2013 Cengage-Wadsworth A National Nutrition Agenda for the Public’s Health.

2013 Cengage-Wadsworth

A National Nutrition Agenda for the Public’s Health


National Nutrition Policy

• National nutrition policy - nationwide guidelines which specify meeting nutritional needs of people

• Address issues of:• hunger• malnutrition• food safety• food labeling and menu labeling• food fortification• sustainable agricultural practices• nutrition research


National Nutrition Policy

• Does the U.S. have a national nutrition policy?

• YES and NO• NO – no single federal agency has

mandate to handle national nutrition policy as its sole function

• YES – responsibility is divided among congressional committees, federal agencies, and major departments


Elements of Nutrition Policy

• Food assistance programs

• National nutrition and health objectives

• Regulations to safeguard food supply and ensure safe handling of food

• Dietary guidance systems

• Monitoring and surveillance programs

• Food labeling legislation


National Nutrition Monitoring

• Tracking of food supply and food consumption began in 1909

• Analyzes relationship between diet and health in the population

National Nutrition Monitoring

• Objectives



National Nutrition Monitoring and Related Research Program

(NNMRRP)

• Established by Congress in 1990 • Implementation and coordination of

activities by USDA and DHHS • Monitoring data are used to assess the

dietary, nutritional, and related health status of the population

• More than 50 surveillance systems are operative


National Nutrition Monitoring and Related Research Program

(NNMRRP)

• Activities associated with NNMRRP grouped into five measurement components:• Nutritional status and nutrition-related health

measurements• Food and nutrient consumption• Knowledge, attitudes, and behavior

assessments• Food composition and nutrient databases• Food supply determinations


Nutritional Status and Nutrition-Related Health

Measurements• National Health and Nutrition Examination

Survey (NHANES) Series • Representative sample of civilian

noninstitutionalized population ages 2 months and older

• Dietary intake (one 24-hour recall)• Body composition• Biochemical analyses of blood and urine• Bone density• Dietary and health behaviors• Collects data at household, family, and individual

level


NHANES Mobile Examination Centers


Food and Nutrient Consumption

• “What We Eat in America Survey” • Dietary interview component of NHANES• Individuals in households, one sample with all

levels of income, another of low-income households

• One-day and 3-day food intakes of individuals (1-day recall, 2-day record)

• Times of eating occasions• Sources of food eaten away from home


Food and Nutrient Consumption

• Total Diet Study (TDS) • Eight age groups, infant through elderly• Assesses for nutrients and contaminants in

foods• Estimates levels of 11 essential minerals• Collects and analyzes 234 foods from retail

markets in urban areas


Knowledge, Attitudes, and Behavior Assessments

• Behavioral Risk Factor Surveillance System (BRFSS) (annually since 1984) – telephone survey of adults 18 y.o. and older • Demographic information• Height, weight• Smoking, alcohol use• Weight control practices• Diabetes• Preventable health problems• Cholesterol-screening practices, awareness, treatment• Food frequencies for dietary fat, fruit, and vegetable

consumption


• National Nutrient Data Bank (established in 1892) – updated on a regular basis• Nutrient content of foods• Published tables of food composition• Computerized databases

Food Composition and Nutrient Data Base



• USDA Nutrient Data Base for Standard Reference (initiated in 1980) – produced from National Nutrient Data Bank• Includes data on food energy, 28 food

components, and 18 amino acids for about 5,200 food items

• Main source of data for USDA Survey Nutrient Data Base



• USDA Survey Nutrient Data Base - updated continuously• Used for analysis of nationwide dietary

intake surveys• Includes data on food energy and 28 food

components for >7,100 food items


Food-Supply Determinations

• U.S. Food and Nutrition Supply Series (annually) – U.S. total population• Quantities of food available for

consumption on a per capita basis• Quantities of food energy, nutrients, and

food components provided by these foods (calculated)

Food-Supply Determinations• Specific uses of NNMRRP surveys



• Specific uses of NNMRRP surveys



Nutrient Intake Standards

• Dietary Reference Intakes (DRIs)• Developed to be used in planning and assessing

the diets of individuals and groups• Are major shift from prevention of nutrient

deficiencies to prevention of chronic disease• Include change in role of dietary supplements in

achieving good health • Include three values in addition to the RDAs:

Estimated Average Requirement, Adequate intake, and Tolerable Upper Intake Level


Dietary Guidance Systems

• Dietary Guidelines for Americans • Were developed to promote health and

reduce chronic disease risks• Includes basic guidelines for healthy eating• Must be revised every 5 years; newest

revision 2010


Following the Dietary Guidelines for Americans


Dietary Guidance Systems

• Other government dietary guidelines:• National Cancer Institute• National Heart, Lung, and Blood Institute

• Nongovernment dietary recommendations:• American Heart Association• American Cancer Society


Food Intake Patterns

• Food Group Plans – first plan published in 1916

• MyPlate:• Was developed to help consumers obtain

the nutrients and substances needed for good health by eating a variety of foods


Implementing the Recommendations

• Translate recommendations into food-specific guides for consumers

• Program directors can use policy tools for implementing programs

• Policy making continues to change – need to address food insecurity, hunger, malnutrition

2013 Cengage-Wadsworth A National Nutrition Agenda for the Public’s Health.

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