Foods, Nutrients, and Dietary Patterns: Interconnections and Implications for Dietary Guidelines

Abstract

Dietary guidelines provide evidence-based statements on food choices to meet nutritional requirements and reduce the risk of prevailing chronic disease. They involve a substantial amount of research translation, and their implementation has important health consequences. Foods, however, are complex combinations of nutrients and other compounds that act synergistically within the food and across food combinations. In addition, the evidence base underpinning dietary guidelines accesses research that reflects different study designs, with inherent strengths and limitations. We propose a systematic approach for the review of evidence that begins with research on dietary patterns. This research will identify the combinations of foods that best protect, or appear deleterious to, health. Next, we suggest that evidence be sought from research that focuses on the effects of individual foods. Finally, nutrient-based research should be considered to explain the mechanisms by which these foods and dietary patterns exert their effects, take into account the effects of ingredients added to the food supply, and enable assessments of dietary sufficiency. The consideration of individual nutrients and food components (e.g., upper limits for saturated fat, added sugar, and sodium) provides important benchmarks for evaluating overall diet quality. The concepts of core and discretionary foods (nutrient-rich and nutrient-poor foods, respectively) enable distinctions between foods, and this has implications for the relation between food policy and food manufacturing. In summary, evidence supporting healthy dietary patterns provides the foundation for the development of dietary guidelines. Further reference to individual foods and nutrients follows from the foundation of healthy dietary patterns.

Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association

“…4,5 Studies that apply substitution methods, for example, replacement of saturated fatty acids (SFAs) with other fatty acids or other foods, clearly demonstrate the benefits of replacing SFAs with unsaturated fatty acids. 6,7 Conversely, studies that ignore randomized trials and experimental or mechanistic studies on lipoprotein metabolism limit the evidence necessary to draw meaningful conclusions. Nutrition research is a dynamic process, and science remains open to new discoveries, but current evidence documents that although dairy fat may be slightly less harmful than other food sources of saturated fat, it is far less beneficial than plant-based fats, especially polyunsaturated fatty acids.…”

Current Evidence on the Association of Dietary Patterns and Bone Health: A Scoping Review

“…In addition to nonmodifiable heritable factors, nutrition and physical activity are the 2 important modifiable factors that have a strong influence on bone accumulation, maintenance, and loss during the evolving life cycle of bone (4). Even though the beneficial impact of several key nutrients and foods on bone outcomes has been established previously, these studies did not account for the complex relation and interactions between different dietary components (5). Describing and quantifying diet through dietary patterns enables the study of the entire diet, rather than individual foods or nutrients; hence, assessing dietary patterns is the preferred approach to explain the association between overall diet and bone health (6).…”

Misvisende om kosthold i ny nasjonal retningslinje for forebygging av hjerte- og karsykdommer

“…Risiko for hjerte-og karsykdom påvirkes av det helhetlige kostholdsmønsteret fremfor kun av enkeltnaeringsstoffer. En mindre andel mettet fett i forhold til umettet fett er likevel en del av alle kostholdsmønstre som er forbundet med lavere risiko for kronisk sykdom og tidlig død 216,[258][259][260][261][262][263] . Dokumentert helsefremmende kostholdsmønster som har et lavt innhold av mettet fett til fordel for umettet fett er blant annet et sunt, nordisk kosthold, middelhavskosthold og DASH-kosthold 134,216,[264][265][266] .…”