Dietary Guidelines
DIETARY GUIDELINES FOR AMERICANS: NO-NONSENSE ADVICE FOR HEALTHY EATING
Reprinted from the November 1985 issue of the FDA Consumer, a publication of the Food and Drug Administration.
Advice on what Americans should or should not be eating to be healthy is as abundant–perhaps as overabundant–as the food supply in the United States. The public’s dilemma was summed up in a recent speech by Sanford A. Miller, Ph.D., director of FDA’s Center for Food Safety and Applied Nutrition, when he noted: “Consumers are bombarded constantly from many sources with an overload of information and misinformation about nutrition and health. Realistic, reliable guidance is critically needed to help the public sift and weigh this barrage of information, to make intelligent nutrition choices among the thousands of attractive foods in supermarkets, and to select food in the many places where it is consumed away from the home.”
The latest “Dietary Guidelines for Americans,” made public in September by the U.S. Department of Health and Human Services, are intended to provide healthy Americans with sensible, uncomplicated guidance of the kinds of foods they should be eating. Basically, their advice to Americans is: concentrate on eating a balanced and varied diet that provides the nutrients essential to good health, increase consumption of starch and fiber, but reduce fat, sugar, sodium and alcohol. A nine-member committee of nutrition experts reviewed the latest scientific data before making its recommendations to the two federal departments. The committee stressed that current scientific evidence does not support more specific advice for the general public.
(For more information, see “Why is Uncle Sam Telling Us What to Eat” in the Rare Disease Reference Materials.)
The 1985 guidelines differ little from those announced by USDA and HHS in February 1980. The advisory committee concluded that no recent nutrition research was persuasive enough to warrant any major changes. Not enough is known to describe an “ideal” diet for every individual because nutrition needs vary according to a person’s sex, age, health, body size, and other factors. So the guidelines are aimed at those Americans who are in good health. They do not apply to people with diseases or conditions that affect nutritional needs.
A healthy, pregnant woman, for example, has special dietary needs. A person suffering from a chronic ailment–heart disease, cancer, high blood pressure, diabetes, and other conditions–may also have special diet requirements. Nutritional requirements also can be influenced by medications.
More than 40 different nutrients–in the form of vitamins, minerals, amino acids (from proteins), essential fatty acids (from fats and oils), and calories from carbohydrates, fats and proteins–are needed for good health. However, no one can be expected to keep track of all of them. Instead, most people generally can expect to satisfy their nutritional requirements by eating a variety of foods.
The guidelines do not suggest specific goals for such substances as fats and dietary fiber because of the need for more research. Instead, the guidelines state that “for the U.S. population as a whole, increasing starch and fiber in our diets and reducing calories (primarily from fats, sugars and alcohol) is sensible. These suggestions are especially appropriate for people who have other risk factors for chronic diseases, such as a family history of obesity, premature heart disease, diabetes, high blood pressure, high blood cholesterol levels, or for those who use tobacco, particularly cigarette smokers.”
Nutritionists are able to offer more specific advice about requirements for energy (calories), protein, and certain vitamins and minerals through the Recommended dietary Allowances that are updated periodically by the Food and Nutrition Board of the National Academy of Sciences. Food product labels, in many instances, also provide consumers with valuable nutrition information, as well as a listing of ingredients used in foods.
Here are the seven guidelines and the rationale for each of them:
- EAT A VARIETY OF FOODS
Most foods have more than one nutrient, but no single food provides all the essential nutrients. That is achieved by eating a balanced, varied diet that emphasizes the major food groups–fruits and vegetables; cereals and other foods made from grains; dairy products; and meats, fish, poultry, eggs, and dry beans and peas.
For example, dairy products such as milk are a source of protein, fats, sugar, vitamin A, riboflavin and other B vitamins, calcium, phosphorus, and other nutrients. But they provide little iron. Meat provides protein, several B vitamins, iron and zinc but little calcium. Vitamins A and C, folic acid, fiber, and various minerals are obtained from fruits and vegetables. Whole-grain and enriched breads, cereals, and other grain products provide B vitamins, iron, protein and fiber.
