PDF Version Dietary Guidance for Americans
Every day, Americans are inundated with health messages from the news media, health professionals, and well-intentioned acquaintances. Most consumers are aware of the seemingly endless array of concerns associated with lifestyle and diet and the implied promise of good health and extended life via the magic bullet of the moment. Solutions to health concerns are not as simplistic as these reports would have us believe. Yet, the sheer volume of information available leaves many consumers confused about what advice to follow.
Fortunately, we can turn to science-based dietary guidance when communicating with consumers about good health. This section looks back at the evolution of dietary guidance in the U.S. and summarizes current policies, programs, and tools.
Dietary Guidance—An Historical Perspective
Over the past several decades, we have come a long way in our knowledge about health. We know an apple a day doesn’t necessarily keep the doctor away, and a walk around the block once a week is not enough to keep fit. Of course, an apple and a short walk are a great start, but there is much more to consider in pursuing good health.
Current concerns about adult nutrition differ significantly from those of the past. Prior to World War II, Americans’ main nutritional problems stemmed from lack of sufficient food or variety of foods. Nutrition scientists of that era focused on defining essential nutrients, primarily vitamins, to outline the minimum food intake necessary for good health.
As American society became more affluent, however, nutritional concerns changed from the effects of too little food or too few nutrients, to an overabundance of food or certain nutrients. Epidemiological and laboratory studies demonstrated a link between dietary excesses and chronic diseases such as heart disease and cancer. These findings led to the development of dietary recommendations intended to reduce Americans’ risk of chronic disease.
In the late 1970s, the U.S. Senate Select Committee on Nutrition and Human Needs issued the Dietary Goals for the United States. Since then, various federal agencies have issued similar recommendations for achieving a healthful diet, including: The Surgeon General’s Report on Nutrition and Health in 1988, the National Research Council Report on Diet and Health: Implications for Reducing Chronic Disease Risk in 1989, and Healthy People 2000 and 2010: National Health Promotion and Disease Prevention Objectives in 1990 and 2000, respectively, by the U.S. Public Health Service of the Department of Health and Human Services (DHHS).
Dietary recommendations developed by independent health organizations, such as the American Heart Association, closely resemble those issued by the federal government, indicating a general consensus among nutrition scientists regarding the role of diet in health and disease.
The Dietary Guidelines for Americans: From Science to Nutrition Policy to the Public’s Plate
The Dietary Guidelines for Americans are based on state-of-the-art nutrition science and form the foundation for U.S. nutrition policy. The U.S. Department of Agriculture (USDA) and DHHS issued the first edition of the Dietary Guidelines in 1980 as a consumer nutrition education tool for healthy Americans aged two years and older. Updated Guidelines are issued every five years, with the next update scheduled for 2010.
The current sixth edition, issued in 2005, not only builds on previous Dietary Guidelines by addressing nutrient adequacy and chronic disease risk prevention, but also places stronger emphasis on reducing calorie consumption and increasing physical activity.
The Departments used the following scientifically rigorous, three-stage process to develop the 2005 Guidelines.
In the first stage, an expert Advisory Committee conducted an extensive evidence-based review of the science related to diet and health. Based on their findings and conclusions, the Committee recommended nine major messages to communicate via the 2005 Dietary Guidelines. View the Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2005 at http://www.health.gov/dietaryguidelines/dga2005/report/.
In the second stage, government scientists and officials used the Advisory Committee’s report, as well as comments from the government agencies and the general public to create the 2005 Dietary Guidelines for Americans.
This report is a policy document containing technical information for policymakers, nutrition educators, nutritionists, and healthcare providers to use, rather than the general public.
The report identified 41 key recommendations, 23 for the general public and 18 for special populations, grouped into nine general topic areas:
View the 2005 Dietary Guidelines for Americans report at http://www.health.gov/dietaryguidelines/dga2005/document/.
