Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page 45
Target Levels and Current Dietary Patterns
CALORIES
Target: Caloric intake matched to indi-
vidual needs anc] appropriate to achieve anc!
maintain clesirable body weight.
All the national organizations issuing di-
etary guidelines include recommendations
regarding caloric intake and belly weight.
The American Cancer Society (1984~; the
National Research Council's Committee on
Diet, Nutrition, and Cancer (National Re-
search Council, 1982~; and the U.S. Senate
Select Committee on Nutrition and Human
Needs (1977) all advise a caloric intake that
would avoid obesity. The American Heart
Association (1986), the National Institutes
of Health (19&4b) consensus development
conference statement, and the U. S. De-
partment of Agriculture (U5DA)/U.S. De-
partment of Health and Human Services
(DHHS) (1985) recommend caloric intake
to maintain desirable body weight, while
the National Research Council's Committee
on Recommended Dietary Allowances (Na-
tional Research Council, 1980) suggests a
caloric intake adequate to meet individual
needs based on sex, age, and level of phys
45
ical activity. This committee accepts as a
target level a caloric intake matched to
individual needs and appropriate to achieve
and maintain desirable body weight.
Dietary Survey Data
Estimates of caloric intake from dietary
survey data can be unreliable because re-
spondents tend to underreport this variable
(U. S. Department of Agriculture/U. S. De-
partment of Health and Human Services,
19864. The loins Nutrition Monitoring Eval-
uation Committee of the U S DA and D H H S
stated that `'if reported diets represent usual
food energy intakes and such a large pro-
portion of the population is overweight, it
must be concluded that many Americans
are underactive" (U. S. Department of Ag-
riculture/U.S. Department of Health and
Human Services, 1986~. The report Pro-
moting HeatthlPreventing Disease: Objec-
tives for the Nation (U.S. Public Health
Service, 1980) recommended that by 1990,
at least 60 percent of American adults ages
18 to 65 should participate in regular phys-
ical exercise; at present, this figure is only
about 10 to 20 percent (Powell et al., 1985~.
OCR for page 46
46
Summary
Data from the 197~1980 National Health
and Nutrition Survey (NHANES) indicate
that approximately 34 million U.S. adults
are obese (body mass index 285th percen-
tile), of which 12.4 million are severely
obese (body mass index-95th percentile).
The incidence of obesity varies widely ac-
cording to age and sex, with black adults
ages 4~54 having the highest incidence
(61.2 percent for females and 41.4 percent
for males) (Table 3-1~. Childhood obesity is
more difficult to estimate but may range
from 4 to 14 percent among low-income
populations (Table 3-2~.
DESIGNING FOODS
TABLE 3-2 Percentage of Low-Income
Children Screened with Weight-for-
Height Above the 95th Percentile,
31 States, United States, 1984
Age and
Group
0-11 months
White
Black
Hispanic
American Indian
Asianb
12-23 months
White
Black
Hispanic
American Indian
Asianb
Number
Exami-
neda
Weight-for-Height
>9Sth Percentile
2-5 years
134,866
68,502
30,595
5,853
3,310
38,260
26,087
5,435
1,259
973
6.0
8.8
7.0
10.3
8.5
9.6
11.3
12.4
13.7
7.4
White82,597 4.1
TABLE 3-l Obese In(livi:luals, Black i53,675 5.3
97 980 in percen American Indian2,455 8.2
Group and Age White Black Asianb 1,791 3.9
Females 6-9 years
25 34 17.9 33.5 White 10,108 7.6
35 - 24.8 40.8 Black 7,836 5.6
45 54 29.9 61.2 Hispanic 417 12.2
55 64 34.8 59.4 American Indian 96 Insufficient data
65-74 36.5 60.8 Asianb 60 Insufficient data
Males
25 34
35 44
45 54
55 64
65-74
Both sexes
(Age adjusted)
25 74
20.9
28.2
30.5
28.5
25.8
17.5
40.9
41.4
26.0
26.4
27.2 41.1
NOTE: Obese is defined for men as a body mass
index of 227.8 k/m2, and for women as a body mass
index of 227.3 k/m2. These definitions are used because
they represent the sex-specific 85th percentiles for
persons 20 to 29 years of age in the 197~1980 National
Health and Nutrition Examination Survey.
SOURCE: Adapted from U. S. Department of Health
and Human Services. 1985. P. 79 in Health United
States, 1985. National Center for Health Statistics,
DHHS Publication (PHS) 86-1232. Washington D C.
U.S. Government Printing Office.
NOTE: The Pediatric Nutrition Surveillance System,
Centers for Disease Control, uses nutrition-related
data collected by local health departments as part of
the routine delivery of child health services. These
data are the result of examinations of 610,439 new
patients at 2,464 clinics in 31 states, the District of
Columbia, and Puerto Rico. Anthropometric data on
height, weight, and age are converted to percentiles
of weight-for-height. These percentages represent the
minimal number of children with obesity; these figures
would be higher if moderate obesity were also included.
aThe total does not equal 610,439 because of unknown
or missing data for some variables and the exclusion
of states with data errors.
bData for Asians include data from an unknown number
of recent Southeast Asian refugees.
SOURCE: Adapted from Centers for Disease Con-
trol. 1986. Annual summary 1984: reported morbidity
and mortality in the United States. Morbidity Mortality
Weekly Report, 32~54):105.
~7
OCR for page 47
TARGET LEVELS AND C URRENT DIETARY PATTERNS
TOTAL FAT AS PE RCE NTAGE OF
CALORIES
Target: Thirty percent or less of calories
from fat for adults.
Excesses of the first four nutrients iden-
tified by the foint Nutrition Monitc~ring
Evaluation Committee (INMEC) (bakeries,
total fat, saturated fatty acids, and choles-
terol) have all been implicated, either di-
rectly or inclirectly, in the etiology of car-
diovascular disease. Despite ~ 2 percent
annual clecline in its prevalence since 1968,
cardiovascular disease remains the leading
cause of death in the Unitecl States (Centers
for Disease Control, 1986a).
Influence of Dietary Fats on Serum
Lipid Levels
The type and amount of fat in the diet
have become increasingly ret ognized as
factors influencing nutritional status and
overall health, as evidenced by numerous
clinical studies (Grundy, 1986; O'Brien and
Reiser, 1980; Reiser et al., 1985~. It should
be remembered that fat contributes about
9 calories/gram, more than twice as many
as protein or carbohydrate (about 4 calories/
gram each). In addition, different fatty acids
of dietary fats can significantly alter serum
lipid levels. In general, saturated fatty acids
raise the serum cholesterol level (certain
exceptions were discussed in Chapter 2~.
Furthermore, monounsaturated fatty acids
have been shown to lower cholesterol levels
relative to saturated fatty acids. The mon-
ounsaturated fatty acids produce reductions
similar to those induced by polyunsaturated
fatty acids (Becker et al., 1983; Mattson and
Grundy, 1985~. Recently, eicosopentaenoic
and docosohexaenoic acids (found mainly in
fish) have generated considerable scientific
and public interest. Studies have shown that
they may reduce platelet aggregation and
lower serum triglyceride levels (lIerold and
Kinsella, 1986~.
47
Dietary Fat and Cancer
Some estimates indicate that nearly three-
fLurths of all cancers in the United States
may be influenced by diet (l)oll ancl Plato,
1981~. Both animal experiments and epi-
demi`'logical studies have Shown an associ-
ation between dietary fat and the inciclence
of cancer, particularly of the l~reast, pros-
tate, and large bowel (L)oll and Peto, 19814.
The National Research Council ~ Comlnit-
tee on Diet, Nutrition, arid Cancer citecl
that of all the dietary eolupol~ellts it stlldiecl,
"the combined epidemiological and expel-
imental evidence is most suggestive for a
causal relationship between fat intake and
the occurrence of cancel-" (National Re-
search Council, 19824. It further concluded
that epidemiok~gical studies arid animal ex-
periments provide convincing evidence that
increasing the intake of total At inCIedSCS
the incidence of cancer at c'Cltain sites,
particularly the breast and colon, awl, con-
versely, that the risk is 1OW0I with lower
intakes of fat" (National Research Council,
1982~.
