3/13/2015
This presentation has 3 aims
Dietary Guidance Development Project for
Children from Birth to 24 Months and Pregnant Women
Joanne M. Spahn
March 12, 2015
…describe how the B‐24/PW and WIC Food Package Review projects are complementary
…state the purpose and goals of the B‐24/PW project
Initiation
USDA Center for Nutrition Policy and Promotion
HHS Office of Disease Prevention and Health Promotion
The purpose of the B-24/PW project is to inform the development of
food-based guidelines for birth to 24 months and pregnant women
Goals:
2012
2. Initiate the review of evidence to support the inclusion of these populations into the 2020 Dietary Guidelines for Americans
Phase I
2013
2014
2015
2016
2017
Phase IV
2018
2019
2020
The multiphase timeline spans 2012-2020
Initiation
2012
1. Review scientific evidence about nutrition and health for:
a) Birth to 24 month olds (B‐24)
b) Women who are pregnant (PW)
…describe the four project phases and their timeline
Phase
II
Phase III
Phase I
2013
Phase II
2014
2015
Phase III
2016
2017
2018
Phase IV
2019
2020
•Collaborative effort involving leading scientists and program leaders
•Broad evidence foundation
•Transparent process
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3/13/2015
The multiphase timeline spans 2012-2020
The multiphase timeline spans 2012-2020
Initiation
2012
Initiation
2013
2014
2015
2016
2017
2018
2019
2020
• B‐24 Project initiated in 2012 by the Office of Disease Prevention and Health Promotion (ODPHP)/HHS and the Center for Nutrition Policy and Promotion (CNPP)/USDA
2012
Phase I
2013
2014
2015
2016
2017
2018
2019
2020
• CNPP and ODPHP partnered with The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
• 50+ experts and Federal policy and program leaders assessed:
1. Feasibility
2. Research and data gaps
3. Identify systematic review topics
Limited coverage of pregnant women
•
Raiten et al, AJCN, 2014;99:663S‐691S; Obbagy et al, AJCN, 2014; 99:1‐5
The multiphase timeline spans 2012-2020
The multiphase timeline spans 2012-2020
Initiation
2012
Phase I
2013
Initiation
Phase II
2014
2015
2016
2017
2018
2019
2020
• Agricultural Act of 2014 officially called for B‐24/PW addition to the 2020 Dietary Guidelines for Americans
• Federal Expert Group (FEG) and Technical Expert Collaboratives(TEC):
1. Collaborate to conduct an evidence review
2. Prepare:
a) Maternal nutrition systematic review priorities
b) Data needs
2012
Phase I
2013
Phase II
2014
2015
Phase III
2016
2017
2018
2019
2020
• Data analysis
• FEG develops a Technical Report using:
1. NEL systematic reviews
2. Data analysis
3. Existing reports
4. Public and Federal Agency comments
• Public comments will be requested
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3/13/2015
The multiphase timeline spans 2012-2020
Initiation
2012
Phase I
2013
Phase II
2014
2015
Phase III
2016
2017
The B-24/PW Project will address
research questions in four broad topic areas
Phase IV
2018
2019
2020
• 2020 Dietary Guidelines Advisory Committee: • FEG Technical Report provided to consider as a source of evidence
• Reviews current scientific evidence
• Develops recommendations within the DGAC Advisory Report
Taste Development
• 2020 Dietary Guidelines for Americans is written by the federal government • Incorporates guidance for children from birth to 24 months of age and women who are pregnant
Human Milk &
Infant Formula
Feeding
Feeding Practices
& Methods
Complementary
Feeding: Foods &
Beverages
NEL reviews will examine the impact of infant feeding practices and
duration of exclusive breastfeeding on a variety of outcomes
NEL review will examine the impact of exposure to nutrient dense,
salted and sweetened foods and feeding style and setting on a variety of
outcomes
Cognitive, behavioral, or
neuromotor development
Taste & preference
development
Physical
growth and
development
Nutritional
status
Body composition/
overweight/obesity
Allergies/
Asthma
Physical growth and
development
Dietary intake
Body composition/
overweight/obesity
Oral health
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NEL review will examine the impact of when complementary feeding
starts and what and how much is fed on a variety of outcomes
Allergies, asthma,
infection, or inflammation
Physical growth and
development
B‐24/PW
Body composition/
Overweight/Obesity
Disease risk
Diet quality
The B-24/PW and WIC Food Package Review initiatives
have some common and some unique goals
Review nutrition To recommend To review scientific and health practical and evidence about scientific nutrition and health evidence related economical changes in the WIC food packages to inform to the birth to 24 that reflect current development of month and nutritional science and dietary guidance for pregnancy life meet the nutritional stages
children birth to 24 months and pregnant Inform federal and cultural needs of the WIC population
women
program guidance
WIC Food Package Review
The B-24/PW and WIC Food Package Review initiatives
have some common and some unique topics of interest
B‐24/PW
Taste and Preference Development
Feeding Practices and Methods
The B-24/PW and WIC Food Package Review initiatives
have some common and some unique questions of interest
B‐24/PW
Complementary feeding/specific food options
Human milk/ breastfeeding and infant formula feeding
Infant feeding practices and health outcomes
Exclusive breastfeeding
Allergy
Breastfeeding incentives
Infant formula Medically Fragile Participants
Food acceptance and preference
Complementary foods
Whole grains
Economic Issues
Methods of complementary food introduction
Canned fish
Caregiver feeding style
Distribution of energy and macronutrients
Out‐of‐home feeding
Cow’s milk
Fruit and vegetable cash vouchers
Cow’s milk products
Medically fragile
Juice
Economic issues
Functional ingredients
WIC Food Package Review
Legumes
WIC Food Package Review
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In conclusion, the B-24/PW and WIC Food Package
Review initiatives are complementary and concurrent
• B‐24/PW systematic reviews may complement work conducted by the IOM Committee
– Human milk and infant formula feeding
– Complementary foods
• B‐24/PW reviews may support implementation of dietary guidance
– Taste and preference development
– Feeding practice and style
Please contact us for more B-24/PW Project Information
• www.cnpp.usda.gov
– Public comments
• www.NEL.gov
– Phase I information
– Systematic review materials
• Joanne.spahn@cnpp.usda.gov
• Jean.altman@cnpp.usda.gov
Questions?
5