Download Scientific basis of dietary recommendations related to carbohydrate

Scienc8fic basis of dietary recommenda8ons related to carbohydrate food sources
Joanne Slavin Professor Department of Food Science and Nutri8on February 2, 2017 Joanne Slavin, PhD, RD Dr. Slavin thanks the following organizations for providing research
funds for her laboratory the past 5 years. American Pulse
Association, MNDrive Global Food Ventures, United States
Department of Agriculture, the Mushroom Council, GSK, Pepsico,
Coca-Cola, Danone, Welch’s, American Egg Board, Minnesota Beef
Council, Minnesota Cultivated Wild Rice Council, Barilla, Nestle
Health Sciences, and DSM. These research projects are in the areas
of dietary fiber, whole grains, legumes, FODMAPS, nutrient losses
in deep winter greenhouses, mushrooms, digestive health, protein
needs, carbohydrate needs, and snacking:
She serves on the scientific advisory board for Tate and Lyle, Kerry
Ingredients, Atkins Nutritionals, and Midwest Dairy Association.
She also owns a 1/3 share of the Slavin Sisters Farm LLC, a 119
acre farm in Walworth, WI that is currently rented. Crops in 2016
included corn, soybeans, and pumpkins.
From the Science to Me The Science
Policy
Me
Carbohydrates in the Diet •  Vegetables, fruits, grains, legumes, and milk are main food sources of carbohydrates •  Grains and certain vegetables (potatoes, corn) high in starch (glucose) – except sweet potatoes (sucrose) •  Fruits and green vegetables contain liGle starch – fruits mostly sugar –  Apples and pears high in fructose (66%), most other fruits 50/50 glucose/fructose (sucrose); milk 50/50 glucose/galactose •  Sugar can be isolated from sugar beets, sugar cane or manufactured from starch (corn sugar) Differences in Carbohydrates •  Chemical structure – mono, di, polysaccharide –  Mono: few in food supply; fructose in apples and pears –  Di: sucrose (glucose, fructose) and lactose (glucose, galactose) –  Poly: starch •  DigesQble vs. non-­‐digesQble •  Speed of digesQon and absorpQon – Glycemic index •  Physical structure – in soluQon, part of a food, associated substances (protein), part of a seed or grain, parQcle size US Carbohydrate Label Total carbohydrate (req) – measured by difference •  Lists sugar (req) – total – although movement to list added sugar •  List dietary fiber (req) – soluble and insoluble (opQonal) •  No required informaQon on glycemic index, glycemic load, glycemic response, net carbs, resistant starch, sugar alcohols, FODMAPs, whole grain – unless provided by manufacturer DRIs for carbohydrate (2006) •  RDA of 130 grams of carbohydrate per day •  14 g/1000 kcalories dietary fiber •  45%–65% of calories should come from carbohydrate (Acceptable Macronutrient DistribuQon Range) •  Added sugar – 25% or less of calories – based on nutrient diluQon, not link to negaQve health status The Purpose of the Dietary Guidelines
for Americans
“Designed for
professionals to help all
individuals ages 2 years
and older … consume a
healthy, adequate diet.”
“Develop food, nutrition
and health policies and
programs.”
Dietary Guidelines for Americans: The Cornerstone of US NutriQon Policy & RegulaQon FDA Food
Labeling
USDA
Nutrition
Programs
FTC Marke*ng & Adver*sing Global
Influence
The Science Behind the Guidelines Dietary Guidelines Advisory Committee
considers:
•  ScienQfic raQonale based on various research methods: •  Original systematic scientific reviews
•  Existing systematic reviews, meta-
Dietary Reference Intakes (DRIs) analyses and scientific reports
•  Dietary data analyses
•  Food pattern modeling analyses
Issues technical report with nutrition and
health recommendations
DHHS/USDA uses technical report and
comments to develop updated Dietary
Guidelines
Systema*c Reviews Diet Modeling And More! 2015-2020 DGA: A Snapshot
Provides 5 Overarching Guidelines:
1. 
2. 
3. 
4. 
5. 
Follow a healthy eating pattern across the lifespan.
Focus on variety, nutrient density, and amount.
Limit calories from added sugars and saturated fats
and reduce sodium intake.
Shift to healthier food and beverage choices.
Support healthy eating patterns for all.