Dietary Guidelines for Total Fat Intake
All national health organizations agree
that total dietary fat intake should be re-
duced by some or all members of the U.S.
population (depending on how much fat
they currently consume) to maintain health
and optimal body weight and to reduce the
risk of certain diseases, particularly cardio-
vascular disease and perhaps cancer. Several
groups have qualified their recommenda-
tions, directing their advice to modify die-
tary fat intake to particular segments of the
population. Other groups have focused their
recommendations more generally. The Na-
tional Research Council's Committee on
Diet, Nutrition, and Cancer (National Re-
search Council, 1982), a Nationa] Institutes
of Ilealth (1984b) consensus development
conference statement, and the American
Cancer Society (1984) have all recom
OCR for page 48
48
mantled that fat intake not contribute more
than 30 percent of total calories. Since 1968,
the American Heart Association (1968, 1982,
1986) has recommender] that 30 to 35 per-
cent of total calories come from fat ant! has
recently revised this recommendation to be
less than 30 percent. Likewise, the National
Research Council's Committee on Dietary
Allowances (National Research Council, 1980)
suggests a fat intake not to exceed 35 percent
of calories, especially in cliets of less than
2,000 total calories. The Committee on
Nutrition of the American Academy of Pe-
diatrics (1981) suggests that dietary fat not
be restricted for children under 1 year of
age; after this age, a decrease in the con-
sumption of saturated fatty acids, choles-
terol, and salt and an increased intake of
polyunsaturated fatty acids should be fol-
lowec3 with moderation. For the purposes
of this report, the committee has accepted,
for adults, the target level of 30 percent or
less of calories from fat.
Dietary Survey Data
The average percentage of calories from
fat for the entire 1977-1978 National Food
Consumption Survey (NFCS) population
was 41 percent (U.S. Department of Agri-
culture/U. S. Department of Health and Hu-
man Services, 1986~. This percentage is
recognizes] as a high estimate for 1987
because of dietary changes that have oc-
curred and the neglect by many respondents
in the survey to report that fat on meat was
not eaten. The 1977-1978 data imply an
average need! across the general population
for an 11 percent reduction in the percent-
age of calories from fat, from the present
41 percent to the target level of 30 percent.
While it is useful to note this as a general
target level, it is important to focus on
individual population subgroups, for which
the 1977-1978 NFCS provides data. Some
subgroups are at or near this 30 percent
target level; others exceed it by a wide
margin. Recommender] alterations in eating
DESIGNING FOODS
habits vary greatly, depending on how large
a reduction is necessary. A summary of the
distribution of individuals from the 1977-
1978 NFCS by population subgroups and
by percentage of calories from fat in the
diet and the reductions needed to meet the
target level are given in Table 3-3; compa-
rable data from the 1985 Continuing Survey
of Food Intake by Individuals (CSFII) are
given in Table 3-4.
The percentage of calories from fat in
1985 was below the 41 percent level re-
ported in the 1977-1978 survey, as evi-
denced by data from the 1985 CSFII. Among
children ages 1 to 5, the percentage of
calories from fat was 34 percent (U.S. De-
partment of Agriculture, 1985~. For women
ages 19 to 50, the percentage of calories
from fat was 37 percent; for men ages 19 to
50, the percentage of calories from fat was
36 percent (U.S. Department of Agricul-
ture, 1985, 1986~. The Nutrition Monitoring
Division of the Human Nutrition Informa-
tion Service within the USDA (U.S. De-
partment of Agriculture, 1985) has sug-
gested that some of the differences between
1977 and 1985 may have been due to changes
in food selections, such as the shift from
whole milk to low-fat milk, as well as to
changes in the way (lata were collected (for
example, more probing questions were asked
about the intake of fat on meat and skin on
poultry and the use of fat on vegetables).
Summary
Data from the 1985 CSFII indicate that
the average percentage of calories from fat
for adults ages 19 to 50 was 36 to 37 percent,
6 to 7 percentage points above the 30
percent target level. For children ages 1 to
5, the percentage of calories from fat was
34 percent. Data from the 1985 CSFII
indicate that 15 percent of children ages 1
to 5 and 12 percent of women ages 19 to 50
had diets meeting the target level (Table 3-
4~.
OCR for page 49
TARGET LEVELS AND CURRENT DIETARY PATTERNS
TABLE 3-3 Distribution (Percent) of Individuals by Percentage of Calories from Fat
and Reductions Needed to Meet Target Level
49
Calories from Fat (%)
Roget ::~Dev~l;
:: ::::: :: :::: :
Dietary Level:
~ ~ ~ ~>30 >40
::: ::: i: ::: : ::
~c~ ~ ~c40 '50 >50
: ~
Reduction Needed
(Percentage Points)
Group and Age to Meet Target Level:
::: : ::: ::
None :
:~: ~ :
:
0-10 10-20
>20
Children
1-2
3-5
Females
19-22
23-34
35-50
Males
19-22
23-34
35-50
All (mean)a
NOTE: The shaded column represents the target level and the percentage of individuals who met it.
:: :::: ::: :::: : ::::: :: :::
: : :: ~ ~:: ~ ~ : :~ ~
1 ~
^:^
::~:: ::::: ::
:: - : I: ~ I::
C7: I: :: ~:~ ~ :
: :::::::::::: ::::::::
: : ::: :
54
57
32 3
32 2
40
38
34
30
u ~ ~ ~: 41
43
46
48
47
52
45
10
10
13
9
14
/
8
aMean for entire survey population (37,785 individuals).
SOURCE: 1977-1978 level of intake of percentage of calories from fat based on data from the 1977-1978
Nationwide Food Consumption Survey. Adapted from E. M. Pao and S. J. Mickle. 1981. Problem nutrients in
the United States. Food Technol. 35:58-79.
TABLE 3-4 Distribution (Percent) of Women and Children by Percentage of Calories
from Fat and Reductions Needed to Meet Target Level
Calories from Fat (%)
Dietary Level:
Reduction Needed
(Percentage Points)
Group and Age to Meet Target Level:
~ - ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .~ ~
Ta~e thy Led
:: ::: ~:~ ~ :: ~:~ ~ :::
:::: ~::~::~: :: I::: I: :~: ~ ~::~ :::: :: ~ ::::: Aft::
:: :~ it: ~ i:: ~ ~ ~ ~ I: :~: ~ ~ ~ :::::: ~ ~ ~ ::~::~ i:::: ~ :: ~ :
.,,~,~
'~ i~ : ~ ~ ~ ~ ~ ~ ~
:: : :: :~: ~ ~ : :~: ~ :: ~ All: ~ ~ ::
:~: : :~::~:: ::: ::: :: :::::::: ::~: :::
All. .~ ~ ~ ~.~ ~ ~ ~ ~ ~.~ ~ ~ ~ ~
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~;~ ~.~.~ ~ ~ ~ ~
:::::::::::: i:: i: ~ :~ :: ~ :: :::: ::: :: ~:::~:
:; ~ ~:~:~ ~;~:~:~;~
Inane ~ ~ ~:
:: ::~:: ::::::: ~: ::~:: :: ~::::~ ::~::::~ At: :: ::
~ : : : ~::~ ~ :::~:: ~ :: ::~::~ ~ : ::~ : :~:: : : :~ ~ ~:~ : ~ ~ ~ : : : ~ :~::: ~ ~ ~ ~ ::: : : ::
::~: ~:~:~ :~ ~ ~ ~:~:~ :::: ~ :~: ::: :
:~:~13~ ~:~ ~:~;~;~
~ ~ ~ ~ ~ ~ ~ .~ ~ ~.~ ~ ~
~i~7~;~ ~ ~ ~ ~
: ~ :~ :~ ~ ::: :: ~ i: A: ~ ~ : :~:: :::
~1~:~ ~ . ~ ~ ~ ~
:~1~ :~:: :~:~::~:~:::~::~::: I:: ::~:: ~:::~ :: ::::
:: ::~ ::::: i::: ::~::: ::::::: ~ i: :::::: ~
:~: :: I::: ::: :~::: ~ ::::: ~ ~ ~ i: At:
::: :: :::::: ~ Ail: :: ::: ~ ~:~:~:~::~:~: ::
: i:: :~: :~ ::~: ~ ~ :::::::: : ~ ::: i: ~ ~ :~: :: i: i: ~ ~::::~: ~ ::::: ::::
::::: ::: :~ ::~::: :::: ::::: ::: :::::::: ::: :::: ::: :~ i: :
~:~1::~-~:~::::~:~:~::-~:~:~
: my:: ~ ~::~::~ ~: ~ I: :::: :: ~:::~
~:~ ~ ~ ~ ~ ~ :~ ~ ~ ~ ~ ~ ~::~: ::: i:
:: :: : :::: :~: :::::::: :::::::: ::: i:::: ::::::::: ::::::::::
2~-~-;~ :~:~:~
. ~ em ~ ~ ~ ~ ~ ~ ~ ~: ~ ~ ~:
>30 >40
50
0-10
10-20
>20
Children
1-3
4-5
All (age 1-5)
Females
19-34
35-50
All (age 19-50)
70
67
69
52
52
52
11
6
6
o
o
o
34
34 2
34
NOTE: The shaded column represents the target level and the percentage of individuals who met it.
