Time for a Change in Approach when the Nutrition ScoreCard is Such a Failure
According to a nationally representative analysis, US children and adolescents, across all age and ethnic groups, are failing to meet minimum federal guidelines for good health. The gap is huge. The minimum standard, measured as a Health Eating Index (HEI) score, is 80. Across all age groups, the average HEI score was ~50.
The prevalence of nutrient deficiencies isn’t changing. Fruit and vegetable intake isn’t increasing among adolescents. Among food sources of fruit, apples, apple juice, citrus juice and bananas account for nearly half of total fruit consumed. 100% fruit juices provide 34% of fruit intake among youth 2 to 19 years of age. Almost 60 years ago, the National Health Survey Act of 1956 institutionalized nationally-representative dietary intake surveys coupled with the USDA National Nutrient Database to measure the nutritional status of the US population.
Why do we still rely upon dietary intake records when we know recall bias is a problem? In telecommunications, we use mobile phones. We don’t depend upon a trans-atlantic cable activated for long-distance international telephone service with Europe in 1956. In 2015, we drive cars have many more features, especially safety technologies, than the standard features being introduced to a 1956 Chevrolet (waterproof voltage regulator, improved headlights, electric temperature gauge and direction signals). Why not adopt new technologies to assess nutrition?
Among the people I know, they want to maintain their health. Beyond monitoring body weight, the only sure-fire approach is to have circulating concentrations of vitamins, omega-3 fatty acids, and key minerals measured. Just like a doctor monitors blood lipids in someone with cardiovascular disease. Just like individuals with diabetes monitor blood glucose daily and their doctors checks their glycosylated hemoglobin. Wouldn't you like to know if a vitamin level was too low to maintain health?
Our nutrition tipping point has arrived. Rapid, minimally-invasive, diagnostic systems are being developed which can make for cheap nutrient status assessment. All of us would benefit by having a nutrition dashboard. By measuring vitamin, omega-3 and mineral status, we wouldn’t have to obsess about foods and diets. People could make informed decisions on foods and supplements. Policy makers could make evidence-based recommendations. Nutritional status of individuals, communities, states, and nations would be accurately tracked.
Banfield EC, Liu Y, Davis JS, Chang S, Frazier-Wood AC. Poor adherence to US dietary guidelines for children and adolescents in the National Health and Nutrition Examination Survey population. 2015 JAND doi: 10.1016/j.jand.2015.08.010
Herrick KA, Rossen LM, Nielsen SJ, Branum AM, Ogden CL. Fruit consumption by youth in the United States. 2015 Pediatrics doi: 10.1542/peds.2015-1709
Ward K. A short history of telecommunications transmissions in the UK. J Commun Network 5(1):30
Dhurandhar NV, Schoeller D, Brown AW, Heymsfeld SB, Thomas D, Sorensen TIA, Speakman JR, Jeansonne M, Allison DB, and the Energy Balance Measurement Working Group. Energy balance measurement: when something is not better than nothing. 2015 Int J Obes doi: 10.1038/ijo.2014.199