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Food as Health: New Proposed Dietary Guidelines for Americans

In late February, the U.S. Dietary Guidelines Advisory Committee (DGAC) issued its report recommending what Americans should be eating. Dietary guidelines are issued every five years, and this is the first step toward publishing the federal government’s official guidelines later this year.

The DGAC only makes recommendations. The feds can choose to take those recommendations or toss them or do something in between, which is what they usually do. They take the DGAC’s advice—for the most part—but tweak it for practical use. 

Speedy trip through supermarket creates major motion blur on shelves

The Latest Findings in Food and Nutrition
When you’re in the nutrition field, the DGAC report is a hotly anticipated event. The media treat it the same way, because it’s the culmination of a lot of committee meetings about the latest and greatest nutrition research, which is used to formulate the DGAC’s report on what Americans should be eating.

The media have a field day, especially if there’s some new and controversial statement contained about what or how much to eat of this or that. Should we stop eating that or start having this every day?

The U.S. Dietary Guidelines are meant for persons ages 2 and up. They serve as a cornerstone for federal nutrition policy and nutrition education efforts. They also provide a reference point for programs such as those used in the military, and large-meal programs such as various school nutrition efforts.  

What Changes, What Doesn’t, in the DGAC Report?

The report is 500 pages long. Here are a few of the highlights:

  • Cholesterol: Forget the 300 mg./day limit. It has been dropped. The guidelines are not a cholesterol-fest, but the DGAC just didn’t find evidence linking dietary cholesterol to cardiovascular disease. While this has been coming for quite some time, it’s quite shocking when you think that cholesterol was once considered such a curse.
  • Saturated fat: The DGAC DID find associations here with cardiovascular disease, so the committee maintained its recommendation of a maximum of 10 percent of calories from this stuff.
  • Sodium: People ages 50 and up and African Americans of all ages can rejoice: forget that previous 1,500 mg./day to which you were advised to adhere. The DGAC says: keep it to 2,300 mg./day. Enough said. This at least allows for a bowl of Mom’s chicken soup and a condiment here and there.
  • Sugar? Yes, but as with the guidelines for saturated fat, not more than 10 percent of calories. The bottom line for patients is this: cut back on added sugar and empty-calorie drinks and spend your sugar calories wisely. They’re rationed.
  • Specific diets are called out: Most weight-loss diets have similar results after about 12 months. Some “eating styles” are better than others, but there’s more than one way to the top of the mountain. The Dietary Approaches to Stop Hypertension (DASH) diet was cited as excellent, as were the Mediterranean diet and a vegetarian diet. Doctors, work with your patients to see what the best fit would be for their style. The world is round, and it’s time we recognized that there can be more than one type of healthful diet.

Guidelines . . . not “Prescriptions”
What the guidelines are NOT is a prescription for each and every American. As health professionals, we don’t have to follow these to the letter when counseling patients and clients. Indeed, that would lead us to constant disappointment. Some years ago, a Journal of Nutrition article found that only about 4 percent of people actually met all the DGAC dietary guidelines, and that was when those weren’t so strict as they are now. One in 25 people eating as recommended? That’s close to batting zero. I like better odds, so I aim first to help my patients at the nutrition clinic of the Children’s Evaluation and Rehabilitation Center at Albert Einstein College of Medicine close their dietary gaps. Then we go from there as best we can.

The best “guideline” I’d give a health professional who counsels patients about diet and lifestyle is to look at the big picture, not each food or each meal or even each day. Stop talking about “good” and “bad” foods, because it backfires and people can’t help feeling “good” or “bad” about eating them. It’s more about how much and how often they eat a food that matters. When it comes to salty, fatty, sugary or empty-calorie food, this means probably less often and less of it, but patients need to know it’s not about “Never eat it again.”

Finally, if all this seems tiresome, maybe you need a good cup of coffee. Fear not, for the DGAC said that up to 400 mg. of caffeine per day has not been associated with negative side effects and may even reduce risk for some diseases, including Parkinson’s, diabetes and cardiovascular disease. That amounts to about four 8-oz. cups of brewed coffee daily, a lot for many people, and no need to start drinking coffee if you don’t already do so.  For those who like it however, just swap the half-and-half for lowfat milk—most of the time.

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Keith-Thomas Ayoob, ED.D.

Keith-Thomas Ayoob, ED.D.

Dr. Ayoob is director, Nutrition Clinic, Children’s Evaluation and Rehabilitation Center at Montefiore and associate clinical professor, pediatrics at Albert Einstein College of Medicine.

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