SOURCE: Adapted from Human Nutrition Information Service, U.S. Department of Agriculture, unpublished
data on 4-day dietary intake, 1987.
OCR for page 50
50
SATURATED, MONOUNSATURATED,
AND POLYUNSATURATED FATTY
ACIDS AS PERCENTAGE OF CALORIES
Target: Ten percent or less of calories
from saturated fatty acids, 10 percent or
less of calories from polyunsaturated fatty
acids, and 15 percent or less of calories
from monounsaturated fatty acicis for aduZts.
"Eating extra saturated fat, high levels of
cholesterol, and excess calories will increase
blood cholesterol in many people. Ofthese,
saturated fat has the greatest influence,"
states the USDA/DHHS (1985) Dietary
Guidelines for Americans. Elevated serum
cholesterol levels, a major cause of cardio-
vascular disease, have been strongly cor-
related to several dietary factors, including
a high intake of calories, certain saturates]
fatty acids, and cholesterol. Genetics and
environmental factors may also play an im-
portant role in the development of high
serum cholesterol. The 1979 Surgeon Gen-
eral's report on health promotion and dis-
ease prevention, Healthy People, stated that
"premature heart disease is unequivocally
associated with elevated blood cholesterol
. . . heart attacks are five times as frequent
in men and women aged 35 to 44 who have
cholesterol levels above 265 (ma per d1) as
among those with levels below 220 (ma per
c31~. In general, the lower one's blood cho-
lesterol level the less the likelihood of heart
disease; the higher the cholesterol level the
greater the risk" (Office of the Assistant
Secretary for Health and the Surgeon Gen-
eral, 1979~.
Saturated Fatty Acids: Influence on
Serum Lipid Levels
Saturated fatty acids are estimated to
currently contribute about 13 percent of the
total caloric intake of the average adult in
the United States. These fatty acids, as a
group, have been positively correlated with
the prevalence of cardiovascular disease in
many epiclemiological studies (Hegsted et
DESIGNING FOODS
al., 1965; Keys, 1970; Stamler, 1979). Sev-
eral specific saturated fatty acids have been
shown to raise plasma levels of cholesterol
and low-(lensity lipoproteins, both of which
are correlated with an increased risk of
cardiovascular disease (Ahrens et al., 1957;
Hegsted et al., 1965; Keys et al., 1965~;
lowering the level of saturated fatty acids
in the diet will reduce the plasma cholesterol
level (Hegstec! et al., 1965; Keys et al.,
1965~.
Saturated fatty acids occur in both animal
and plant fats. Particularly rich sources of
saturated fatty acids from plants are coconut
ant] palm oils. Animal fats contain saturated
fatty acids of a wide range of chain lengths.
Specific saturated fatty acids are believed
to differ in their ejects on plasma choles-
terol. Three saturates palmitic (Cur),
myristic (Ci40), and lauric (Cur) acids-
have been shown to raise the plasma cho-
lesterol level, while stearic acid (Cur), which
is high in beef, lamb, and pork fat, appar-
ently does not raise the plasma cholesterol
level (Hegstec! et al., 1965; Keys et al.,
1965~. The actions of the medium-chain fatty
acids (C80, C~00) on cholesterol levels are
not well stucliec3. As research confirms and
refines the effects of stearic acid on the
plasma cholesterol level, dietary recom-
mendations may change to exclude this
saturated fatty acid from the 10 percent
caloric recommendation (Bonanome and
Grundy, 1987).
Dietary Guidelines for Fatty Acid
Intake
A "reduction" in saturated fatty acid in-
take or "avoidance" of excessive intakes,
without citing specific levels, has been rec-
ommended by the USDA and DHHS (U.S.
Department of Agriculture/U. S. Depart-
ment of Health and Human Services, 1985),
the National Research Council's Committee
on Recommended Dietary Allowances (Na-
tional Research Council, 1980), and the
Surgeon General (Office of the Assistant
OCR for page 51
TARGET LEVELS AND C URRENT DIETARY PATTERNS
Secretary for Health and the Surgeon Gen-
eral, 1979~. Recommendations that intakes
be reduced to less than 10 percent of total
caloric intake have been made by the A~ner-
ican Heart Association (1982) and a National
Institutes of Health (1984b) consensus de-
velopment conference statement; the U.S.
Senate Select Committee on Nutrition and
Human Needs (1977) suggested a range of
8 to 12 percent. This committee accepts,
for adults, a target level of 10 percent or
less of calories from saturated fatty acicis.
Due to the unknown potential adverse
eEects of prolonged intakes of high levels
of polyunsaturated fatty acids, the American
Heart Association (1968) the National Insti-
tutes of Health (1984b), and the National
Research Council's Committee on Dietary
Allowances (National Research Council, 1980)
have all cautioned against exceeding 10
percent of total calories from polyunsatur-
ated fatty acids. This committee accepts, for
adults, a target level of 10 percent or less
of calories from polyunsaturated fatty acids.
The remainder of dietary fatty acids (15
percent of calories or less) should come from
monounsaturated fatty acids, which are found
in both animal and plant fats. The monoun
51
saturated fatty acids have been shown in
some studies to cause a lowering of serum
cholesterol when exchanged for saturated
fatty acids. They reduce low-density lipo-
protein levels to about the same extent as
do polyunsaturated fatty acids. There is
no evidence that monounsaturates uniquely
increase the risk for cancer. The committee
accepts, for adults, a target level of 15 per-
cent of calories or less from monounsatur-
ated fatty acids.
Dietary Survey Data
Data from the 1985 CSFII indicate that
saturated fatty acids, as percentage of cal-
ories, average about 13.2 percent in the
diets of adults ages 19 to 50 and 13.9 percent
for children ages 1 to 5 (Table 3-5~. Data
on 4-day intakes for women and children
indicate that 10 percent of women (ages 19
to 50) and 4 percent of children (ages 1 t<'
5) had diets that met the target level for
percentage of calories from saturated fatty
acids (Table 3-6~. Comparable data are not
available for men, but the trend is thought
to be similar.
Data from the 1985 CSFII indicate that
1Al3LL 3-5 (calories from Fat and Fatty Acids, 1985 (in percent)
Children at Age
Fat or Fatty Acid
1-3 4-5
Females at Age:
All (1-5) 1~34
35-50 All (1~50)
Males at Age:
.
1~34 35-50
All (1~50)
37.6 36.4
Total fat a
Saturated
fatty acidsb
Monounsaturated
fatty acids 12.3 12.6
Polyunsaturated
fatty acids
5.4 5.5
34.3 34.4
34.3
14.0 13.8 13.9
12.4
5.5
36.2
13.1
37.2
13.4
13.7
7.5
36.6
13.2
13.5
7.3
35.3
12.7
13.5
6.7
13.&
7.0
13.2
13.8
6.8
aThe value for the percentage of calories from total fat exeeds the value for the sum of the total saturated,
monounsaturated, and polyunsaturated fatty acids by an amount equal to the value for glycerol and all other non
fatty lipid components.
bThis category includes all types of saturated fatty acids, with carbon chain lengths front 6 to 18.
