Pre-surgical factors related to latent trajectories of 5-year weight loss for a diverse bariatric surgery population.

BACKGROUND: Analyzing trajectories of weight loss may address how particular groups of patients respond to metabolic and bariatric surgery. OBJECTIVES: The Bariatric Experience Long Term (BELONG) study was designed to use a theoretical model to examine determinants of weight loss and recurrence. SETTING: Large integrated health system in Southern California with 11 surgical practices and 23 surgeons. METHODS: A total of n = 1338 patients who had metabolic and bariatric surgery were surveyed before surgery to measure factors related to median percent total weight loss (%TWL) over 5 years. Longitudinal weight data were available for n = 1024 (76.5% of the sample). Data were analyzed using latent growth mixture models (GMM) to estimate trajectories of weight change separately for gastric sleeve and bypass operations. These trajectories were then described using relevant variables from the baseline survey. RESULTS: For both gastric sleeve (n = 733) and bypass (n = 291) operations, 3 latent trajectories of median %TWL were found corresponding to most, moderate, and least %TWL. Sleeve trajectories were distinguished by body mass index at surgery and geocoded environmental factors. Bypass trajectories varied by self-reported and geocoded environmental factors, comorbidity burden, race, experiential avoidance, and weight control strategies. CONCLUSIONS: Future research should examine the role of the built and perceived environment in surgical weight loss. Bariatric practices should focus less on the presurgical period for predictors of long-term weight loss and begin efforts to monitor real-time patient-reported outcomes to help tailor intervention strategies for patients who either do not lose an expected amount of weight or who begin to experience weight recurrence.

Making Healthy, Sustainable Diets Accessible and Achievable: A New Framework for Assessing the Nutrition, Environmental, and Equity Impacts of Packaged Foods.

There is a growing global consensus among food system experts that diets and how we source our foods must change. The sustainable nutrition community continues exploring the environmental impact and dietary value of foods. Packaged foods have been largely ignored within the dialogue, and if they are addressed, existing frameworks tend to label them all as "ultraprocessed" and uniformly discourage their consumption. This approach lacks the nuance needed to holistically evaluate packaged foods within recommended dietary patterns. Additionally, there is considerable diversity of opinion within the literature on these topics, especially on how best to improve nutrition security in populations most at risk of diet-related chronic disease. In support of addressing these challenges, 8 sustainability and nutrition experts were convened by Clif Bar & Company for a facilitated discussion on the urgent need to drive adoption of healthy, sustainable diets; the crucial role that certain packaged foods can play in helping make such diets achievable and accessible; and the need for actionable guidance around how to recommend and choose packaged foods that consider human, societal, and planetary health. This article summarizes the meeting discussion, which informed the development of a proposed framework based on guiding principles for defining sustainable, nutritious packaged foods across key nutrition, environmental, economic, and sociocultural well-being indicators. Although additional research is needed to substantiate specific metrics in order to operationalize the framework, it is intended to be a foundation from which to build and refine as science and measurement capabilities advance, and an important step toward broader adoption of healthy, sustainable diets.

A New Carbohydrate Food Quality Scoring System to Reflect Dietary Guidelines: An Expert Panel Report.

Existing metrics of carbohydrate food quality have been based, for the most part, on favorable fiber- and free sugar-to-carbohydrate ratios. In these metrics, higher nutritional quality carbohydrate foods are defined as those with >10% fiber and <10% free sugar per 100 g carbohydrate. Although fiber- and sugar-based metrics may help to differentiate the nutritional quality of various types of grain products, they may not aptly capture the nutritional quality of other healthy carbohydrate foods, including beans, legumes, vegetables, and fruits. Carbohydrate food quality metrics need to be applicable across these diverse food groups. This report introduces a new carbohydrate food scoring system known as a Carbohydrate Food Quality Score (CFQS), which supplements the fiber and free sugar components of previous metrics with additional dietary components of public health concern (e.g., sodium, potassium, and whole grains) as identified by the Dietary Guidelines for Americans. Two CFQS models are developed and tested in this study: one that includes four dietary components (CFQS-4: fiber, free sugars, sodium, potassium) and one that considers five dietary components (CFQS-5: fiber, free sugars, sodium, potassium, and whole grains). These models are applied to 2596 carbohydrate foods in the Food and Nutrient Database for Dietary Studies (FNDDS) 2017−2018. Consistent with past studies, the new carbohydrate food scoring system places large percentages of beans, vegetables, and fruits among the top scoring carbohydrate foods. The whole grain component, which only applies to grain foods (N = 1561), identifies ready-to-eat cereals, oatmeal, other cooked cereals, and selected whole grain breads and crackers as higher-quality carbohydrate foods. The new carbohydrate food scoring system shows a high correlation with the Nutrient Rich Food (NRF9.3) index and the Nutri-Score. Metrics of carbohydrate food quality that incorporate whole grains, potassium, and sodium, in addition to sugar and fiber, are strategically aligned with multiple 2020−2025 dietary recommendations and may therefore help with the implementation of present and future dietary guidelines.

