Transcript Rebuilding the Food Guide Pyramid

The
2005 Dietary Guidelines for
Americans
Benjamin Caballero, MD, PhD
Center for Human Nutrition
History of Dietary Guidelines
• 1977 Dietary Goals for the U.S.
(Senate)
• 1979 Healthy People Surgeon
General’s Report (HHS)
• 1980 First Edition of Dietary Guidelines
(HHS and USDA)
1980
1985
1995
1990
2000
Dietary Guidelines For Americans
• Science-based advice for ages 2+ (gold
standard)
– Promote health
– Prevent chronic disease
• Federal nutrition policy/programs
• Vehicle to speak with one voice
• Jointly developed by HHS/USDA
What the Guidelines Do
• Provide dietary advice to consumers
• Set policy for food assistance programs
(e.g., school lunches, elderly nutrition)
• Establish overarching goals for
National health objectives
Nutrition monitoring
Nutrition research
• Set framework for standards in
Food labeling/ fortification
 Food product development

Legislated Mandate for the
DGA
National Nutrition Monitoring and Related
Research Act of 1990
Dietary guidelines must be issued every 5 years
Dietary guidance issued by the Federal
government for the general public is to be
reviewed by the Secretaries of Agriculture, and
Health and Human Services. (Departments
alternate the lead role.)
Systematic Review of Scientific
Literature
• Identification of research questions
• Questions were prioritized by:
– Publication/availability of recent systematic
reviews by an authoritative source (e.g. IOM,
CDC, NIH)
– Preliminary literature search to determine if there
were enough data (from peer-reviewed sources)
to examine the research question
• Iterative process
Systematic Review of Scientific
Literature
• All literature examined was peer-reviewed
• Human studies were primary focus
• Committee assessed study quality and the
strength of the evidence
• Priority was given to:
– trials with well-accepted, clinically relevant
outcomes (e.g., incidence of cancer and myocardial
infarction) and well-accepted risk factors (e.g.,
systolic blood pressure, low-density lipoprotein
cholesterol, and weight)
– longitudinal, cohort studies
Opportunities for Public
Comments
• Over 400 public
comments submitted to
the Committee
• Written comments were
accepted throughout
the Committee’s
deliberations
• Oral presentations were
made at the January
2004 meeting
Content of Science Base
• Aiming to Meet Nutrient Intake
Recommendations
• Energy
• Discretionary Calories
• Fats
• Carbohydrates
• Selected Food Groups
• Fluid and Electrolytes
• Ethanol
• Food Safety
Key Scientific
Recommendations
1. Consume a variety of foods within and among the
basic food groups while staying within energy needs
2. Control calorie intake to manage body weight
3. Be physically active every day
4. Increase daily intake of fruits and vegetables, whole
grains, and reduced-fat milk and milk products
5. Choose fats wisely for good health
6. Choose carbohydrates wisely for good health
7. Choose and prepare foods with little salt
8. If you drink alcoholic beverages, do so in moderation
9. Keep food safe to eat
Nutrient Adequacy
Consume a variety of foods within and among the basic
food groups, while staying within energy needs.
Basic food groups:
–
–
–
–
–
Fruits
Vegetables
Grains
Milk, yogurt and cheese
Meat, poultry, fish, dry beans, eggs, and nuts
Nutrient Adequacy
Nutrient Density
• Nutrient-dense foods are those that provide
substantial amounts of vitamins and minerals in
relatively few calories. Foods of low nutrient density
are those that supply calories but little or no amounts
of vitamins and minerals.
• The greater the consumption of foods or beverages
that are low in nutrient density, the more difficult it is
to consume enough nutrients without gaining weight,
especially for sedentary individuals.
• The consumption of added sugars, solid fats, and
alcohol provides calories while providing little, if any,
essential nutrients.
Nutrient Adequacy
Nutrient Intake
• Adults do not consume enough vitamins A, C,
and E; calcium; magnesium; potassium; and
fiber.
• Children do not consume enough vitamin E,
calcium, magnesium, potassium, and fiber.
• At the same time, in general, Americans
consume too many calories and too much
saturated and trans fat, cholesterol, added
sugars, and salt.
Nutrient Adequacy
Special Groups
Iron:
For adolescent females and women
of childbearing age
Folic Acid:
For women capable of becoming
pregnant and in the first trimester of
pregnancy
Vitamin B12: For those over age 50
Vitamin D:
For the elderly, persons with dark
skin, and persons exposed to
insufficient UVB radiation
Energy Balance
Discretionary calories:
= Total estimated daily energy
requirement minus essential calories.
To make discretionary calories available or to
increase their amount, individuals need to
– increase their physical activity AND/OR
– consume nutrient-rich foods that are relatively
low in energy density.
Discretionary calories
2500
Discretionary
2000
EER
1500
1000
Essential
500
0
A
B
Energy Balance
Control calorie intake to manage body weight
• Most Americans need to reduce the calories they
consume.
• For weight control, calories do count—not proportions
of carbohydrate, fat, and protein.
