Secrets of Uncle Sams Nutrition Prescription

0

IMAGE © THINKSTOCK

Every five years, your Uncle Sam rounds up the latest scientific evidence about nutrition and serves up advice about what to eat and drink for better health. The resulting Dietary Guidelines for Americans (DGA) – whose eighth edition was released in January – provides basic guidance to the American public about healthy eating patterns and shapes nutrition education programs. The DGA also affects billions of dollars in federal spending on feeding programs and influences foods available in markets and restaurants.

But what do the guidelines mean for your everyday food and beverage choices? “These guidelines outline simple steps for small shifts in your eating habits to improve the quality of your diet, or in some cases – for example, replacing sugar-sweetened beverages with water or seltzer – to make large shifts in quality,” says Alice H. Lichtenstein, DSc, executive editor of the Tufts Health & Nutrition Letter, who served as vice chair of the scientific advisory committee whose report formed the foundation of the updated guidelines. Two other Tufts faculty served on or advised this committee. (See the May 2015 newsletter.)

PATTERNS PAY OFF: In this edition, the DGA dramatically increases emphasis on the importance of overall healthy eating patterns – rather than focusing just on individual foods or nutrients. That emphasis is not on any one eating pattern but on improving the quality of individuals’ current diets. For those who want it, examples are given of patterns such as the Healthy US-Style Eating Pattern, Mediterranean-style diet, the DASH eating plan or a vegetarian diet. (See bottom of next page.)

It’s estimated that half of all US adults – about 117 million people – suffer from preventable, diet-related chronic diseases. Shifting to healthier eating patterns can help bring about lasting improvements in individual health, according to the DGA report.

Dariush Mozaffarian, MD, DrPH, dean of Tufts’ Friedman School and editor-in-chief of the Health & Nutrition Letter, praises the emphasis on dietary patterns and also the new emphasis on healthy fats, including vegetable oils and nuts.

The new DGA also made headlines for recommendations regarding specific nutrients, such as limiting added sugars, as well as for reducing emphasis on concern about total fat and dietary cholesterol. For the first time, too, the DGA mentions coffee, stating that “moderate coffee consumption can be incorporated into healthy eating patterns.” Other key guidance should be familiar, such as the importance of eating more vegetables, fruits and whole grains.

As before, the updated DGA recommends engaging in moderate levels of physical activity. Although physical activity is now covered by a separate report, those recommendations have been brought forth and included in the DGA.

Here are seven key points to keep in mind about what Uncle Sam’s updated nutrition prescription means to you and your health:

1. All your food and beverage choices matter: A healthy eating pattern isn’t just eating more of one or two foods and less of a few others. The whole of your diet, at an appropriate calorie level, is important to help achieve and maintain a healthy body weight, obtain adequate nutrients, and reduce the risk of chronic disease. According to the DGA, a healthy eating pattern includes:

– A variety of vegetables. (Be careful here, though, Dr. Mozaffarian adds, about loading up on just starchy vegetables such as white potatoes.)

– Fruits, especially whole fruits.

– Grains, at least half of which are whole grains.

– Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages.

– A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products. (Tufts’ Lichtenstein recommends limiting red and processed meat, and eating more of the other healthier options.)

– Oils, including those from plants such as canola, corn, olive, peanut, safflower, soybean and sunflower, as well as those naturally present in nuts, seeds, olives, seafood and avocados.

2. Aim for nutrient density: To get the nutrients you need without consuming empty calories, choose foods that are “nutrient dense.” According to the DGA, “All vegetables, fruits, whole grains, seafood, eggs, beans and peas, unsalted nuts and seeds, fat-free and low-fat dairy products, and lean meats and poultry – when prepared with little or no added solid fats, sugars, refined starches, and sodium – are nutrient-dense foods.” Avoid foods that have been “diluted” by the addition of calories from added animal fats, sugars or refined starches.

3. Cut down on added sugars: For the first time, the new DGA calls for limiting added sugars to less than 10% of calories per day. In a 2,000-calorie daily diet, that means no more than 200 calories from added sugars, roughly 12 teaspoons or 52 grams – about the amount in a single regular 16-ounce soft drink. Since Americans get added sugars from so many foods, in practice this means much less than one soda per day. Naturally occurring sugars such as those in milk or fruits don’t count toward this limit, because they come with valuable nutrients and fiber. Americans currently get about 13% of daily calories from added sugars, with teens closer to 17%; nearly half of added sugars come from sweetened beverages, such as sodas, sports drinks and fruit drinks.

The Food and Drug Administration has proposed including a line for added sugars in revising the Nutrition Facts panel. Pending that change, use common sense, compare the total amount of sugars in similar products, and check ingredients lists for terms indicating sugar of any type. Simply cutting out soda, sports drinks and fruit drinks will get most Americans in line with the 10% limit.