Perspective: How to Develop Nutrient Profiling Models Intended for Global Use: A Manual.

Nutrient profiling (NP) models aim to assess the nutritional quality of individual foods, according to their energy content and nutrient composition. NP models, initially created to prevent obesity in high-income countries, have tended to penalize dietary energy by giving lower ratings to foods containing excessive calories, fat, sugar, and salt. Energy-driven NP models may need to be reconceptualized for use in low- and middle-income countries (LMIC) where hunger, undernutrition, and micronutrient deficiencies continue to be issues of public health concern. Consistent with the position of the WHO that the purpose of NP methods is to address an identified public health problem, NP models intended for use in LMIC ought to address inadequate intakes of vitamin A, B vitamins, folate, calcium, iron, iodine, and zinc and the frequent lack of high-quality protein. Those models of nutrient density that feature beneficial nutrients (high-quality protein, vitamins, minerals, and trace elements) may be better suited to LMIC needs than are some current NP models that are wholly based around nutrients to limit. NP models intended for LMIC and global use will also need to take food fortification into account. The challenge for LMIC public health agencies is how to balance the future risk of excess "empty" calories against the continuing danger of inadequate nutrients and micronutrient deficiencies that persist at the population level.

Key Considerations for Policymakers-Iodized Salt as a Vehicle for Iron Fortification: Current Evidence, Challenges, and Knowledge Gaps.

Could DFS help prevent iron deficiency and anemia? Studies in controlled settings (efficacy) demonstrate that double-fortified salt (DFS; iron added to iodized salt) reduces the prevalence of anemia and iron deficiency anemia. Studies in program settings (effectiveness) are limited and reported differing levels of DFS coverage, resulting in mixed evidence of impact on anemia. What iron formulations are available and how do they affect iodized salt? Ferrous sulfate and encapsulated ferrous fumarate (both with various enhancers and/or coating materials) are the main iron formulations currently in use for DFS. Adding iron to iodized salt may lead to adverse changes in the product, specifically discoloration and losses in iodine content. These changes are greatest when the iodized salt used in DFS production is of low quality (e.g., contain impurities, has high moisture, and is of large crystal size). DFS requires iodized salt of the highest quality and a high-quality iron formulation in order to minimize adverse sensory changes and iodine losses. Appropriate packaging of iodized salt is also important to prevent losses. What is known about the minimum requirements to manufacture DFS? DFS producers must use high-quality refined iodized salt meeting the minimum standards for DFS production (which is higher than standards for salt intended for iodization alone), and an iron formulation for which there are rigid quality-assurance measures to ensure consistent quality and blending techniques. The actual proportion of iodized salt meeting the stringent requirements necessary for DFS production is unclear, but likely to be low in many countries, especially those with fragmented salt industries and a low proportion of industrially produced salt. What are the financial implications of adding iron to iodized salt? As a result of higher input costs both for input salt and the iron compound, DFS is more expensive to produce than iodized salt and thus has a higher production cost. Various grades of iodized salt are produced and consumed in different sectors of the market. Experience in India indicates that, on average, producing DFS costs 31-40 US dollars/metric ton or 0.03-0.04 US dollars/kg more than high-quality refined iodized salt. The exact impact of this production-level cost difference on profit margins and consumer price is specific to the conditions of different salt markets. Factors such as transport costs, customary wholesale and retail mark-ups, and taxes all vary greatly and need to be assessed on a case by case basis. Is DFS in alignment with salt-reduction efforts? The WHO has long recognized that salt iodization is an important public health intervention to achieve optimal iodine nutrition and is compatible with salt-reduction goals. Fortification of salt (with any nutrient) should not be used to justify or encourage an increase in salt intake to the public. Any effort to expand salt fortification to other nutrients should be done in close consultation with WHO and those working on salt reduction. What has been the experience with DFS delivery under different platforms? To date, DFS has been introduced into the retail market and in social safety net (primarily in India) programs, but sensory changes in DFS have been raised as concerns. The higher price for DFS has limited expansion in the retail market. In social safety net programs where the cost of DFS is subsidized for beneficiaries, programs must consider long-term resourcing for sustainability. Overall: The optimal production and delivery of DFS are still under development, as many challenges need to be overcome. There is a beneficial impact on hemoglobin in efficacy trials. Thus, if those conditions can be replicated in programs or the technology can be adapted to better fit current production and delivery realities, DFS may provide an effective contribution in countries that need additional food-fortification vehicles to improve iron intake.

