2005 Dietary Guidelines and MyPyramid: Simple Steps To Improving the Health Of Your Patients

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2005 Dietary Guidelines and MyPyramid Simple
Steps To Improving the Health Of Your Patients
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Objectives

• Review history of Food Guide and Dietary
  Guidelines
• Review 2005 Dietary Guidelines and MyPyramid
• Review research supporting these recommendations
• Provide resources for health professionals and
  patients

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History of Dietary Recommendations

• 1894- First published dietary guidance by USDA
• 1941- 1st RDAs released by National Academy of
  Sciences
• Recommended intakes for calories and nine
  essential nutrients
• 1943- Basic Seven released by USDA
• Aided in meeting RDAs
• Addressed coping with limited food supply during
  wartime

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History of Dietary Recommendations

• 1956- Basic Four released by USDA
• Recommended 4 food groups milk, meat, fruits and
  vegetables, grains
• 1979- Hassle Free Guide to a Better Diet
  released by USDA
• Added 5th group to encourage moderation of fat,
  sugar and sodium

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History of Dietary Recommendations

• 1980- 1st Dietary Guidelines released by
  USDA/DHHS
• Provide authoritative, consistent guidance on
  diet and health
• 1984- A Pattern For Daily Food Choices released
  by USDA/Red Cross
• Designed to help consumers implement dietary
  guidelines

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History Of Dietary Recommendations

• 1990- National Nutrition Monitoring and Related
  Research Act-
• Legislation requiring USDA and DHHS to jointly
  publish DGs every 5 years
• 1992- Introduction of Food Guide Pyramid
• Nutrient recommendations become food
  recommendations
• Helps put DGs into action
• Shows variety, proportionality and moderation
• Target Healthy Americans age 2 and over

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History Of Dietary Guidance2005

• January 12th- 2005 Dietary Guidelines For
  American released
• April 19th- MyPyramid unveiled

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What are the Dietary Guidelines for Americans?

• Science-based advice to promote health and reduce
  risk of chronic diseases through diet and
  physical activity
• Basis for federal food, nutrition education, and
  information programs (NSLP, WIC)
• helps policymakers, educators, clinicians and
  others to speak with one voice on nutrition and
  health. -DG Report

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2005 Dietary Guidelines Process

• Dietary Guidelines Advisory Committee Appointed-
• 13 nutrition experts
• Reviewed scientific literature
• Sought advice of experts
• Considered public comment
• Wrote conclusive statements
• Sent recommendations to the Secretaries to form
  basis of guidelines

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9 Key Focus Areas

• Adequate nutrients within calorie needs
• Weight management
• Physical activity
• Food groups to encourage

• Fats
• Carbohydrates
• Sodium and Potassium
• Alcoholic beverages
• Food safety

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Food Guidance System MyPyramid

• Updates the Food Guide Pyramid
• Tool which incorporates 2005 Dietary Guidelines
  and makes recommendations on what and how much to
  eat.
• Simple
• Interactive
• Web Based
• Easily accessible (60 million hits first day)
• Individualized
• Uses familiar household measures

http//www.health.gov/dietaryguidelines/dga2005/fa
qs.htm
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MyPyramid Key Messages

• Make smart choices within every food group and
  between food groups
• Keep a balance between food intake and physical
  activity
• Get the most nutrients from your calories

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MyPyramid Recommendations Grains

• Make at least ½ of total grains eaten whole
  grains
• Consume 3 or more ounce-equivalents of whole
  grain products/day
• Individual needs based on calorie needs

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Whole Grains vs. Refined Grains

• Whole Grains- Foods made from the entire grain
  seed (usually called the kernel) which consists
  of
• Bran
• Germ
• Endosperm
• Refined Grains- Milled to remove bran and germ

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Health Benefits of Whole Grains

• Fiber rich foods, such as whole grains, can
• -- reduce risk of coronary heart disease
• may reduce constipation and maintain adequate
  laxation 
• gt/ 3 ounce equivalents/day of whole grains may
  help with weight management.
• Grains fortified with folate before/during
  pregnancy helps prevent neural tube defects

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What counts as an ounce equivalent of grains?

• 1 slice of bread
• 1 cup of ready to eat cereal
• ½ cup of cooked pasta, rice or cooked cereal

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Tips To Selecting Grains

• Choose foods with one of the these whole-grain
  ingredients first
• brown ricebulgurgraham flouroatmealwh
  ole-grain cornwhole oatswhole ryewhole
  wheatwild rice
• Probably not whole grain
• multi-grain, stone-ground, 100 wheat,
  cracked wheat, seven-grain, or bran
• Use Nutrition Facts label to choose grain
  products with a higher Daily Value (DV) for
  fiber
• Color is not an indication

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MyPyramid Vegetables

• Eat the equivalent of 2½ cups of raw or cooked
  vegetables per day (for a 2,000 calorie diet)

• Note this equivalent
• 2 cups raw leafy greens 1 cup of vegetable

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Recommendations for vegetables