For many food choices, Dr. Mozaffarian adds, it’s important to focus on added sugars plus starch. See: (Choose the Right Carbs to Help Control Your Diabetes Risk)

4. Not all fats are the same: The DGA also broke new ground by abandoning previous guidelines’ limits on total fats. This change reflects the scientific consensus that different fats affect health differently, and a recognition that too many Americans have replaced fats with refined carbohydrates.

The DGA still recommends limiting saturated fat to less than 10% of calories a day, with replacement with polyunsaturated fat, despite some recent controversies over the role of saturated fat in heart disease. Foods high in saturated fat include butter, whole milk, meats not labeled as “lean,” and tropical oils such as palm and coconut oil. Dr. Mozaffarian notes that increasing healthy fats, in place of saturated fat or carbohydrates, leads to similar heart benefits.

Not surprisingly, the DGA also continues to warn against trans fats such as those found in partially hydrogenated vegetable oils. Last year the FDA announced that such trans fats would no longer be “generally recognized as safe” in foods by mid-2018. (See the September 2015 newsletter.)

Another change from prior guidelines, however, has the DGA following the headline-making recommendation of the advisory committee to drop emphasis on dietary cholesterol, which was hailed by egg lovers. (See the February 2016 newsletter.) But that doesn’t mean you should gobble eggs or other high-cholesterol foods every day: “This change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns,” the DGA report cautions. “As recommended by the Institute of Medicine, individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern.”

5. Go moderate on meat: Although the DGA does not explicitly echo the advisory committee’s advice to consume less red and processed meat, the recommendations do emphasize eating a variety of types of protein-rich foods such as those that come from plants and seafood instead. Processed meats and poultry are also sources of sodium and saturated fats, the DGA notes.

“The DGA explicitly does not say to moderate meat intake,” Dr. Mozaffarian notes. “This was a major departure from the advisory committee report.” He advises going beyond the DGA in cutting back on meat and especially processed meat: “Extensive evidence suggests that processed meats increase the risk of cardiovascular disease and diabetes.”

In another new development, the DGA advises men and teen boys to “reduce overall intake of protein foods by decreasing intakes of meats, poultry and eggs and increasing amounts of vegetables or other underconsumed food groups.”

6. Keep watching your sodium: Despite some controversy over the optimal levels of salt, the DGA retains the previous advice to limit sodium intake to less than 2,300 milligrams daily. That does represent some loosening of the limits, however, dropping a 2010 caveat that people 51 and older, African-Americans, and those with hypertension, diabetes or kidney disease aim instead for 1,500 milligrams daily. That lower limit applied to almost half the population and a majority of adults. Nearly all Americans consume more than 2,300 milligrams a day, however, so choosing low-sodium foods should be a priority for all.

7. Limit refined grains and starches: Though not as headline-making as other DGA recommendations, the updated guidelines advise limiting intake of refined grains and products made with refined grains and starches. Dr. Mozaffarian suggests that this should have been more prominent: “Refined grains should clearly be limited to reduce diabetes, obesity and heart disease.”

Of course, you should especially avoid such products that are also high in saturated fats, added sugars and/or sodium, such as cookies, cakes and many snack foods. The recommended amount of grains in the DGA’s “Healthy US-Style Eating Pattern” at the 2,000-calorie level is six ounce-equivalents per day, of which at least half should be whole grains.

More than half the population, the report notes, meets or exceeds recommended intakes for total grains – but falls short in consuming whole grains. If your diet is heavy on white bread, crackers, rolls and buns, baked goods, pasta and white rice, you’re probably getting more than three ounces of refined grains daily. The fix is easy: Switch part of these choices to whole grains, and replace the rest with fruits, nuts, vegetables, beans, fish, yogurt and vegetable oils.

HEALTHY DIETARY PATTERNS

You can read the entire new Dietary Guidelines for Americans at <health.gov/dietaryguidelines/2015/guidelines>.

It includes examples of healthy eating patterns such as:

Healthy US-Style Eating Pattern <health.gov/dietaryguidelines/2015/guidelines/appendix-3>.

Healthy Mediterranean-Style Eating Pattern <health.gov/dietaryguidelines/2015/guidelines/appendix-4>. You can also learn more about the Mediterranean diet at <oldwayspt.org/resources/heritage-pyramids/mediterranean-diet-pyramid>.

Healthy Vegetarian Eating Pattern <health.gov/dietaryguidelines/2015/guidelines/appendix-5>.

DASH (Dietary Approaches to Stop Hypertension) Eating Plan. You can learn more about DASH at <www.nhlbi.nih.gov/health/health-topics/topics/dash>.

LEAVE A REPLY

Please enter your comment!
Please enter your name here