WHAT EFFECT THE ANTICIPATED
DIETARY GUIDELINES ADVISORY
COMMITTEE CONSUMPTION
RECOMMENDATIONS MAY HAVE ON THE
MEAT AND POULTRY INDUSTRY?
Molly Miller, M.S., R.D.,
Nutrition Manager-Regulatory Services R&D, Tyson Foods,
Inc.
Thomas Boileau, Ph.D.,
Scientific, Nutrition and Regulatory Affairs, Kraft Foods
Group Inc./Oscar Mayer
FROM NUTRITION SCIENCE TO
NUTRITION POLICY: CHALLENGES
AND OPPORTUNITIES FOR THE
MEAT INDUSTRY
Thomas Boileau, Ph.D.,
Scientific, Nutrition and Regulatory Affairs, Kraft Foods
Group Inc./Oscar Mayer
A Little About Me:
•  New to the meat industry
•  12 years in the food industry
•  Ph.D. in Nutritional Sciences
•  I believe in meat and poultry
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Outline
•  Overview of the relationship between meat intake and
health
–  DGAC 2010 evidence review process
–  Limitations of the current evidence
•  Challenges in assessing the nutritional benefits of meats
–  Dietary assessment of nutritional contribution of meats
–  Meat components associated with nutritional value of meats
•  Future opportunities
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From Nutrition Science to Consumer Food Products
Nutrition Science
Nutrition Policy
(Dietary Guidelines For Americans)
Product Development
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External Nutrition Policy Environment
•  Dietary Guidelines 2015 Advisory Committee
•  General anti-meat, pro plant-based diet sentiment
•  Active Federal regulatory agencies (PHO / Sodium)
•  Sustainability / Animal welfare
•  Emerging nutrition science
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OVERVIEW OF THE RELATIONSHIP
BETWEEN MEAT INTAKE AND
HEALTH
Dietary Guidelines 2010
Nutrition Science Influences Federal Nutrition Policy
Dietary Guidelines Advisory Committee 2015 Appointed by USDA & HHS Nutrition Evidence Library Public Comment Dietary Guidelines Advisory Committee 2015 Report US Dept. of Agriculture (USDA) US Dept. of Health & Human Services (HHS) Dietary Guidelines for Americans 2015 Policy Document “Translation” by USDA & HHS Nutritionists American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Scie
Assessing Strength of Science in Nutrition
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Randomized controlled trials •  Blinding •  Generalizable population •  Appropriateness of control •  Meta-­‐analyses Observational studies •  Adjustment for confounders •  Methods of diet assessment Animal studies •  Physiological differences •  Nutritional differences In vitro studies •  Bioavailability Expert Opinions Increasing Strength American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Scie
Strengths and Weaknesses of Epidemiological Studies
Strengths:
Weaknesses:
•  Assess diet and disease
•  Cannot determine cause and
associations
•  Large number of participants
•  Hypothesis generating
•  Able to address some research
questions RCTs cannot
effect
–  Regardless of the number of studies
•  Diet and lifestyle confounders
•  Inaccurate diet assessments
•  Inaccurate nutrient assessments
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USDA Nutrition Evidence Library (NEL)
•  USDA’s Nutrition Evidence Library (NEL) specializes in conducting
systematic reviews to inform Federal nutrition policy and programs.
•  NEL staff collaborate with stakeholders and leading scientists using
state-of-the-art methodology to objectively review, evaluate, and
synthesize research to answer important diet-related questions.
