Why You Should Care About the Dietary Guidelines for Americans

The 2010 Dietary Guidelines for Americans were released on January 31st.  The guidelines, updated every 5 years, are a very big deal in the nutrition world.  But I don’t think the public cares or notices the nuanced changes.

I think you should care and I’m going to tell you why.

While the Dietary Guidelines are not perfect, they do summarize the research.  And at a time when everyone is doling out nutrition advice, this can be helpful.

You see, when you receive nutrition advice, or someone quotes a study, they may or may not include all the evidence available.  So if there’s one study saying too much of X is bad for you, there might be 10 other studies saying it isn’t.  So it’s really important to look at what researchers call “the weight of the evidence.”

So I spent last weekend curled up with the Dietary Guidelines Policy Report, (great read — totally recommend it!) and pulled out important tidbits of information for my readers.

Message one: Balance Calories to Manage Weight:

Background: There’s a big focus on obesity prevention — and the guidelines talk about how Americans are in calorie imbalance (taking in more than burning).  While people still try to target specific food groups (like carbs or the glycemic index) as being more weight-promoting, research still shows that total calories matter most.  Strong evidence shows children who consume sugar-sweetened beverages have higher body weights than those who don’t.  The same is not seen with 100% fruit juice.

There is strong evidence that regular physical activity helps maintain weight and prevent excess gains.  Increased screen time, especially TV viewing, is associated with higher weights in children, adolescents and adults (strong evidence).

Recommendations:   Control total calorie intake and increase physical activity to manage weight and stay in “calorie balance” through all stages of life.

What’s missing? There’s nothing about the how of eating: watching hunger or fullness, eating meals at the table and tuning into your body.  People don’t count calories — and they shouldn’t.  Having to fend off food and eat less than you really want never works.  Eating slowly, enjoying and stopping when you start to feel full/satisfied is much more powerful not to mention doable.

Message two: Reduce certain foods and nutrients

Background:  A strong body of evidence shows that high sodium intake increases blood pressure.  Most sodium comes from the added salt during food processing.  The type of fat someone consumes is more important than the total amount.  A strong body of evidence shows that saturated fatty acids (animal fats) are associated with higher total cholesterol and LDL cholesterol.  Man-made trans fat, also bad for the heart, has decreased substantially from the food supply since the 2006 label law went into effect. Dietary cholesterol may increase bad cholesterol (LDL) in certain individuals.  Added sugars contribute 16% of total calories in the American diet (too much).

Recommendations: Reduce sodium to 2300mg in the general population and 1500mg for those 51 and older, all African Americans, and people with hypertension and diabetes (average American sodium intakes is 3400mg). Consume less than 10% of calories from saturated fats and replace with unsaturated fats (10% of 2000 calories = 20g saturated fat).  Consume less than 300mg cholesterol per day (1 egg =212 mg).  Keep trans fat as low as possible.  Reduce the intake of calories from solid fats and sugars.

What’s Missing?  A new tool (like the old food pyramid) is going to be created to help people utilize the guidelines.  I think they will benefit from showing people how to eat nutrition-poor foods.  For example, the policy report says “Foods containing solid fats and added sugars are no more likely to contribute to weight gain than another source of calories in an eating pattern that is within calorie limits.”  And they go on to state that 5-15% of the diet can come from solid fats and added sugar.  So let’s show people how to navigate the real world and sensibly include all foods in their diet instead of just telling them to “reduce” or “avoid” certain foods.

Message three: Increase Certain Foods and Nutrients 

Background:  There is moderate evidence for the health benefits of fruits, vegetables, whole grains, dairy products, nuts and seeds and fish intake.  Many Americans are not meeting their needs for potassium, fiber, calcium and vitamin D.  Dietary potassium can help lower blood pressure by counteracting the effect of sodium. Certain population groups have special nutrition needs, such as pregnant women and those capable of becoming pregnant who need more iron and folic acid.  People over 50 need additional vitamin B12 as absorption rates decrease with age.

For the first time the benefits of eating more seafood, including the essential fatty acids DHA/EPA, were highlighted, especially for pregnant and developing children.  The average intake of seafood is 3.5 ounces per week, while 8 ounces is associated with health benefits.  Amounts are not specified for children as they will just eat “smaller portions” than adults.

Recommendations: Eat more fruits, vegetables (especially dark green, organ veggies and beans and peas), whole grains (half of the grain intake), fat-free or low-fat milk and milk products, lean protein foods (lean meat, beans, seafood, eggs, poultry, soy and nuts and seeds), seafood and replace vegetable oils with solids fats when possible.  Choose foods higher in potassium, dietary fiber, calcium and vitamin D.

Women capable of becoming pregnant should choose foods that supply more iron and 400mcg folic acid from fortified food or supplements.  Women who are pregnant or breastfeeding should consume 8-12 ounces of low-mercury seafood per week from a variety of seafood types.  People who are 50 or older should get a supplemental source of vitamin B12.

What’s missing?  They fail to say that most people will not be able to get enough vitamin D through food.  One of my readers asked about vitamin D during pregnancy.  I recommend all adults, especially those who are planning on becoming pregnant (or are), get a vitamin D test.  If your D levels are low, most people will need to take more than their prenatal or multivitamin contains.  The guidelines also don’t mention that people can take fish oils if they fall short on fish intake.

The guidelines wrap up discussing dietary patterns and how to help people adopt the guidelines.  This is the real issue — how to help people eat better.  From my experience, telling people what is healthy for them is not motivating over the long haul.

There’s nowhere in the guidelines about eating food that tastes good, a number one motivator for people.  In fact, I encourage people to make food decisions based on three areas: taste, nutrition and how food makes them feel.  I mean, I love cookies and ice cream but if I ate them all day I’d be a slug.  It’s that balance of all food I aim for so I get taste, lasting energy and the nutrition I need.

I recently talked to a man who only eats for taste.  He said, “I eat what I want!”  He told me he eats a sausage and egg breakfast every morning.  I ask him how that makes him feel and he said, “I take a nap a half an hour after I eat it.”  I replied, “Well maybe if you ate something different you would have more energy all day long — and then you could eat that on Sunday when there’s less to do.”

“I’m retired,” he said with a smile.