The Bariatric Experience Long Term (BELONG): Factors Related to Having Bariatric Surgery in a Large Integrated Healthcare System.

PURPOSE: Bariatric surgery is the most effective treatment for severe obesity, but currently, only 1-2% of all eligible patients undergo surgery each year. This study examined which factors were associated with a patient receiving bariatric surgery after referral in a real-world healthcare setting. MATERIALS AND METHODS: The current study used the baseline survey and electronic medical record (EMR) data from the Bariatric Experience Long Term (BELONG) study (n = 1975). Predictors of who did (n = 1680) and who did not (n = 295) have surgery were analyzed using multivariate logistic regression. RESULTS: Participants (n = 1975; 42.4% response rate) were primarily women (84%) and either non-Hispanic Black or Hispanic (60%). In the fully adjusted multivariate model, the strongest predictors of having surgery were being a woman (OR = 3.17; 95% CI = 2.15, 4.68; p < .001) and losing at least 5% of their body weight in the year before surgery (OR = 3.16; 95% CI = 2.28, 4.38; p < .001). The strongest predictors of not having surgery were a ≥ BMI 50 kg/m2 (OR = .39; 95% CI = .27, .56; p < .001) and having a higher physical comorbidity burden (OR = .84; 95% CI = .75, .94; p = .004). CONCLUSIONS: Practices such as 5-10% total weight loss before surgery and selection of patients with safer operative risk profiles (younger with lower comorbidity burden) may inadvertently contribute to under-utilization of bariatric surgery among some demographic subpopulations who could most benefit from this intervention.

Coffee Consumption among Adults in the United States by Demographic Variables and Purchase Location: Analyses of NHANES 2011-2016 Data.

Coffee, obtained from various sources, is consumed by most United States adults. The present analyses of one and two 24-h dietary recalls for 14,865 persons aged ≥20 years in the 2011-2016 National Health and Nutrition Examination Survey (NHANES 2011-2016) aimed to identify socio-demographic predictors of coffee consumption and to examine whether coffee purchase locations differed by population sub-group. Given the emphasis on food and beverage consumption patterns, the relation between coffee consumption and compliance with the Dietary Guidelines of Americans was also examined. Coffee was consumed by 59% of the sample (n = 8551). Survey-adjusted mean intake among consumers was 544.7 g/day. Percent consumers and mean amounts consumed were highest among adults aged 51-70 years (p < 0.001), higher income groups (p < 0.001), and non-Hispanic Whites (p < 0.001). About 74% of coffee consumers obtained their coffee from stores, 9.8% from fast food restaurants, 4.3% from convenience stores, and 4.2% from someone else. Coffee source locations also varied by age, education, income, and race/ethnicity. Coffee consumers had significantly higher Healthy Eating Index (HEI-2015) and higher Nutrient-Rich Foods (NRF9.3) scores in energy-adjusted models and significantly higher HEI 2015 scores in multivariable models. In multivariable models, coffee consumers had diets with less added sugar (p < 0.001) but slightly more fat (of all types, including monounsaturated (MUFA), polyunsaturated (PUFA), saturated and solid fats), cholesterol, and alcohol. Their diets had more potassium and magnesium (p < 0.001) but less vitamin C (p < 0.001). Mean caffeine consumption was 233 mg/day for consumers and 72.3 mg/day for non-consumers. Coffee consumption patterns in the US vary across socio-demographic groups.