• Vary your Veggies
• Eat more dark green vegetables
• This includes broccoli, kale, romaine lettuce and
  spinach
• Antioxidant properties are being studied for
  their ability to protect your eyes and keep your
  retinas strong as well as reduce the risk of
  cancerous tumors
• Eat more orange vegetables
• This includes carrots, sweet potatoes, pumpkin
  and winter squash
• Contain beta carotene that can help maintain
  heart health, vision health, enhance your immune
  system and may help prevent birth defects
• Keep the amount of starchy vegetables consumed
  each week to approximately 3 cups per week (on a
  2000 calorie diet)

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Health Benefits of Vegetables

• Provides a variety of nutrients and dietary fiber
  to your diet
• Helps reduce the risk of chronic diseases as part
  of an overall healthy diet

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MyPyramid Fruits

• Eat the equivalent of 2 cups of fresh, canned or
  frozen fruits per day (for a 2,000 calorie diet)

• Note this equivalent
• ¼ cup dried fruit ½ cup fruit

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Focus on fruits

• Eat 2 cups of fruits per day for a 2,000 diet
• Select fresh, frozen, canned, or dried fruit,
  rather than drinking fruit juice, for most of
  fruit choices

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Health benefits of fruit

• Nutrition research shows that colorful fruit and
  vegetables contain essential vitamins, minerals,
  fiber and phytochemicals that your body needs to
  promote health and help you feel great.

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How much do Americans pay for fruits and
vegetables?

• Among the 69 forms of fruits and 85 forms of
  vegetables included in an analysis, more than
  half were estimated to cost 25 cents or less per
  serving in 1999, and 86 percent of all vegetables
  and 78 percent of all fruit cost less than 50
  cents a serving.

http//www.ers.usda.gov/publications/aib790/
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• For optimum health, scientists say eat a
  rainbow of colors. Your plate should look like a
  box of Crayolas.
• Janice M. Horowitz,TIME, January 12, 2002

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MyPyramid Meat beans

• Eat 5½ ounce-equivalents (for a 2,000 calorie
  diet). Choose lean meat and poultry. Vary your
  choices more fish, beans, peas, nuts and seeds.

• 1 oz. Equivalents
• 1 oz. meat, poultry or fish
• ¼ cup cooked dry beans or peas
• 1 egg
• 1 tablespoon peanut butter
• ½ oz. of nuts or seeds

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Go Lean with Protein

• To be considered lean by the Government
  Guidelines, a 3 oz serving of meat must contain
• Less than 10 grams of fat
• Less than 4.5 grams of saturated fat
• Less than 95 milligrams of cholesterol

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Go Lean with Protein

• The leanest cuts of red meat have the word loin
  or round in the name.
• Tenderloin
• Beef top round steak
• Sirloin
• Round roast
• 17 of the top 20 most popular retail whole muscle
  cuts are lean

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Health benefits of meat and beans

• Protein helps you feel satiated
• Iron deficiency is the 1 nutrient deficiency in
  America. Eating meat and beans can help prevent
  this deficiency
• Provide a variety of nutrients to the body
  including essential fatty acids and vitamin E,
  zinc, and the B vitamins

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MyPyramid Dairy products

• Consume 3 cups per day of fat-free or low-fat
  milk or equivalent milk products
• Children ages 2 to 8 2 cups per day

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What counts as a dairy serving?

• 8 ounces of milk
• 8 ounces of yogurt
• 1 ½ ounces of natural cheese
• 2 ounces of processed cheese

• Foods made from milk that retain their calcium
  content are part of dairy group,
• Foods made from milk that have little to no
  calcium, such as cream cheese, cream, and butter,
  are not part of dairy group

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What if You Cant Consume Dairy?

• Calcium fortified beverages
• Fortified cereals
• sardines
• Tofu (fortified with calcium)
• Bioavailability of non-dairy sources may vary
• Calcium fortified foods/beverages (soy, juice,
  etc) may provide calcium, but may not provide
  other nutrients found in milk products

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Dairy products Health Benefits

• Provides nutrients necessary for bone health
• DASH Diet shown to significantly reduce blood
  pressure and reduce risk factors for heart
  disease
• May also be beneficial for wt management, certain
  cancers

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MyPyramid Oils and Fats

• Make most of your fat from mono/polyunsaturated
  sources fish, nuts and vegetable oils
• Limit solid fats like butter, stick margarine,
  shortening and lard
• Check Nutrition Facts label to keep saturated and
  trans fats low

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Why Are Oils Important to Our Diet?

• Major source of MUFAs and PUFAs in the diet
  which contain essential fatty acids necessary for
  health
• Major source of vitamin E in typical American diet

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Making Sense of Fats

• All fats and oils are a mixture of saturated and
  unsaturated fat
• Solid fats contain more sat fat and/or trans fats
  
• Oils contain more MUFA and PUFAs
• Saturated and trans fats tend to increase LDL
  cholesterol which increases risk of heart disease

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Making Sense of Fats

• Choose more
• Fish rich in Omega 3s salmon, trout, herring
• Vegetable oils Olive, canola, peanut, soybean,
  corn, safflower, sunflower
• Nuts and seeds

• Choose less
• Butter, stick margarine, shortening, lard
• Fried foods
• Partially hydrogenated vegetable oils (trans fat)

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How much oil should we have?