SOURCES: Adapted from U.S. Department of Agriculture. 1985. P. 49 in Women 1~50 Years and Their
Children 1-5 Years, 1 Day. Nationwide Food Consumption Survey, Continuing Survey of Food Intakes by
Individuals. Report 85-1, Human Nutrition Information Service. Hyattsville, Md.: U. S. Department of Agriculture.
U. S. Department of Agriculture. 1986. P. 47 in Men 1~50 Years, 1 Day. Nationwide Food Consumption Survey,
Continuing Survey of Food Intakes by Individuals. Report 85-3, Human Nutrition Information Service. Hyattsville,
Md.: U. S. Department of Agriculture.
OCR for page 52
52
DESIGNING FOODS
TABLE 3-6 Distribution (Percent) of Women and Children by Percentage of Calories
from Saturated Fatty Acids and Reductions Needed to Meet Target Level
Calories from Saturated Fatty Acids (%)
Dietary Level:
>10'14 '15'19 -20
Group and Age
Reduction Needed
(Percentage Points)
to Meet Target Level:
0-5
5-9 210
Children
1-3
~5
All (age 1-5)
Females
1~34
3~50
All (age 1~50)
59
65
61
55
55
55
35
32
34
35
31 2
33 2
1
NOTE: The shaded column represents the target level and the percentage of individuals who met it.
SOURCE: Adapted from Human Nutrition Information Service, U.S. Department of Agriculture, unpublished
data on 4-day dietary intake, 1987.
monounsaturatec] fatty acids accounted for
13.5 to 13.8 percent of calories in the diets
of adults ages 19 to 50 ant! 12.6 percent in
the diets of children ages 1 to 5 (Table 3-
5~. Data on 4-clay intakes indicate that 74
to 80 percent of children ages 1 to 5 and 64
to 66 percent of women ages 19 to 50 had
diets that met the target level of 15 percent
or less of calories from monounsaturated
fatty acids (Table 3-7~. Comparable data for
men are not available, but the trend is
thought to be similar.
Data from the 1985 CSFII indicate that
polyunsaturated fatty acids accounted for
~ ~ . ~ ~. (% 1
and 4 percent of children ages 1 to 5 years
had diets that met the target level for
saturated fatty acids. Between 64 to 66
percent of women and 74 to 80 percent of
children hail diets that met the target level
for monounsaturated fatty acids. About 98
to 99 percent of children and 86 percent of
women met the target level for polyunsa-
turated fatty acids (Tables ~6 through
8~.
CHOLESTEROL
. ~at. . r
Target: Three hundred milligrams or less
o.o to `.~ percent or calories In the cllets ot
1 1 ~ r of cholesterol per day for adults.
acquits ages 19 to 50 anct 5.5 percent or
calories in the diets of children ages 1 to 5
(Table 3-5~. Four-ciay intake data indicate
that 98 to 99 percent of children ages 1 to
5 ant] 85 to 87 percent of women ages 19
to 50 had diets that met the target level for
10 percent or less of calories from polyun-
saturatec3 fatty acids (Table 3-8~.
Summary
Data from the 1985 CSFII indicate that
about 10 percent of women ages 19 to 50
In some epidemiological studies, the risk
of cardiovascular heart disease has been
positively correlated to intakes of dietary
cholesterol (Kanne! et al., 1971; Shekelle et
al., 1981~. In one study, with intakes of up
to about 400 mgll,OOO kcal, the plasma
cholesterol response to dietary intakes of
cholesterol was approximately linear: Each
1 mg/1,000 keel resulted in a plasma cho-
lesterol increase of about 0.1 mg/(11 (Hegstecl,
1986~. Based on the results of that study,
with a 2,500-kcal diet, an increase in dietary
OCR for page 53
TARGET LEVELS AND CURRENT DIETARY PATTERNS
TABLE 3-7 Distribution (Percent) of Women and Children by Percentage of Calories
from Monounsaturated Fatty Acids and Reductions Needed to Meet Target Level
Calories from Monounsat~rated Fatty Acids (Jo)
53
Dietary Level:
_ ~ ~ ~ ~ ~ ~ ~.~ ~ ~ ~.~.~ ~
A - ~ ~ Levels
~ tic ill ~ ~ ~ ~ ~ ~ ~ -aft ~ ~ ~ ~ ~ ~ ~ ~ ~ ,
::: -~1~ J~ ~ All. :: ~ ~ . ~.:~.'~:::~ . ~ ~ . ::
. .. .
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ i. ~ ~ ~ ~ ~ ~ ~
~ ~ ~ :~ ~: i: ~ ~ ..: ~. ~ ~ ~
~ ~ ~ ~ ~ ~ ~.~.~
::: :~ : :: ~ :~ ~:~:~:~ ~ ~:
~ ~ ~.~ ~.~ ~
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .~ ~ ~ ~ ~ . ~ ~
. ~ ~ ~: ~ ~ ~- ~
One ~ ~ ~ ~-~
~ ~ ~ ~ ~ ~ ~ ~-~ -- ~ ~ I- ~ ~ ~
.
: it: ~ :
~:~ ::
.vv~ ~ at: :~ ~ ~.~ ~ ~ ~ it.
~ ~ i 4~ ~ ~ ~ ~ ~ ~.~ ~ ~ ~ ~ ~ ~
: ::: :::::::::: ~ ::: :::: :::::::: ::: ::::::::: :::::::
M7^ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ at.
: :~1 A: i: ~ ~ ~ -. ~ ~ ~
~ : ~ ~ ~,~
:~ :::: i:: :: :::: i: :::: :~:: :: i::
:::: ::::::: ::: :~ ~::~:::::~:: ::::
~ i: ~ ~ ~ ~ ~ ~ ~ ~ A:
66~ :~: ~ ~ ~
: :~ : :::: ~ ~::~ :: :::: at:: ::: :~:::~:~:::~:~:::~:
: `: At ~ ~ ~ ~ ~ ~ i:: ~ ~ ~ ~ ~ ~ i: :: ~ ~ ~ :~: :
: Em:: ~ a: ~:~::~::~ ::~ :: ::::::::::::
: ::::::::::::: :::::::: :::::::::::: i::::: :::::: ::::: :: ::
:~ ~ ~:~:~,~,~:~ ~:~,~ ail:
: ~ ~ ~,~:~ ~:~ .: :~ ~ ~:~ ~
> 15' 19 220
Group and Age
Reduction Needed
(Percentage Points)
to Meet Target Level:
0-5
2~10
Children
1-3
~5
All (age 1-5)
Females
1~34
3~50
All (age 1~50)
20
26
23
33
34
o
o
o
1
2
1
NOTE:: The shaded column represents the target level and the percentage of individuals who met it.
SOURCE: Adapted from Human Nutrition Information Service, U.S. Department of Agriculture, unpublished
data on 4-day dietary intake, 1987.
cholesterol of 100 mg/day would be expected
to increase the plasma levels by about
4 mg/dl. Likewise, a decrease in dietary
cholesterol of 100 mg/day would decrease
plasma levels by about 4 mg/dl.
Dietary Guidelines for Cholesterol
Intake
Reports from the USDA/DHHS (1985)
and the Surgeon General (Office of the
Assistant Secretary for Health and the Sur-
geon General, 1979) recommend a "reduc-
tion" in dietary intakes of cholesterol but
do not cite precise levels. Organizations
suggesting specific intakes include the U. S.
Senate Select Committee on Nutrition and
Human Needs (1977) (250 to 350 midday),
the National Institutes of Health (1984b)
consensus development conference state-
ment (250 to 300 mg/day), and the American
Heart Association (1986) ('300 mg/day or
100 mg/1,000 kcal). Restriction of dietary
cholesterol in children remains controver-
sial, although a lowering of total dietary fat
and an avoidance of obesity among this age
group have been recognized as good pre-
ventive measures (Barness, 1986~. This com
mittee accepts, for adults, a target level for
cholesterol of less than 300 mg/day.
Dietary Survey Data
Data from the 1977-1978 NFCS indicate
that the average cholesterol intake for the
survey population was 385 mg/day, or 214
mg/1,000 kcal (U.S. Department of Agri-
culture/U. S. Department of Health and Hu-
man Services, 1986~. Fifty-eight percent of
the survey population had intakes greater
than 300 mg of dietary cholesterol per day.