Flavonoid Intakes in the US Diet Are Linked to Higher Socioeconomic Status and to Tea Consumption: Analyses of NHANES 2011-16 Data.

BACKGROUND: Many of the health benefits of tea have been attributed to its flavonoid content. Tea consumption in US adults varies by socioeconomic status (SES). OBJECTIVES: The present objective was to explore intakes of total flavonoids and flavonoid subclasses by participant sociodemographics and by patterns of tea consumption. METHODS: The present analyses were based on 2 d of dietary recalls for 17,506 persons aged >9 y in the 2011-2016 NHANES. The What We Eat in America nutrient composition database was merged with the USDA Expanded Flavonoid database, which included total flavonoids and flavan-3-ols (including catechins), flavanones, flavonols, anthocyanidins, flavones, and isoflavones. Flavonoid intakes were compared by sex, age, race/ethnicity, education, and income-to-poverty ratio (IPR) in univariate analyses. Flavonoid intakes of children and adults were also compared by tea consumption status. Time trends in flavonoid intakes were also examined. RESULTS: Mean total flavonoid intake was 219 mg/d, of which flavan-3-ols provided 174 mg/d, or 79%. The highest total flavonoid intakes were found in adults aged 51-70 y (293 mg/d), non-Hispanic whites (251 mg/d) and in groups with college education (251 mg/d) and higher income (IPR >3.5: 249 mg/d) (P < 0.001 for all). The socioeconomic gradient was significant for anthocyanidins, flavonols, and flavones (P < 0.001 for all) but not for flavan-3-ols, and persisted across 3 cycles of NHANES. Adult tea consumers had higher intakes of total flavonoids (610 mg/d compared with 141 mg/d) and flavan-3-ols (542 mg/d compared with 97.8 mg/d) than did nonconsumers (P < 0.001). Time trend analyses showed that both tea consumption and flavonoid intakes were unchanged from 2011 to 2016. CONCLUSIONS: Flavonoid intakes in children and adults in the NHANES 2011-16 sample were associated with higher SES and were largely determined by tea consumption. Studies of diet and disease risk need to take sociodemographic gradients and eating and drinking habits into account.

Impact of nutrition interventions and dietary nutrient density on productivity in the workplace.

The global spread of diet-related noncommunicable diseases represents a threat to public health and national economies alike. The elimination of poverty and the eradication of hunger, two key United Nations Sustainable Development Goals, cannot be accomplished without a well-nourished labor force. Easy access to low-cost diets that are energy dense but nutrient poor has resulted in hidden hunger, in which micronutrient deficiencies coexist with obesity or overweight. Workplace interventions in low- and middle-income countries have addressed nutrient adequacy and micronutrient deficiencies, often using fortified foods. Workplace interventions in high-income countries have largely focused on weight loss, smoking cessation, stress reduction, and physical activity. Even though improvement of productivity may have been the ultimate goal, relatively few interventions in high-income countries have explored the likely impact of improved dietary nutrient density on workplace performance. Given that optimal nutrition benefits both physical and mental health, interventions to improve diet quality ought to have a measurable impact on the productivity of the labor force. The present review examines the evidence linking workplace dietary interventions with workplace productivity measures.

Tea Consumption Patterns in Relation to Diet Quality among Children and Adults in the United States: Analyses of NHANES 2011-2016 Data.

