Understanding Dietary Patterns: A Step toward Devising a Global Nutrition Strategy
This session was sponsored by ILSI, the ILSI Research Foundation, and ILSI branches worldwide.
One size does not fit all. However, around the global, poor diet and nutritional status are linked to negative health outcomes: diabetes; obesity and its comorbidities; some cancers; etc. National and regional governments and world health bodies strive to provide scientifically accurate, clearly communicated, and easily adopted nutrition guidance that helps people choose healthy diets. In this session, presenters helped us understand what we need to know if we are to improve existing strategies or develop new ones for better health guidance. Speakers will explore the biology and culture of food choice; how food systems affect dietary patterns; and the strength of existing methods and data to make accurate dietary pattern comparisons across diverse populations.
Nutrition Guidance in the Age of Globalized Markets
Georgina Gómez, MSc
University of Costa Rica, Costa Rica
What Are Dietary Patterns: Physiology and Psychology Underlying Food Choice
Adam Drewnowski, PhD
University of Washington, USA
Methods to Collect and Compare Data Across Geography
Regina Fisberg, PhD
University of São Paulo, Brazil
Data Mining to Find Protective or Risky Dietary Patterns for Common Complex Diseases: Implications on Devising Dietary Guidelines
Wen-Harn Pan, PhD
Academia Sinica, Taiwan
Nutrition Guidance in the Age of Globalized Markets
Georgina Gómez, MSc
University of Costa Rica
Costa Rica
Modernization, globalization and industrialization are active words used very often associated to modified nutritional habits, and to the epidemiological and nutrition stages of transition in different parts of the world. The double burden of malnutrition and obesity raises costs of health management specially in developing countries. These areas still are counting the number of malnourished inhabitants and the increasing figures of diseases related to excessive weight. At the same time, we do need to understand role of modified nutritional habits, changes in life style, with the decrease of physical activity, despite rising numbers in institutionalized system for physical activity (gyms and sport activities).
Urbanization is a well-known phenomenon seen in many countries, and food production shifts from small producers to huge corporations and large scale soil modification. Industrialized food guarantees the access to food for increasing number of dwellings in urban areas, in a practical, possibly affordable and easy way. Nonetheless this is considered an issue for some researchers, based on the fact that shifting from home made and more natural systems of food producing for the more processed items, the amount of fat, sugar and salt intake could be increased. Many surveys do associate these changes with health outcomes as obesity, hypertension and cardio vascular diseases.
But it is not easily discussed that home and away from home recipes, using the so called natural food, could have higher levels of the same constituents as fat, sugar and sodium. Nutritional education is not so easily accessed as it is possible to control food processing methods in order to reduce this combination of nutrients.
In a globalized market, food is accessible and many items anteriorly only available to higher classes, are now been bought by new population of consumers. Low cost items are usually rich in fat and energy, changing importance in the menus with ancient local and traditional food combinations.
Global brands substitute regional recipes or preparations, modifying the way that families are preparing and consuming different meals. Many families are skipping meals, specially breakfast and dinners and family meals are scarce, rising possible health hazardous outcomes.
How to cope with modern times, with the new possibility of having access to more food items, in a practical and convenient way to combine industrialized and local and traditional food is a puzzle for all health planners. But it is very important to understand that the final consumer has the final word. And he decides what is best for him and his family. Convenience, price, culture and habits do determine his choices.
Key words: globalization, industrialization, obesity, processed food, family meals
What Are Dietary Patterns: Physiology and Psychology Underlying Food Choice
Adam Drewnowski, PhD
University of Washington
USA
Nutrients are not consumed in isolation. Neither are beverages or foods. It is becoming increasingly difficult to separate food patterns from the person and separate the person from society. Old-style studies in nutritional epidemiology have tended to link individual foods, nutrients, or dietary ingredients with specific health outcomes, adjusting for covariates. This reductionist approach is inherently flawed. Observational data on diets and health cannot be adjusted for the myriad dimensions of social class.
The focus is now shifting to food patterns, defined as varied combinations of foods eaten regularly by individuals and by social groups. Patterns of food selection are driven by physiology, psychology, economics, and culture. Physiology determines taste responses to sweet and bitter tastes and the universal cravings for energy-dense foods. Psychology drives food-related attitudes, beliefs and behaviors. Economic factors drive consumer responses to food prices, whereas culture and religion can determine how foods are prepared, served and consumed. These disciplines need to be integrated into new nutritional epidemiology studies.
Dietary patterns are more subject to social influences than are single foods. In Seattle-based studies, drinkers of sugary beverages consumed more empty calories but also ate less seafood, vegetables, and fruit. Salad eaters consumed more greens but also more fruit. Based on geographic heat maps, soda drinkers lived in more modest neighborhoods; salad eaters tended to live on waterfront estates. The social gradient was clearly visible. Dietary patterns, driven by socioeconomic status, rather than single foods, are largely responsible for the social inequalities in health.
