Nutritious Dietary Patterns

Dietary patterns (also called eating patterns) are the combinations and quantities of food and beverages consumed over time. Consistent evidence indicates that, in general, a plant-based dietary pattern is more health-promoting than the current average U.S. diet. However, a “plant-based” eating patterns doesn’t mean only plants; pairing high-quality protein foods, like eggs, with plants is essential for the synthesis and maintenance of muscle tissue, and for achieving optimal vitamin and mineral intakes.

The 2015-2020 Dietary Guidelines for Americans recommend three healthy eating patterns, all of which include eggs. But what are the sample eating patterns, and what are the key differences between them?

To learn more about healthy eating patterns, including those recommended in the 2015-2020 Dietary Guidelines, and how eggs fit within those patterns, explore the following PowerPoint, and feel free to share it with friends!

Healthy Eating Patterns: How do Eggs Fit?

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How Many Eggs Can I Eat? The NY Times Provides Answers

Today’s post comes from guest blogger Kristen Wilk, MS, RDN. Kristen holds a BA in psychology from Yale University and an MS in nutrition from Boston University. Having completed her dietetic internship at Boston Medical Center, Kristen is a registered dietitian nutritionist and incoming Treasurer of the Chicago Food & Nutrition Network. With interests in consumer behavior and nutrition communications, Kristen joined the Edelman Public Relations Nutrition Solutions team in 2013, where she works to spread nutritional knowledge and rectify misconceptions about what constitutes a “healthy diet.”

Eggs-One-CrackedAs a health professional, you likely regularly encounter consumer confusion regarding nutrition topics in the form of frequent questions from your patients and clients. Given the constant state of change that comprises the field of nutrition science, this confusion is by no means surprising.

So what do you say when your patients ask, “How many eggs can I eat?”

The New York Times’ Health and Wellness blog recently addressed this very issue with an informative article and corresponding video, both of which are certainly worth a view1. In sum, the post suggests you can feel confident recommending eggs to your patients and clients, knowing that studies continue to show that eggs only modestly impact serum cholesterol levels and heart disease risk2-4, while providing a range of critical nutrients including high-quality protein, vitamin B12, riboflavin, folate and vitamin D. Moreover, by encouraging the consumption of eggs, you’ll be in the company of expert sources in health and nutrition, including the American Heart Association, the Dietary Guidelines for Americans and Dr. Frank Hu of the Harvard School of Public Health.

 

 

References:

  1. O’Connor A. Ask well: How many eggs can I eat? Ask Well, The New York Times. Published November 14, 2014. http://well.blogs.nytimes.com/2014/11/14/ask-well-how-many-eggs-can-i-eat/?ref=health&_r=1. Accessed November 14, 2014.
  2. Hu FB, Stampfer MJ, Rimm EB, Manson JE, Ascherio A, Colditz GA, Rosner BA, Spiegelman D, Speizer FE, Sacks FM, Hennekens CH, Willett WC. A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA. 1999; 281(15):1387-94.
  3. Rong Y, Chen L, Zhu T, Song Y, Yu M, Shan Z, Sands A, Hu FB, Liu L. Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. BMJ. 2013; 346:e8539.
  4. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010; 91(3):502-9.

Trends in the Eating Patterns of Hispanics in the United States


Araceli-Vazquez-150x150Today’s post comes from Araceli Vázquez, MS, RD, LD. Vázquez is one of the few bilingual/bicultural dietitians in North Texas. She began her career in nutrition in 1996 after a successful career as a microbiologist and now offers nutrition counseling as part of her private practice, DietGenics. Vázquez is also a member of ENC’s Health Professional Advisor panel.

