Diet is estimated to contribute to about one-third of preventable cancers -- about the same amount as smoking. Inadequate intake of essential vitamins and minerals might explain the epidemiological findings that people who eat only small amounts of fruits and vegetables have an increased risk of developing cancer. Recent experimental evidence indicates that vitamin and mineral deficiencies can lead to DNA damage. Optimizing vitamin and mineral intake by encouraging dietary change, multivitamin and mineral supplements, and fortifying foods might therefore prevent cancer and other chronic diseases.
Cohort and cross-sectional data were reviewed to describe the changes in dietary intake with age. Total energy intake decreases varied substantially with age, by 1000 to 1200 kcal in men and by 600 to 800 kcal in women. This resulted in concomitant declines in most nutrient intakes. For some nutrients, substantial numbers of older Americans consumed only one fifth to one third of the recommended dietary allowance. For most nutrients, research is lacking with which to judge the health impact of reduced nutrient consumption with age, although there is some evidence of an age-related decline in absorptive and metabolic function. With the aging of the population, more research is needed on nutrient requirements and health outcomes, and public health efforts are needed to increase physical activity and food intake among older people.
OBJECTIVES: This study examined US trends in nutrient intake, using almost identical methods and nutrient databases in two time periods. METHODS: An extensive dietary intake questionnaire was included in supplements to the 1987 and 1992 National Health Interview Surveys. Dietary data from approximately 11,000 persons in each of those years were analyzed. RESULTS: The total and saturated fat intake and the percentage of energy from fat declined among Whites and Hispanics, but only minimal changes were seen in Black Americans. The changes in fat intake were attributable principally to behavioral changes in frequency and type of fat-containing foods consumed rather than to the increased availability of leaner cuts of meat. Dietary cholesterol showed one of the largest declines of the nutrients examined. Less desirable changes were also seen. Cereal fortification played an important role in the observed changes in several micronutrients. CONCLUSIONS: Educational campaigns on dietary fat and cholesterol have been moderately effective, but not in all racial/ethnic groups. Future campaigns should emphasize maintaining or increasing micronutrient intake.
In low-income neighborhoods without supermarkets, lack of healthy food access often is exacerbated by the saturation of small corner stores with tobacco and unhealthy foods and beverages. We describe a municipal healthy retail program in San Francisco, California, focusing on the role of a local coalition in program implementation and outcomes in the city’s low income Tenderloin neighborhood. By incentivizing selected corner stores to become healthy retailers, and through community engagement and cross-sector partnerships, the program is seeing promising outcomes, including a “ripple effect” of improvement across nonparticipating neighborhood stores.
Multifaceted community interventions directed at improving food environments are emerging, but their impact on dietary change and obesity prevalence has not been documented adequately. The Healthy Communities Study (HCS) is seeking to identify characteristics and combinations of programs and policies that are associated with children’s diets and obesity-related outcomes in various types of communities across the U.S. The purpose of this paper is to describe the methods used in 2013–2015 in the HCS to assess dietary intake, school nutrition environments, and other nutrition-related behaviors. The conceptual framework of the HCS is based on the socioecological model and behaviors shown in previous studies to be related to obesity in children-guided selection of domains. Nine domains were identified as essential measures of nutrition in the HCS: (1) intake of selected foods and beverages; (2) food patterns and behaviors; (3) social support; (4) home environment; (5) school environment; (6) community environment; (7) breastfeeding history; (8) household food insecurity; and (9) dieting behaviors and body image. Children’s dietary intake was assessed using a dietary screener and up to two automated 24-hour recalls. Dietary-related behaviors were assessed by a survey administered to the parent, child, or both, depending on child age. School nutrition measures were obtained from a combination of school staff surveys and researcher observations. Information from these measures is expected to contribute to a better understanding of “what is working” to improve the dietary behaviors that are likely to prevent obesity and improve health in children.
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