Although there are some exceptions, a varied diet based on these food groups will satisfy the nutrient requirements of most healthy individuals without the need for supplements. “There are no known advantages and some potential harm in consuming excessive amounts of any nutrient,” the guidelines stress. “Large dose supplements of any nutrient should be avoided. You will rarely need to take vitamin or mineral supplements if you eat a variety of foods.”
However, there are some exceptions. Iron supplements often are needed by women in their childbearing years. Pregnant and breast-feeding women have an increased need for certain nutrients, notably iron, folic acid, vitamin A, and calicum. Infants also have special nutritional needs. Breast- feeding is recommended for the first three to six months because infants absorb nutrients from breast milk better than cow’s milk. Breast milk also contains substances that provide immunity to some diseases until the infant’s body is able to produce these substances itself.
After three to six months, babies can start taking solid foods. Prolonged breast- or bottle-feeding without solid foods or iron supplements can result in iron deficiency, the guidelines point out. Flavoring baby foods with salt and sugar also is discouraged.
Elderly people also have to be extra careful about getting enough of all the essential nutrients because many older people eat less. The guidelines stress meals based on the basic food groups and a reduction in the consumption of fats, oils, sugars, sweets, alcohol and other foods that are high in calories but low in other nutrients. Some elderly men and women who take certain medications that affect nutrient intake also may require supplements. Such supplements, however, should be taken only under the guidance of a physician.
2. MAINTAIN A DESIRABLE WEIGHT
Experts estimate that one-third or more of all adult Americans are overweight and that, at any given time, more than 20 million Americans are resorting to diets to shed excess weight. Obesity is a major health concern in the United States, for it increases the risk of such chronic diseases as high blood pressure, heart disease, stroke and diabetes.
Although many Americans keep searching for easy paths to losing weight, most such efforts are doomed to failure, in the view of most nutrition experts. Losing weight and not regaining it, the guidelines suggest, means eating foods high in nutritional value but with fewer calories, getting more exercise, and shedding weight at a sensible, gradual rate, a pound or two each week.
Quick weight-loss schemes are looked upon with disfavor. “Long-term success depends on new and better habits of eating and exercise,” the guidelines stress. “That is why so-called ‘crash’ and ‘fad’ diets usually fail in the long run.
The guidelines warn that diets of less than 800 calories a day can be hazardous and should be followed only under medical supervision. Severely restricted, low-calories diets make it extremely difficult to obtain the nutrients essential to maintaining good health, and they can have adverse effects. The guidelines warned: “Some people have developed kidney stones, disturbing psychological changes, and other complications while following such diets. A few people have died suddenly and without warning.”
Frequent use of laxatives, induced vomiting, and other extreme measures should not be used to lose weight, according to the guidelines. Such actions can cause chemical imbalances that can lead to irregular heartbeats and even death.
The emphasis should be on keeping body weight at a reasonable level for one’s sex, age and height. A table of “desirable body weight ranges” is included in the guidelines.
Severe weight loss–below what is recommended–also is discouraged. Some people have suffered nutrient deficiencies, infertility, hair loss, skin changes, cold intolerance, severe constipation, psychiatric disturbances, and other complications from excessive weight losses. A doctor should be seen about any sudden, unexplained loss of weight.
3. AVOID TOO MUCH FAT, SATURATED FAT, AND CHOLESTEROL
The American diet generally is high in fat and cholesterol compared to some countries, and Americans tend to have high blood cholesterol levels. High blood cholesterol is one of the risk factors for heart attack. Nutritionists lack enough research data to make specific recommendations about how much fat and cholesterol the general public should eat, but the guidelines urge a sensible reduction in total fat–especially saturated fat- -and cholesterol.
Among the suggested ways of doing this is to trim excess fat off meats and to eat lean meat, fish, poultry, and dry beans and peas as protein sources; use low-fat dairy products; eat moderate amounts of eggs and organ meats; limit intake of foods high in saturated fat, such as butter, cream, heavily hydrogenated fats, shortenings, and foods with palm and coconut oils; and broil or bake, rather than fry, foods.
