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Nutrient Density and the Evolving Nutrition Profiling Environment Nutrient Rich Foods Coalition: A New Approach. Obesity is Driving Change. Consumers Strive to Make Healthful Choices. Americans Are Overweight Yet Undernourished.
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Nutrient Density and the Evolving Nutrition Profiling EnvironmentNutrient Rich Foods Coalition: A New Approach
Americans Are Overweight Yet Undernourished Americans are not meeting nutrient recommendations • 97%: Potassium • 93%: Vitamin E • 70%: Calcium • 56%: Magnesium • 44%: Vitamin A • 31%: Vitamin C • 14%: Vitamin B6 • 12%: Zinc *Ages 1 year and higher, USDA, ARS 2005, What We Eat in America, NHANES 2001-2002
Nutrient Profiling at Retail Overall Nutritional Quality Index (ONQI) NUTRITION Three-Star Snacks In Aisle Five By Anne Underwood NOV 12, 2007 ISSUE FDA Public Hearing September 10-11, 2007: Use of Symbols to Communicate Nutrition Information,Consideration of Consumer Studies and Nutritional Criteria 6
The Nutrient Rich Foods Approach An evolution from being based on what to avoid … To being based on what to include, and considering the “whole food” or total nutrient package … A positive, common-sense approach to eating that emphasizes the total diet …
The Nutrient Rich Foods InitiativeWhat’s Best for Consumers?
Funded by The Beef Checkoff Nutrient Rich Foods Coalition
Beginning the Dialogue • Nutrient density to help consumers select the most nutrient-rich foods • “We want to help consumers choose naturally nutrient-rich foods first - and then the less nutrient-dense foods as calorie needs allow.” • Drewnowski 3/16/2004
Nutrient Density: Cornerstone of 2005 Dietary Guidelines for Americans Get the most nutrition out of your calories Maximizing your nutrients -- making calories count for you Choose the most nutritionally rich foods you can from each food group each day. 12
Dietary Guidelines Advisory Committee Call-to-Action • Develop a scientifically valid definition for "nutrient density” that could be useful on the food label • Determine what criteria are necessary for foods to meet this definition Overall Theme of 2005 DGAC Technical Report: Importance of Nutrient-Rich Diets 13
NRF Coalition Advisory Committees • Consumer Communications & Nutrition Behavior Committee • Jane Andrews, MS, RD, Wegmans • Robert McKinnon, YellowBrick Road • Amy Mobley, PhD, RD, Purdue University • Laura Peracchio, PhD, University of Milwaukee • Connie Diekman, MEd, RD, LD, FADA, Washington University St. Louis • Kathleen Zelman, MPH, RD, nutrition consultant • Scientific Advisory Committee • Adam Drewnowski, PhD, University of Washington • Victor Fulgoni, PhD, Nutrition Impact, LLC • Robert Heaney, MD, FACP, FAIN, Creighton University • Eileen Kennedy, PhD, Tufts University • Janet King, PhD, University of California, Berkeley & Davis • Nancy Krebs, MD, University of Colorado • Paul LaChance, PhD, Rutgers University • Esther Myers, PhD, RD, American Dietetic Association
NRF Coalition Vision The Nutrient Rich Foods approach is a scientifically proven, consumer-tested system that is widely accepted and makes it easy for people to build and enjoy healthier diets by getting the most nutrition from their calories.
