2010 Dietary Guidelines for Americans: Background
This issue of Staying Well focuses on eating well, the cornerstone of staying well. The timing of this topic is no coincidence. It corresponds to the release of the 2010 Dietary Guidelines for Americans,[1] the holy grail of dietary advice for Americans age 2 and older. The guidelines, a joint effort of the Department of Agriculture (USDA) and Department of Health and Human Services (HHS), were first published in 1980 and are updated every 5 years. The final recommendations were unveiled on January 31, 2011, at a press conference led by heads of the sponsoring government departments, Agriculture Secretary Tom Vilsack and HHS Secretary Kathleen Sebelius. The recommendations are the basis of federal nutrition policies, including food assistance programs.
Under Siege by Obesity and Chronic Disease
Americans are under siege from an epidemic of obesity. America is fat. We eat too much, and too much of the wrong things. Obesity rates over the past 30 years have doubled for adults and tripled for kids. Currently, two thirds of all US adults and one third of children are overweight or obese. More than one third of all US adults (34%) and nearly one fifth of children (17%) are obese.
As our population has grown in girth, so have the people with chronic diseases. Cancer affects nearly 1 in 2 men and women at some time during their lives.
Certain cancers, including breast, endometrium, colon, kidney, mouth, pharynx, larynx, and esophagus, have dietary risk factors. Nearly 24 million American adults already have diabetes. More than 81 million people already have heart disease that’s. Nearly 75 million Americans have hypertension. In addition, there are 78 million Americans with pre-diabetes and more than 75 million with pre-hypertension headed down this dangerous path.
The latest is the “Total Diet”, one that is nutrient dense, energy balanced, and portion controlled. The guidelines emphasize vegetables, fruits, and high fiber whole grains. It is more plant-based with vegetables (including cooked dry beans and peas), fruits, whole grains, nuts, and seeds. More seafood and moderate intake of lean meats, poultry, and eggs. Low-fat,fat-free dairy products are best. Decrease solid fats and added sugars because they are high calorie. Watch salt intake. And exercise: we don’t get enough.
What to Reduce
Salt. The guidelines hit hard on sodium. Our average daily salt intake is about 3400 mg sodium. The new guidelines call for a reduction to under 2300 mg sodium daily, the amount in 1 tsp of salt. Nearly half of us, including everyone 51 and older, need to further reduce intake to 1500 mg daily, which is three fourths a teaspoon of salt. That is also the desirable maximum for blacks of any age, and anyone with high blood pressure, diabetes, or chronic kidney disease.
Reach less for the shaker and shake less when you do. Check labels on prepared foods. Making these changes may not ensure that we can reduce salt to recommended levels. Previous studies have shown that the vast majority of sodium (75%) comes from processed and restaurant foods.
Fat warnings. Avoid trans-fats, partially hydrogenated and saturated fats, including coconut, palm, and palm kernel oils. Use soft instead of stick margarines, and, in cooking, use vegetable oils instead of butter. Monounsaturated and polyunsaturated oils are best, including safflower, canola, and olive oils.
Cholesterol. For dietary cholesterol, the guidelines say no more than 300 mg total per day. Cutting dietary cholesterol to less than 200 mg daily can be beneficial for people at high risk for heart disease.
Sugary drinks and alcohol. Go with water instead. Sodas, energy drinks, and sports drinks are to blame for 36% of added sugars in our diet.
Consume alcohol only in moderation defined as a max of 1 drink a day for women, and 2 drinks a day for men. One drink is 12 ounces of beer, 5 ounces of wine, or 1 1/2 ounces of 80 proof distilled spirits. Alcohol also has calories: 7 “empty” calories per gram.
What to Increase
Fruits and vegetables. Eat more fruits and vegetables. Fill half your plate with fruits and vegetables, and l with a variety of dark green, red, and orange vegetables, including beans and peas. They are low in calories, rich in the nutrients we often lack (folate, magnesium, dietary fiber, and vitamins A, C, and K), and they may help prevent chronic diseases. Eating fruits and veggies is linked to lower risks for heart attack, stroke, and certain cancers.
More whole grains. Make sure at least half the grains you consume are whole grains (as opposed to refined grains).
Whole grains mean the entire seed, kernel (germ, bran, and endosperm). The minimal goal for most people is 3 ounces of whole grains per day. Refined means the grains have been milled, stripping away valuable nutrients like iron and B vitamins, like thiamine, riboflavin, niacin, and folic acid. If you consume refined grains (and it is hard not to), make sure they are “enriched,” which means extra iron and B vitamins have been added.
The guidelines contain practical tips that can help when checking food labels and ingredients. Buzz words for whole grains include buckwheat, bulgur, millet, oatmeal, quinoa, rolled oats, brown or wild rice, whole grain barley, whole rye, whole wheat. The guidelines also dispel a myth about bran: Bran is not whole grain (but it is a good source of dietary fiber.)
However, even with the best intentions, it is hard to figure out what you are getting. Labels can be misleading. The guidelines say “Multi-grain, stone-ground, 100% wheat, cracked wheat, seven grain, and bran are not usually 100% whole grain products and may not contain any whole grains.” Checking the “% Daily Value” on labels can help. Products that contain 10-19% daily value of fiber, “good” source of dietary fiber, or 20% daily value or more, “excellent” source of dietary fiber.