The effect of diet on blood cholesterol levels varies among individuals. Some people–for reasons not completely understood–can eat foods high in saturated fat and cholesterol and maintain reasonable blood cholesterol levels, while others on low-fat, low-cholesterol diets still end up with high cholesterol levels. Heredity is believed to play a role. Acknowledging the controversy over what recommendations would be appropriate for the general public, the guidelines state that it would be “sensible” for Americans to reduce their daily consumption of fat. This is especially appropriate, the guidelines say, for individuals who have other cardiovascular risk factors, such as smoking or family histories of premature heart disease, high blood pressure, and diabetes. The guidelines do not suggest complete avoidance of any foods, because many foods that contain fat and cholesterol also provide high-quality protein and many essential vitamins and minerals.
4. EAT FOODS WITH ADEQUATE STARCH AND FIBER
As in 1980, the guidelines favor a moderate increase in consumption of fiber-containing foods. The American diet generally is low in fiber, yet there is evidence that fiber can help reduce chronic constipation, diverticular disease, and some types of “irritable bowel.” Fruits, wholegrain breads and cereals, vegetables, dry beans and peas, and nuts are good sources of starch and fiber.
Carbohydrates and fat are major sources of energy (calories). If Americans cut back on fat consumption, energy needs can still be met from carbohydrates, especially the complex carbohydrates. “Carbohydrates are especially helpful in weight reduction diets because, ounce for ounce, they contain about half as many calories as fats do,” the guidelines said.
Simple carbohydrates like sugar provide calories but little other nutritional benefit. In contrast, complex carbohydrates–such as starch in bread and other grain products, beans, peas, nuts, seeds, fruits and vegetables–contain other essential nutrients. Also, eating more foods with complex carbohydrates adds dietary fiber.
(Dietary fiber describes parts of plant foods that generally are not digestible by humans. Foods differ in the kinds of fiber they contain. Wheat bran has several kinds of fiber and has laxative properties but does not affect blood cholesterol levels. Other kinds of fiber have no laxative effects but seem to reduce blood cholesterol.)
Although in recent years there have been studies suggesting that the risk of colon cancer is greater among those with low-fiber diets, the guidelines state that more research is needed before definitive judgments can be made. “How dietary fiber relates to cancer is one of many fiber topics under study,” the guidelines state.
5. AVOID TOO MUCH SUGAR
It is not necessary to avoid eating simple sugars. It would, in fact, be difficult, because sugars are naturally present in many foods and are added to many processed products, usually in the form of sucrose, glucose, maltose, dextrose, lactose, fructose, corn sweeteners, honey and syrups. The major health concern with excess sugar consumption is tooth decay, especially when sugars (and starches, as well) are consumed between meals. The guidelines also restate the age-old advice about proper dental hygiene, brushing after meals, drinking fluoridated water, and using fluoridated toothpastes or mouth rinses.
6. AVOID TOO MUCH SODIUM
Sodium is essential to the human body, but most Americans consume far more than they need, especially from table salt (which is 40 percent sodium). An intake of 1,100 to 3,300 milligrams a day is generally recommended. Salt is not the only source, for a wide variety of sodium compounds is used in many processed foods and beverages. The principal concern with high sodium consumption is for people with hypertension (high blood pressure) and those who may be susceptible to it.
7. IF YOU DRINK ALCOHOLIC BEVERAGES, DO SO IN MODERATION
In urging moderate use of alcohol, the guidelines also support the national effort to discourage drinking and driving. From a nutritional standpoint, alcohol is high in calories but provides virtually no other nutritional benefit. The guidelines note that one or two standard-sized drinks daily appear to cause no harm in healthy adults.
Overweight people should be aware that alcohol adds calories. Heavy drinkers especially can suffer appetite loss, and this can lead to nutritional deficiencies and other health problems, such as cirrhosis of the liver and some types of cancer.
Pregnant women are advised by the National Institute of Alcohol Abuse and Alcoholism to refrain from drinking alcohol because excessive consumption may cause birth defects or other problems during pregnancy. The level of consumption at which risks to an unborn child occur has not been established, the guidelines declare.