In the final stage, the government agencies used the 2005 Dietary Guidelines to develop the following consumer research- based messages for the public and health educators:
- Make smart choices from every food group.
- Find your balance between food and physical activity.
- Get the most nutrition out of your calories.
Discussed below are two public education programs that translate the Dietary Guidelines into comprehensive healthful eating and physical activity advice for consumers.
MyPyramid: A Personal Plan for Healthful Eating and Physical Activity
In 1992, the USDA released the Food Guide Pyramid as a nutrition education tool to help put the Dietary Guidelines for Americans into action. The Pyramid served as a visual translation and general guide for daily food choices including specific recommendations for daily intake from the five food groups, including serving sizes, and guidelines for moderating intake of dietary fats and sugars.
In 2005, USDA updated the Food Guide Pyramid to become MyPyramid. MyPyramid differs from its predecessor by including recommendations for physical activity and promoting a personalized, “one size doesn’t fit all” approach. Like other government programs, MyPyramid encourages gradual, “small steps” toward improvement. The MyPyramid graphic, with its six colored bands (representing the five food groups, plus oils), is designed to convey moderation, variety, and proportionality between and within food groups. Consumers who visit www.MyPyramid.gov can receive their “personal pyramid” based on their calorie needs by entering their age, gender, and physical activity level in the My Pyramid Plan box. The site also features numerous tips for making smart choices from every food group and being physically active.
It’s All About You: Applying Dietary Guidance to American Life
The Dietary Guidelines Alliance was formed in the mid-1990s with members from health organizations, the food industry, and the government to develop effective, consumer-focused messages to convey the Dietary Guidelines for Americans.
The Alliance developed It’s All About You—a consumer research-tested message campaign that translates the Guidelines into simple, positive steps consumers can take toward more healthful lifestyles. The campaign is based on the following five core messages, designed to help motivate consumers to make positive changes in their eating and physical activity habits:
- Be Realistic: Make small changes over time in what you eat and the level of activity you do. After all, small steps work better than giant leaps.
- Be Adventurous: Expand your tastes to enjoy a variety of foods.
- Be Flexible: Go ahead and balance what you eat and the physical activity you do over several days. No need to worry about just one meal or one day.
- Be Sensible: Enjoy all foods, just don’t overdo it.
- Be Active: Walk the dog, don’t just watch the dog walk.
Supporting nutrition education materials feature practical tips to help consumers act on the advice from each campaign message, follow MyPyramid and use tools such as the Nutrition Facts panel to make healthful food choices. The materials are continually updated to reflect the latest Dietary Guidelines and food guidance system.
Nutrition Labeling—A Tool for Following Dietary Guidance
Today’s nutrition labels help consumers make wise food choices by monitoring serving sizes and calories per serving, keeping saturated fats, trans fats, cholesterol, and sodium low, and consuming enough of certain vitamins and minerals.
Attention to nutrition labeling was first sparked following increased visibility to nutrition and health after the 1969 White House Conference on Food, Nutrition and Health. In 1973, the Food and Drug Administration (FDA) took the first steps to establish the current framework for the nutrition labeling of foods. From then until 1990, FDA’s regulations allowed information on nutrition content to be provided voluntarily, but prescribed a standard format when nutrition labeling appeared on food packages. However, nutrition labeling was mandatory on any food for which a nutrient was added (i.e., enriched with vitamin C) or for which a nutrition claim was made (i.e., low fat).
Beginning in the 1980s, mounting evidence about nutrients and food components with an influence on diet and health inspired efforts to reform nutrition labeling on food products. The nutrition labeling reform effort culminated with the passage of the Nutrition Labeling and Education Act of 1990 (NLEA; Public Law 101-535). In addition to reforming nutrition labeling, the law required the federal government to engage in educational activities to enable consumers to understand and use the improved label information to make better dietary choices consistent with the Dietary Guidelines for Americans.