The highest intakes were among 19- to 64-
year-olds, with 78 percent of the males and
52 percent of the females consuming more
than 300 mg/day. These data are summa-
rized in Table 3-9. Data on cholesterol
intakes from the 1985 CSFII are presented
in Tables W10 and ~11. About 77 percent
of children ages 1 to 5 and 62 percent of
women ages 19 to 50 had diets that met the
target level of '300 mg/day.
Summary
Data from the 1977-1978 NFCS indicate
that about 52 percent of the survey popu
OCR for page 54
54
DESIGNING FOODS
TABLE 3-8 Distribution (Percent) of Women and Children by Percentage of Calories
from Polyunsaturated Fatty Acids and Reductions Needed to Meet Target Level
Calories from Polyunsaturated Fatty Acids (%)
Group and Age
Children
1-3
4-5
All (age 1-5)
Females
19-34
35-50
All (age 19-50)
:~t L - ells
i ~ .... if - ~ A. ~ ~ ~ . ~ ~ ~ -. ~ ~ ~
-G10 ~ - -
~.~:.:.:,~::.~.,.:.:::::~:~.~:~...:~:~.~.:::::~.~:::~: ..: :.::: :: :,:,:,:. ::
. ,.;,,.,,,~,., ~,,,,,~,,~,.~,
.. -.2-.~-~.' ~ , , - ,:, ~ ~ jot ~
. ~.~.~,, ~-- ~-.-~. ~'--,',~.'.'--,'.',''~,''.~.~.~.
; 's,.o,.-. ~,.; ;
I'.'"-"-''".
i.... -, -,,....-,: ~...~ i.,- ~.-.~ ~ ~ . it- ~ ~ ~ . ~ ~ ~.~.-~ ~ ,~ ~ ~ - -.. ~ ~ ~ ~
-~.~.~.~.~..-,..~.~.~. ~,~,~,.~,. .-~,- -.~.. ~.~..~ .-~ .,,,,
. ~ ~ ~ ~ ~ - - ~ . :. -~...~ ~ i: ~ ~ i. -A . A. ~ ~ i, ~ . ~ i. . in: ~:-~ ~
~ ~.-..~.,~..~:.~. ..:,.,.-, ..-.., .,, ,.-,-.
it'. ~ ~ ~ ~ em- "A ..'.'. ~ .~..'.',~',~.~,~.-~-~.~ ~ , ~ i'. ~ ~-~ '.' . . ~ ~
. ,~. -.. --,.,- ,~ .,, ,, ~ ,. ~ i.- i. ~ ~ i, ~ ~ . .~ .~ ~-
...~.-.~.,~ .:..,.-:.-,.., ~,,~
... i.. :-- ,-,~,~,~...,~,~.-~-~-~ ~.~,~,~,.,~..~.~.~.
'if ~'2.2~2."~"~'~ ~'~.,~'~'~2S~.~
~-,~,~-',-,.~'~2 ~2~2 ~'.~,-~''~'.-,~.~-~,~.~,
~ ~ ~,~ ~ ~: ~ ~ ~,~,~,~ ~ ,-~ ~
~ i: ~ . in: ~ :: :::: ~ ~ ~ ~ ~ : ~ ~ ~:~
~ ~:~ ~ ~.~.~ ~ ~ ~ ~: ~ ~ ~ ~
i: ::: ~ :: ~ ~ i:: ~:~:~ ~ ~ ~:~
.~ ~ ~.~ ~ ~.~ :~ ~ ~
:~ ~ ::: ~::~:~::~ ~ ~: -
.~. ~ i.: ..: ~ hi: ~ ~ i: ~:~.
`:s' ~ ~ ~ ~ ~ ~ ~ ~ ~
~:~;;'~ :~ hi: ~ ~:~ ~: ~ ~ i:: ~:~:~
:~::::::~::::::::~.~. ~:~ :::: ~:~:~ ~:~
JO ~ ~: ~:~
oo~: i. ~ :~ ~.~ ~ in: ~ ~ ~
:::::::: ~ :~. i: ~ :~ ~::~ ::: ::: :.::
Dietary Level:
> 105 14 2 15' 19 220
Reduction Needed
(Percentage Points)
to Meet Target Level
0-5 5-9 2 10
2
2
o
o
o
12 1
15 0
14
o
o
o
o
NOTE: The shaded column represents the target level and the percentage of individuals who met it.
SOURCE: Adapted from Human Nutrition Information Service, U. S. Department of Agriculture, unpublished
data on 4-day dietary intake, 1987.
ration had mean daily cholesterol intakes
above 300 ma. This group included 78
percent of males ages 19 to 64 and 52 percent
of females ages 19 to 64 years (Table ~9~.
Dietary cholesterol intakes from the 1985
CSFII averaged 254 mg/clay for children
ages 1 to 5, 304 mg!ciay for women ages 19
to 50, and 439 mg/day for men ages 19 to
50 (Table ~10~. Nearly 77 percent of chil-
clren ages 1 to 5 and 62 percent of women
ages 19 to 50 from the 1985 CSFII consumed
'300 mg of cholesterol per day (Table
11~.
CALCIUM
TABLE 3-9 Mean Daily Cholesterol
Intakes in Relation to Target Level
% of Population
with the Following
Mean Intakes
per Day (mg):
Group and Age
Children
1~
Mean
Intake (mg)
>300
~18
19 64
65+
Males
~18
Target: Calcium intake of the Recom- 19~4
mended Dietary Allowance (RDAJ for age 65+
and sex.
Dietary Guidelines
The National Institutes of Health consen
sus development conference statement on
osteoporosis recommended adequate nutri
tion that included an elemental calcium
intake of 1,000 to 1,500 mg/day for post
289
All
328
345
316
442
511
461
385
39
49
52
47
70
78
71
58
NOTE: The shaded column represents the target
level and the percentage of individuals who met it.
SOURCE: Adapted from U.S. Department of Agri-
culture/U. S. Department of Health and Human Serv-
ices. 1986. P. 255 in Nutrition Monitoring in the
United States: A Progress Report from the Joint Nu-
trition Monitoring Committee. DHHS Publication (PHS)
86-1255. Washington, D.C.: U.S. Government Print-
ing Office.
OCR for page 55
TARGET LEVELS AND CURRENT DIETARY PATTERNS
TABLE 3-10 Mean Daily Cholesterol and Calorie Intakes, 1985
55
Children at Age:
All
(1-5)
N utrient
1-3 4-5
Females at Age:
Males at Age:
All
19-3435-50 (1~50)
1,7071,602 1,661
306302 304 443 427 435
1~34 3.~5()
All
(1~50)
2 560
Calories (kcal)
Cholesterol (nag)
1,3721,564 1,446
247266 254
2 ? 667 2,428
SOURCES: Adapted from the U.S. Department of Agriculture. 1985. Pp. 22 Slid 74 III W<'lnel1 1~5() Years
and Their Children 1-5 Years, 1 Day. Nationwide Food Consumption S~lrv~v, Col~tin~lillg S~lrv~v of Food Intakes
by Individuals. Report 85-1, Human Nutrition Information Service. Hvattsville? Md.: U. S. Department of
Agriculture. U. S. Department of Agriculture. 1986. Pp. 20 and 22 in Men 1~50 Y~;~rs' 1 Rev. Nationwide Food
Consumption Survey, Continuing Survey of Food Intakes by Individuals. Rep`'rt 85-3, Hulllall Nutrition
Information Service. Hyattsville, Md.: U.S. Department of Agriculture.
menopausal women, as well as a program
of modest weight-bearing exercise and es-
trogen replacement (National Institutes of
Health, 1984a). The National Research
Council's Committee on Dietary Allowances
recommended calcium intakes of 800 ma/
day for children ages 1 to 10 and adults ages
19 and older (National Research Council,
1980~. For males and females ages 11 to 18,
the recommended daily intake is 1,200 ma.
For infants under 6 months, the RDA is
360 ma; for children ages 6 months to 1
year, the RDA is 540 ma. During pregnancy
and lactation, an increase of 400 mg/day is
recommended for women. This committee
accepts as the target level the RDA for
calcium for the various age and sex groups.
