practice applications

EDITORS OUTLOOK

Achieving Nutrient Density: A Vegetarian Approach

hat could be more nutrient

dense than a vegetarian diet?
In this era of obesity and
heightened interest in reducing excess calorie intake, the interest in increasing fruits and vegetables and
reducing foods with added sugar and
solid fats would seem to point to the
benefit of more vegetarian meals.
This month, Farmer and colleagues (p
819) investigate this question by considering a diet absent of meat, poultry, or fish based on the National
Health and Nutrition Examination
Survey data from 1999-2004. They
reviewed data for adults over age 19
years and compared those whose
intake reflected vegetarian vs nonvegetarian patterns. Lacto-ovo vegetarians vs nonvegetarians were considered. While this cross-sectional
analysis can only reflect associations,
not causality, there are some interesting and useful observations that can
apply to diet counseling and intervention efforts that may be focused on
enhancing overall nutrient intake
within a reduced or calorie controlled
environment. Please also be sure to
check out the interesting Research Editorial by Thedford and Raj (p 816).
Questions of nutrient density and
overall nutrition quality arise in the
study by Kreider and colleagues (p
828) as they explore whether adherence to a meal replacement based
diet program with encouragement to
increase physical activity was as effective as a meal plan based diet and
supervised exercise program in sedentary obese women. Emphasis on
the physical activity aspect of this
study illustrates benefits, especially
in previously sedentary populations.
The usefulness of meal replacement
as a potential key to portion control
and simplification of diet intervention
has been gaining research attention
(1-3). The overall nutrient density compared across studies and approaches
would be of interest, especially related
to sodium, sugar, and other ingredients
associated with processed foods.

EATING LESS SALT?

Along with eating fewer calories, there
is emphasis on the need to reduce
sodium. On average, Americans consume around 3,400 mg sodium per day,
well above the US Dietary Guidelines
recommendation of 2,300 mg per day;
the Japanese are reported to consume
even more sodium, around 4,600 mg
per day (4). This month, Otsuka and
colleagues (p 844) report results from a
longitudinal investigation of community-dwelling middle-aged and elderly
Japanese people regarding their overall intake of sodium. Data collected
as part of the National Institute for
Longevity Sciences Longitudinal Study
of Aging were compared over the course
of 8 years among participants living
in Obu-shi and Higashiura-cho, Aichi
Prefecture, Japan. Three-day dietary
records were collected and foods
were weighed and measured to help
increase the accuracy of these data.
Results showed decreases among
men but increases among women in
certain age groups, regardless of
reduced calorie intake. Associated
blood pressure changes and the implications for future diet and intervention efforts aimed at improving
overall health are discussed.
CHANGING OF THE BOARD
This month marks the time when
changes take place on our Board of
Editors. Unlike last year when several changes were made as several
members had earned well-deserved
time off, this year we have only one
retiring member and one new member.
We would like to express our sincere appreciation to:
Julie Eichenberger Gilmore, PhD,
RD
Term 2008-2011
University of Iowa
Institute for Clinical & Translational Science
Iowa City, IA

2011 by the American Dietetic Association

And welcome our newest Editorial

Board member:
Frances E. Thompson, PhD,
MPH
Epidemiologist
Risk Factor Monitoring and Methods Branch
Applied Research Program Division of Cancer Control and Population Sciences
National Cancer Institute
Bethesda, MD
Dr Thompsons research interests
focus on dietary assessment methodology, including evaluating existing
methods and developing new methods, and research design in epidemiologic studies, particularly related to
cancer prevention and obesity.
Best regards.

Linda Van Horn, PhD, RD

Editor-in-Chief
doi: 10.1016/j.jada.2011.04.002
References
1. Rock CL, Flatt SW, Sherwood NE, Karanja N,
Pakiz B, Thomson CA. Effect of a free prepared meal and incentivized weight loss program on weight loss and weight loss maintenance in obese and overweight women: a
randomized controlled trial. JAMA. 2010;304:
1803-1810.
2. Lee K, Lee J, Bae WK, Choi JK, Kim HJ, Cho
B. Efficacy of low-calorie, partial meal replacement diet plans on weight and abdominal fat in obese subjects with metabolic syndrome: A double blind randomized controlled
trial of two diet plansOne high in protein
and one nutritionally balanced. Int J Clin
Pract. 2009;63:195-201.
3. Mattes RD. Ready-to-eat cereal used as a
meal replacement promotes weight loss in human. J Am Coll Nutr. 2002;21:570-577.
4. Anderson CA, Appel LJ, Okuda N, Brown IJ,
Chan Q, Zhao L, Ueshima H, Kesteloot H,
Miura K, Curb JD, Yoshita K, Elliott P,
Yamamoto ME, Stamler J. Dietary sources of
sodium in China, Japan, the United Kingdom
and the United States, women and men aged
40-59 years: The INTERMAP study. J Am
Diet Assoc. 2010;110:736-745.

Journal of the AMERICAN DIETETIC ASSOCIATION

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