Since the passage of the NLEA, nutrition labeling became mandatory on all food products under the authority of the FDA. On May 8, 1994, labeling was required for all packaged foods and point-of-purchase information on fresh fruits, vegetables, and seafood. Also, on July 6, 1994, the USDA issued regulations mandating nutrition labeling on packaged meat and poultry; labeling for fresh meat and poultry remained voluntary. At the same time, the listing of nutrients and food components required on the new Nutrition Facts panel was modified to focus on those nutrients of greatest public health concern while incorporating the Dietary Guidelines and Recommended Dietary Allowances (RDAs).
| GETTING SAVVY ABOUT SODIUM |
| Sodium, a component of salt (sodium chloride) is an essential mineral for life and health. The body cannot produce sodium by itself, so it must be supplied by food. Salt and other sodium compounds used in food processing are the biggest contributors of sodium in people’s diets. One teaspoon of salt contains about 2,300 milligrams of sodium. Dietary Sodium Requirements According to the Institute of Medicine’s (IOM) 2004 Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate report, the Adequate Intake (AI) level for sodium, or daily amount sufficient to meet the needs of most healthy people, is 1,500 mg per day (3,800 mg of salt) for 19- to 50-year-olds with normal blood pressure. The Tolerable Upper Intake Level (UL) for adults is 2,300 mg per day. Consistent with IOM recommendations, the 2005 Dietary Guidelines for Americans recommend consuming less than 2,300 mg of sodium per day. Dietary Sodium and Health Research suggests that, in some individuals, there is a link between high sodium and salt intake and high blood pressure, which is a major risk factor for heart disease, stroke, and kidney disease. However, intake of other key minerals, including potassium, magnesium, and calcium, may affect this relationship. Older individuals, African Americans, and people with chronic diseases such as hypertension, diabetes, and kidney disease are especially sensitive to the blood pressure-raising effects of salt and are advised to reduce sodium intake even further than the general Dietary Guidelines recommendation of 2300 mg per day. Treatment of hypertension often involves lifestyle modifications combined with medications. According to the National Heart, Lung and Blood Institute, lifestyle modifications include weight reduction, dietary sodium reduction, aerobic physical activity, moderation of alcohol consumption and the DASH eating plan (Dietary Approaches to Stop Hypertension). Tips to Help Consumers Desiring to Manage Dietary Sodium Communicating the following tips can help consumers reduce the amount of sodium they consume. - Read the Nutrition Facts panel to determine how much sodium a serving of food contains. Check the ingredients list for salt or sodium-containing compounds.
- Replace traditional higher-sodium foods with modified versions labeled as “low in sodium,” “reduced sodium,” or “lower sodium.”
- Balance the sodium content of higher-sodium foods with food choices naturally low in sodium, such as fresh foods.
- Eat smaller portions of high sodium foods.
- Remove or decrease salt from recipes whenever possible and don’t add salt at the table. Use herbs, spices, lemon, lime, vinegar, or salt-free seasoning blends instead of salt.
- Choose more fruits, vegetables, and milk products in forms that contain no added salt. These foods are also important sources of potassium, which can help lower blood pressure.
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The Nutrition Facts panel now presents the following nutrients and food components per serving on the label: energy as calories, calories from fat, total fat, saturated fat, trans fat, cholesterol, sodium, total carbohydrate, dietary fiber, sugars, protein, vitamins A and C, and minerals calcium and iron.
Other changes in nutrition labeling included standardizing serving sizes; defining nutrition claims such as free, low, light or “lite,” reduced, less, and high; permitting statements describing the amount and percentage of a nutrient in a food; developing criteria for making health claims about the relationship between food components and disease reduction on food labels; and labeling possible food allergens in “plain English.”
Fighting America’s Obesity Epidemic: Finding the Balance between Food and Physical Activity
Over the past 20 years, the increasing incidence of obesity and overweight among Americans has become a national concern.
Today, approximately two-thirds of U.S. adult males and females are overweight, according to the 2003-2004 NHANES survey. In addition, data suggest the greatest increases in obesity and overweight have been among Hispanic and African-American women and those with lower income and less education. Overweight and obesity are also particularly common among Pacific Islander women.