Dietary Survey Data
Data from the 1977-1978 NECS indicate
that about 42 percent of the survey popu-
lation had calcium intakes below 70 percent
of the RDA, and 26 percent had intakes
between 70 and 100 percent of the RDA.
These data are presented in Table ~12.
Table ~13 compares Calvin intakes from
the 1977-1978 NFCS and the 1985 CSFII
TABLE 3-11 Distribution (Percent) of Women and Children by Cholesterol Intakes and
Reduction Needed to Meet Target Level
Cholesterol (mg)
Ret Clever
::~
Dietary Level: c3~ ;~;~ ~ ~ ;~; >30()~ 400 >400~ 500 >500
Group and Age
Reduction Needed
(Percentage Points)
to Meet Target Level:
::: ::
:: :::: :
Iron ~ ~ ~
::: :::
:: :
::: :::
0^ :
of
::
:~ ::: ~ ~ ~ ~ ~ ~ :::
:7q:: ::
, ~:
<100
100-200 >200
Children
1-3
4-5
All (age 1-5)
Females
19--34
35-50
All (age 19-50)
::
Aid:: :: ::::
A,
:: : ::: :: :::
:~6~.~;~;~:~ ~ ~
Do::::
``, ~
,~
I:
11
20
15
20
22
21
7
7
7
11
7
9
-
8
8
NOTE: The shaded column represents the target level and the percentage of individuals who met it.
SOURCE: Adapted from Human Nutrition Information Service, U.S. Department of Agriculture, unpublished
data on 4-day dietary intake, 1987.
OCR for page 56
56
DESIGNING FOODS
TABLE 3-12 Distribution (Percent) of Individuals by Calcium Intakes and Increases (as
a percentage of RDA) Needed to Meet Target Level
Calcium (% RDA)
Dietary Level:
Shell ~
;~:':
... . .. . ... ,, ;; .; . ; ..
it'
-70< 100 <70
Group and Age
Children
~1
1-8
Females
9-18
19-64
65+
Males
9-18
19-64
65+
Increase Needed
(Percentage Points)
to Meet Target Level:
0-30 >30
All (mean)
14
27
28
23
26
29
27
28
26
25
49
58
56
29
32
39
42
NOTE: The shaded column represents the target level and the percentage of individuals who met it.
SOURCE: Adapted from U.S. Department of Agriculture/U.S. Department of Health and Human Services.
1986. P. 272 in Nutrition Monitoring in the United States: A Progress Report from the Joint Nutrition Monitoring
Evaluation Committee. DHHS Publication (PHS) 86-1255. Washington, D.C.: U.S. Government Printing Office.
TABLE 3-13 Mean Daily Dietary Calcium Intakes for Individuals
Group and Age
Target
Level,
RDA (mg)
Total Intake (mg)
1977 1985
mg/1,000 keel
1977 1985
Children
1~
4-5
All (age 1-5)
Females
19-34
35-50
All (age 19-50)
Males
19-34
35-50
All (age 1~50)
800
800
800
800
800
800
800
800
800
717
728
722
611
515
570
871
736
815
824
864
840
685
606
651
975
849
919
602
498
555
389
352
374
364
315
343
622
564
600
402
392
398
366
353
360
SOURCES: Adapted from the U.S. Department of Agriculture. 1985. Pp. 23 and 46 in Women 19-50 Years
and Their Children 1-5 Years, 1 Day. Nationwide Food Consumption Survey, Continuing Survey of Food Intakes
by Individuals. Report 85-1, Human Nutrition Information Service. Hyattsville, Md.: U. S. Department of
Agriculture. U. S. Department of Agriculture. 1986. Pp. 21 and 44 in Men 1~50 Years, 1 Day. Nationwide Food
Consumption Survey, Continuing Survey of Food Intakes by Individuals. Report 85-3, Human Nutrition
Information Service. Hyattsville, Md.: U.S. Department of Agriculture.
OCR for page 57
TARGET LEVELS AND CURRENT DIETARY PATTERNS
for men, women, and children. Average
intakes as well as intakes per 1,000 kcal
have increased for all three of these popu-
lation groups. CSFII dietary levels of cal-
cium averaged above the RDA for men and
children and were about half the RDA for
adult women.
Of interest in the 1977-1978 NFCS and
the 1985 CSFII data are the percentage of
individuals using vitamin and mineral sup-
plements and how this figure has changed
recently (Table ~144. The percentage of
children ages 1 to 3 using supplements has
increased by about 20 percent and for chil-
dren ages 4 to 5, by about 35 percent, with
an overall increase for children ages 1 to 5
of about 26 percent. For women ages 19 to
34, there has been a 37 percent increase
and for women ages 35 to 50, a 66 percent
increase, for an overall increase among
LABILE 3-14 Use of Vitamin and
Mineral Supplements
Individuals
Using (%)
Group and Age
1977 1985
Increase from
1977 to 1985 (%)
Children
1-3
~5
All (age 1-5)
Females
1~34
3~50
All (age 1~50)
Males
1~34
3~50
All (age 1~50)
50.8 60.7
43.2 58.5
47.4 59.8
40.8 56.0
36.1 59.8
38.9 57.6
19.5
35.4
26.2
37.3
65.7
48.1
42.5 70.0
47.9 66.9
44.9 69.4
SOURCES: Adapted from the U.S. Department of
Agriculture. 1985. P. 58 in Women 1~50 Years and
Their Children 1-5 Years, 1 Day. Nationwide Food
Consumption Survey, Continuing Survey of Food
Intakes by Individuals. Report 85-1, Human Nutrition
Information Service. Hyattsville, Md.: U. S. Depart-
ment of Agriculture. U. S. Department of Agriculture.
1986. P. 56 in Men 1~50 Years, 1 Day. Nationwide
Food Consumption Survey, Continuing Survey of Food
Intakes by Individuals. Report 85-3, Human Nutrition
Information Service. Hyattsville, Md.: U.S. Depart-
ment of Agriculture.
57
women ages 19 to 50 of about 48 percent.
For men ages 19 to 34, there has been a 70
percent increase, and for men ages 35 to
50, a 67 percent increase, for an overall
increase among men ages 19 to 50 of about
69 percent.
Summary
Data from the 1977-1978 NFCS indicate
that 42 percent of the survey population
have diets containing less than 70 percent
of the RDA for calcium, including more
than 50 percent of females age 19 and older.
Another 26 percent of the survey population
have diets containing from 70 to 100 percent
of the RDA for calcium, including 31 percent
of adolescents ages 9 to 18 (Table W12~.
Slean calcium intakes increased from the
1977-1978 N FCS to the 1985 CSFII for
men, women, and children; but women's
mean intakes still fell short of the RDA
(Table ~13~. About three-fourths of the
women did not meet 100 percent of the
RDA; of this group, half did not achieve 70
percent of the RDA.
IRON
Target: Iron Intake of the RDA for age
and sex.
Definition and Prevalence of Iron-
Deficiency Anemia
Iron deficiency is frequently cited as the
most common single nutritional deficiency
in the world and the cause of the most
common form of childhood anemia in the
United States (Dallman et al., 1984~. Nu-
tritional iron deficiency is caused by inad-
equate amounts of iron in the diet and can
adversely affect health status, including a
reduction in maximal work capacity, altered
immune response, and, in children, behav-
ioral abnormalities and a reduction in in-
tellectual performance (Federation of Amer-
ican Societies for Experimental Biology,
Life Sciences Research Office, 19844.
OCR for page 58
58
The NHANES II (1976-1980) data on iron
status were analyzed by an expert scientific
working group of the Life Sciences Research
Office, Federation of American Societies for
Experimental Biology (1984~. The group's
findings on the prevalence of impaired iron
status are summarized in Table ~15. It
concluded that several population segments
had relatively high prevalences of impaired
iron status ant! warranted further consid-
eration, including children ages 1 to 2, males
ages 11 to 14, ant! females ages 15 to 44. It
also concluded that the prevalence of im-
pairecT iron status was higher for blacks than
for whites, was higher for persons below
the defined poverty level than for those
above it, and was associated with lower
education level and, for women, higher
parity.
