Heather Eicher-Miller, PhD, who leads the Food Pattern and Data Analysis subcommittee, discussed current findings on food patterns among individuals age one year and above at the Sept. 13 meeting for the Dietary Guidelines Advisory Committee. While only referencing a sample of the current data, Eicher-Miller emphasized that the committee “can’t see the big picture yet…and we will be able to draw from the other systematic reviews and…food pattern modeling to…put this all together in a better picture.”
Of the analysis, Eicher-Miller explained that the committee paid “special attention to those nutrients, and components that are of public health concern…[which] are the ones the population is under consuming or over consuming and presenting health risks. Then putting those things back together, we want to consider what the current overall patterns of dietary intake, including foods and beverages, are in the United States. And then finally, this should all be grounded in what our current prevalence of nutrition-related chronic health conditions are in the US.”
The subcommittee examined the impact of the pandemic (from March 2020 through December 2022) on data collection using the Nesser methodology and sought out published literature that would give insight on the dietary intakes from that time. They found that within the regional sub samples of the population, “there was no indication that they were significantly different during the window of the pandemic.”
Further, the committee included other factors that provide nuance to the dietary intakes in the US, which were food security, including household adult and child food security, country of birth, health insurance coverage and type, living in urban and rural areas, social vulnerability index, household food benefits (i.e. SNAP, food stamps, WIC and food pantries); as well as disability status, acculturation and length of time in US.
Adolescents and adults are consuming more grains, but overall exceeding sodium, saturated fat and added sugar
With data sourced from the National Health and Nutrition Examination Survey, Eicher-Miller and her team tracked the dietary intakes of adolescents aged 12-19 years and adults 20 years old.
The committee found that adolescents consume less dairy, vegetables and fruit juice over time. Within these groups, only adults exhibited a decrease in fruit juice over time.
Adolescents and adults both show a slight decrease in grains consumption, while whole grains intake increased slightly over time. Only adults, Eicher-Miller noted, exhibited an increase in nuts, seeds, soy and legumes.
Across all age groups above 1 year, 44% are not meeting the recommendation for calcium, 96% are not meeting the recommendation for vitamin D; whereas 6% are meeting recommendations for dietary fiber and 30% for potassium.
“There are also nutrients we need to get less of…sodium, saturated fat and added sugars,” she emphasized. “Unfortunately, our trend is that we are exceeding limits of these nutrients.”
The recommended limit for sodium is less than 2,300 mg a day for ages 14 and older—89% are exceeding the limit; while 80% are exceeding the recommended limit for saturated fat, which is to get 10% of total daily energy from fat; and 63% are exceeding the recommended limit for added sugars based on a recommendation of less than 10% of total daily energy from added sugars, Eicher-Miller detailed.
While the presentation did not include intake data on sugary drinks and protein sources, Eicher-Miller emphasized that data will be included in upcoming analyses.
Regardless of demographics, she stated, “everyone is really exceeding the limits on sodium.”
Overall diet quality is poor, although toddlers are eating better
Looking at diet quality using the Healthy Eating Index (HEI) over time, “our diet quality score is maximally aligned with the dietary guidelines when it is at 100.”
Scores tracked from 2005-2006 and 2017-2018 were 56 and 58, respectively. “They’re not really changing over time. Diet quality is poor. Overall, it’s almost half of what we’d like to see it be…it’s very interesting to see how these [scores] change over our life,” she emphasized.
Those ages 2-4 years have the highest diet quality, which Eicher-Miller notes is “somewhat comparable to where we are at the end of our lives at 61, and they do take this big dip in the middle.”
Most notably, the committee introduced the newly released HEI toddlers score of 63. Eicher-Miller detailed that whole grains are low, while protein foods are relatively high along with total fruits and whole fruits, compared to other age groups.
Contrastingly, adolescents have the lowest HEI score of the lifespan. Younger age groups, she noted, have a lower prevalence for obesity (ages 2-19), however, obesity has increased by 20%.
“There are things worth celebrating,” she added. Seafood and plant proteins are in alignment with HEI, as well as total protein foods. Different racial and ethnic groups are seeing similar alignments for total protein foods, seafood and plant proteins, as well as fatty acids in dairy.
For greens and beans, total vegetables, whole fruits and total fruits, Eicher-Miller noted, “there’s a lot of diversity in alignment with the various components [and] meeting the recommendations for those components.”