 

The Hispanic population in the United States is currently over 54.1 million and, according to the U.S. Census bureau data, is expected to reach 59.7 million (17.8% of the total population in the U.S.) by 2020, making Hispanics the nation’s second-largest racial or ethnic group. 1,2

In celebrating National Hispanic Heritage Month, we explore how Hispanic traditions are influencing national consumptions patterns and how, in turn, Hispanic dietary patterns are transformed by the process of acculturation. Eating patterns of Hispanics in the U.S. are influenced by their country of origin, customs, religion, family traditions and socio-economic status, and many families still maintain their traditional flavors and meal customs. One of the categories where Hispanics are influencing consumption is at breakfast, where the preferred carbohydrates include non-toasted bread and cold cereal, while eggs constitute the most common source of protein. Dinner is also being influenced by Hispanic patterns. Rice, which is consumed more by Hispanics than non-Hispanics, is now increasingly being included as a side dish by the overall population.3 Hispanics tend to seek the fruits they are accustomed to consuming in their native countries. The increased demand, and in turn increased availability, allows the overall population as well to access and enjoy more tropical fruits. Supermarkets, in particular, offer greater availability of fruits such as guava, mangos and papaya, which are not only delicious but also nutritious; these fruits are excellent sources of Vitamins A and C and other nutrients. 4

Acculturation of eating patterns, however, comes with both benefits and consequences. The reciprocal influence between Hispanic and American cuisines has been found to alter the diet as well as the eating behaviors of the Hispanic population leading to both positive and negative associations with healthy dietary patterns. For instance, while acculturation has led the Hispanic population to consume fewer refined carbohydrates such as white bread, it has also led them to lower their consumption of legumes (an important source of protein in the Hispanic diet), fruits and non-starchy vegetables. In addition, acculturation is also associated with a more sedentary lifestyle.5

Adaption of U.S. cultural practices while maintaining the core of Hispanic traditions needs further understanding, so as to combine the healthiest habits of both cultures. This could result in closing the gap in health disparities. After all, everyone wants to move in the direction of a healthier lifestyle and reduce the incidence of chronic diseases such as diabetes and cardiovascular disease, which are more prevalent in the Hispanic population.

 

References:

1Pew Research Center 11 facts for National Hispanic Heritage month: http://www.pewrearsh.org/fact. Accessed September16, 2014.

2U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement, 2011. Accessed September 16, 2014.

3Hispanics’ Growing Number and Eating Traditions Begin to Influence Country’s Overall Eating Patterns. NPD Reports. Accessed September 16, 2014.https://www.npd.com/wps/portal/npd/us/news/press-releases

4Thomas R, Gebhardt S. Tropical fruits and nectars typically consumed in Latino communities are excellent sources of Vit A, C, and other nutrients.  USDA website.http://www.ars.usda.gov/Articles/ADA2009. Accessed September 16, 2014.

5Rompay V, Mckeown N, Casteneda-Sceppa C, et al.  Acculturation and sociocultural influences on dietary intake and health status among Puerto Rican adults in Massachusetts. J Acad Nutri  Diet. 2012;112(1):64-74.

Policy on the Plate: An Overview of Presentations and Dialogue from the Fourth Meeting of the DGAC

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Today’s post comes from guest blogger, Apeksha Gulvady, PhD. Apeksha holds an MA and PhD in Nutritional Sciences from the University of Texas in Austin, where her research focused on the role of aging and diet-induced obesity on immune cell function. Apeksha previously worked with PepsiCo R&D, where she supported core nutrition business activities and priorities in both global foods and beverages, and she has recently joined Edelman Public Relations to pursue her passion for nutrition communications.

The 2015 Dietary Guidelines Advisory Committee (DGAC), consisting of nationally recognized experts in the field of nutrition and health, recently reviewed the latest in nutrition research in pursuit of developing evidence-based recommendations for the next edition of the Dietary Guidelines for Americans. The overarching goal of these new recommendations is to encourage Americans to eat a well-balanced diet to help achieve and maintain a healthy weight, promote health and prevent disease.

