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Title: A simulation study of the potenial effects of healthy food and beverage substitutions on diet quality and total energy intake in lower Mississippi Delta adults

Author
item Thomson, Jessica
item Tussing Humphreys, Lisa
item ONUFRAK, STEPHEN - Centers For Disease Control And Prevention (CDC) - United States
item CONNELL, CAROL - University Of Southern Mississippi
item ZOELLNER, JAMIE - Virginia Polytechnic Institution & State University
item Bogle, Margaret
item YADRICK, KATHY - University Of Southern Mississippi

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/31/2011
Publication Date: 11/18/2011
Citation: Thomson, J.L., Tussing Humphreys, L.M., Onufrak, S., Connell, C., Zoellner, J., Bogle, M.L., Yadrick, K. 2011. A simulation study of the potenial effects of healthy food and beverage substitutions on diet quality and total energy intake in lower Mississippi Delta adults. Journal of Nutrition 2011. 141:2191-2197.

Interpretive Summary: Proper nutrition is necessary for good health, yet the majority of adults in the US, especially in the South, do not consume an adequate diet. In this study, we wanted to determine the effects of replacing unhealthy foods and beverages with more healthful ones in terms of diet quality and calories consumed. We used data collected from a representative sample of Lower Mississippi Delta adults in the year 2000. Our results showed that the substitutions resulting in the greatest improvements in diet quality and reductions in calories consumed were grain desserts (e.g. cookies, cakes, pies, and pastries) replaced with fruit cocktail packed in juice and sugary drinks (e.g. soda and fruit drinks) replaced with water. Combining all substitutions together resulted in impressive diet quality improvement and potential reduction in calories consumed with just half of the unhealthy foods being replaced. These results suggest that an approach based on simultaneous changes within several food and beverage groups may be a more effective means of improving diet quality, decreasing caloric intake, and potentially reducing body weight than will an approach focusing exclusively on a single food or beverage. The promotion of policy and environmental changes which make nutritious food and beverage choices the easier choice should be encouraged at all levels of the community.

Technical Abstract: The majority of adult diets in the United States, particularly the South, are of poor quality, putting these individuals at increased risk for chronic diseases. In this study, simulation modeling was used to determine the effects of substituting familiar, more healthful foods and beverages for less healthy ones on diet quality and total energy intake in Lower Mississippi Delta (LMD) adults. Dietary data collected in 2000 for 1,689 LMD adults who participated in the Foods of Our Delta Study were analyzed. The Healthy Eating Index-2005 (HEI-2005) was used to measure diet quality. The effects of substituting targeted foods and beverages with more healthful items on diet quality were simulated by replacing the targeted items’ nutrient profile with their replacements’ profile. For the single food and beverage groups, 100% replacement of grain desserts with juice-packed fruit cocktail and sugar-sweetened beverages with water resulted in the largest improvements in diet quality (4.0 and 3.8 points, respectively) and greatest decreases in total energy intake (98 and 215 kcal/day, respectively). The 100% substitution of all food and beverage groups combined resulted in a 12.0-point increase in HEI-2005 score and a decrease of 785 kcal/day in total energy intake. Community interventions designed to improve the diet of LMD adults through the use of familiar, healthy food and beverage substitutions have the potential to improve diet quality and decrease energy intake of this health disparate population.