Saturday, May 28, 2016

Limits on Calories That Remain After Food Group Needs Are Met in Nutrient-Dense Forms

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The USDA Food Patterns are designed to meet food group and nutrient recommendations while staying within calorie needs. To achieve this goal, the Patterns are based on consuming foods in their nutrient-dense forms (i.e., without added sugars and in the leanest and lowest fat forms, seeAppendix 6). For nearly all calorie levels, most of the calories in the USDA Food Patterns are needed for nutrient-dense food choices, and only a limited number remain for other uses. These calories are indicated in the USDA Food Patterns as “limits on calories for other uses.” For example, after food group needs are met in the Healthy U.S.-Style Eating Pattern from 1,000 to 1,600 calories, only 100 to 170 calories per day remain within the limit for other uses. In the 2,000-calorie pattern, the limit for other uses is 270 calories and in the 2800-calorie pattern, 400 calories (see Appendix 3Appendix 4, and Appendix 5). Calories up to the limit for the specific pattern can be used to eat foods that are not in nutrient-dense forms (e.g., to accommodate calories from added sugars, added refined starches, or solid fats) or to eat more than the recommended amount of nutrient-dense foods. If alcohol is consumed, calories from alcoholic beverages should also be accounted for within this limit to keep total calorie intake at an appropriate level.
As discussed in Chapter 2, in contrast to the healthy choices that make up the Patterns, foods from most food groups as they are typically consumed in the United States are not in nutrient-dense forms. In addition, foods and beverages are consumed that are primarily composed of added sugars and/or solid fats, and provide excess calories without contributing to meeting food group recommendations. The excess calories consumed from these sources far exceed the limited number of calories available for choices other than nutrient-dense foods in each food group.
From a public health perspective, it is important to identify the calories that are needed to meet food group needs to help inform guidance on limits from calories from added sugars, solid fats, alcohol[21], or other sources, in order to help individuals move toward healthy eating patterns within calorie limits. The USDA Food Patterns can be used to plan and serve meals for individuals, households, and in a variety of organizational settings (e.g., schools, worksites, and other community settings). The limit on calories for other uses can assist in determining how to plan and select foods that can fit within healthy eating patterns, such as how many calories are available to select foods from a food group that are not in nutrient-dense forms. As discussed in the next portion of the chapter, additional constraints apply related to other dietary components when building healthy eating patterns.

Other Dietary Components

In addition to the food groups, it is important to consider other food components when making food and beverage choices. The components discussed below include added sugars, saturated fats, transfats, cholesterol, sodium, alcohol, and caffeine. For each component, information is provided on how the component relates to eating patterns and outlines considerations related to the component. SeeChapter 2 for a further discussion of each of these components, current intakes, and shifts that are needed to help individuals align with a healthy eating pattern.

Added Sugars

Healthy intake: Added sugars include syrups and other caloric sweeteners. When sugars are added to foods and beverages to sweeten them, they add calories without contributing essential nutrients. Consumption of added sugars can make it difficult for individuals to meet their nutrient needs while staying within calorie limits. Naturally occurring sugars, such as those in fruit or milk, are not added sugars. Specific examples of added sugars that can be listed as an ingredient include brown sugar, corn sweetener, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey, invert sugar, lactose, malt syrup, maltose, molasses, raw sugar, sucrose, trehalose, and turbinado sugar.
Healthy eating patterns limit added sugars to less than 10 percent of calories per day. This recommendation is a target to help the public achieve a healthy eating pattern, which means meeting nutrient and food group needs through nutrient-dense food and beverage choices and staying within calorie limits. When added sugars in foods and beverages exceed 10 percent of calories, a healthy eating pattern may be difficult to achieve. This target also is informed by national data on intakes of calories from added sugars, which as discussed in Chapter 2, account on average for almost 270 calories, or more than 13 percent of calories per day in the U.S. population.
The USDA Food Patterns show that an eating pattern with enough foods from all food groups to meet nutrient needs without eating too many calories has only limited room for calories from added sugars. At most lower calorie levels (i.e., 1,200 to 1,800 calories), the calories that remain after meeting food group recommendations in nutrient-dense forms (“limits on calories for other uses”) are less than 10 percent per day of calories; however, at higher calorie levels, the limits on calories for other uses are more than 10 percent per day. The recommendation to limit added sugars to no more than 10 percent of calories is a target that applies to all calorie levels to help individuals move toward healthy eating patterns within calorie limits.
Although the evidence for added sugars and health outcomes is still developing, the recommendation to limit calories from added sugars is consistent with research examining eating patterns and health. Strong evidence from mostly prospective cohort studies but also randomized controlled trials has shown that eating patterns that include lower intake of sources of added sugars are associated with reduced risk of CVD in adults, and moderate evidence indicates that these eating patterns are associated with reduced risk of obesity, type 2 diabetes, and some types of cancer in adults. As described earlier, eating patterns consist of multiple, interacting food components, and the relationships to health exist for the overall eating pattern, not necessarily to an isolated aspect of the diet. Moderate evidence indicates a relationship between added sugars and dental caries in children and adults.
Considerations: Added sugars provide sweetness that can help improve the palatability of foods, help with preservation, and/or contribute to functional attributes such as viscosity, texture, body, color, and browning capability. As discussed in Chapter 2, the two main sources of added sugars in U.S. diets are sugar-sweetened beverages and snacks and sweets. Many foods high in calories from added sugars provide few or no essential nutrients or dietary fiber and, therefore, may contribute to excess calorie intake without contributing to diet quality; intake of these foods should be limited to help achieve healthy eating patterns within calorie limits. There is room for Americans to include limited amounts of added sugars in their eating patterns, including to improve the palatability of some nutrient-dense foods, such as fruits and vegetables that are naturally tart (e.g., cranberries and rhubarb). Healthy eating patterns can accommodate other nutrient-dense foods with small amounts of added sugars, such as whole-grain breakfast cereals or fat-free yogurt, as long as calories from added sugars do not exceed 10 percent per day, total carbohydrate intake remains within the AMDR, and total calorie intake remains within limits.
It should be noted that replacing added sugars with high-intensity sweeteners may reduce calorie intake in the short-term, yet questions remain about their effectiveness as a long-term weight management strategy. High-intensity sweeteners that have been approved by the U.S. Food and Drug Administration (FDA) include saccharin, aspartame, acesulfame potassium (Ace-K), and sucralose.[22] Based on the available scientific evidence, these high-intensity sweeteners have been determined to be safe for the general population. This means that there is reasonable certainty of no harm under the intended conditions of use because the estimated daily intake is not expected to exceed the acceptable daily intake for each sweetener. The FDA has determined that the estimated daily intake of these high-intensity sweeteners would not exceed the acceptable daily intake, even for high consumers of each substance.

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