Revised Dietary Guidelines Promote Healthy Lifestyle

The U.S. Dept. of Health and Human Services and the U.S. Dept. of Agriculture have jointly published Dietary Guidelines for Americans every five years since 1980. The Guidelines provide authoritative advice for people two years and older about how good dietary habits can promote health and reduce risk for major chronic diseases. They serve as the basis for federal food and nutrition education programs. HHS and USDA issued the most recent revision on January 12, 2005. Here’s a discussion of the Dietary Guidelines and the science behind them.  

How the New Guidelines Were Developed
The process for development of the 2005 Dietary Guidelines was modified in significant ways from that for the previous guidelines. These changes were an important evolution to make the Guidelines more relevant to their target users, which include policy makers and consumers, as well as to strengthen the scientific basis of the Dietary Guidelines. In past years, the review process produced two publications: the advisory committee’s report and the bulletin containing the Dietary Guidelines. The committee report in previous years comprised the recommended wording of the guidelines, including recommended changes from the previous version, plus the scientific justification for the changes to the Guidelines. For 2005, there are three separate publications: an evidence-based review of the science from the Dietary Guidelines Advisory Committee (www.health.gov/dietaryguidelines/dga2005/report); the 2005 Dietary Guidelines for Americans (www.health.gov/dietaryguidelines/dga2005/document), which is targeted toward policy makers, educators, and health care providers; and a consumer brochure, Finding Your Way to a Healthier You (www.health.gov/dietaryguidelines/dga2005/document/pdf/brochure.pdf).

The 13 members of the Dietary Guidelines Advisory Committee deliberated during five public meetings during 2003–04 and received public oral and written comments. The advisory committee identified 34 prioritized questions on the relationship of diet and physical activity and health. With the help of staff from USDA and HHS, the advisory committee assembled evidence-based tables to address the priority questions.

The advisory committee’s goal was to translate the Dietary Recommended Intakes (DRIs) set by the Institute of Medicine into food patterns. Food pattern modeling was used to identify changes needed from current consumption patterns and to determine the potential flexibility in food choices to achieve the DRIs for nutrients. Adoption of a conclusive statement to each question required a unanimous vote.

The evidence-based document produced by the advisory committee was available for comment from both external and internal stakeholders, and more than 400 comments were received and reviewed by USDA and HHS. A committee of scientific experts from federal agencies was appointed by the Joint Executive Review Board (an interdepartment review board) to draft the policy document based on the advisory committee report. The draft was reviewed by a panel of independent scientific experts in the government, then revisions were made based on their input and were published as the 2005 Dietary Guidelines for Americans.

Under contract with HHS, a public relations firm used the policy document to develop and test messages for consumers that communicate the recommendations to the public. They developed the consumer brochure, which was reviewed and revised by the departments based on the policies laid out in the Dietary Guidelines and consumer research.

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How They Differ from Previous Guidelines
In addition to modifications in the process and using an evidence-based review for the first time in the development of the Guidelines, the recommendations themselves reflect new and emerging science. The Dietary Guidelines presents recommendations in nine chapters. Some of the highlights are outlined by chapter below.

• Adequate Nutrients within Calorie Needs. This chapter focuses on using a food guidance plan for healthful eating and uses both the eating patterns in the new USDA Food Guidance System and the Dietary Approaches to Stop Hypertension (DASH) plan (www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf) as examples to illustrate healthful eating. The consumer brochure builds on this message with a colorful graph of food choices.

• Weight Management. As in past guidelines, this chapter emphasizes the importance of balancing calorie intake with physical activity for weight maintenance, but incorporates a new message that small decreases in intake and increases in activity can prevent weight gain. This message is also illustrated in the consumer brochure.

• Physical Activity. This chapter provides more information on activity and the importance of various amounts of physical activity most days to achieve certain health benefits (e.g., 30 minutes to reduce chronic disease risk, up to 60 minutes to prevent weight gain, and 60–90 minutes to maintain weight loss).

• Food Groups to Encourage. This chapter emphasizes the reasons to include fruits, vegetables, whole grains, and milk (low-fat or fat-free) in the diet. The key recommendations indicate specific amounts of these foods to consume, with reference to a daily energy intake of 2,000 kcal.

• Fats. This chapter recognizes the importance of limiting trans fats, saturated fats, and cholesterol and that all three factors are important for lowering the risk of heart disease. In addition, the key recommendations encourage use of sources of polyunsaturated and monounsaturated fats such as fish, nuts, and vegetable oils and thus is more specific about certain foods as sources of fats.