•  The NEL Process
–  Step 1: Develop systematic review questions
–  Step 2: Search, screen, and select studies to review
–  Step 3: Extract data and assess the risk of bias of the research
–  Step 4: Describe and synthesize the evidence
–  Step 5: Develop conclusion statements and grade the evidence
–  Step 6: Identify research recommendations
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Nutrition Evidence Library: Evaluation Criteria
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DG2010 NEL Findings for Meat and Health Outcomes
What is the relationship between animal protein intake and …? Question Blood Breast Pressure Cancer Body Weight CVD Colon Cancer Conclusion No association No association Inconsistent evidence Limited inconsistent evidence suggests a link, somewhat more positive for processed meats Inconsistent positive associations Limited evidence shows association Limited inconsistent evidence suggests a link Moderate Limited Limited Limited Moderate Limited Limited Grade Prostate Type II Cancer Diabetes 1.“No independent relationship between intake of meat and body weight.” p. 16 6 Epi 6 Epi 1 RCT, 2 Epi 7 Epi 13 Epi 6 Epi 7 Epi Evidence 2. “Moderate evidence suggests an association between the increased intake of processed meats (e.g., franks, sausage, and bacon) and increased risk of colorectal cancer and cardiovascular disease.” p. 27 American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Scie
Limitations of Epidemiological Studies
Example: Red Meat Intake and Breast Cancer
Baseline Differences by Quintile: •  BMI •  Smoking Status •  Total energy intake (30% more) •  Parity Red Meat Intake •  Age-­‐adjusted model not signiXicant •  Multivariable RR=1.22, P=0.01 •  No effect when women divided by menopausal status BMJ, 2014 American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Scie
Limitations of Epidemiological Studies
Example: Red Meat Intake and Mortality
Baseline Differences by Quartile: •  BMI •  Smoking Status •  Diabetes •  Physical activity •  High cholesterol •  Family history of heart attack •  History of cancer •  Alcohol intake •  Total energy intake Arch Intern Med, 2012 American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Scie
Limitations of Epidemiological Studies
Example: Red Meat Intake and Biomarkers Inflammation
Baseline Differences by Quartile: •  BMI •  Smoking Status •  Physical activity •  High cholesterol •  Total energy intake •  Healthy eating index “After adjustment for BMI, most of these associations with inXlammation and glucose metabolic biomarkers were…no longer signiXicant.” AJCN, 2014 American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Scie
Conclusions
•  The evidence linking meat consumption
to negative health outcomes is limited in
strength
–  Most of the evidence is indirect and associative
–  Future work should seek to establish cause and effect
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ASSESSMENT OF THE DIETARY
CONTRIBUTIONS OF MEATS
Challenges and Opportunities
Diet Assessment relies on USDA Nutrient Database
•  Federal nutrition policy relies on data provided by
–  USDA nutrient database
•  Limited resources result in lack of frequent updates
–  What We Eat in American (WWEIA) diet survey
•  Much of the data from 2010 and earlier
•  Relies on 24-hr recall for diet assessment
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Dietary Assessment of the Nutritional Contribution of
Meats
USDA Nutrient Database What dietary patterns are associated with meat intake? When is meat eaten? What We Eat In America (NHANES III) 2010 Accuracy of nutrient database is key! What are the most commonly consumed meats? Who eats meat? What nutrients do meat provide? 20
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Food Databases May Not Reflect What People Eat
Turkey breast, luncheon meat USDA 07079* Deli Fresh Oven Roasted Turkey Breast Roast Beef, luncheon meat USDA 07043 Deli Fresh Roast Beef Bologna, chicken and pork USDA 07960 Oscar Mayer Bologna, chicken and pork Serving size (g) 55 55 56 56 28 28 Calories (kcal) 57 49 (↓14%) 66 60 (↓9%) 94 80 (↓15%) Fat (g) 1 1 2 2 8 7 Saturated fat (g) 0 0 1 1 2.5 2.5 510 432(↓15%) 494 410 (↓17%) 347 250 (↓28%) 9 9 10 10 3 3 Sodium (mg) Protein (g) *Number corresponds to food code in USDA nutrient database American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Scie
Opportunity: Branded Food Products Database
•  Improve accuracy and abundance of nutrition data in USDA database
–  Currently limited number of branded products in USDA database
•  Enable data stratification by year
–  Match NHANES data from a given year with nutrition data from same year
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Nutritional Contribution of Meat: A Balancing Act
Protein Iron, Zinc, Selenium B-­‐vitamins Calories Sodium Saturated Fat Meat & Poultry American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Scie
Meat is Guilty By Association
Meat Sodium Saturated Fat Calories Disease Endpoints American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Scie
Dietary Contributors to Sodium and Saturated Fat
∼21% of Sodium from Meats ∼19% of Saturated Fats from Meats Source: Dietary Guidelines 2010 American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Scie
Sodium: Current Science Perspective
•  Current target is <2300 mg/day and as low as <1500 mg/day in certain
populations
–  Based primarily on relationship between sodium intake and blood pressure (DASH diet)
–  Current USA intakes ∼3500 mg/day
•  IOM report from 2013 could not define a healthy intake range based on
direct health outcomes
•  New research studies suggest increased risk of
cardiovascular disease at low intake levels
–  “U-shaped curve”
–  What is the best target?
