The Role of Dairy in Meeting the Recommendations for Shortfall Nutrients in the American Diet

ArticleinJournal of the American College of Nutrition 28 Suppl 1(suppl 1):73S-81S · February 2009with22 Reads
DOI: 10.1080/07315724.2009.10719807 · Source: PubMed
Abstract
The 2005 Dietary Guidelines Advisory Committee (DGAC) recognized calcium, potassium and magnesium, all found in high levels in dairy foods, among the shortfall nutrients in both children and adults' diets. The objectives were to determine: 1) the percentage of the population with intakes greater than the Adequate Intakes (AI) for calcium and potassium and the percentage of the population with inadequate magnesium intake (based on Estimated Average Requirement [EAR]) and 2) the impact of various levels of dairy consumption on intake of calcium, potassium and magnesium. Secondary analysis of data from the 1999-2004 NHANES. SUBJECTS/ SETTING: Participants 2 years of age and older. Percentage of the population meeting current recommendations for calcium, potassium and magnesium. Percentage of EAR/AI for nutrients was calculated based on age/gender specific values. All analyses were weighted using the NHANES six-year sample weights and adjusted for the complex sample design of NHANES with the statistical package SUDAAN. The most recent NHANES data demonstrated that a significant proportion of the American population did not meet recommendations for calcium, potassium, and magnesium. Less than 3% of the population consumed the recommended level or more of potassium. Only 30% of the US population 2 years of age and older obtained the recommended level of calcium or more and 55% consumed less than the EAR for magnesium. Recommending 3-4 servings from the dairy group for all people greater than 9 years of age may be necessary in order to ensure adequate intake of calcium and magnesium, assuming the current diet remains the same. More than 4 servings of dairy would be needed to meet the potassium recommendation at all ages. For those individuals who do not consume dairy products, we need to better understand the barriers to consuming specific dairy products. In addition, more research is needed to examine whether food-based recommendations are practical, feasible and cost effective to meet nutrient needs.
    • "Diets arise from a complex network of foods consumed within and between meals where clustering of " healthy " or " unhealthy " behaviors is common. Specifically, yogurt and milk consumption have often been associated with a better overall dietary profile and inversely associated with the consumption of sugar-sweetened beverages, especially soda and fruit juices [70][71][72]. Regarding anthropometric outcomes, a longitudinal study showed that a healthy dietary pattern high in reduced-fat dairy was inversely associated with BMI and with waist circumfer- ence [73]. In the case of dietary patterns as exposures, the individual contribution of specific food groups to the effect cannot be quantified, but rather the results are seen as the effect of the interaction of this complex network of foods over the outcome. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: The current state of knowledge regarding the association of dairy products and weight gain, overweight, and obesity is based on studies reporting contradicting and inconclusive results. The aim of the present study was thus to clarify the link between dairy consumption in relation to changes in anthropometric measures/adiposity by a meta-analytical approach. Methods: For the meta-analysis PubMed, EMBASE, Web of Sciences, and google scholar were searched by two independent authors up to May 2016 with no restriction to language or calendar date. Prospective cohort studies reporting about intake of dairy consumption (including milk, yogurt, cheese, butter) and changes in body weight or waist circumference, risk of overweight, obesity, or weight gain were eligible. Pooled effects were calculated using a random effects model, and also a fixed effect model for sensitivity analysis. Due to the heterogeneity of statistical analytical approaches of the studies the analysis were done separately for beta-coefficients of changes in body weight and/or waist circumference per serving of dairy, for differences in weight gain/gain in waist circumference when comparing extreme categories of dairy consumption, and for odds ratios in regard to weight gain, overweight/obesity, or abdominal obesity. Findings: 24 studies (27 reports) met the inclusion criteria for the systematic review, and 22 studies provided sufficient data for inclusion in the meta-analysis. The meta-analysis of the five studies on changes in body weight per serving of dairy no significant results could be found for whole fat dairy and low fat dairy. However, there was inverse association between changes in body weight for each serving's increase of yogurt (beta: -40.99 gram/year, 95% CI, -48.09 to -33.88), whereas each serving's increase of cheese was positively associated (beta: -10.97 gram/year, 95% CI, 2.86 to 19.07). Furthermore, the highest dairy intake category was associated with a reduced risk of abdominal obesity (OR: 0.85; 95% CI, 0.76 to 0.95), and risk of overweight (OR: 0.87; 95% CI, 0.76 to 1.00) compared to the lowest intake category. No significant association could be observed for risk of weight gain. Conclusion: In summary the results of the meta-analysis still reflect that dairy consumption was not positively related to changes in body weight. Yogurt was the only dairy food that showed some evidence for a beneficial effect, where higher intakes were inversely associated a reduced risk of obesity, changes in body weight or waist circumference. Further research is needed, since the overall interpretation of the results is limited by heterogeneous risk estimates.