As a strategy to fight this epidemic, the 2005 Dietary Guidelines for Americans include weight management as a priority focus, with the following key recommendations:
- To maintain body weight in a healthy range, balance calories from foods and beverages with calories expended.
- To prevent gradual weight gain over time, make small decreases in food and beverage calories and increase physical activity.
Both the Dietary Guidelines and MyPyramid communicate these recommendations to consumers as, “Find your balance between food and physical activity.”
The Food Factor
According to the Dietary Guidelines, to reverse the trend toward obesity, most Americans should eat fewer calories, make wiser food choices, and be more active.
For most adults, reducing 50 to 100 calories per day may prevent gradual weight gain; reducing 500 calories per day may lead to gradual weight loss. To reduce calories, the Guidelines advise eating lower-calorie foods such as fruits and vegetables, decreasing intake of added sugars, fats, and alcohol, and controlling portion sizes, especially for calorie-dense foods.
Most Americans Not Up to Par on Physical Activity
The Behavioral Risk Factor Surveillance System indicates that only 48.7 percent of American adults engage in regular physical activity consistent with recommendations. According to 2005 IFIC Foundation data, 36 percent of Americans report not being active at all.
In addition to contributing to weight control, a growing body of research suggests that regular physical activity can reduce the risks of heart disease, cancer, hypertension, type 2 diabetes, osteoporosis, and many other health problems. The American College of Sports Medicine, the Centers for Disease Control and Prevention, and the U.S. Surgeon General recommend accumulating 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week to gain health benefits from physical activity.
The Dietary Guidelines and MyPyramid recommend that adults accumulate at least 30 minutes of moderate-intensity physical activity, above usual activity, on most days of the week. To prevent weight gain, adults should get about 60 minutes of moderate- to vigorous-intensity physical activity on most days and, to maintain weight loss, at least 60 to 90 minutes of daily moderate-intensity physical activity. Individuals should consult their health care provider before beginning any type of exercise program.
A Look to the Future
As nutrition science evolves, so will dietary guidance for Americans. But even as recommendations are fine-tuned, the importance of healthful eating and regular physical activity are sure to remain constants for good health and disease prevention.
| PROMOTING ORAL HEALTH TO THE PUBLIC |
| For many years, the primary focus of oral health care was preventing cavities (dental caries) in children, with an emphasis on dietary influences on caries formation. As science has evolved, however, specific foods are no longer singled out as major risk factors for caries. According to the 2005 Dietary Guidelines, the most effective way to decrease incidence of dental caries is to reduce the frequency and duration of exposure to fermentable carbohydrates and to optimize oral hygiene practices such as drinking fluoridated water and brushing and flossing teeth. Healthful eating habits, regular brushing, flossing, fluoride treatments, and checkups are all part of maintaining good oral health. In addition, advising consumers about factors involved in plaque build-up or acid production on the teeth can help promote oral health. These factors include: - Frequency of eating. Each time carbohydrate containing foods are consumed, acids are released on teeth for about 20 to 40 minutes. The greater the frequency of eating, the more opportunity for acid production.
- Food characteristics. Whether foods tend to cling or stick to the teeth affects the time they remain in the mouth. Foods that are slow to dissolve, such as cookies and granola bars, are in longer contact with the teeth, providing more time for the acids to damage enamel, as opposed to foods that dissolve quickly such as caramels and jelly beans.
- Whether or not the food is eaten as part of a meal. Saliva production is increased during a meal to help neutralize acid and clear food from the mouth.
- Whether or not it’s a starchy food. Starches in general—from bread to crackers to sugars from fruit, milk, honey, molasses, corn sweeteners, and refined sugar—can all produce the acids that damage teeth.
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Originally printed in the 2007-2009 IFIC Foundation Media Guide on Food Safety and Nutrition 