A recent report from the Pediatric Nu
TABLE 3-15 Prevalence of Impaired
Iron Status, 1976-1980
Group and Age
Estimated Range
of Prevalence (%)
Children
1-2
3 -
~10
Females
11-14
1~19
20~4
45 64
6~74
Males
11-14
1~19
20~4
45 64
6~74
9.~9.4
3.6 5.5
3.2 4.5
2.7~.1 ~
2. ~14. 2 r
4.~9.6
3.8~.8
2.7~.7
3.~12. 1
0.1~.9
0.6 0.S
1.~2.0
1.8 3.6
SOURCE: Federation of American Societies for Ex-
perimental Biology, Life Sciences Research Office.
1984. P. v in Assessment of the Iron Nutritional Status
of the U. S. Population based on Data Collected in the
Second National Health and Nutrition Examination
Survey, 197~1980, S. M. Pitch and F. R. Senti, eds.
Bethesda, Md.: Life Sciences Research Office, Fed-
eration of American Societies for Experimental Biology.
DESIGNING FOODS
trition Surveillance System of the Centers
for Disease Control (1986b) indicated a
clecline in the prevalence of anemia among
children enrolled in public nutrition and
health programs cluring 1975 to 1985. The
prevalence of anemia dropped from 7.8
percent in 1975 to 2.9 percent in 1985, with
greater declines among children examined
at follow-up visits as compared to those of
the same age at initial visits. Vasquez-
Seoane et al. (1985) have suggested that the
decline was probably related to improve-
ments in iron nutrition during infancy and
childhood, due partly to participation in
public nutrition and health programs.
Data on children from public health pro-
grams with hematocrit values below the 5th
percentile are presenter! in Table ~16. As
with other indicators of poor nutritional
status, the incidence of low hematocrits
differs widely among age and ethnic groups.
Dietary Guidelines for Iron Intake
The National Research Council's Com-
mittee on Dietary Allowances (National Re-
search Council, 1980) recommends an iron
intake of 10 mg/`lay for infants up to age 6
months, children ages 4 to 10, males 19 and
older, and females 51 and older. It recom-
mends an intake of 15 mglday for children
ages 6 months to 3 years, and an intake of
i~ mg/day for males ages 11 to 18 and
females ages 11 to 50. During pregnancy
and lactation, it suggests a daily supplement
of 30 to 60 mg of iron. This committee
accepts as a target level the RDA for iron
for the various age en cl sex groups.
Dietary Survey Data
The data from the 1977-1978 NFCS in-
icate that approximately 33 percent of the
survey population had iron intakes of less
than 70 percent of the RDA, 23 percent
had intakes between 70 and 100 percent of
the RDA, and about 44 percent had intakes
that met or exceeded the RDA (U.S. De
OCR for page 59
TARGET LEVELS AND CURRENT DIETARY PATTERNS
TABLE 3-16 Percentage of Low-Income Children Screened
with Hematocrit Values Below the 5th Percentile, 31 States,
United States, 1984
Hen~tocrit
Age and Group
Number Examineda
<5th Percentile
~11 months
White21,278 7.0
Black13,883 6.9
Hispanic4,365 8.0
American Indian967 7.9
Asianl'467 8.1
12-23 months
White31,960 6.3
Black24,202 7.7
Hispanic4,516 8.3
American Indian1,153 5.8
Asian ~'660 6.2
2-5 years
White66,485 7.6
Black49,985 11.6
Hispanic8,324 10.8
American Indian2,234 6.S
Asian 1'1,222 8.6
~9 years
White10,355 3.8
Black8, 277 6.5
Hispanic366 3.6
American Indian103 2.9
Asianb12 Insufficient
data
NOTE: The Pediatric Nutrition Surveillance System, Centers for Disease
Control, uses nutrition-related data collected by local health departments as part
of the routine delivery of child health services. These data are the result of
examinations of 610,439 new patients at 2,464 clinics in 31 states, the District
of Columbia, and Puerto Rico. Hematocrit is the volume of red blood cells in
whole blood.
aTotal does not equal 610,439 because of unknown or missing data for some
variables and the exclusion of states with data errors.
bData for Asians include data from an unknown number of recent Southeast
Asian refugees.
SOURCE: Adapted from Centers for Disease Control. 1986. Annual Summary
1984: reported morbidity and mortality in the United States. Morbidity Mortality
Weekly Report 32 (54):107.
partment of Agriculture/U.S. Department
of Health and Human Services, 1986~. These
data are summarized in Table ~17. Groups
with the lowest intakes are those previously
described as having the highest prevalences
of impaired iron status, including children
to age 5, males ages 11 to 14, and females
their reproductive years, ages 15 to 50.
In
59
The most current dietary intake data on
men, women, and children are presented
and compared to data from the 1977-1978
NFCS in Table ~18. Mean intakes for all
three groups have increased somewhat from
1977 to 1985. For children, intakes per
1,000 kcal have also risen, but for men and
women the figure has fallen.
OCR for page 60
Group and Age
Children
<1
1-8
Females
9-18
19-64
65+
Males
9-18
19-64
65+
All
Increase Needed
(Percentage Points)
to Meet Target Level:
60
DESIGNING FOODS
TABLE 3-17 Distribution (Percent) of Individuals by Iron Intakes and Increases (as a
pecentage of RDA) Needed to Meet Target Level
Iron (% RDA)
Dietary Level:
-70
< 10~0 <70
::~: :~::::::: :~:: :~:.:.:~:: :~: :.:~:~:::~:.:.:~::::.::. ~:~.~:~.~ ~:~4~: ~
0~30
>30
12
18
27
26
34
38
10
14
23
30
44
55
56
13
26
2
4
33
NOTE: The shaded column represents the target level and the percentage of individuals who met it.
SOURCE: Adapted from U.S. Department of Agriculture/U.S. Department of Health and Human Services.
1986. P. 228 in Nutrition Monitoring in the United States: A Progress Report from the Joint Nutrition Monitoring
Evaluation Committee. DHHS Publication (PHS) 86-1255. Washington, D.G.: U.S. Government Printing Office.
TABLE 3-18 Mean Daily Iron Intakes for Individuals
Target Level, Total Intake (mg) mg/1,000 kcal
Group and Age RDA (mg) 1977 1985 1977 1985
Children
1-3 15 8.4 10.5 7.1 7.8
4-5 10 9.7 11.6 6.7 7.5
All (age 1-5) 9.0 10.9 6.9 7.7
Females
19-34 18 10.7 11.3 6.9 6.7
35-50 18 10.8 10.8 7.6 7.1
All (age 19-50) 10.7 11.1 7.2 6.9
Males
19-34 10 15.7 16.0 6.7 6.2
35-50 10 16.6 15.8 7.3 6.7
All (age 19-50) 16.1 15.9 7.0 6.4
SOURCES: Adapted from the U.S. Department of Agriculture. 1985. Pp. 23 and 46 in Women 19-50 Years
and Their Children 1-5 Years, 1 Day. Nationwide Food Consumption Survey, Continuing Survey of Food Intakes
by Individuals. Report 85-1, Human Nutrition Information Service. Hyattsville, Md.: U.S. Department of
Agriculture. U.S. Department of Agriculture. 1986. Pp. 21 and 44 in Men 19-50 Years, 1 Day. Nationwide Food
Consumption Survey, Continuing Survey of Food Intakes by Individuals. Report 85-3, Human Nutrition
Information Service. Hyattsville, Md.: U. S. Department of Agriculture.
OCR for page 61
TARGET LEVELS AND CURRENT DIETARY PATTERNS
Summary
Data from the 1977-1978 NFCS indicate
that 33 percent of the survey population
have diets containing less than 70 percent
of the RDA, including more than 50 percent
of females ages 9 to 64. Another 23 percent
of the population have diets containing only
70 to 100 percent of the RDA for iron,
including 38 percent of males and 27 percent
of females ages 9 to 18 (Table ~174. A1-
though the mean dietary intakes of iron
increased from 1977-1978 to 1985 for men,
women, and children, they still averaged
below the RDA for women (Table .~181.
About 95 percent of the women did not
meet 100 percent of the RDA; of this group,
three-fourths did not achieve 70 percent of
the RDA.
