Transcript DIETARY GUIDELINES FOR AMERICANS 2015-2020

DIETARY GUIDELINES FOR
AMERICANS 2015-2020
Gabriela Proaño, MS, RD
Central Texas Veterans Health Care System
December 2016
Outline
 Introduction on Dietary Guidelines- background on research and
development behind dietary guidelines
 Discussion of Chapter 1: Key Elements in Healthy Eating Patterns
 Discussion of Chapter 2: Shifts Needed to Align With Healthy
Eating Patterns
 Discussion of Chapter 3: Everyone Has a Role in Supporting
Healthy Eating Patterns
 Review of past and current guidelines- what is new with 20152020 guidelines and what has remained the same
 Application- how this can be applied in clinic and in the
community for patients, students, and general population.
Introduction
 1990 National Nutrition Monitoring and Related Research Act-
 “At least every five years the Secretaries shall publish a report entitled
`Dietary Guidelines for Americans'. Each such report shall contain
nutritional and dietary information and guidelines for the general public,
and shall be promoted by each Federal agency in carrying out any
Federal food, nutrition, or health program.
 BASIS OF GUIDELINES- The information and guidelines contained in each
report required under paragraph (1) shall be based on the
preponderance of the scientific and medical knowledge which is current
at the time the report is prepared.”
 Document published every 5 years by U.S. Department of Health
and Human Services (HHS) and of Agriculture (USDA) with
information from the Scientific Report of the 2015 Dietary Guidelines
Advisory Committee.
Introduction
 Approximately 50% of American adults have one or more
diet preventable chronic diseases (cardiovascular disease,
type 2 diabetes, overweight/obesity).
 In 2009-2012, 65% of adult females and 73% of adult males
were overweight/obese and one in three youths age 2-19
were overweight/obese.
 Guidelines are focused on PREVENTION and are used to
formulate federal health and nutrition programs and
educate the public
General Guidelines
1. Follow a healthy eating pattern across the lifespan at an
appropriate calorie level.
2. Focus on variety, nutrient density, and amount of foods.
Choose within all food groups
3.Limit calories from added sugars and saturated fats and
reduce sodium intake.
4.Shift to healthier, more nutrient dense food and beverage
choices
5.Support healthy eating patterns for all (multiple settingsschool, work, etc.)
Key recommendations
 Variety of vegetables from subgroups such as dark green, red
and orange, legumes, starchy and other
 Whole fruits
 Whole grains
 Low fat or fat free dairy
 Protein foods such as seafood, lean meats, poultry, eggs,
legumes, nuts/seeds, and soy
 Healthy diet includes oils
 Limit intake of saturated fat, trans fat, and added sugars to less
than 10% of calories per day
 Consume less than 2300 mg sodium per day
 Alcohol consumption should be in moderation
 Physical activity guidelines for Americans
Chapter 1: Key Elements in Healthy
Eating Patterns
 Healthy eating pattern includes total foods and
beverages consumed
 Nutrition needs should be met primarily through food
 Adapt healthy eating pattern based on cultural and
personal preferences
Vegetables
 Goal for 2,000 calorie diet is 2.5 cup equivalents.
 Include all 5 vegetable subgroups (dark green, red and orange,
legumes (beans/peas), starchy and other.
 Important source of fiber, potassium, vitamin A, C, K, B6, folate,
iron, magnesium, etc.
 Include wide variety of vegetables in nutrient dense form. Limit
butter, salt, or creamy sauces. If canned or frozen, choose lower
sodium versions.
Fruits
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Goal for 2,000 calorie diet is 2 cup-equivalents
Include whole fruits (at least 50%) and 100% juice
Fruit can be fresh, canned, frozen, and dried
Important source of dietary fiber, potassium, vitamin C.
etc.
Grains
 Goal for 2,000 calorie diet is 6 oz-equivalents
 Limit the intake of refined grains and include whole
grains (make ½ whole).
 Include grains as single foods or ingredient.
 Whole grains sources of fiber, iron, zinc, manganese,
folate, thiamin, riboflavin, etc.
Dairy
 Goal for 2,000 calorie diet is 3 cup equivalents
 Include fat-free and low-fat (1%) dairy- milk, yogurt, cheese, or
fortified soy.
 Important source of calcium, phosphorus, vitamin A, vitamin B12,
protein, etc.
Protein
 Goal for 2,000 calories is 5.5 ounce-equivalents per
day
 Broad group from both animal and plant sources.
 Subgroups include: seafood, meats, poultry, and
eggs; and nuts, seeds, and soy products (also
included in this group are legumes and dairy).
