2010 Dietary Guidelines Target Unhealthy Americans

With more than one-third of children and more than two-thirds of adults in the United States either overweight or obese, the 2010 Dietary Guidelines for Americans—released January 31, 2011, by the U.S. Dept. of Agriculture (USDA) and U.S. Dept. of Health and Human Services (HHS)—offer practical nutritional and lifestyle advice for these unhealthy individuals. “The bottom line is that most Americans need to trim our waistlines to reduce the risk of developing diet-related chronic disease. Improving our eating habits is not only good for every individual and family, but also for our country,” declared USDA Secretary Tom Vilsack. He also stated that obesity “is a crisis that we can no longer ignore.”

A large proportion of dollars for healthcare in America is spent on diet-related chronic diseases. These maladies include type 2 diabetes, hypertension, osteoporosis, some forms of cancer, and cardiovascular disease. “Helping Americans incorporate these guidelines into their everyday lives is important to improving the overall health of the American people. The new dietary guidelines provide concrete action steps to help people live healthier, more physically active, and longer lives,” said HHS Secretary Kathleen Sebelius.

Key Dietary Recommendations
The scientific evidence-based guidelines—which form the basis of federal nutrition policy, education, communication outreach, and food assistance programs used by consumers, industry, nutrition educators, and health professionals—emphasize calorie balance (i.e., calories consumed vs. calories expended through physical activity) and eating less to maintain a healthy weight. The guidelines also encourage Americans to eat more nutrient-dense and healthy foods (e.g., fruits, vegetables, whole grains, fat-free and low-fat dairy products, and seafood) and to consume less sodium, saturated and trans fats, added sugars, and refined grains (Figure 1).

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The guidelines include 23 key recommendations for the general population and six additional ones for specific population groups, such as pregnant women. To simplify the messages in the recommendations and make them actionable for consumers, the guidelines also include some everyday tips, such as:

• Enjoy your food, but eat less.

• Make half your plate fruits and vegetables.

• Switch to fat-free or low-fat milk.

• Drink water instead of sugary drinks.

“Since the 2005 guidelines, we have learned that consumer messages need to be simple, direct, actionable and focused on behavior change—more or less giving a how-to as opposed to just giving information,” stated Robert Post, Deputy Director, USDA’s Center for Nutrition Policy and Promotion (CNPP). Informational messages are not effective. The messages need to be motivating and answer the question of what’s in it for me, added Post.

In addition to delivering the right messages, CNPP is making sure that the messages reach consumers where they make their food choices, such as supermarkets, restaurants, homes, schools, healthcare facilities, and fitness centers, through collaborative partnerships. CNPP is also enhancing its interactive, online education tools to help consumers manage their weight, achieve dietary goals, plan menus, create recipes, and easily find nutrition and calorie information on a variety of foods and beverages.

Perhaps the greatest asset for communicating the dietary guidelines to consumers is the White House. “All of our stars have aligned,” declared Post. “One of the top goals of this administration is to improve public health, reduce healthcare costs, and improve productivity, and they all relate to the 2010 Dietary Guidelines for Americans, President Barack Obama’s Task Force on Childhood Obesity, and First Lady Michelle Obama’s Let’s Move! campaign to reduce or eliminate childhood obesity within a generation. We have tremendous commitment, dedication, and visibility.”

Foods & Components to Avoid
Chapter 3 of the dietary guidelines policy document details foods and food components to reduce in the diet. These include sodium, solid fats/saturated fats/trans fats, added sugars, and refined grains.

• Sodium. Americans consume about 3,400 mg of sodium/day. The guidelines recommend daily sodium intake of less than 2,300 mg, and 1,500 mg for persons over 50 years of age, African Americans, and those who have hypertension, diabetes, or chronic kidney disease. The 1,500 mg limit applies to about half of the U.S. population, including children, and most adults. Yeast breads contribute 7.3% of sodium in the diet and are the largest source of sodium, followed by chicken and chicken mixed dishes (6.8%), pizza (6.3%), pasta and pasta dishes (5.1%), and cold cuts (4.5%).