REFERENCES
61
cular disease. Morbid. Mortal. Weekly Rep.
35(42):65~654.
Centers for Disease Control. 1986b. Current trends:
Declining anemia prevalence among children en
rolled in public nutrition and health programs,
selected states, 1975 to 1985. Morbid. Mortal. Weekly
Rep. 35(36~:565-566.
Dallman, P. R., R. Yip, and C. Johnson. 1984. Prev
alence and causes of anemia in the United States,
1976 to 1980. Am. J. Clin. Nutr. 39:437.
Doll, R., and R. Peto. 1981. The causes of cancer.
Quantitative estimates of avoidable risks of cancer
in the United States today. J. Natl. Cancer Inst.
66:1191.
Federation of American Societies for Experimental
Biology, Life Sciences Research Office. 1984. As
sessment of the Nutritional Status of the U.S. Pop
ulation Based on Data Collected in the Second
National Health and Nutrition Examination Survey,
1976-1980. Washington, D. C.: Federation of Amer
ican Societies for Experimental Biology.
Grundv, S. M . 1986. Comparison of monounsaturated
fatty acids and carbohydrates for lowering plasma
cholesterol. N. Engl. J. Med. 314:745.
Hegsted, D. M. 1986. Serun~ cholesterol response to
dietary cholesterol: A re-evaluation. Am. J. Clin.
Ahrens, E. H., Jr., W. Insull, Jr., R. Blomstrand, J. Nor. 44:299.
Hirsch, T. T. Tsaltas, and M. L. Peterson. 1957. Hegsted, D. M., R. B. McGandy, M. L. Myer, and
The influence of dietary fats on serum-lipid levels
in man. Lancet 1:943.
American Academy of Pediatrics, Committee on Nu
trition. 1981. Nutritional aspects of obesity in infancy
and childhood. Pediatrics 68:880.
American Cancer Society. 1984. Nutrition and cancer,
cause and prevention. An American Cancer Society
special report. Ca A Cancer Journal for Clinicians
34(2): 121-126.
American Heart Association. 1968. Diet and Heart
Disease. Dallas, Tex.: American Heart Association.
American Heart Association. 1982. Rationale of the
diet-heart statement of the American Heart Associ
ation. Report of the Nutrition Committee. Circula
tion 65:839A.
American Heart Association. 1986. Dietary guidelines
for healthy adult Americans. Circulation 74:1465A.
Barness, L. A. 1986. Cholesterol and children. J. Am.
Med. Assoc. 256:2871.
Becker, N., D. R. Illingworth, P. Alaupovic, W. E.
Connor, and W. E. Sundberg. 1983. Effects of
saturated, monounsaturated, and omega-6 polyun
saturated fatty acids on plasma lipids, lipoproteins,
and apoproteins in humans. Am. J. Clin. Nutr.
37:355.
Bonanome, A., and S. Grundy. 1987. Stearic acid does
not raise plasma cholesterol. Clin. Res. 35:365A.
Centers for Disease Control. 1986a. Epidemiologic
notes and reports: Years of life lost from cardiovas
F. J. Stare. 1965. Quantitative effects of dietary fat
on serum cholesterol in man. Am. J. Clin. Nutr.
17:281.
Herold, P. M., and J. E. Kinsella. 1986. Fish oil
consumption and decreased risk of cardiovascular
disease: A comparison of findings from animal and
human feeding trials. Am. J. Clin. Nutr. 43:566.
Kannel, W. B., W. P. Castelli, T. Gordon, and P. M.
McNamara. 1971. Serum cholesterol lipoproteins
and the risk of coronary heart disease. The Fra-
mingham Study. Ann. Intern. Med. 74:1.
Keys, A. 1970. Coronary heart disease in seven coun-
tries. Circulation 41(Suppl. l):I-1-211.
Keys, A., J. T. Anderson, and F. Grande. 1965. Serum
cholesterol response to changes in the diet. IV.
Particular saturated fatty acids in the diet. Metab-
olism 14:776.
Mattson, F. H., and S. M. Grundy. 1985. Comparison
of effects of dietary saturated, monounsaturated, and
polyunsaturated fatty acids on plasma lipids and
lipoproteins in man. J. Lipid Res. 26:194.
National Institutes of Health. 1984a. NIH Consensus
Development Conference Statement on Osteopo-
rosis. Vol. S. No. 3. Washington, D. C.: National
Institutes of Health.
National Institutes of Health. 1984b. NIH Consensus
Development Statement on Lowering Blood Cho-
lesterol to Prevent Heart Disease. Vol. 5, No. 7.
Washington, D.C.: National Institutes of Health.
OCR for page 62
62
National Research Council. 1980. Recommended Di-
etary Allowances, 9th ed. Washington, D.C.: Na-
tional Academy Press.
National Research Council. 1982. Diet, Nutrition, and
Cancer. Washington, D.C.: National Academy Press.
O'Brien, B. C., and R. Reiser. 1980. Human plasma
lipid responses to red meat, poultry, fish, and eggs.
Am. J. Clin. Nutr. 33:2573.
Office of the Assistant Secretary for Health and the
Surgeon General. 1979. Healthy People, the Sur-
geon General's Report on Health Promotion and
Disease Prevention. DHEW (PHS) Publication No.
79~5071. Washington, D.C.: U.S. Public Health
~ .
service.
Powell, K. E., K. G. Spain, G. M. Christenson, and
M. P. Mollenkamp. 1985. The status of the 1990
objectives for physical fitness and exercise. Public
Health Rep. 100:180.
Reiser, R., J. L. Probstfield, and A. Silvers. 1985.
Plasma lipid and lipoprotein response of humans to
beef fat, coconut oil, and safflower oil. Am. J. Clin.
Nutr. 42:190.
Shekelle, R. B., A. M. Shyrock, O. Paul, M. Lepper,
J. Stamler, S. Liu, and W. J. Raynor. 1981. Diet,
serum cholesterol and death from coronary heart
disease. The Western Electric Study. N. Engl. J.
Med. 304:65.
Stamler, J. 1979. Population studies. Pp. 2~88 in
Nutrition, Lipids, and Coronary Disease: A Global
View, R. I. Levy, B. M. Rilkind, B. H. Dennis,
and N. Ernst, eds. New York: Raven Press.
U. S. Department of Agriculutre. 1985. P. 48 in Women
19~0 years and their children 1-5 years, 1 day,
DESIGNING FOODS
1985. Nationwide Food Consumption Survey,
Continuing Survey of Food Intakes by Individuals.
Report 85-1, Human Nutrition Information Serv-
ice. Hyattsville, Md.: U.S. Department of Agri-
culture.
U. S. Department of Agriculture. 1986. P. 46 in Men
19-50 years, 1 Day, 1985. Nationwide Food Con-
sumption Survey, Continuing Survey of Food In-
takes by Individuals. Report 8~3, Human Nutrition
Information Service. Hyattsville, Md.: U. S. De-
partment of Agriculture.
U. S. Department of Agriculture/U. S. Department of
Health and Human Services. 1985. Nutrition and
Your Health: Dietary Guidelines for Americans, 2nd
ed. Home and Garden Bulletin No. 232. Washing-
ton, D.C.: U.S. Government Printing Office.
U. S. Department of Agriculture/U. S. Department of
Health and Human Services. 1986. Nutrition Mon-
itoring in the United States: A Progress Report from
the Joint Nutrition Monitoring Evaluation Commit-
tee. DHHS Publication No. (PHS) 8~1255. Wash-
ington, D.C.: U.S. Government Printing Office.
U.S. Public Health Service. 1980. Promoting Health/
Preventing Disease: Objectives for the Nation.
Washington, D.C.: U.S. Public Health Service.
U.S. Senate Select Committee on Nutrition and Hu-
man Needs. 1977. Dietary goals for the U.S., 2nd
ea., No. 052-070 0437~8. Washington, D.C.: U.S.
Government Printing Office.
Vasquez-Seoane, P., R. Windom, and H. A. Pearson.
1985. Disappearance of iron-deficiency anemia in a
high-risk infant population given supplemental iron.
N. Engl. J. Med. 313:1239.
Representative terms from entire chapter:
target level