Flavonoid-rich tea offers an alternative to sugar-sweetened beverages. The present analyses, based on 2 24-hour dietary recalls for 17,506 persons aged ≥9 years old in the 2011-2016 National Health and Nutrition Examination Survey database (NHANES 2011-2016), explored tea consumption patterns in relation to demographics, diet quality, cardiovascular disease (CVD) biomarkers (lipids and blood pressure), and body weight. Beverage categories were unsweetened tea, other tea (herbal and presweetened tea), coffee, milk, 100% juice, water and other high-calorie (HC) and low-calorie (LC) beverages. Tea consumption (18.5% of the sample) was highest among older adults (51-70 years old), non-Hispanic Asians and Whites, and those with college education and higher incomes. The effects of age, gender, education, income, and race/ethnicity were all significant (p < 0.001 for all). Adult tea consumers had diets with more protein, fiber, potassium, iron, and magnesium, and less added sugars and alcohol. Their diets contained fewer HC beverages and coffee but had more total and citrus fruit, more total dark green and orange vegetables, and more seafood, eggs, soy and milk. Tea consumers had higher Healthy Eating Index (HEI-2015) and higher Nutrient-Rich Foods (NRF9.3) nutrient density scores. Few children drank tea and no differences in diet quality between consumers and non-consumers were observed. Adult tea consumers had slightly higher high-density lipoprotein (HDL) cholesterol and lower body mass index (BMI) values. Tea consumption was associated with higher socioeconomic status and better diets.

Replacing American Breakfast Foods with Ready-To-Eat (RTE) Cereals Increases Consumption of Key Food Groups and Nutrients among US Children and Adults: Results of an NHANES Modeling Study.

Replacing the typical American breakfast with ready-to-eat cereals (RTECs) may improve diet quality. Our goal was to assess the impact of RTECs on diet quality measures for different age groups, using substitution modeling. Dietary intakes came from the 2007-2010 National Health and Examination Surveys (NHANES; n = 18,112). All breakfast foods, excluding beverages, were replaced on a per calorie basis, with frequency-weighted and age/race specific RTECs. Model 1 replaced foods with RTECs alone; Model 2 replaced foods with RTECs and milk. Diet quality measures were based on desirable food groups and nutrients, Healthy Eating Index (HEI)-2010 scores, and estimated diet costs. Model 1 diets were significantly higher in whole grains (+84.6%), fiber (+14.3%), vitamin D (+14.0%), iron (+54.5%) and folic acid (+104.6%), as compared to observed diets. Model 2 diets were additionally higher in dairy (+15.8%), calcium (+11.3%) and potassium (+3.95%). In Model 1, added sugar increased (+5.0%), but solid fats declined (-10.9%). Energy from solid fats and added sugars declined (-3.2%) in both models. Model 2 offered higher diet quality (57.1 vs. 54.6, p-value < 0.01) at a lower cost ($6.70 vs. $6.92; p < 0.01), compared to observed diets. Substitution modeling of NHANES data can assess the nutritional and economic impact of dietary guidance.

Sources of Caffeine in Diets of US Children and Adults: Trends by Beverage Type and Purchase Location.

New sources of caffeine, besides coffee and tea, have been introduced into the US food supply. Data on caffeine consumption age and purchase location can help guide public health policy. National Health and Nutrition Examination Surveys (NHANES) were used to estimate population-level caffeine intakes, using data from 24-h dietary recall. First, caffeine intakes by age-group and beverage type were estimated using the most recent 2011-2012 data (n = 7456). Second, fourteen years trends in caffeine consumption, overall and by beverage type, were evaluated for adults and children. Trend analyses were conducted by age groups. Last, trends in caffeine intakes by purchase location and beverage type were estimated. In 2011-2012, children aged four to eight years consumed the least caffeine (15 mg/day), and adults aged 51-70 years consumed the most (213 mg/day). The population mean (age ≥ four years) was 135 mg/day, driven largely by coffee (90 mg/day), tea (25 mg/day), and soda (21 mg/day). For the 14-19 years and 20-34 years age-groups, energy drinks contributed 6 mg/day (9.9%) and 5 mg/day (4.5%), respectively. The bulk of caffeine came from store-bought coffee and tea. Among both children and adults combined, caffeine intakes declined from 175 mg/day (1999-2000) to 142 mg/day (2011-2012), largely driven by a drop in caffeine from soda (41 mg/day to 21 mg/day). Store-bought coffee and tea remain principal drivers of caffeine intake in the US. Sodas and energy drinks make minor contributions to overall caffeine intakes.