• Most Americans consume enough oil in the foods
  they eat, such as
• fish
• nuts
• cooking oil
• salad dressings
• A persons allowance for oils depends on age,
  sex, and level of physical activity.
• See MyPyramid.gov for individual allowances

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Know Limits on Sugars, Sweets and Salt

• Keep amount of sugars/sweets consumed within
  discretionary calorie allowance
• Choose food and beverages low in added sugars
• Added sugars contribute calories and few
  nutrients
• Keep sodium intake to lt2300 mg/day

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Discretionary Calories

• Calories remaining from estimated energy
  requirements (EER) after accounting for calories
  needed to meet nutrient needs
• EER represents intake to maintain energy balance
  in healthy person of specific age, gender,
  activity level, wt, ht
• Discretionary calories can be used to
• Eat more foods from any food group
• Select foods that contain added fat or sugar, ex,
  fried chicken vs. baked
• Add fats or sweeteners to foods (sauces,
  dressing, syrup)
• Eat or drink items that contain only fats,
  sweeteners or ETOH (soda, candy, beer)

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Source MyPyramid.gov
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Activity
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Find Your Balance between food and Physical
Activity

• Be physically active for at least 30 minutes most
  days of the week
• About 60 minutes a day of physical activity may
  be needed to prevent weight gain
• For sustaining weight loss, at least 60-90
  minutes a day of physical activity may be
  required
• Children and teenagers should be physically
  active for 60 minutes every day, or most days.

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• Moderate physical activities include
• Walking briskly (about 3 ½ miles per hour)
• Hiking
• Gardening/yard work
• Dancing
• Golf (walking and carrying clubs)
• Bicycling (less than 10 miles per hour)
• Weight training (general light workout)

• Vigorous physical activities include
• Running/jogging (5 miles per hour)
• Bicycling
• (more than 10 miles per hour)
• Swimming (freestyle laps)
• Aerobics
• Walking very fast (4 ½ miles per hour)
• Heavy yard work, such as chopping wood
• Weight lifting (vigorous effort)
• Basketball (competitive)

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How Can MyPyramid Help Improve the Health of Your
Patients?
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• In 2000, the total cost of obesity in the United
  States was estimated to be 117 billion in
  healthcare costs
• In 2000, health care costs associated with
  physical inactivity were more than 76 billion.
• If 10 of adults began a regular walking program,
  5.6 billion in heart disease costs could be
  saved.

http//www.cdc.gov/nccdphp/pe_factsheets/pe_pa.htm
August 2003, retrieved 3/5/05
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Cost of pills/month

• High cholesterol
• 95 to 100
• Diabetes
• 125 to 150
• High blood pressure
• 40 to 50
• Costs vary with type of medication and may be
  more or less than these amounts

Diet may help eliminate the need for medications
for some people
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Pills vs. food ever see side effects on a
food label?

• Dizziness
• Nausea
• Blurred vision
• Muscle cramps
• Headache
• Constipation
• Breathing difficulties
• Insomnia
• Decreased sex drive
• Tremors

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Tools and Resources For You and Your Patients
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Learn how much and what to eat for YOUR calorie
level at MyPyramid.gov
Submit age, gender and activity level for a
personalized MyPyramid
Check here for more information on food
groups related topics
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Individualized Recommendations
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Individualized Menu
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Diet Assessment Tools
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Diet Assessment Tools
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Physical Activity Assessment Tools
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Tracking Worksheet
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Customizing the Guidelines For Your Patients

• Identify one or two target recommendations that
  target a patients primary health needs to prevent
  info overload
• Acknowledge the concept of discretionary calories
  to meet patients desire to include foods higher
  in fat/sugar.

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Customizing the Guidelines For Your Patients

• Familiarize yourself with www.mypyramid.gov
• Stay abreast of current nutrition so you are well
  prepared to respond to patient questions in a
  informed way.

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USDA/HHS Resources

• www.healthierus.gov/dietaryguidelines
• www.MyPyramid.gov

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MyPyramid Resources

• www.beefnutrition.org
• Power foods tool
• MyPyramid tear pads and posters
• Nutrition research special reports
• Healthy School Nutrition resources

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MyPyramid Resources

• Nationaldairycouncil.org
• 5 day meal plan
• Superfoods checklist
• Information on science behind dairy group
  recommendations
• Health Education Kits
• Patient Education Materials

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Other resources

• www.eatright.org
• American Dietetic Association
• www.americaonthemove.org
• www.usda.org
• www.3aday.org
• Nutrition tips and recipes
• www.assessyourdiet.webmd.com
• WebMD Weight Loss Clinic
• www.nebeef.org
• Nebraska Beef Council
• www.drinkmilk.org
• Dairy Council of Nebraska