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Saturated Fat: Current Perspective
•  Saturated fat increases LDL cholesterol, a known risk factor for CVD
–  DGA 2010: Limit intake to <10% of total kcal
–  AHA/ACC 2013: Reduce intake to 5-6% total kcal
–  ADA: Limit to <7% kcal total kcal
•  Saturated fat from different dietary sources behave differently
•  Different saturated fats have different physiological effects
–  DGAC 2010: Moderate evidence that stearic acid is ‘cholesterol neutral’
–  25-30% of saturated fat in meats is stearic acid
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Meat is a Key Dietary Source of Quality Protein
•  Processed meats provide high quality protein vs. plant sources
–  E.g., legumes limiting in methionine, corn is limiting in lysine
•  Americans get enough protein, but some controversy exists
–  RDA is 0.8 grams / kg body weight (56 grams /day)
•  Most dietary protein is consumed at dinner (42%)
–  Snacking(14%) and Breakfast (17%) are underrepresented
•  Protein has a positive health halo (78% consumers)
–  >50% trying to get more
–  50% primary grocery shoppers view animal sources as best
•  Protein could be positioned as displacing fat & carbs
–  Carbohydrates are targeted related to obesity
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Advancing Meats with RCTS
Example: Protein and Satiety
Background: •  Protein is recognized as the most satiating macronutrient •  Only 15% of protein is consumed at breakfast Research Findings •  Randomized controlled trial •  35 grams of protein from beef and eggs vs. 13 grams from cereal breakfast increased fullness, reduced snacking 29
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Conclusions
•  Opportunities exist to build the evidence
for the benefits of meat in a balanced diet
–  Contribution of meats to nutrient intakes
–  Benefits associated with meat intake
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Summary
•  The evidence linking meat consumption
to negative health outcomes is limited in
strength
–  Most of the evidence is indirect and associative
–  Future work should seek to establish cause and effect
•  Opportunities exist to build the evidence
for the benefits of meat in a balanced diet
–  Contribution of meats to nutrient intakes
–  Benefits associated with meat intake
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Opportunities for the Meat Industry
•  Work towards establishing accurate nutrient databases
•  Continue to demonstrate the benefits of consuming meat
–  Unique nutritional contributions
–  RCTs where possible
–  Consumer benefits
Industry •  Continue to engage together in:
–  Science
–  Policy (e.g., DG2015)
–  Product Development
Academia Government American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Science Association AMSA American Meat Scie
Thanks To Our Sponsor
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AMI Projects – Defend Meat Category
•  Menu modelling
•  Demonstrate that meat can be incorporated in to diets that meet dietary guidelines
•  NHANES analysis
•  Healthy Eating Index assessment
•  Understand the importance of meat’s contribution to diet
•  Protein, vitamins, minerals
•  USDA database
•  Examine accuracy of USDA database in meat category
•  Most recent NHANES analysis is 2010
•  In last 3 years, Meat industry has significantly reduced sodium
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