Is there a relationship between dietary MSG and [corrected] obesity in animals or humans?

The sodium salt of glutamate (monosodium glutamate; MSG) imparts a savory/meaty taste to foods, and has been used as a flavoring agent for millennia. Past research on MSG/glutamate has evaluated its physiologic, metabolic and behavioral actions, and its safety. Ingested MSG has been found to be safe, and to produce no remarkable effects, except on taste. However, some recent epidemiologic and animal studies have associated MSG use with obesity and aberrations in fat metabolism. Reported effects are usually attributed to direct actions of ingested MSG in brain. As these observations conflict with past MSG research findings, a symposium was convened at the 13th International Congress on Amino Acids, Peptides and Proteins to discuss them. The principal conclusions were: (1) the proposed link between MSG intake and weight gain is likely explained by co-varying environmental factors (e.g., diet, physical activity) linked to the "nutrition transition" in developing Asian countries. (2) Controlled intervention studies adding MSG to the diet of animals and humans show no effect on body weight. (3) Hypotheses positing dietary MSG effects on body weight involve results from rodent MSG injection studies that link MSG to actions in brain not applicable to MSG ingestion studies. The fundamental reason is that glutamate is metabolically compartmentalized in the body, and generally does not passively cross biologic membranes. Hence, almost no ingested glutamate/MSG passes from gut into blood, and essentially none transits placenta from maternal to fetal circulation, or crosses the blood-brain barrier. Dietary MSG, therefore, does not gain access to brain. Overall, it appears that normal dietary MSG use is unlikely to influence energy intake, body weight or fat metabolism.

Water and beverage consumption among children age 4-13y in the United States: analyses of 2005-2010 NHANES data.

BACKGROUND: Few studies have examined water consumption patterns among U.S. children. Additionally, recent data on total water consumption as it relates to the Dietary Reference Intakes (DRI) are lacking. This study evaluated the consumption of plain water (tap and bottled) and other beverages among US children by age group, gender, income-to-poverty ratio, and race/ethnicity. Comparisons were made to DRI values for water consumption from all sources. METHODS: Data from two non-consecutive 24-hour recalls from 3 cycles of NHANES (2005-2006, 2007-2008 and 2009-2010) were used to assess water and beverage consumption among 4,766 children age 4-13y. Beverages were classified into 9 groups: water (tap and bottled), plain and flavored milk, 100% fruit juice, soda/soft drinks (regular and diet), fruit drinks, sports drinks, coffee, tea, and energy drinks. Total water intakes from plain water, beverages, and food were compared to DRIs for the U.S. Total water volume per 1,000 kcal was also examined. RESULTS: Water and other beverages contributed 70-75% of dietary water, with 25-30% provided by moisture in foods, depending on age. Plain water, tap and bottled, contributed 25-30% of total dietary water. In general, tap water represented 60% of drinking water volume whereas bottled water represented 40%. Non-Hispanic white children consumed the most tap water, whereas Mexican-American children consumed the most bottled water. Plain water consumption (bottled and tap) tended to be associated with higher incomes. No group of U.S. children came close to satisfying the DRIs for water. At least 75% of children 4-8y, 87% of girls 9-13y, and 85% of boys 9-13y did not meet DRIs for total water intake. Water volume per 1,000 kcal, another criterion of adequate hydration, was 0.85-0.95 L/1,000 kcal, short of the desirable levels of 1.0-1.5 L/1,000 kcal. CONCLUSIONS: Water intakes at below-recommended levels may be a cause for concern. Data on water and beverage intake for the population and by socio-demographic group provides useful information to target interventions for increasing water intake among children.

Vegetable cost metrics show that potatoes and beans provide most nutrients per penny.

