Replacing American snacks with tree nuts increases consumption of key nutrients among US children and adults: results of an NHANES modeling study.
BACKGROUND: Replacing typical American snacks with tree nuts may be an effective way to improve diet quality and compliance with the 2015-2020 Dietary Guidelines for Americans (DGAs). OBJECTIVE: To assess and quantify the impact of replacing typical snacks with composite tree nuts or almonds on diet metrics, including empty calories (i.e., added sugars and solid fats), individual fatty acids, macronutrients, nutrients of public health concern, including sodium, fiber and potassium, and summary measures of diet quality. METHODS: Food pattern modeling was implemented in the nationally representative 2009-2012 National Health and Examination Survey (NHANES) in a population of 17,444 children and adults. All between-meal snacks, excluding beverages, were replaced on a per calorie basis with a weighted tree nut composite, reflecting consumption patterns in the population. Model 1 replaced all snacks with tree nuts, while Model 2 exempted whole fruits, non-starchy vegetables, and whole grains (>50% of total grain content). Additional analyses were conducted using almonds only. Outcomes of interest were empty calories (i.e., solid fats and added sugars), saturated and mono- and polyunsaturated fatty acids, fiber, protein, sodium, potassium and magnesium. The Healthy Eating Index-2010, which measures adherence to the 2010 Dietary Guidelines for Americans, was used as a summary measure of diet quality. RESULTS: Compared to observed diets, modeled food patterns were significantly lower in empty calories (-20.1% and -18.7% in Model 1 and Model 2, respectively), added sugars (-17.8% and -16.9%), solid fats (-21.0% and -19.3%), saturated fat (-6.6% and -7.1%)., and sodium (-12.3% and -11.2%). Modeled patterns were higher in oils (65.3% and 55.2%), monounsaturated (35.4% and 26.9%) and polyunsaturated fats (42.0% and 35.7%), plant omega 3 s (53.1% and 44.7%), dietary fiber (11.1% and 14.8%), and magnesium (29.9% and 27.0%), and were modestly higher in potassium (1.5% and 2.9%). HEI-2010 scores were significantly higher in Model 1 (67.8) and in Model 2 (69.7) compared to observed diets (58.5). Replacing snacks with almonds only produced similar results; the decrease in sodium was more modest and no increase in plant omega-3 fats was observed. CONCLUSION: Replacing between-meal snacks with tree nuts or almonds led to more nutrient-rich diets that were lower in empty calories and sodium and had more favorable fatty acid profiles. Food pattern modeling using NHANES data can be used to assess the likely nutritional impact of dietary guidance.
A healthier US diet could reduce greenhouse gas emissions from both the food and health care systems.
The standard US diet contributes to greenhouse gas emissions (GHGE) from both the food system, and from the health system through its contribution to non-communicable diseases. To estimate the potential for diet change to reduce GHGE and improve public health, we analyzed the effect of adopting healthier model diets in the USA on the risk of disease, health care costs, and GHGE. We found that adoption of healthier diets reduced the relative risk of coronary heart disease, colorectal cancer, and type 2 diabetes by 20–45%, US health care costs by US$B 77–93 per year, and direct GHGE by 222–826 kg CO2e capita−1 year−1 (69–84 kg from the health care system, 153–742 kg from the food system). Emission reductions were equivalent to 6–23% of the US Climate Action Plan’s target of a 17% reduction in 2005 GHGE by 2020, and 24–134% of California’s target of 1990 GHGE levels by 2020. However, there is potential for investment of health care savings to result in rebound up to and greater than 100%, which would increase net GHGE. Given the urgency of improving public health and of mitigating GHGE over the short term, the potential contribution of diet change, and the options for reducing rebound, deserve more research in support of policy.
Energy compensation and nutrient displacement following regular consumption of hazelnuts and other energy-dense snack foods in non-obese individuals.
PURPOSE: Regular nut consumption reduces cardiovascular disease risk, partly from improvements to dietary quality. Examining how individuals make dietary changes when consuming nuts may reveal key behavioural eating patterns beneficial for the development of dietary interventions. We examined the effects of nuts in comparison with other energy-dense snacks on energy compensation, nutrient displacement, and food group patterns. METHODS: This was a 12-week randomised, controlled, parallel study with four arms: ~1100 kJ/day for each of hazelnuts (42 g), chocolate (50 g), potato crisps (50 g), or no added snack food. Diet records, body composition, and physical activity were measured at baseline and week 12, in 102 non-obese participants. RESULTS: Significant improvements in diet quality were observed in the hazelnut group, particularly when consumed as snacks. Intakes of monounsaturated fat (MUFA) and vitamin E were significantly higher (all P < 0.05), whereas saturated fat and carbohydrate were significantly lower (both P ≤ 0.022) in the hazelnut group compared to the other groups. Partial energy compensation did not differ significantly between groups, but nutrient displacement values for MUFA and fibre differed significantly. Within the hazelnut group, there was nearly complete displacement for fibre, partial displacement for energy, protein, total fat, MUFA, PUFA, potassium, folate, and vitamin E, and overcompensation for carbohydrate and sugar. CONCLUSIONS: Our results demonstrate that energy compensation occurs for all three intervention snacks in this non-obese population. Regular nut consumption significantly improves nutrient profiles compared to other snacks with changes occurring at the snack level.