• Carbohydrates. The key recommendations for carbohydrates recognize that foods with fiber are among those to be encouraged, while the use of added sugars or caloric sweeteners should be limited.

• Sodium and Potassium. This chapter recommends a daily intake of sodium of 2,300 mg rather than the previous 2,400 mg, to be consistent with the DRI report from IOM (www.iom.edu/report.asp?id=18495). It also places increased emphasis on potassium intake.

• Alcoholic Beverages: This chapter’s recommendations are similar to those of past years and focus on moderation.

• Food Safety: This chapter’s key recommendations are similar to those of the 2000 guidelines, which included food safety as a guideline for the first time. The chapter emphasizes the principles of the FightBAC! national campaign to promote food safety to consumers and educate them on how to handle and prepare food safely (www.fightbac.org).

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How They Will Affect Government Programs and the Food Industry
The 2005 Dietary Guidelines will affect government nutrition programs, including research, education, school lunch programs, food assistance, labeling, and nutrition information.

The publication is considered a policy document and used by the federal government to develop consistent policies and messages in educational materials related to nutrition and health.

USDA has used the Dietary Guidelines for development of policy in food assistance programs such as the Child Nutrition Programs, which include school lunch, and the Elderly Nutrition Program. As the Food and Drug Administration reviews future regulations for nutrition labeling, it will consider the information in the Dietary Guidelines. An interagency working group reviews educational materials developed by federal agencies to ensure that the information is consistent with the Guidelines.The Dietary Guidelines will also have implications for food and beverage processors and may affect product development and product formulations. The food and beverage industries can help Americans achieve the Dietary Guidelines. Packaged serving sizes have expanded so much in recent years that many Americans have difficulty estimating appropriate portions of food. This led the advisory committee to give food recommendations in measurements rather than number of servings. However, this requires the consumer to study package labels. It may be easier for consumers to stay within their calorie budget if a muffin comes as a single serving rather than as a large muffin which is labeled as two servings, for example.

Food and beverage processors can help consumers reach their goals for reducing intakes of salt and trans fats. The advisory committee acknowledged that it is difficult to reduce sodium intakes substantially below the Upper Level of 2,300 mg/day using common foods in the current food supply. Product developers and food formulators could help decrease the risk for hypertension by gradually reducing the sodium content of their products. Many products would be as acceptable to consumers with modest reductions in salt content, and the Guidelines encourage consumers to compare the sodium content of similar products.

The requirement for trans fat labeling in 2006 has encouraged product reformulation. New technologies for hydrogenation as well as new sources of fats and oils will help lower the content of trans fat. However, the Guidelines emphasize the importance of managing the intake of both saturated fats and trans fat as well as cholesterol to lower risk of cardiovascular disease.

Product developers can do much to help Americans enjoy foods while making their calories count through products flavored with spices, herbs, nuts, fruits, and other ingredients rather than added solid fats, sweeteners, and salt.

Food processors can help consumers make smart choices even when eating on the go by packaging whole-grain fruits, vegetables, and dairy products in easy-to-carry, calorie-controlled units. Baby carrots is an example of the type of innovation that can lead to greater consumption of a vegetable and a marketing success to boot. Vegetable-coated cereal snacks are new delicious snack options. Because so many Americans consume food away from home, the partnership of the foodservice industry in providing nutrient-dense foods and appropriate portion control is essential.

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Communicating the Messages
Previous Dietary Guidelines have focused on 8–10 guidance statements with additional background material under each guidance statement. The 2005 Dietary Guidelines have incorporated the nine chapters identified by the advisory committee, but the guidelines themselves are listed as 41 key recommendations in each chapter. The more specific guidance found in these key recommendations is appropriate for the role of the publication as a policy document for federal agencies.

The consumer brochure is based on these key recommendations but communicates them as motivational messages, such as "Make smart choices from every food group," "Find your balance between food and physical activity," and "Get the most nutrition out of your choices."

The 2005 Dietary Guidelines for Americans offers more detailed, specific and quantitative advice than previous versions. This will delight some and dismay others. Many consumers have difficulty in meeting their nutrient recommendations while staying within their calorie limits. Communicating these messages will require more-sophisticated tools than for previous dietary guidelines. New approaches will be necessary. The stakes are high for success in moving the population closer to achieving the Dietary Guidelines. The new Dietary Guidelines, if followed, can improve the health of the nation.

The key recommendations of the 2005 Dietary Guidelines for Americans follow on pages ----
• Consume a variety of nutrient-dense foods and beverages within and among the basic food groups while choosing foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol.

• Meet recommended intakes within energy needs by adopting a balanced eating pattern, such as the USDA Food Guide or the DASH Eating Plan.

