Editor-in-Chief of the Journal, Chair of the Dietary Guidelines Advisory Committee, and Professor and Associate Dean, Northwestern University, Feinberg School of Medicine, highlights the key features and noteworthy findings of the 2010 US Dietary Guidelines Advisory Committee (DGAC) Report.

While many of the recommendations from previous reports are reinforced, new evidence-based findings will help registered dietitians and other health care providers prioritize effective approaches towards facilitating better eating habits among Americans.

Dietary Goals for Americans (DGA) were first set in 1977 at a time when the average total fat intake was 42% of total energy intake, saturated fatty acids (SFA) intake was about 14%, and cardiovascular disease mortality was at an all-time high. Population-wide improvement in these parameters has occurred. By 2010, average American intake of total fat and SFA has decreased significantly to 33.6% and 11.4%, respectively – still higher than recommended, but certainly improved.

Meanwhile, the obesity epidemic in the US continues. “The literal ‘elephant in the room’ is the persistent and pervasive obesity epidemic that continues to perpetuate and perplex health care providers in all specialty areas, as well as consumers,” commented Professor Van Horn. This report indicates that the US population consumes inadequate nutrient-rich foods such as whole grains, fruits, and vegetables, and over consumes calorie-dense, nutrient-poor foods that include solid fats, added sugars, salt, and refined grains. The result is a population that is overfed and undernourished.

Key features of the 2010 US DGAC Report:

  • It is the first totally evidence-based report that maximizes the quality, quantity, and critical organization of the underlying scientific data that fully substantiate and raise to new levels of significance the importance of these recommendations.
  • It addresses, for the first time, an unhealthy American public, with the majority (72.3% of women, 64.1% of men) classified as overweight or obese and the rest at risk of becoming obese. This increases the level of intensity, urgency, and significance associated with the translation and implementation of these DGA.
  • It includes a strong and emerging evidence base on infants, children, and pregnant women, vulnerable subgroups. All previous DGA have been directed at the population age 2 years and older.
  • It was conducted in a completely transparent manner with six public meetings, including three Webinars that uniquely provided worldwide, complete real-time access to all the proceedings as they occurred.
  • It includes two new chapters, one regarding the “Total Diet” to present the totality of the recommended eating patterns, and a “Translation/Implementation” chapter that provides the environmental context that affects the overall usefulness and adaptation of the DGA.

The report highlights other noteworthy findings of particular importance for registered dietitians.

Between 1970 and 2010, energy intake has increased by over 600 calories per day. Grain-based desserts (for example, cakes and cookies) are the highest ranking contributor to energy intake in the US population, while sodas and sports drinks provide the highest source of calories to adolescents, followed closely by pizza.

Given the dismal success rate of weight loss efforts in adulthood, and the even less successful efforts to maintain weight loss once it is achieved, this report stresses the importance of recognizing that primary prevention of obesity beginning in childhood is potentially the single most powerful method for halting and reversing America’s obesity epidemic.

Professor Van Horn writes that “tremendous input was provided by an exceptional team of highly qualified, experienced, knowledgeable, and dedicated registered dietitians from many different backgrounds whose efforts made all the difference in achieving this herculean effort. In conclusion, this commentary serves to congratulate and distinguish the many contributions of RDs, American Dietetic Association members, and others throughout this process.” She notes further that, “Encouraging these changes will require partnership with policymakers, industry, and consumers. RDs are key to facilitating these changes, along with dietetic technicians, registered dieticians, and other health care providers.”

Let’s not forget the impact the school districts, farmers and parents can have when optimal health is at stake.

The 2010 DGAC report is available online at the link below.

http://www.dietaryguidelines.gov

  • Full bibliographic information“Development of the 2010 US Dietary Guidelines Advisory Committee Report: Perspectives from a Registered Dietitian” by Linda Van Horn, PhD, RD. It appears in the Journal of the American Dietetic Association, Volume 110 Issue 11 (November 2010) published by Elsevier.

