Plant foods in the American diet? As we sow...
Prevention Research Center, Yale University School of Medicine, New Haven, Connecticut, USA. Medscape journal of medicine
Available from: ajcn.nutrition.org
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ABSTRACT: Improving diets has considerable potential to improve health, but progress in this area has been limited, and advice to increase fruit and vegetable intake has largely gone unheeded.
Our objective was to test the performance characteristics of the Overall Nutritional Quality Index (ONQI), a tool designed to help improve dietary patterns one well-informed choice at a time.
The ONQI was developed by a multidisciplinary group of nutrition and public health scientists independent of food industry interests and is the basis for the NuVal Nutritional Guidance System. Dietary guidelines, existing nutritional scoring systems, and other pertinent scientific literature were reviewed. An algorithm incorporating >30 entries that represent both micro- and macronutrient properties of foods, as well as weighting coefficients representing epidemiologic associations between nutrients and health outcomes, was developed and subjected to consumer research and testing of performance characteristics.
ONQI and expert panel rankings correlated highly (R = 0.92, P < 0.001). In consumer testing, approximately 80% of >800 study participants indicated that the ONQI would influence their purchase intent. ONQI scoring distinguished the more-healthful DASH (Dietary Approaches to Stop Hypertension) diet (mean score: 46) from the typical American diet according to the National Health and Nutrition Examination Survey (NHANES) 2003-2006 (mean score: 26.5; P < 0.01). In linear regression analysis of the NHANES 2003-2006 populations (n = 15,900), the NuVal system was significantly associated with the Healthy Eating Index 2005 (P < 0.0001). Recently generated data from ongoing studies indicate favorable effects on purchase patterns and significant correlation with health outcomes in large cohorts of men and women followed for decades.
NuVal offers universally applicable nutrition guidance that is independent of food industry interests and is supported by consumer research and scientific evaluation of its performance characteristics.
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ABSTRACT: Childhood obesity rates have risen alarmingly for decades, and while recent data suggest a possible plateau, obesity is seen in ever-younger children, and is increasingly severe. The proximal cause of obesity is energy imbalance; the root cause is modern living. Throughout most of human history, calories were relatively scarce and hard to get, and physical activity was unavoidable. We have devised a modern world in which physical activity is scarce and hard to get, and calories are unavoidable. The "obesigenic" environment propagates a veritable daily flood of influences into the lives of children and adults alike that favor excess intake of energy-dense foods and inadequate energy expenditure. The requisite defense against this flood is a commensurate barrier of programs, policies, and practices that cultivate the will, and pave the way for the pursuit of better eating, more activity, and better health. Each individual program, policy, or practice that is part of this composite solution constitutes a sandbag in the levee needed to turn the tide of childhood obesity. Since children live with adults, and since family is the basic functional unit of our society, children and adults will attain weight control and achieve health together-or they are unlikely to attain it at all. Studies to date showing limited successes have, by and large, expected too much from a single 'sand bag.' School-based obesity prevention and control interventions, for example, may well be necessary, but are almost certainly not sufficient in the absence of complementary programming in diverse community settings. When, and only, we take enough corrective actions in enough settings; when we reach all members of households in all the places they live, love, work, and play; when the levee stands above the height of the obesigenic flood tide, will we see that tide turn. It will, indeed, take the whole village to get there from here.
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