• For people over age 50: Consume vitamin B12 in its crystalline form (i.e., fortified foods or supplements).

• For women of childbearing age who may become pregnant: Eat foods high in heme-iron and/or consume iron-rich plant foods or iron-fortified foods with an enhancer of iron absorption, such as vitamin C–rich foods.

• For women of childbearing age who may become pregnant and those in the first trimester of pregnancy: Consume adequate synthetic folic acid daily (from fortified foods or supplements) in addition to food forms of folate from a varied diet.

• For older adults, people with dark skin, and people exposed to insufficient ultraviolet band radiation (i.e., sunlight): Consume extra vitamin D from vitamin D-fortified foods and/or supplements.

• To maintain body weight in a healthy range, balance calories from foods and beverages with calories expended.

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• To prevent gradual weight gain over time, make small decreases in food and beverage calories and increase physical activity.

• For those who need to lose weight: Aim for a slow, steady weight loss by decreasing calorie intake while maintaining an adequate nutrient intake and increasing physical activity.

• For overweight children: Reduce the rate of body weight gain while allowing growth and development. Consult a healthcare provider before placing a child on a weight-reduction diet.

• For pregnant women: Ensure appropriate weight gain as specified by a healthcare provider.

• For breastfeeding women: Moderate weight reduction is safe and does not compromise weight gain of the nursing infant.

• For overweight adults and overweight children with chronic diseases and/or on medication: Consult a healthcare provider about weight loss strategies prior to starting a weight-reduction program to ensure appropriate management of other health conditions.

• Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being, and a healthy body weight.

• To reduce the risk of chronic disease in adulthood: Engage in at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week.

• For most people, greater health benefits can be obtained by engaging in physical activity of more vigorous intensity or longer duration.

• To help manage body weight and prevent gradual, unhealthy body weight gain in adulthood: Engage in approximately 60 minutes of moderate- to vigorous-intensity activity on most days of the week while not exceeding caloric intake requirements.

• To sustain weight loss in adulthood: Participate in at least 60 to 90 minutes of daily moderate-intensity physical activity while not exceeding caloric intake requirements. Some people may need to consult with a healthcare provider before participating in this level of activity.

• Achieve physical fitness by including cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises or calisthenics for muscle strength and endurance.

• For children and adolescents: Engage in at least 60 minutes of physical activity on most, preferably all, days of the week.

• For pregnant women: In the absence of medical or obstetric complications, incorporate 30 minutes or more of moderate-intensity physical activity on most, if not all, days of the week. Avoid activities with a high risk of falling or abdominal trauma.

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• For breastfeeding women: Be aware that neither acute nor regular exercise adversely affects the mother’s ability to successfully breastfeed.

• For older adults: Participate in regular physical activity to reduce functional declines associated with aging and to achieve the other benefits of physical activity identified for all adults.

• Consume a sufficient amount of fruits and vegetables while staying within energy needs. Two cups of fruit and 2½ cups of vegetables per day are recommended for a reference 2,000-calorie intake, with higher or lower amounts depending on the calorie level.

• Choose a variety of fruits and vegetables each day. In particular, select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables, and other vegetables) several times a week.

• Consume 3 or more ounce-equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products. In general, at least half the grains should come from whole grains.

• Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products.

• For children and adolescents: Consume whole-grain products often; at least half the grains should be whole grains. Children 2 to 8 years should consume 2 cups per day of fat-free or low-fat milk or equivalent milk products. Children 9 years of age and older should consume 3 cups per day of fat-free or low-fat milk or equivalent milk products.

• Consume less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep transfatty acid consumption as low as possible.

• Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.

• When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free.

• Limit intake of fats and oils high in saturated and/or transfatty acids, and choose products low in such fats and oils.

• For children and adolescents: Keep total fat intake between 30 to 35 percent of calories for children 2 to 3 years of age and between 25 to 35 percent of calories for children and from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.

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• Choose fiber-rich fruits, vegetables, and whole grains often.

• Choose and prepare foods and beverages with little added sugars or caloric sweeteners, such as amounts suggested by the USDA Food Guide and the DASH Eating Plan.

• Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar- and starch-containing foods and beverages less frequently.

• Consume less than 2,300 mg (approximately 1 tsp of salt) of sodium per day.

• Choose and prepare foods with little salt. At the same time, consume potassium-rich foods, such as fruits and vegetables.

• For individuals with hypertension, blacks, and middle-aged and older adults: Aim to consume no more than 1,500 mg of sodium per day, and meet the potassium recommendation (4,700 mg/day) with food.

