Nutrition and HealthTopics and Controversies

Felix Bronner

• Publisher: CRC Press
• Year: 2020
• Print ISBN: 9780849378492
• eBook ISBN: 9781000142204
• Edition: 1
• Topic: Biological Sciences
• Subtopic: Nutrition, Dietics & Bariatrics
• Index: Biological Sciences

Nutrition and Health: Topics and Controversies explores in detail the relationship between diet, nutritional status, and disease, and evaluates nutritional practices intended to minimize the incidence of and slow the progress of major chronic illnesses. National trends in nutritional awareness and the resulting changes in consumer behavior are discussed. Unlike other books on this subject, the authors take a stand on controversial issues in the field and document their positions with scientific data. Nutrients such as calcium, vitamin E, selenium, and antioxidants, their importance in overall nutrition, and their role in specific diseases are covered. Expertise in nutritional science is not required to gain the highly practical information in this book.

Chapter 1

TRENDS IN AMERICAN DIETARY PATTERNS: RESEARCH ISSUES AND POLICY IMPLICATIONS

Marion Nestle and Catherine Woteki

CONTENTS

I.	Introduction
II.	Background A. Historical Trends B. Early Federal Monitoring Activities C. National Nutrition Monitoring System
III.	Research Issues A. Analytical Approaches B. Inferences C. Bias Issues D. Assessment Methods 1. Food Composition Data 2. Serving Size Estimations 3. Food Supply Surveys 4. Dietary Intake Surveys a. 24-Hour Recalls b. Food Records or Diaries c. Food Frequency Questionnaires (FFQs) d. Household Food Consumption 5. Questions of Comparability
IV.	Standards of Dietary Adequacy A. Recommended Dietary Allowances B. Quantitative Dietary Goals C. Qualitative Dietary Guidelines
V.	Trends in Fat Consumption A. Food Supply B. Dietary Intake 1. Method Comparisons 2. NHANES I to NHANES II 3. NHANES II to NHANES III 4. Meta-Analysis C. Summary: Dietary Fat
VI.	Trends in Antioxidant Consumption A. Food Supply Data B. Food Additives Survey C. National Health Interview Survey D. Dietary Intake Surveys E. Dietary Patterns 1. Serum Antioxidant Levels 2. Variables Affecting Intake F. Summary: Antioxidant Trends
VII.	Factors that Affect Dietary Trends A. Food System Economics 1. Agricultural Production 2. Marketing Trends 3. New Product Introductions 4. Food Advertising B. Lifestyle Issues 1. Work and Family Structure 2. Meals Away from Home 3. Poverty C. Taste Preferences D. Education 1. Nutrition Knowledge 2. Dietary Behavior 3. Education Campaigns 4. Key Elements
VIII.	Policy Implications
Acknowledgments
References

I. INTRODUCTION

Accurate information about trends in American dietary patterns is critical to the development of rational policies, programs, and resource allocations designed to improve the nutritional intake and health status of the population. The importance of this information is illustrated, for example, by its use to establish dietary recommendations to reduce intake of fat from one level to another, to assess progress toward achieving national nutrition objectives, and to identify changes in the proportion of the population requiring food assistance.⁹⁷ Although assessing changes in the dietary intake of individuals or population groups might appear to be a simple task, it is in fact exceedingly difficult to accomplish with any acceptable degree of scientific rigor. The determination of usual dietary intake at any one point in time presents formidable difficulties that are further complicated when it is necessary to determine time trends. Indeed, the assessment of dietary changes over time constitutes one of the most intellectually challenging problems in the field of nutrition, and is currently the focus of intense professional interest.¹⁷

As many authorities have noted, no “gold standard” exists for dietary intake measurement.^72,86 Each of the methods commonly used to assess dietary intake is limited in its ability to produce reliable information, and results obtained by any one method are not necessarily comparable to those obtained by another. Therefore, inferences about time trends can only be made with many caveats, especially when the measures used to assess dietary intake and nutritional status differ from one survey period to another. Such problems impair the differentiation of genuine trends from apparent changes that are artifacts of alterations in methods or interpretations.

Despite such difficulties, much useful information can be obtained through careful analysis and interpretation of existing survey data, especially when methodologic limitations are taken into account. In this chapter, we review current methods for assessing the dietary intake of individuals and populations, review the strengths and limitations of these methods, and describe the ways they are used to determine trends in food and nutrient intake. We use this information to draw inferences about time trends in the intake of certain dietary factors selected for their relevance to current public health concerns. Because nutrition policy objectives are designed to improve the health of the population, we examine the ways in which societal trends influence dietary intake from one point in time to another. Finally, we suggest directions for policy and research initiatives designed to promote more favorable dietary trends among American population groups.

II. BACKGROUND

A. HISTORICAL TRENDS

Current dietary practices reflect thousands of years of an almost Darwinian process of natural selection: the foods that have survived and are still consumed by modern cultures are those that have been grown successfully and enjoyed throughout history, and existing dietary patterns are those that have evolved over the ages in response to food availability, biologic need, and taste preferences.^46,134 Interactions between eating behavior and food availability, as modified by cultural, social, economic, and agricultural practices and trends, at least in part explain the wide variation in the ways the world’s many populations successfully achieve nutritional needs.¹¹⁷

As much as can be determined, prehistoric humans obtained food by hunting, fishing, and collecting plants. Life expectancy was short, and people suffered from the consequences of vitamin deficiencies, seasonal malnutrition, plant poisons, and microbial contamination. With the development of agriculture, thought to have taken place some 10,000 years ago, diets became increasingly based on plants cultivated for food.²⁸ The domestication of crop plants permitted their increased storage and consumption, and reliance on plant foods as the principal energy source continues to be typical of nonindustrialized populations today.⁴⁹

In the early years of the United States, foods were obtained through farming, gathering, hunting, fishing, and — to some extent — internal and external trade. Diets varied according to season, climate, and geographical location and, as trade became more extensive, according to social status.^149,150 By 1800, meat had become the focus of the main meal, accompanied by fruit, vegetables, grains, dairy foods, sweets, and alcohol. This pattern reflected the Northern European origin of early immigrants to this country.⁶⁸ Increasing industrialization and urbanization throughout the 19th century fostered improvements in the ability...

Table of contents

• Cover
• Title Page
• Copyright Page
• Modern Nutrition
• Series Preface for Modern Nutrition
• Preface
• The Editor
• Contributors
• Table of Contents
• Chapter 1. Trends in American Dietary Patterns: Research Issues and Policy Implications
• Chapter 2. Controversies in Changing Dietary Behavior
• Chapter 3. Nutrition in Cancer Prevention and Adjuvant Therapy
• Chapter 4. Cholesterol and Cardiovascular Disease: How Can Nutrition Help?
• Chapter 5. Calcium Nutrition and Osteoporosis
• Chapter 6. Calcium and the Myocardium: What Can Nutrition Do?
• Chapter 7. Vitamin E: Do We Need It?
• Chapter 8. Selenium: Do We Dare Neglect It?
• Chapter 9. Antioxidants and Atherosclerosis
• Index