• The healthiest way to reduce calorie intake is to
reduce intake of added sugars, solid fat, and
alcohol—they all provide calories, but they do not
provide essential nutrients.
• Controlling portion sizes helps limit calorie intake,
especially when eating energy-dense foods.
• For most people, a reduction of 50 to 100 calories per
day will prevent weight gain.
Physical Activity and Health
Be physically active every day
Adults:
• Thirty minutes of at least moderate physical activity on
most days provide important health benefits and
reduces the risk of chronic disease. More than 30
minutes of moderate to vigorous physical activity on
most days provide even more health benefits.
• Participating in up to 60 minutes of moderate to
vigorous physical activity on most days is recommended
to prevent unhealthy weight gain.
• After losing weight, adults who perform 60 to 90 minutes
of moderate physical activity daily are more successful
at maintaining their reduced weight than those who rely
only on limiting calorie intake.
Physical Activity and Health
Be physically active every day
Children and Adolescents:
• At least 60 minutes of moderate to vigorous physical
activity on most days to maintain good health and
fitness and for healthy weight during growth.
Increasing physical activity can lower the BMI of
overweight children
• During leisure time, it is advisable for all individuals
to limit sedentary behaviors, such as television
watching and video viewing, and replace them with
activities that require more movement.
Physical Activity
Additional Health Benefits:
• Exercise that loads the skeleton has potential to
reduce the risk of osteoporosis.
• Resistance training (8 to 10 exercises twice or
more per week) increases muscular strength
and endurance and maintains or increases lean
body weight.
Fats and Fatty Acids
Choose fats wisely for good health.
Total fat: 20% and 35% of energy for adults
Intakes as low as possible of:
– Saturated fats: Less than 10% of calories
– Trans fats: About 1% of calories or less
– Cholesterol: Less than 300 mg of cholesterol per day
Fatty
Acids
Omega-3 fatty acids
• Consuming two servings of fish per week
(approximately 8 ounces total) may reduce
the risks from cardiovascular disease,
especially mortality from coronary heart
disease.
• Other sources of EPA and DHA may provide
similar benefits; however, more research is
needed.
NOTE: Caution for pregnant or lactating women and
children to avoid fish with high mercury content.
Carbohydrates
Choose carbohydrates wisely for good health.
Total carbohydrates: Intake 45% to 65% of energy
Dietary Fiber: Intake 14 grams per 1000 calories.
Added Sugars: Reducing intake of added sugars
(especially sugar-sweetened beverages) can lower
calorie intake, and may be helpful in achieving
recommended nutrient intakes and weight control.
Dental caries: Reducing frequency of consuming sugars
and starches and optimizing oral hygiene practices is
advised
Glycemic index/load: Few advantages in using these for
dietary guidance
Selected Food Groups
Increase daily intakes of fruits and vegetables, whole grains,
and reduced-fat milk and milk products.
Fruits and Vegetables: At 2000 kcal/day, 9 servings (4 ½
cups)
Whole Grains: At least three servings (3 ounces) per day
Milk: At 1600 kcal/day or more, 3 cups of non-fat or low-fat
milk or the equivalent
Sodium
and
Potassium
Choose and prepare foods with little salt.
•
•
•
•
Nearly all Americans consume substantially more salt
than they need.
The general goal for adults is to consume less than
2,300 mg of sodium per day. Many persons will benefit
from reducing salt intake even more.
At the same time, individuals are encouraged to
increase their consumption of foods rich in potassium.
Potassium lowers blood pressure and blunts the
effects of salt on blood pressure.
Increasing potassium to at least 4,700 mg daily is
advised.
Alcohol
If you drink alcoholic beverages, do so in moderation.
•
•
•
•
Moderation is up to one drink per day for women and
up to two drinks per day for men.
One drink is defined as 12 ounces of regular beer, 5
ounces of wine (12 percent alcohol), or 1.5 ounces of
80-proof distilled spirits.
Drinking alcoholic beverages should be avoided
before or when driving, or whenever it puts anyone at
risk.
Studies suggest adverse effects even at moderate
alcohol consumption levels in specific individuals and
situations.
Food Safety
Keep food safe to eat.
•
Behaviors in the home most likely to prevent microbial
foodborne illnesses:
Clean, Separate, Cook, Chill
– Cleaning hands, contact surfaces, and fruits and vegetables
(but not meat and poultry, which should not be washed)
– Separating raw, cooked, and ready-to-eat foods while
shopping, preparing, or storing.
– Cooking foods to a safe temperature.
– Chilling (refrigerating) perishable foods promptly.
Food Safety
• An important protective measure against
foodborne illness is avoiding higher-risk foods.
• In the case of listeriosis, high-risk groups such
as the very young, pregnant women, the elderly
and those who are immunocompromised,
should avoid higher-risk foods (e.g. frankfurters
and deli meats which have not been heated to
a safe temperature).
% change in current intake needed to
meet the 2005 DG
- Main food groups
% change in current intake needed to meet
the 2005 DG
- Subgroups, solid fats and added sugars
www.health.gov/dietaryguidelines
www.cnpp.usda.gov/DG2005