 Important source of B vitamins, selenium,
phosphorus, copper, zinc, etc.
Oils
 Goal for 2,000 calories is 27g (5 tsp) per day.
 Include fats high in monounsaturated and
polyunsaturated fats.
 Important source in essential fatty acids and vitamin E.
 Include nuts, seeds, seafood, olives, avocados, as well
as corn, canola, olive, peanut, safflower, soybean, and
sunflower oil.
Figure 1-2: Fatty Acid Profiles of Common Fats & Oils
Chapter 2: Shifts Needed to Align
With Healthy Eating Patterns
 Focus on 4th dietary guideline
 75% of population have eating patterns low in
vegetables, fruits, dairy and oils.
 More than half of population exceeding total grain
and protein recommendations but NOT for
subgroups.
 Most Americans exceed the recommendation for
added sugars, saturated fats, and sodium.
Figure 2-1: Dietary Intakes Compared to Recommendations. Percent of the U.S. Population
Ages 1 year & Older Who Are Below, At, or Above each Dietary Goal or Limit
Vegetable and Fruit Intake
 Vegetable consumption tends to be lowest among boys ages 913 yo and girls ages 14-18 yo.
 Vegetables most often consumed as separate food items
 Shift by increasing vegetable content of mixed dishes and
reducing portions of overconsumed food and choose green
salad or vegetable as side dish
 Average intake of fruit is lowest among girls 14-18 yo and adults
ages 19-50 yo.
 Fruits most often consumed alone
 Shift by increasing whole fruit as snacks, in salads, and side
dishes
Grains and Dairy Intake
 Total grains are closest to target amounts but do not meet
whole grain recommendations
 50% of intake of refined grains from mixed dishes
 Shift from white to whole grain or 100% whole wheat. Looking at
ingredient list and reducing intake of refined desserts and sweet
snacks
 Intake of dairy only met for children ages 1-3 but not for other
age groups
 Dairy intake mostly from milk and cheese
 Shift to increasing low fat dairy and yogurt if low in added sugars
and reducing cheese due to high saturated fat intake. Choose
low fat milk with meals or yogurt as a snack.
Protein and Oils Intake
 While protein intake is close to recommendations,
vary for subgroups (low for seafood and legumes and
high for nuts/seeds and meat, poultry, and eggs.
 Shift to increase seafood by adding to meals twice
per week and using legumes instead of meat and
poultry (choose lower sodium options)
 Oil intake is below recommendations for age groups
 Shift to use oils instead of solid fats
Other Dietary Components
 Added sugars account
for more than 13% of
calories per day in U.S.
population
 Shift to use beverages
with no added sugars
and reduce portion
sizes for sugar
sweetened beverages
and desserts/sweet
snacks
Chapter 3: Everyone Has a Role in
Supporting Healthy Eating Patterns
Figure 3-1: A Social- Ecological Model for Food & Physical
Activity Decision
Chapter 3: Everyone Has a Role in
Supporting Healthy Eating Patterns
 Sectors include systems (government, health care) and
businesses/industries that may influence degree in which
people have access to food or opportunities to be
physically active.
 Setting affects what choices individuals make home and
away from home. Setting = opportunities
 Social and cultural norms can be dictated by sectors an
setting and difficult to change.
 Individual settings- adapt eating pattern to fit all
requirements, budget, etc.
Strategies for Action
1. Sectors to foster relationship with food producers,
suppliers, and retailers
2. Sectors to identify policies and programs that promote
healthy eating/PA
3.Expand access to healthy and affordable safe and
affordable food choices
4.Provide nutrition programs that meet tailored needs for
community
5.Help individuals become more aware of nutrition patterns
and shift to align with dietary guidelines
6.Teach skills such as gardening, cooking, meal planning and
label reading
What is new?
 2015 dietary guidelines builds off of 2010 guidelines.
 Focus is on dietary patterns as a whole instead to specific
nutrients.
 Focus on shift to healthier, more nutrient dense food and
beverage choices rather than increasing intake of certain
foods
 Does not include dietary cholesterol for key
recommendations- IOM still suggests to consume as little
dietary cholesterol as possible within healthy eating
patterns
Application
 Used to help make programs such as the USDA
National School Lunch and Breakfast program, WIC,
and programs for older adults.
 Used by nutrition professionals to educate through
programs.
 General public is NOT the target audience
 Up to federal agencies how they wish to implementuse MyPlate, SuperTracker, and other federal
government resources for education
Questions?
“Let food be thy medicine, and medicine be thy food.” ―
Hippocrates, Greek Philosopher