Adherence to the 2019 Canada’s Food Guide and the risk of nutrient inadequacy in older adults

The 2019 Canada’s Food Guide (CFG) shifted its recommendations away from quantitative servings to now recommending proportions of broader food categories within a plate, with an emphasis on plant-based foods.  

Consequently, there have been rising concerns regarding the risk of nutrient inadequacies in vulnerable groups, as it is possible to follow the guidelines while failing to include nutrient-rich foods. While they primarily aim to target chronic disease risk, whether these guidelines mitigate the risk of nutritional inadequacy in the older Canadian population remains unknown.  

To this effect, a cross-sectional study evaluated the relationship between adherence to recommendations from CFG-2019, as measured through the Healthy Eating Food Index – 2019 (HEFI-2019), and dietary intake of key nutrients in 4,089 adults aged ≥ 65 from the 2015 Canadian Community Health Survey (CCHS). 

The following 12 key nutrients were assessed through 24-hour recalls: 

• Macronutrients: Protein and fibre;
• Vitamins: Vitamins B6 & B12, vitamin D, and vitamin A;
• Minerals: Calcium, iron, zinc, folate, magnesium, and potassium. 

The results reveal the following: 

• Within the study population, there was a high prevalence of inadequate intake for vitamin D (96%), calcium (83%), and magnesium (64%), followed by vitamin B6 (38%), vitamin A (36%), folate (30%), and zinc (28%); 
• While CFG adherence was related to a reduction in prevalence of inadequacy for some nutrients (ex. fibre, vitamin B6, and magnesium), it did not reduce inadequacy for calcium, zinc, and vitamin A;
• Higher CFG adherence was linked to lower intakes of iron, folate, vitamin B12, and vitamin D; 
• Unsweetened milk was the food with the strongest correlations with both calcium and vitamin D intake.  

Overall, the authors conclude that these dietary guidelines do not adequately address the risk of inadequacy for many key nutrients in older adults. The results notably reveal a gap in ability of the CFG-2019 guidelines to mitigate vitamin D and calcium intake inadequacies. The authors partly attributed this to a lack of specific guidelines on dairy food consumption, which is considered the main food source of calcium and vitamin D in the Canadian diet.