• Those who choose to drink alcoholic beverages should do so sensibly and in moderation—defined as the consumption of up to one drink per day for women and up to two drinks per day for men.

• Alcoholic beverages should not be consumed by some individuals, including those who cannot restrict their alcohol intake, women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions.

• Alcoholic beverages should be avoided by individuals engaging in activities that require attention, skill, or coordination, such as driving or operating machinery.

• To avoid microbial foodborne illness:

• Clean hands, food contact surfaces, and fruits and vegetables. Meat and poultry should not be washed or rinsed.

• Separate raw, cooked, and ready-to-eat foods while shopping, preparing, or storing foods.

• Cook foods to a safe temperature to kill microorganisms.

• Chill (refrigerate) perishable food promptly and defrost foods properly.

• Avoid raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs or foods containing raw eggs, raw or undercooked meat and poultry, unpasteurized juices, and raw sprouts.

• For infants and young children, pregnant women, older adults, and those who are immunocompromised: Do not eat or drink raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs or foods containing raw eggs, raw or undercooked meat and poultry, raw or undercooked fish or shellfish, unpasteurized juices, and raw sprouts.

• For pregnant women, older adults, and those who are immunocompromised: Only eat certain deli meats and frankfurters that have been reheated to steaming hot.

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2005 Dietary Guidelines Advisory Committee Members

Janet King, Ph.D., R.D. (Chair), Lead Scientist, Children’s Hospital Oakland Research Institute; Professor of Nutrition and Professor of Internal Medicine, University of California, Davis; Professor Emeritus of Nutrition, University of California, Berkeley.

Lawrence Appel, M.D., M.P.H., Professor of Medicine, Johns Hopkins University School of Medicine; Adjunct Professor, Depts. of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health; Welch Center for Prevention, Epidemiology, and Clinical Research.

Yvonne Bronner, Sc.D., R.D., L.D., Professor and Director, Public Health Program, Morgan State University.

Benjamin Caballero, M.D., Ph.D., Professor of International Health, Johns Hopkins Bloomberg School of Public Health; Professor of Pediatrics and Director of the Center for Human Nutrition, Johns Hopkins Bloomberg School of Medicine,

Carlos A. Camargo, M.D., Dr.P.H., Associate Professor of Medicine and Epidemiology, Harvard University; Emergency Physician, Massachusetts General Hospital; Research Epidemiologist, Channing Laboratory, Brigham and Women’s Hospital.

Fergus Clydesdale, Ph.D., Distinguished Professor and Head, Dept. of Food Science, and Director of the Strategic Research Alliance, University of Massachusetts, Amherst.

Vay Liang W. (Bill) Go, M.D., Professor of Medicine, David Geffen School of Medicine, University of California, Los Angeles.

Penny Kris-Etherton, Ph.D., R.D., Distinguished Professor of Nutrition, Dept. of Nutritional Sciences, Pennsylvania State University.

Joanne Lupton, Ph.D., Regent’s Professor, University Faculty Fellow, and holder of the William W. Allen Endowed Chair in Human Nutrition, Texas A&M University.

Theresa Nicklas, Dr.P.H., M.P.H., Professor of Pediatrics, USDA’s Agricultural Research Service Children’s Nutrition Research Center, Dept. of Pediatrics, Baylor College of Medicine.

Russell Pate, Ph.D., Professor, Dept. of Exercise Science, and Associate Dean for Research, School of Public Health, University of South Carolina.

F. Xavier Pi-Sunyer, M.D., M.P.H., Director, Obesity Research Center, and Chief of Endocrinology, Diabetes and Nutrition, St. Luke’s-Roosevelt Hospital Center; Professor of Medicine, College of Physicians and Surgeons, Columbia University; Senior Attending Physician, St. Luke’s-Roosevelt and New York Presbyterian Hospitals; Professor of Applied Physiology, Columbia Teachers College; faculty member, Institute of Human Nutrition, Columbia University College of Physicians and Surgeons.

Connie Weaver, Ph.D., Distinguished Professor and Head, Dept. of Foods and Nutrition, and Director, NIH-funded Botanicals Center, Purdue University.

Author Weaver, a Fellow and Professional Member of IFT and a member of the Dietary Guidelines Advisory Committee is Distinguished Professor and Head, Dept. of Foods and Nutrition, Purdue University, West Lafayette, IN 47907. Author Schneeman, a Professional Member of IFT and Co-Chair of the Inter-Department Drafting Committee, is Director, Office of Nutritional Products, Labeling and Dietary Supplements, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD 20740. Send reprint requests to author Weaver ([email protected]).