Vegetables are important sources of dietary fiber, vitamins and minerals in the diets of children. The United States Department of Agriculture (USDA) National School Lunch Program has new requirements for weekly servings of vegetable subgroups as well as beans and peas. This study estimated the cost impact of meeting the USDA requirements using 2008 national prices for 98 vegetables, fresh, frozen, and canned. Food costs were calculated per 100 grams, per 100 calories, and per edible cup. Rank 6 score, a nutrient density measure was based on six nutrients: dietary fiber; potassium; magnesium; and vitamins A, C, and K. Individual nutrient costs were measured as the monetary cost of 10% daily value of each nutrient per cup equivalent. ANOVAs with post hoc tests showed that beans and starchy vegetables, including white potatoes, were cheaper per 100 calories than were dark-green and deep-yellow vegetables. Fresh, frozen, and canned vegetables had similar nutrient profiles and provided comparable nutritional value. However, less than half (n = 46) of the 98 vegetables listed by the USDA were were consumed >5 times by children and adolescents in the 2003-4 National Health and Nutrition Examination Survey database. For the more frequently consumed vegetables, potatoes and beans were the lowest-cost sources of potassium and fiber. These new metrics of affordable nutrition can help food service and health professionals identify those vegetable subgroups in the school lunch that provide the best nutritional value per penny.

New metrics of affordable nutrition: which vegetables provide most nutrients for least cost?

Measuring food prices per gram, rather than per calorie, is one way to make healthful vegetables appear less expensive. However, a better measure of affordability would take the nutrient content of vegetables into account. This study, based on analyses of US Department of Agriculture datasets, aimed to identify which vegetables, including juices and soups, provided the most nutrients per unit cost. Nutrient density was measured using the Nutrient Rich Foods (NRF) index, based on nine nutrients to encourage: protein; fiber; vitamins A, C, and E; calcium; iron; magnesium; and potassium; and on three nutrients to limit: saturated fat, added sugar, and sodium. Food cost in dollars was calculated per 100 g, per 100 kcal, per serving, and per nutrient content. One-way analyses of variance with post hoc tests were used to determine statistical significance. Results showed that tomato juices and tomato soups, dark green leafy and nonleafy vegetables, and deep yellow vegetables, including sweet potatoes, had the highest NRF scores overall. Highest NRF scores per dollar were obtained for sweet potatoes, white potatoes, tomato juices and tomato soups, carrots, and broccoli. Tomato sauces, raw tomatoes, and potato chips were eaten more frequently than were many other vegetables that were both more affordable and more nutrient-rich. These new measures of affordable nutrition can help foodservice and health professionals identify those vegetables that provide the highest nutrient density per unit cost. Processed vegetables, including soups and juices, can contribute to the quality and the affordability of the diet.

Beverages containing soluble fiber, caffeine, and green tea catechins suppress hunger and lead to less energy consumption at the next meal.

Previous research has shown that beverages containing soluble fibers can decrease energy intake at the next meal among normal weight participants. Caffeine and green tea catechins have separately been associated with increased satiety. The present study examined the satiating power of a beverage containing soluble fiber as well as a beverage containing the same fiber, caffeine and green tea catechins. These two test beverages were evaluated in comparison to an equal calorie control beverage as well as a no-beverage control condition. All beverage preloads were presented three times for a total of 0.28-0.35MJ and 0-30g fiber. Dependent measures were appetite ratings and calorie intake at a test meal. The no-beverage condition was associated with the highest ratings for hunger and the lowest ratings for fullness when compared to the other three beverage conditions. Of the three beverage conditions, the beverage containing the fiber, green tea catechins, and caffeine created the lowest hunger and the highest fullness ratings. That condition was also associated with the lowest energy intake at the next meal. The present findings indicate that the beverage containing caffeine and green tea catechins in combination with soluble fiber decrease appetite and energy intake relative to a beverage with equal caloric content.

The contribution of milk and milk products to micronutrient density and affordability of the U.S. diet.