Hispanic Children In US At Greater Risk For Obesity Than Other Ethnic/Racial Groups

Culturally appropriate nutritional intervention needed, according to nutrition experts

St. Louis, MO, June 1, 2009 – The prevalence of overweight in the US population is among the highest in Mexican-American children and adolescents. In a study of 1,030 Hispanic children between the ages of 4 and 19, published in the June 2009 issue of the Journal of the American Dietetic Association, researchers from the Baylor College of Medicine found less than optimal diets in both overweight and non-overweight participants.

According to the National Health and Nutrition Examination Surveys (NHANES), in 2005-2006 the prevalence of overweight among children (2-19 years) from all ethnic/racial groups was 15.5%. For Mexican-American males and females (2-19 years) the prevalence was 23.2% and 18.5%, respectively. Although the US environment encourages a sedentary lifestyle and excess food intake, the Hispanic population is burdened with additional risk factors for childhood obesity including parental obesity, low socioeconomic status (SES), recent immigration, acculturation to US diet and lifestyle, and limited health insurance coverage.

The VIVA LA FAMILIA Study was designed to identify genetic and environmental factors contributing to childhood  obesity in the Hispanic population. It provided the novel opportunity to assess the diet of a large cohort of Hispanic children from low-SES families at high risk for obesity (1,030 children from 319 families in Houston, Texas). On average, 91% of parents were overweight or obese and parental income and education levels were low. Food insecurity was reported by 49% of households.

Writing in the article, Nancy F. Butte, PhD, Professor, USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, states, “The diets of these low-SES Hispanic children were adequate in most essential nutrients, but suboptimal for the promotion of long-term health. Diet quality did not satisfy US dietary guidelines for fat, cholesterol, saturated fatty acids, fiber, added sugar, and sodium. Although energy intake was higher in overweight children, food sources, diet quality, and macro- and micronutrient composition were similar between non-overweight and overweight siblings…Knowledge of the dietary intake of children from low-SES Hispanic families at high risk for obesity will provide a basis on which to build nutritional interventions and policy that are appropriately tailored to population sub-groups.”

In a commentary published in the same issue of the Journal of the American Dietetic Association, Rafael Pérez-Escamilla, PhD, Professor of Nutritional Sciences & Public Health, Director, NIH EXPORT Center for Eliminating, Health Disparities among Latinos (CEHDL), University of Connecticut, Storrs, asks whether the process of acculturation into “mainstream” US society is having negative effects on Hispanics. Citing numerous studies, he explores many of the factors that both support and contradict the assimilation argument, and concludes that while acculturation is likely a negative influence, further study is warranted. He writes, “However, we still need to elucidate the mechanisms and the extent to which acculturation to the USA ‘mainstream’ culture per se explain deterioration in dietary quality, and increased risks for obesity and associated chronic diseases among Latinos. Filling in this gap in knowledge is essential for developing culturally appropriate and behavioral change based interventions targeting Latinos with different levels of acculturation.”

The article is “Nutrient adequacy and diet quality in non-overweight and overweight Hispanic children of low socioeconomic status – the VIVA LA FAMILIA Study” by Theresa A. Wilson, MS, RD, Anne L. Adolph, BS, and Nancy F. Butte, PhD. The commentary is “Dietary quality among Latinos: Is acculturation making us sick?” by Rafael Pérez-Escamilla, PhD. Both appear in the Journal of the American Dietetic Association, Volume 109, Issue 6 (June 2009) published by Elsevier.

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Full text of the article and commentary featured above is available upon request. Contact Lynelle Korte at 314-453-4841 or jadamedia@elsevier.com to obtain a copy. Journalists wishing to interview Dr. Butte or her co-authors may contact Dipali Pathak, Media Relations Specialist, Baylor College of Medicine, via email at pathak@bcm.edu or phone at 713-798-6826. Journalists wishing to interview Professor Pérez-Escamilla may contact him directly at rafael.perez-escamilla@uconn.edu or at 860-805-2502.

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