A healthy pattern includes:
• 
• 
• 
• 
• 
• 
A variety of vegetables
Fruits, especially whole fruits
Grains, at least half of which are WG
Fat-free /low-fat dairy, including milk & yogurt
A variety of protein foods
Oils
A healthy pattern limits:
•  Sat fat: <10% of calories/day
•  Trans fat: keep as low as possible
•  Added sugars: <10% of calories/day
•  Sodium: < 2,300 mg of sodium/day
Shift from Individual Foods and Ingredients to Healthy Eating Patterns!
A Healthy PaGern Includes: Vegetables & Fruits •  What’s the recommendaQon? –  2½ cups vegetables; 2 cups fruits daily •  Intakes remain significantly below recommended amounts –  Vegetables: 87% have intakes below goal –  Fruits: 75% have intakes below goal • What’s changed since 2010? •  Similar to 2010 recommenda*ons: •  Vegetables: A variety of vegetables from all subgroups – dark green, red and orange, legume, starchy and other •  Fruit: especially whole fruit A Healthy PaGern Includes: Grains •  What’s the recommendaQon? –  At least half of grain intake should be whole grain •  ConQnued imbalance of intake between refined grain and whole grain •  Enriched/forQfied grain recognized as important source of folic acid –  Recommenda*on for most adults: 6 ounce equivalents of Grain foods per day •  At least 3 should be whole grain •  What’s changed since 2010? •  Similar to 2010 recommenda*ons: •  At least half of grain intake should be whole grain •  Differences from 2010 recommenda*ons: •  16g whole grain = 1 whole grain ounce-­‐equivalent –  Progression from 2010! •  Acknowledgement that whole grains vary in fiber content •  What’s the scienQfic basis? –  Systema*c Reviews, Modeling A Healthy PaGern Limits: Added Sugars •  What’s the recommendaQon? –  Less than 10% calories per day from added sugar •  Current intakes average >13% of calories, ~270 calories/day –  Nutrient-­‐dense foods with added sugars OK within limits (e.g. fat-­‐free yogurt and whole grain breakfast cereals) •  What’s changed since 2010? – Similar to 2010 recommenda*ons: •  Reduce added sugar consumpQon •  Differences from 2010 recommenda*ons: •  First-­‐Qme quanQtaQve number •  What’s the scienQfic basis? –  World Health Organiza*on Systema*c Review, Modeling –  Acknowledgement that evidence is s*ll developing 2015 Healthy EaQng PaGerns •  US-­‐Style •  Vegetarian •  Mediterranean Fiber Agreement •  Marker of a healthy diet –  whole grains, fruits, vegetables, legumes •  Concept –  carbohydrates and lignin that escape digesQon in the upper GI tract but may be fermented in the gut •  Requirement in the diet –  according to Dietary Reference Intakes (DRIs) •  Regulated –  On the NutriQon Facts panel – 25 g Daily Value (DV) – proposed to increase to 28 g DV •  Health claims –  oat bran, barley bran, and psyllium and CVD in US RelaQve Risk of Death From CHD Dietary Fiber Intake is Low •  Typical fiber intake in US is 15 grams per day – •  95% of Americans don’t get recommended intake of fiber – nutrient of concern in Dietary Guidelines for Americans •  Most fiber-­‐containing foods contain liGle fiber –  Apple – 3 grams –  LeGuce – 1 gram –  WW bread – 2 grams –  Oatmeal – 3 grams •  Refined grains and white potatoes important fiber sources in the US diet because they are widely consumed •  Interest in the addiQon of funcQonal fibers to the food supply to increase fiber intake •  Slavin. Health implicaQons of dietary fiber. J Am Diet Assoc 2008;108:1716. MyPlate.gov (6/2/11) 19 Conclusions DigesJble carbohydrates (starches and sugars) should provide 45 – 65% of the calories in the diet. (AMDR) Most of these calories should come from starches which have a high glycemic index. DRI, 2006, DGAC, 2015 Dietary fiber from grains, fruits, vegetables, and legumes is associated with decreased risk of coronary heart disease. Adequate Intake (AI) for fiber is based on the median fiber intake level observed to achieve the lowest risk of CHD, 14 g/1000 kcal DRI, 2006, DGAC, 2015 It is theoreJcally plausible to expect a low GI diet to reduce risk of Type II diabetes and CVD. However, sufficient evidence needed to recommend substanJal dietary changes based on GI is not available DRI, 2006