BACKGROUND: To be successful, dietary guidance needs to identify foods that are nutrient rich, affordable, and appealing. Analyses of dietary surveys on "what we eat in America" can now be supplemented by analyses of nutrient density as well as nutrient cost. OBJECTIVE: To explore the relative contribution of 9 food groups to energy and nutrient intakes and to assess the relative cost of selected nutrients by major food group. METHOD: Dietary intake data were provided by the 4 cycles of the continuous National Health and Nutrition Examination Survey (NHANES 2001-2002, 2003-2004, 2005-2006, and 2007-2008). Research on the nutritive value and cost of U.S. foods was made possible by the merging of the U.S. Department of Agriculture (USDA) Food and Nutrition Database for Dietary Studies (FNDDS 2.0) with the USDA food prices database. Nutrient densities were calculated per 100 kcal. Nutrient costs were calculated as the dollar cost of meeting 10% daily value for a given nutrient. RESULTS: Despite their low energy contribution (10%-13% of energy), milk and milk products contributed 47% of calcium, 42% of retinol, and 65% of vitamin D to the diets of children and adults. Milk and milk products were among the top sources of riboflavin, phosphorous, and vitamin B(12). Cost analyses showed that milk and milk products were by far the lowest-cost source of dietary calcium and were among the lowest-cost sources of riboflavin and vitamin B(12). Vegetables and fruit were the lowest-cost sources of vitamin C, whereas dry beans and legumes were the lowest-cost sources of fiber. CONCLUSION: The nutrients-per-calorie and nutrient cost metrics can help identify affordable nutrient-rich foods.

Supplementing chicken broth with monosodium glutamate reduces hunger and desire to snack but does not affect energy intake in women.

The effect of monosodium glutamate (MSG) supplementation in soup or broth on satiety is not well understood. In the present study, the relative effects of four chicken broths with or without added MSG on motivational ratings and energy intakes at the next meal were compared using a double-blinded, within-subject design. A total of thirty-five normal-weight women, aged 20-40 years, took part in four study sessions. The four broths were base chicken broth (63 kJ), broth with added MSG (1.19 g) and nucleotides (0.03 g), broth with added MSG (1.22 g), and broth with added fat (BAF; 681 kJ). The preloads were presented twice at 09.00 and 11.15 hours for a maximum cumulative dose of 2.44 g MSG. Motivational ratings were collected before and at 15 min intervals post-ingestion for a total of 210 min. A test lunch meal was served at 12.00 hours, and plate waste was measured. The addition of MSG to chicken broth did not increase energy intakes at lunch or affect motivational ratings over the entire testing session. Both hunger and desire to snack between the second preload exposure and the test meal were significantly reduced in the MSG condition relative to the base broth condition (both, P = 0.03). However, only the BAF significantly suppressed energy intakes at lunch compared with the base broth control condition. Supplementing chicken broth with MSG can increase subjective ratings for satiety but does not alter energy intake at the next meal relative to an equal energy broth without added MSG.

Comparing the nutrient rich foods index with "Go," "Slow," and "Whoa," foods.

The US National Heart, Lung, and Blood Institute has grouped foods and beverages into three classes: "Go," "Slow," and "Whoa," as part of a children's guide to eating right. Using nutrient composition data in the 2004 Food and Nutrient Database for Dietary Studies, this descriptive study compared the Go, Slow, and Whoa food classes to tertiles of food rankings generated by the Nutrient Rich Foods Index. A total of 1,045 foods and beverages were first assigned into Go, Slow, and Whoa classes and then ranked by the Nutrient Rich Foods Index nutrient profile model. The Nutrient Rich Foods Index model was based on nine nutrients to encourage: protein, fiber, vitamins A, C, and E, calcium, iron, magnesium, and potassium; and on three nutrients to limit: saturated fat, added sugar, and sodium, all calculated per 100 calories. Both the Go, Slow, and Whoa and the Nutrient Rich Foods Index models readily distinguished between energy-dense and nutrient-rich beverages and foods, and the three Go, Slow, and Whoa classes closely corresponded to tertiles of Nutrient Rich Foods Index scores. There were some disagreements in the class assignment of fortified cereals, some dairy products, and diet beverages. Unlike the Go, Slow, and Whoa model, the Nutrient Rich Foods Index model produced continuous scores that could be used to rank foods within a given class. The study provides an illustration of how diverse nutrient profiling systems can be used to identify healthful foods and beverages.