The DGAC’s fourth meeting, held July 17-18, commenced with an introduction by DGAC Chair, Barbara Millen, who underscored the broad scope of work the Committee has undertaken and the Committee’s three core themes: 1) Dietary Patterns; 2) “What works” to help people actually implement the Dietary Guidelines; and 3) a Systems Approach focusing on what, where and how people consume food and exercise.

Subcommittee 1 on food and nutrient Intakes, and health: current status and trends found that there are multiple ways to build a healthful diet, and it can be done by way of the current food supply. The challenge then becomes, how to make these diets accessible to people and inspire them to make healthier choices. During the discussion, Wayne Campbell stated that proteins are notoriously under-consumed at breakfast, and Barbara Millen agreed, calling out eggs as an important protein source to consider.

Subcommittee 2 on dietary patterns, foods and nutrients, and health outcomes presented a review of evidence on dietary patterns associated with reduced risk for the development of cardiovascular disease, type 2 diabetes, overweight/ obesity and cancer. Overall, they observed that “common dietary patterns confer benefits across a variety of outcomes.” During the Committee’s discussion about the need for more specificity regarding individual foods and amounts within these dietary patterns (e.g. lean red meat vs. chicken vs. fish; low-fat vs full-fat dairy; refined grains and added sugars), a Committee member mentioned research indicating that dietary patterns associated with favorable outcomes related to body weight and reduction of CVD risk include low intakes of cholesterol, among other nutrients. This prompted Miriam Nelson, to challenge whether it was cholesterol itself or rather food sources of cholesterol that were related to observed health risks. Frank Hu clarified that observed health outcomes were attributed to dietary patterns rather than individual effects of cholesterol or any single nutrient.

Subcommittee 3 on diet and physical activity behavior change examined emerging areas of research including acculturation, eating out and mobile technology as it relates to health behavior change strategies. Overall, these areas had very limited research available, and more research is needed.

Subcommittee 4 on food and physical activity environments presented updates in three areas: food access, early childhood and school environment. Overall, they found limited evidence in these areas and that more research needs to be explored. Also, initial conclusions within additional areas of exploration are yet to come at future meetings.

Findings of Subcommittee 5 on food sustainability and safety were similar to the dietary patterns associated with positive health outcomes presented by Subcommittee 2 (e.g. Mediterranean, vegetarian, etc.). The Committee found that in general, a dietary pattern that is lower in animal-based foods and higher in plant-based foods has lesser environmental impact.

The physical activity writing group lead by Miriam Nelson stated that the DGAC will include physical activity recommendations for various age groups, based on recommendations from the 2008 Physical Activity Guidelines for Americans.

While this fourth meeting of the DGAC indicated the directions that the 2015 Dietary Guidelines for Americans may take, it is clear that more research is needed in each focus area, and final determinations and recommendations for all topics under the Committee’s broad scope are as of yet undecided. With multiple meetings and opportunities for public and private entities to provide feedback and comments, the 2015 Dietary Guidelines for Americans remains a work in progress, and the ongoing dialogue of the DGAC will become increasingly important for health professionals to monitor.

Apeksha Gulvady, PhD

ENC Partnership Builds a Better Plate

PBH_LogoENC has partnered with the Produce for Better Health (PBH) Foundation on a variety of projects.

Through PBH’s Half Your Plate Fruits and Veggies Program, we have co-created several recipes and meals in a way that gives eggs the company they deserve! The most recent plate was a Garden Frittata. Many of the recipes from this program are highlighted in USDA MyPlate’s Sample Menus and Recipes.

The recipes are online and are also shared across social media sites so that consumers and health professionals can easily find healthy and delicious recipes!

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Spinach Salad with Apples & Eggs

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Herbed Spinach Quiche Portabella Caps

In addition, a recorded webinar, Building a Better Breakfast with High-Quality Protein and Produce, with Registered Dietitian Neva Cochran is available for 1 CPEU through CDR. The webinar was sponsored by Egg Nutrition Center and Produce for Better Health Foundation.