Nutrient Profiling Criteria • Objective - based on accepted nutrition science and labeling practices • Simple – based on published daily values and meaningful amounts of food • Balanced – based on nutrients to encourage and on nutrients to limit • Validated– against measures of a healthful diet • Transparent – based onpublished algorithms and open-source data • Consumer-driven – likely to guide better food choices and more healthful diets 17 Drewnowski, Fulgoni. Nutr Rev 2008
The Nutrient Rich Foods Index is the only index that meets all 6 criteria: • Objective - based on 2005 Dietary Guidelines; 2005 MyPyramid and other expert panel data • Simple – based on percent Daily Values and reference amounts (RACC) published by the FDA • Balanced – based on nutrients to encourage and nutrients to limit • Validated– against 2005 Healthy Eating Index (HEI) • Transparent – algorithms published in peer-review journals; based on FNDDS and SR-20 data from USDA • Consumer-driven – research on helping consumers to build healthier diets is in progress 18 Drewnowski, Fulgoni. Nutr Rev 2008
Objective and Simple Select Nutrients to Encourage: The 2005 Dietary Guidelines seven Fiber, vitamins A, C, E, Ca, K, Mg The Food and Drug Administration six FDA defines “healthy” foods as those that contain >10% DV of protein, fiber, vitamins A, C, Ca, Fe Additional special population needs Zn, Fe, folate, vitamins D, B12 19
Objective and Simple Select Nutrients to Limit: The 2005 Dietary Guidelines five Saturated fat, trans fat, cholesterol, added sugar, and sodium The Food and Drug Administration four FDA disqualifies foods from health claims if they contain fat, saturated fat, cholesterol or sodium above specified amounts The European Union five Article 4 lists total fat, saturated fat, trans fat, sugar, and sodium The French three AFSSA uses saturated fat, added sugar, and sodium 20
Objective and Simple • Determine Nutrition Criteria: • Select reference amounts: use those used in food labels: FDA’s Daily Values • Use algorithm across Food Groups but apply within Food Groups • Use USDA sources for nutrient composition • Select basis for calculations: 100 kcal, 100 g, FDA’s RACC 21
Objective and Simple • NRF RACC-based scores: • Consistent with US labeling regulations (100g EU) • Scores/serving (RACC) more relevant to consumers • RACC-based scores rank foods similarly to 100 kcal • Consistent with the nutrient density definition 22
Balanced Create Algorithm: • The total score balances nutrients to encourage and nutrients to limit • Calculate % Daily Value for nutrients to encourage (capped at 100%DV/100 kcal or RACC) • Subtract same for saturated fat, added sugars and sodium 23
Validated 24
Validated • Family of NRF Indices have been validated against objective measures of a healthy diet • Measure of diet quality (Healthy Eating Index) • Body Mass Index • Blood pressure • Cholesterol levels • Validation identified NRF 9.3 to be consumer tested • Protein, Fiber, Vitamin A, C, E, Calcium, Magnesium. Iron, Potassium • Saturated Fat, Sodium and Added Sugars 25
Transparent Sept/Oct ‘07 Jan ‘08 Feb ‘08 Additional Articles in Development … 27 2008
Making it Relevant for Consumers I • Talked to consumers about nutrient density and what it means to them to • Determine which messages resonate • Understand the right ways to communicate nutrient density concepts
Making it Relevant for Consumers I • Consumers want to get more nutrients in their diets … • But they don’t know how to • Overwhelmed • Tend to give up on nutrients/nutrition • Tools • “Dense” means heavy or stupid “I don’t know how to shop for nutrient-dense foods.” -- Consumer, Denver
Headlines Must Empathize and Empower • Take Small Steps for a Healthier You • Get more nutrition out of your calories by choosing the most nutritionally rich foods from each food group each day • Recognized that healthy eating can be difficult … made the goal seem less intimidating and less challenging • Gave them permission to make changes a little bit at a time • Avoid “calories,” which can intimidate consumers “Take small steps, so someone might not be overwhelmed … They can do a little bit at a time.” -- Consumer, Denver 31
Headlines Must Deliver A Strong Consumer Benefit • Live Well • Enjoy nutrient-rich foods from all five food groups including fruits, vegetables, nonfat and lowfat dairy, lean meats, and whole grains • Spoke to their primary goals related to food and health: taste and general well-being • Liked messages that emphasized the health benefits of all food groups “I like how they point out non-fat, lowfat, lean and whole … and that you’re going to be satisfied.” -- Consumer, Denver “If you follow these rules forthese food groups, you’regoing to live well.” -- Consumer, Chicago 32
Making it Relevant for Consumers II • Consumer research to bring index application to life for consumers • Application will be where consumers interact with food • User-driven design • Consumer-driven brand/design • Educational tools • Total diet translation • Diets/menus/recipes • Expanded web site
Supporting the Research: Influencer & Consumer Communications
Health Professional/ScientistBriefings & Symposia EB 2008: NRF Scientific Forum and PIC Symposium
Resources www.NutrientRichFoods.org 36
Nutrient Rich Foods: A New Way • A science-based, simple, objective, and validated approach • A consumer-driven eating system that helps people get more nutrition from their calories by emphasizing the complete nutrient package of foods and beverages • A positive, total food / total diet approach 37