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• Solid fats, saturated fats, and cholesterol. The American diet contains too much solid fat, which contributes significantly to excess calorie intake and about 19% of total calories. Despite years of advice to reduce fat in the diet, total fat intake supplies about 34% of the calories eaten today. The dietary guidelines recommend reducing saturated fats to less than 10% of calories and replacing them with monounsaturated (i.e., canola, olive, and safflower oils) and polyunsaturated (i.e., soybean, corn, and cottonseed oils) fatty acids, which have been shown to reduce blood cholesterol levels and thus lower the risk of cardiovascular disease. Major sources of saturated fat in the diet include full-fat cheese (8.5%), pizza (5.9%), grain-based desserts (5.8%), dairy desserts (5.8%), and chicken and chicken mixed dishes (5.5%). The guidelines recommend that cholesterol intake be less than 300 mg/day. Eggs and egg dishes are a major source of cholesterol and represent about 25% of total cholesterol intake. However, scientific evidence suggests that eating one egg/day does not result in increased blood cholesterol levels, nor does it heighten the risk of cardiovascular disease in healthy individuals.

• Added sugars. Food manufacturers add sugar and other nutritive sweeteners to improve the taste of their products, as a preserving agent, and to provide functional attributes, such as texture. Added sugars contribute about 16% of total calories in the American diet. Major sources of added sugars include soft drinks/energy drinks/sports drinks (35.7%), grain-based desserts (12.9%), fruit drinks (10.5%), dairy desserts (6.5%), and candy (6.1%). In combination, added sugars and solid fats contribute about 35% of total calories or nearly 800 calories/day, with minimal contribution of nutrients. The dietary guidelines recommend that most individuals should consume no more than 5–15% of calories from solid fats and added sugars, which are also known by the acronym SoFAS.

• Refined grains. In many cases, refined grains are formulated with solid fats and added sugars. Major sources of refined grains include yeast breads (25.9%), pizza (11.4%), grain-based desserts (9.9%), tortillas/burritos/tacos (8%), and pasta and pasta dishes (6.7%). Every day, Americans consume about 6.3 oz-equivalents of refined grains, and the dietary guidelines suggest that refined grains make up no more than 3 oz-equivalents/day. Consumers are urged to replace refined grains with whole grains, which should be at least half of all grains eaten. Moderate scientific evidence suggests that eating whole grains may decrease the risk of cardiovascular disease and is related to a lower body weight.

Foods & Nutrients to Embrace
Chapter 4 of the dietary guidelines document outlines foods that are nutrient dense and are needed to overcome nutrient deficiencies. These include fruits and vegetables, whole grains, fat-free or low-fat milk products, various plant proteins, seafood, oils, and four nutrients of public health concern—dietary fiber, potassium, calcium, and vitamin D.

• Fruits and vegetables. The dietary guidelines recommend that fruits and vegetables make up half of Americans’ typical plate of food. Why? Because fruits and vegetables contain many nutrients that are under-consumed in the American diet. Eating these foods is associated with reduced risk of many chronic diseases and, when prepared without added fats or sugars, most fruits and veggies are low in calories. The dietary guidelines advise eating a variety of vegetables, especially dark green and orange vegetables and beans and peas.

Roger Clemens, President-Elect of IFT and a member of the 2010 Dietary Guidelines Advisory Committee, questions the feasibility of the message “make half your plate fruits and vegetables.” Clemens has examined agricultural production and doesn’t believe we can produce enough fruits, vegetables, legumes, and dietary fiber in the U.S. to meet the recommendations of the dietary guidelines. “This is a farming, agriculture, and supply chain issue that we need to address,” declared Clemens. “Millions of acres of cropland need to be added. We cannot feed 310 million consumers with backyard gardens.”

• Proteins. Protein foods—including seafood, meat, poultry, eggs, beans and peas, soy products, nuts, and seeds—contribute B vitamins (e.g., niacin, thiamin, riboflavin, and B-6), vitamin E, iron, zinc, and magnesium to the diet. Eating a balanced variety of protein foods can contribute to improved nutrient intake and health benefits. For example, moderate evidence indicates that eating peanuts and certain tree nuts (i.e., walnuts, almonds, and pistachios) reduces risk factors for cardiovascular disease. Americans consume about 3.5 oz of seafood per week. The dietary guidelines recommend increasing consumption of seafood to two servings or 8 oz/week, which is associated with reduced cardiac deaths and thus the prevention of heart disease.

The dietary guidelines recognize four nutrients of public health concern and urge Americans to consume 4,700 mg/day of potassium, 25 g of dietary fiber/day for women and 38 g for men, more calcium, and more vitamin D.

