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Question

[For 2 years and older] Are changes to the USDA Food Patterns needed based on the relationships identified [in the systematic reviews]? If so, how well do USDA Food Pattern variations meet nutrient recommendations for each stage of life? If nutrient needs are not met, is there evidence to support supplementation and/or consumption of fortified foods to meet nutrient adequacy?

Approach to Answering the Question
Food Pattern Modeling

Subcommittee
Data Analysis and Food Pattern Modeling Cross-Cutting Working Group

Food Pattern Modeling Protocol
Developed for each scientific question being examined, the protocol describes how the food pattern modeling methodology will be used to answer the question, including:

  • Updating nutrient profiles for food groups/subgroups used in modeling
  • Testing changes to USDA Food Patterns
  • Testing nutrient adequacy of healthy eating variations
  • Developing conclusion statements to summarize each question
  • Making recommendations to inform future work on this topic

For additional details, see the full protocol for the questions, [For 2 years and older] Are changes to the USDA Food Patterns needed based on the relationships identified [in the systematic reviews]? If so, how well do USDA Food Pattern variations meet nutrient recommendations for each stage of life? If nutrient needs are not met, is there evidence to support supplementation and/or consumption of fortified foods to meet nutrient adequacy?

View Full Protocol

Draft Conclusion Statement

The draft conclusion statements listed below describe the state of the science related to the specific question examined. Draft conclusions are not considered final until they have been deliberated with and decided upon by the full Committee and published in the Committee’s final advisory report. Individual conclusion statements should not be interpreted as dietary guidance or the Committee’s overarching advice to the Departments. 

Are changes to the USDA Food Patterns needed based on the relationships identified in the systematic reviews?

No major changes to the three USDA Food Patterns were needed based on the relationships identified in the systematic reviews by other Committee subgroups. The three patterns published as part of the 2015-2020 Dietary Guidelines for Americans include the Healthy U.S.-Style Eating Pattern, Healthy Vegetarian Eating Pattern, and Healthy Mediterranean-Style Eating Pattern. The Healthy U.S.-Style serves as a basis of the Healthy Eating Index (HEI). These three food patterns represent healthy dietary patterns positively associated with health outcomes observed in the Committee’s review of evidence using NESR systematic reviews. No additional patterns were identified that provided both the defined food pattern and were consistently associated with the prevention of chronic health outcomes across life stages. 

The Committee adapted the 2015 USDA Food Patterns to facilitate the life-stage approach review of the evidence. Nutrient profiles for food groups and subgroups within the Patterns were developed for specific age groups (ages 4 to 18 years, ages 19 to 30 years, ages 31 to 70 years, and ages 71 years and older) and life stages (i.e., women who are pregnant and lactating) to capture variation in the population by age. Life-stage dietary preferences inform the nutrient profiles which gives an opportunity to consider how best to fulfill nutrient needs through the patterns.

If so, how well do USDA Food Pattern variations meet nutrient recommendations for each stage of life?

The three USDA Food Patterns meet the Recommended Dietary Allowance (RDA) or Adequate Intake (AI) and stay within limits for the Upper Limit (UL) and Chronic Disease Risk Reduction Intakes (CDRR) for the majority of nutritional goals for ages 2 years and older, including women who are pregnant or lactating. This applies both when using a general nutrient profile for the total population or an age-sex group specific nutrient profile.

Nutrients that do not meet RDA or AI goals include the following. Iron: The patterns provide less than 90 percent of the RDA for females ages 4-8 years, 19-30 years, 31-50 years, and less than 75 percent for women who are pregnant. Vitamin D: For children younger than 8 years of age, the patterns achieve less than 40 percent of the RDA for vitamin D and approximately 50 percent the RDA for the rest of the population. Vitamin E: The patterns generally provide less than 80 percent of the RDA for Vitamin E, except for children younger than 8 years, where 85 to 98 percent of the RDA is achieved. Choline: The patterns generally provide less than 85 percent of the AI for choline, with higher-calorie patterns achieving between 65 and 74 percent of the AI for men.

If nutrient needs are not met, is there evidence to support supplementation and/or consumption of fortified foods to meet nutrient adequacy?

There is evidence to support supplementation or targeted-efforts to increase iron intakes through fortification or dietary diversity for women who are pregnant or who are planning to become pregnant. Careful choices of foods high in iron, including fortified foods, should be considered by females especially during adolescence and pregnancy to meet the increased iron requirements through dietary sources. Some women may need an iron supplement and should consult with their health care provider. 

As noted by the 2015 Committee, Vitamin D, an identified nutrient of public health concern for all age-sex groups, requires careful attention to dietary sources (both natural sources and fortified foods). Supplementation may be advised by a health care provider.