ENC and PBH Foundation both offer a variety of continuing education materials that may be of interest to health professionals.

Re-evaluating What Constitutes a Healthy Diet

The-Big-Fat-Surprise-209x300The ongoing, seemingly endless nutrition debate about what constitutes a healthy diet just got a little hotter. In recent weeks a new book entitled The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet [1] hit bookstore shelves, and was followed by an article in the current issue ofTime magazine called “Ending the War on Fat.” The primary message of both the book and the article is that the past fifty years or so of diet advice dispensed by various health agencies, and countless research studies performed on the diet/heart disease relationship, have been mostly flawed.  And before you discount these two recent sources as the work of lay authors, it should be pointed out that a couple of well-done, albeit controversial, meta analyses out of UC-Berkeley [2] andCambridge University [3] in England largely support the principal conclusions of the book and the Time article -that current evidence does not support low consumption of saturated fats or cholesterol as antidotes to cardiovascular disease (CVD).

How did this change in thinking come about, and where might it lead us in the future? Regarding the former, the realization that fifty years of dietary advice (that was mostly adhered to by a large segment of the population) suggesting we eat less red meat, fewer eggs and less dairy products has done little to limit the rate of CVD in the U.S. and that at the same time we were becoming more and more overweight and obese as a nation, has caused many health experts to re-evaluate the data on which these recommendations were based. And what this re-analysis indicates, among other things, is that the majority of the studies on which macronutrient intake recommendations are based were epidemiological studies, which are great for hypothesis generation but marginal for establishing cause-and-effect. Worse yet, information gleaned from some of these studies have been extrapolated or inferred to help create a story that may not exist. Both the aforementioned book and Time article tell the story of how some of the data from Ancel Keys’ well-known Seven Countries Study was apparently cherry-picked so that only data from countries that supported a saturated fat/CVD relationship were included in Keys’ analysis, and countries that did not fit this paradigm were excluded.

Another point worth noting is the possible unintended consequence of food substitution: if a person adheres to dietary advice suggesting less saturated fat and cholesterol consumption, what would he/she likely add into the diet to make up for the nutritional and caloric shortfall created by removing fats? The answer is, of course, carbohydrates. Primarily refined carbs and sugars. And newer research indicates that many of the consequences of a low fat/high refined carb diet – elevated triglycerides, decreased insulin sensitivity, more small, dense LDL particles, greater vascular inflammation, increased body weight, etc. may be the real culprits in elevated CVD risk. Ironic, isn’t it, that the foods once promoted as a healthier alternative to higher fat fare may turn out to be “the bad guys” after all?

Where will this new information lead? Still too early to tell. As any nutrition professional can tell you, diet research is fickle, and alternative hypotheses on what constitutes the healthiest diet will undoubtedly change many times in the future as new data become available. One thing that seems obvious is our need for more diet-based studies, and less single-nutrient research. When single nutrients are studied outside the context of the entire diet, misinterpretations are bound to occur. For example, dietary cholesterol as a part of a diet loaded with fruits and vegetables, whole grains, and various healthy fats and proteins may be largely innocuous; the same amount of cholesterol in a high calorie, high sugar and refined carb diet may be disease-promoting.

A healthy re-evaluation of the data on which we’ve based many of our dietary beliefs is certainly in order if we’re ever to move closer to understanding what constitutes a truly healthy diet.

 

References:

1.            Teicholz N: The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet.Simon & Schuster; 2014.

2.            Siri-Tarino PW, Sun Q, Hu FB, Krauss RM: Saturated fat, carbohydrate, and cardiovascular disease. The American Journal of Clinical Nutrition 2010, 91:502-509.

3.            Chowdhury R, Warnakula S, Kunutsor S, Crowe F, Ward HA, Johnson L, Franco OH, Butterworth AS, Forouhi NG, Thompson SG, et al: Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Annals of Internal Medicine2014, 160:398-406.