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Formulation Challenges
Some of the dietary guidelines recommendations have been high on the agendas of food manufacturers for many months. Numerous food companies have reduced or have pledged to reduce sodium in their products while others have switched to whole grains. In addition, some food marketers have increased the amount of dietary fiber in their products. But reformulating products to make them healthier is not a simple task. Many of the food components to reduce in the diet (e.g., sodium, added sugars, and saturated fats) contribute significant functionality to foods, such as preservation and shelf life, volume and texture, and palatability.

Speaking at a February 11, 2011, IFT webcast on “Implications of the 2010 Dietary Guidelines for Americans for the Food Industry,” Richard Black, Vice President of Nutrition, Kraft Foods Global, outlined some of the steps that the food industry and Kraft are taking to help consumers meet the recommendations of the guidelines as well as the challenges and opportunities.

Enabling people to make small changes to their diet will probably be more effective than asking them to make dramatic changes, noted Black. An example of this approach is getting consumers to move from consuming indulgent snacks (e.g., potato chips) to better-for-you snacks (e.g., trail mix).

With fewer than 15% of Americans consuming the daily sodium recommendation of less than 2,300 mg, what is the best approach for reducing sodium? Black believes that government and public health organizations should focus on all foods and the entire population. Led by New York City, the National Salt Reduction Initiative (NSRI) takes this approach, targeting all foods in equal measure and seeking a gradual 25% reduction.

But food companies cannot look at all foods in the diet, declared Black. Instead, they need to be concerned with removing the maximum amount of sodium possible from the foods they make, and prioritizing their sodium reduction efforts to foods with the greatest sales volume. For example, reducing 15 mg of sodium/serving in a product with 100 million lbs annual sales will have about twice the public health impact (actual sodium removed from the diet) compared to a reduction of 200 mg of sodium/serving in a product with 3 million lbs annual sales, explained Black.

On average, Kraft Foods North America will reduce sodium 10% by 2012, stated Black. Based on the example above, some foods will see a sodium reduction greater than 10% while others foods will have a smaller reduction. Kraft has about 10,000 products in its portfolio in North America and is focusing on reducing sodium in those products that will have the greatest public health impact, revealed Black. By the end of 2012, Kraft will remove about 2,200 tons of sodium from its products and exceed the targets of NSRI.

Black discussed the challenge of meeting the dietary guidelines recommendations for fat-free and low-fat dairy products. Full-fat (regular) cheese is a major contributor of saturated fat in the diet. Kraft’s 2% cheese has 45% less fat and 30% fewer calories than regular cheese, but does not meet the dietary guidelines recommendation of fat-free (0%) or low-fat (1%) dairy products. The project that led to the development of the 2% cheese was called TAGAR or tastes as good as regular, but Kraft has yet to reach this taste target with 0% or 1% milk fat, revealed Black.

The dietary guidelines recommend replacing refined grains with whole grains. To that end, Kraft is making changes to its conventional products so that whole grains become the standard. For example, Wheat Thins crackers will go from 11 g to 22 g of whole grains per serving and Honey Maid Graham crackers will go from 5 g to 20 g. While the products with greater whole grains taste slightly different than the original products, consumer research has shown an equal preference for the products. “The eating behavior stays the same; the product changes for the consumer,” explained Black.

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The Buzz About the Dietary Guidelines
Since the 2010 Dietary Guidelines for Americans were released in late January, PoliPulse, an online monitoring tool from communications agency Powell Tate, Washington, D.C., has been “listening” to conversations about the dietary guidelines taking place on various online social media sites.

About 22% of the talk has focused on the need for the guidelines, especially when it comes to reducing salt consumption. About 17% of the chatter says that these new guidelines do not differ from the 2005 guidelines, while an equal percentage of the exchanges applaud the guidelines for their stance on reducing obesity. But 16% of the conversations say the guidelines are meaningless. About 15% of the discussions center around the high price of healthy eating, and 13% think that the guidelines were negatively influenced by lobbyists.

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IFT Webcast on Dietary Guidelines
To access the on-demand webcast “Implications of the 2010 Dietary Guidelines for Americans for the Food Industry,” please visit http://www.ift.org/knowledge-center/learn-online/on-demand-webcasts.aspx .

Bob Swientek is Editor-in-Chief of Food Technology ([email protected]).