Methods to Collect and Compare Data Across Geography
Regina Fisberg, PhD
University of São Paulo
Brazil
coming soon
Data Mining to Find Protective or Risky Dietary Patterns for Common Complex Diseases: Implications on Devising Dietary Guidelines
Wen-Harn Pan, PhD
Academia Sinica
Taiwan
Current dietary guidelines and food guides focus primarily on adequate levels of caloric intake, healthy eating patterns (balanced among the 6 food groups), and selecting nutrient dense foods from varieties of sources. While it is important to recommend general healthy eating pattern to follow across lifespan, people will experience some changing needs in different periods of life cycle, such as women at childbearing age, men susceptible to hyperuricemia and gout, and elders susceptible to frailty and dementia.
More and more dimension reduction tools are made available to find dietary patterns associated with various disease conditions. Among them, reduced rank regression (RRR) facilitates finding dietary patterns which maximize the degree of variation explained not only for outcomes of interest but also for food items.
Recently we employed RRR method to find dietary pattern inversely associated with asthma, hyperuricemia, nasopharyngeal cancer, frailty, and mild cognitive decline. Not only most of the discovered dietary patterns confer with the current dietary guidelines and food guides, but certain individual foods or drinks stand out to show their potential protective functions (or harmful effects) to health conditions.
Dietary patterns associated with disease risks may contain more detailed information on foods of choice which can be used to enrich dietary guidelines tailored to needs of different stages of lifecycle.
Georgina Gómez, MSc
University of Costa Rica
Costa Rica
I am a full professor and researcher at the University of Costa Rica where I have been working and studding for the last 25 years. I am a nutritionist graduated form the University of Costa Rica with a Master's Degree in Biochemistry and a Master`s Degree in Human Nutrition, and currently a PhD student at the same university.
My interests are in the area of public health nutrition, particularly in the epidemiology of obesity and its association with lifestyles and dietary patterns. I have been working on several collaborative projects focused on the impact of food quality, food patterns and food choices on obesity and chronic diseases.
My research includes the assessment of obesity biomarkers as indicators of nutritional interventions impact, the design of an animal model of cafeteria diet induced obesity in rats, with specific Costa Rican foods. As PI of the Latin American Nutrition and Health Study (ELANS) I am leading the dietary assessment of urban Costa Rican population.
In addition, I have supervised several undergraduate research students, participated as speaker in national and international conferences and produced several peer-reviewed publications.
Adam Drewnowski, PhD
University of Washington
USA
Prof. Dr. Adam Drewnowski is the Director of the Center for Public Health Nutrition at the University of Washington. He also directs the UW Nutritional Sciences Program and the UW Center for Obesity Research, and is Joint Member of the Fred Hutchinson Cancer Research Center in Seattle.
Dr. Drewnowski obtained his MA degree in biochemistry at Balliol College, Oxford University, and PhD degree in psychology at The Rockefeller University in New York. His early studies on hunger, appetite, and satiety have helped the food industry develop innovative foods and beverages for better weight and health. His work on nutrient profiling led the field in helping consumers identify foods that are nutrient-rich, affordable, accessible, and appealing. The Nutrient Rich Foods (NRF) Index is a widely accepted tool to assess nutrient density of foods, meals, and total diets. The Affordability Index measures calories and nutrients per penny. Other metrics address the sustainability of the current food supply in relation to greenhouse gas emissions and environmental cost.
Nutrient profiling methods have helped the food industry align product portfolios with national and international guidelines. Dr. Drewnowski ‘s work on diet quality and cost has identified unequal access to healthy foods as one of the socioeconomic determinants of health.
Dr. Drewnowski is a trustee of the International Life Sciences Institute (ILSI) and chair of the board of trustees of the ILSI Research Foundation. He advises governments, foundations, NGOs, and the private sector on geopolitical strategies related to diets and health.
Regina Fisberg, PhD
University of São Paulo
Brazil
coming soon
Wen-Harn Pan, PhD
Academia Sinica
Taiwan
Dr. Wen-Harn Pan graduated from National Taiwan University (Agricultural Chemistry) in 1976 and obtained her Nutrition PhD from Cornell University in 1983. During the period of 1983 to1986, she received her NHLBI post-doctoral training in cardiovascular epidemiology, statistics, and nutrition at the Department of Preventive Medicine, Northwestern University.
She had been an associate research professor since 1987 and became professor since 1994 in the Institute of Biomedical Sciences, Academia Sinica, Taiwan. From 2011-2013, she had been appointed as the director for Division of Preventive Medicine and Health Services Research in National Health Research Institutes, Taiwan.
Dr. Pan has established a community-based cardiovascular cohort study in Chu-Dong and Putze since 1989. She has led the Nutrition and Health Survey in Taiwan since 1992. She also established the Taiwan Han Chinese DNA and Genome Bank and AS multicenter young onset hypertension cohort. Dr. Pan has more than 260 publications and currently engages in food-disease metabolomics research, dietary therapy for geriatric diseases and worksite health body promotion programs.
She obtained Outstanding Research Award from Taiwan Society of Nutrition in 2004, Lifetime Achievement Award from Asia Pacific Society of Clinical Nutrition in 2010, and Outstanding Contributions in Science & Technology Award of Executive Yuan, Taiwan in 2015. She has served in various national and international committees and research activities concerning nutrition, cardiometabolic disease epidemiology, omics, and public health policy.
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