    Full-text · Article · Jun 2016
    • "For instance in The Netherlands, the median consumption of dairy products among community dwelling older adults (>70 years) is around 300 g a day instead of the recommended 650 g a day (Ocke et al., 2013). Data from the United States also show a suboptimal intake of dairy products , with over 90% of persons of age >71 who do not meet the 3 servings a day, as recommended in the Dietary Guidelines for Americans (Fulgoni et al., 2007; Krebs-Smith et al., 2010; Nicklas, O'Neil, & Fulgoni, 2009). As dairy foods are an important source of protein, calcium and B-vitamins, the finding that older adults with a poor appetite do not prefer these products is of concern. "
    [Show abstract] [Hide abstract] ABSTRACT: A poor appetite in older adults is an important determinant of reduced food intake and undernutrition. Food preferences may influence food intake. The aim of this study was to investigate food preferences of older adults with a poor appetite and compare these with preferences of older adults with a good appetite. Older adults (n = 349, aged 65–101 years) in nursing/residential care homes, hospitals or at home receiving home care participated in a computer-based forced-choice food preference assessment. Selfreported appetite in the past week was classified as ‘good’ or ‘poor’ using a validated instrument. Food preferences were determined by counting the relative frequency of choices for food images according to 11 dichotomous categories: high/low 1) protein; 2) fat; 3) carbohydrates; 4) fiber; 5) variation; and 6) animal/vegetarian proteins; 7) sweet/savory taste; 8) solid/liquid texture; 9) dairy/non-dairy; with/ without 10) sauce or 11) color variation. Specific food preferences in participants with a poor appetite were identified by one-sample t-tests comparing frequencies to the expected value of 48. Preference differences between those with a good and a poor appetitewere analyzed using GLM adjusting for confounders. The results showed that older adults with a poor appetite (n = 113; 32.4%) preferred variation (51.6 vs. 48, P < 0.001), color variation (55.9 vs. 48, P < 0.01), non-dairy (53.0 vs. 48, P < 0.001), high-fiber (51.8 vs. 48, P < 0.05), and solid texture (53.5 vs. 48, P < 0.05). Participants with a poor appetite had a higher frequency score for variation than participants with a good appetite (51.6 vs. 48.5, P < 0.001). In conclusion, older adults with a poor appetite may have specific food preferences. Their preference for variation differs from those with a good appetite. These results may be used to develop meals that are preferred by older adults with poor appetite in order to increase food intake and prevent undernutrition.
    Full-text · Article · Mar 2015
    • "For instance in The Netherlands, the median consumption of dairy products among community dwelling older adults (>70 years) is around 300 g a day instead of the recommended 650 g a day (Ocke et al., 2013). Data from the United States also show a suboptimal intake of dairy products , with over 90% of persons of age >71 who do not meet the 3 servings a day, as recommended in the Dietary Guidelines for Americans (Fulgoni et al., 2007; Krebs-Smith et al., 2010; Nicklas, O'Neil, & Fulgoni, 2009). As dairy foods are an important source of protein, calcium and B-vitamins, the finding that older adults with a poor appetite do not prefer these products is of concern. "
    [Show abstract] [Hide abstract] ABSTRACT: A poor appetite in older adults is an important determinant of reduced food intake and undernutrition. Food preferences may influence food intake. The aim of this study was to investigate food preferences of older adults with a poor appetite and compare these with preferences of older adults with a good appetite. Older adults (n = 349, aged 65–101 years) in nursing/residential care homes, hospitals or at home receiving home care participated in a computer-based forced-choice food preference assessment. Self reported appetite in the past week was classified as ‘good’ or ‘poor’ using a validated instrument. Food preferences were determined by counting the relative frequency of choices for food images according to 11 dichotomous categories: high/low 1) protein; 2) fat; 3) carbohydrates; 4) fiber; 5) variation; and 6) animal/vegetarian proteins; 7) sweet/savory taste; 8) solid/liquid texture; 9) dairy/non-dairy; with/without 10) sauce or 11) color variation. Specific food preferences in participants with a poor appetite were identified by one-sample t-tests comparing frequencies to the expected value of 48. Preference differences between those with a good and a poor appetitewere analyzed using GLM adjusting for confounders. The results showed that older adults with a poor appetite (n = 113; 32.4%) preferred variation (51.6 vs. 48, P < 0.001), color variation (55.9 vs. 48, P < 0.01), non-dairy (53.0 vs. 48, P < 0.001), high-fiber (51.8 vs. 48, P < 0.05), and solid texture (53.5 vs. 48, P < 0.05). Participants with a poor appetite had a higher frequency score for variation than participants with a good appetite (51.6 vs. 48.5, P < 0.001). In conclusion, older adults with a poor appetite may have specific food preferences. Their preference for variation differs from those with a good appetite. These results may be used to develop meals that are preferred by older adults with poor appetite in order to increase food intake and prevent undernutrition.
    Full-text · Article · Mar 2015
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