Title: Rebuilding the Food Guide Pyramid
1 The 2005 Dietary Guidelines for Americans
Benjamin Caballero, MD, PhD Center for Human
Nutrition
2History of Dietary Guidelines
- 1977 Dietary Goals for the U.S. (Senate)
- 1979 Healthy People Surgeon Generals Report
(HHS) - 1980 First Edition of Dietary Guidelines (HHS and
USDA)
31980 1985 1990 1995
42000
5(No Transcript)
6Dietary 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
7What 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
8Legislated 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.)
92005 DGA Committee
- Vay Liang W. Go, MD
- University of California at Los Angeles, Los
Angeles, CA - Penny M. Kris-Etherton, PhD, RD
- Penn State University, University Park, PA
- Joanne R. Lupton, PhD
- Texas AM University, College Station, TX
- Theresa A. Nicklas, DrPH, MPH, LN
- Baylor College of Medicine, Houston, TX
- Russell R. Pate, PhD
- University of South Carolina, Columbia, SC
- F. Xavier Pi-Sunyer, MD, MPH
- Columbia University College of Physicians and
Surgeons, - New York, NY
- Janet King, PhD, RD (Chair)
- Childrens Hospital Oakland Research Institute,
Oakland, CA - Lawrence J. Appel, MD, MPH
- Johns Hopkins Medical Institutions, Baltimore, MD
- Yvonne L. Bronner, ScD, RD, LD
- Morgan State University, Baltimore, MD
- Benjamin Caballero, MD, PhD
- Johns Hopkins University Bloomberg School of
Public Health, Baltimore, MD - Carlos A. Camargo, MD, DrPH
- Harvard University, Boston, MA
- Fergus M. Clydesdale, PhD,
- University of Massachusetts, Amherst, Amherst, MA
10Systematic 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
11Systematic 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
12Opportunities for Public Comments
- Over 400 public comments submitted to the
Committee - Written comments were accepted throughout the
Committees deliberations - Oral presentations were made at the January 2004
meeting
13Content of Science Base
- Aiming to Meet Nutrient Intake Recommendations
- Energy
- Discretionary Calories
- Fats
- Carbohydrates
- Selected Food Groups
- Fluid and Electrolytes
- Ethanol
- Food Safety
14Key Scientific Recommendations
- Consume a variety of foods within and among the
basic food groups while staying within energy
needs - Control calorie intake to manage body weight
- Be physically active every day
- Increase daily intake of fruits and vegetables,
whole grains, and reduced-fat milk and milk
products - Choose fats wisely for good health
- Choose carbohydrates wisely for good health
- Choose and prepare foods with little salt
- If you drink alcoholic beverages, do so in
moderation - Keep food safe to eat
15Nutrient 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
16Nutrient 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.
17Nutrient 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.
18Nutrient 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
19Energy 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.
20Discretionary calories
Discretionary
EER
Essential
21Energy Balance
Control calorie intake to manage body weight
- Most Americans need to reduce the calories they
consume. - For weight control, calories do countnot
proportions of carbohydrate, fat, and protein. - The healthiest way to reduce calorie intake is to
reduce intake of added sugars, solid fat, and
alcoholthey 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.
22Physical 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.
23Physical 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.
24Physical 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.
25Fats 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
26Fatty 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.
27Carbohydrates
- 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 -
28Selected 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
29Sodium 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.
30Alcohol
- 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.
31Food 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.
32Food 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).
33 change in current intake needed to meet the
2005 DG - Main food groups
34 change in current intake needed to meet the
2005 DG - Subgroups, solid fats and added sugars
35- www.health.gov/dietaryguidelines
- www.cnpp.usda.gov/DG2005