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MyPyramid level to the mean of the total energy expenditure for the four age groups in the National Health and Nutrition Examination Survey (NHANES) 2003–2004: men and women, ages 19–59 years and 60 years or older, when body mass index was imputed at 22.5 for the younger and at 25 for the older group of adults (see Chapter 3). Because of the variation in available facilities in adult day care programs, it was not considered practical to set different calorie levels for subgroups at the meal planning stage. It should be noted, however, that portion sizes may be adjusted within facilities, as appropriate.

The data in Table 5-1 show the areas that mean adult intakes of all the food groups and subgroups were below the MyPyramid amounts, with the exception of total grains for the 19–59-year age group. For both age groups, mean fruit intake was only about half of the amount that would be consistent with the MyPyramid pattern. Furthermore, within the vegetables group, the consumption of dark green vegetables, orange vegetables, and dried beans and peas was lower than the MyPyramid amount specified for each of these individual subgroups. Neither age group approached the recommended amount of whole grains.

Note that the 2005 DGA (HHS/USDA, 2005) encourages the intake of increased amounts of a variety of vegetables and fruits and recommends that at least half of the grain be whole grain. In addition to providing nutrients, fruits and vegetables provide numerous beneficial phytochemicals, which may be protective of a wide variety of age-related conditions (Carlsen et al., 2010). The 2010 Dietary Guidelines Advisory Committee (USDA/HHS, 2010) placed strong emphasis on a diet that is primarily plant-based—rich in vegetables, fruits, whole grains, nuts, and seeds.

Meeting the nutrient needs of older and disabled adults with lower calorie requirements poses great challenges in the context of the typical American diet. As seen in the analyses above, calories from solid fats and added sugars for the general adult population far exceed caloric requirements. Placing limits on energy-dense foods such as fatty meats, full-fat dairy products, sugar-sweetened drinks, and pastries and other desserts can reduce the intake of solid fat, sugars, and calories. This change makes room for more vegetables, fruits, whole grains, and low-fat or nonfat fluid milk and milk products without providing excess calories.

ENERGY AND NUTRIENT INTAKES

Energy

The committee considered estimated energy intakes by adults as discussed in Chapter 3.



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