Dietary Guidelines For Americans

Today, government authorities are as concerned about overnutrition as they once were about undernutrition. Research confirms that dietary excesses, especially in energy, sodium, certain fats, and alcohol, contribute to many chronic diseases, including heart disease, cancer, stroke, diabetes, and liver disease. Only two common lifestyle habits have more influence on health than a person’s choice of diet: smoking and other tobacco use, and excessive drinking of alcohol.

The leading causes of death in the United States include 

  • Heart disease
  • Cancers
  • Chronic lung diseases
  • Strokes
  • Accidents
  • Alzheimer’s disease
  • Diabetes mellitus
  • Pneumonia and influenza
  • Kidney disease
  • Suicide

Notice that three of the top four are nutrition-related (and related to tobacco use). Note, however, that although the diet is a powerful influence on these diseases, they cannot be prevented by a healthy diet alone; genetics, physical activity, age, gender, and other factors also play a role. Within the range set by genetic inheritance, however, disease development is strongly influenced by the foods a person chooses to eat.

Sound nutrition does not depend on the selection of any one food. Instead, it depends on the overall eating pattern—the combination of many different foods and beverages at numerous meals over days, months, and years.

So how can health care professionals help people select foods to create an eating pattern that supplies all the needed nutrients in amounts consistent with good health? The principle is simple enough: encourage clients to eat a variety of foods that supply all the nutrients the body needs. In practice, how do people do this? It helps to keep in mind that a nutritious diet achieves six basic ideals.

6 Basic Ideals of A Nutritious Diet

A nutritious diet has the following six characteristics:

  • Adequacy
  • Balance
  • Kcalorie (energy) control
  • Nutrient density
  • Moderation
  • Variety

The first, adequacy, was already addressed in the earlier discussion on the DRI. An adequate diet has enough energy and enough of every nutrient (as well as fiber) to meet the needs of healthy people. The second is balance: the food choices do not overemphasize one nutrient or food type at the expense of another. Balance in the diet helps to ensure adequacy.

The essential minerals calcium and iron illustrate the importance of dietary balance. Meat is rich in iron but poor in calcium. Conversely, milk is rich in calcium but poor in iron. Use some meat for iron; use some milk for calcium; and save some space for other foods, too, because a diet consisting of milk and meat alone would not be adequate. For other nutrients, people need to consume other protein foods, whole grains, vegetables, and fruit.

The third characteristic is kcalorie (energy) control: the foods provide the amount of energy needed to maintain healthy body weight—not more, not less. The key to calorie control is to select foods that deliver the most nutrients for the least food energy. This fourth characteristic is known as nutrient density. Nutrient density promotes adequacy and kcalorie control. Consider foods containing calcium, for example.

You can get about 300 milligrams of calcium from either 11⁄2 ounces of cheddar cheese or 1 cup of fat-free milk, but the cheese delivers about twice as much food energy (calories) as the milk. The fat-free milk, then, is twice as calcium dense as the cheddar cheese; it offers the same amount of calcium for half the calories. Both foods are excellent choices for adequacy’s sake alone, but to achieve adequacy while controlling calories, fat-free milk is the better choice. (Alternatively, a person could select a low-fat cheddar cheese providing calories comparable to fat-free milk.)

Just as a financially responsible person pays for rent, food, clothes, and tuition on a limited budget, healthy people obtain iron, calcium, and all the other essential nutrients on a limited energy (kcalorie) allowance. Success depends on getting many nutrients for each kcalorie “dollar.” For example, a can of cola and a handful of grapes may both provide about the same number of calories, but grapes deliver many more nutrients. A person who makes nutrient-dense choices, such as fruit instead of cola, can meet daily nutrient needs on a lower energy budget. Such choices support good health.

Foods that are notably low in nutrient density—such as potato chips, candy, and colas—are called empty-kcalorie foods. The calories these foods provide are called “empty” because they deliver a lot of energy (from added sugars, solid fats, or both) but little or no protein, vitamins, or minerals.

The concept of nutrient density is relatively simple when examining the contributions of one nutrient to food or diet. With respect to calcium, milk ranks high, and meats rank low. With respect to iron, meats rank high and milk ranks low. But which food is more nutritious? Answering that question is a more complex task because we need to consider several nutrients—those that may harm health and those that may be beneficial. Ranking foods based on their overall nutrient composition is known as nutrient profiling. Researchers have yet to agree on an ideal way to rate foods based on the nutrient profile, but when they do, nutrient profiling will be quite useful in helping consumers identify nutritious foods and plan healthy diets.

The fifth characteristic of a nutritious diet is moderation. Moderation contributes to adequacy, balance, and calorie control. Foods rich in fat and sugar often provide enjoyment and energy but relatively few nutrients. In addition, they promote weight gain when eaten in excess. A person who practices moderation eats such foods only on occasion and regularly selects foods low in solid fats and added sugars, a practice that automatically improves nutrient density. Returning to the example of cheddar cheese and fat-free milk, the milk not only offers more calcium for less energy but also it contains far less fat than the cheese.

Finally, the sixth characteristic of a nutritious diet is variety: the foods chosen differ from one day to the next. A diet may have all the virtues just described and still lack variety if a person eats the same foods day after day. People should select foods from each of the food groups daily and vary their choices within each food group from day to day, for a couple of reasons. First, different foods within the same group contain different arrays of nutrients. Among the fruits, for example, strawberries are especially rich in vitamin C while apricots are rich in vitamin A. Variety improves nutrient adequacy. Second, no food is guaranteed entirely free of substances that, in excess, could be harmful. The strawberries might contain trace amounts of one contaminant, the apricots another. By alternating fruit choices, a person will ingest very little of either contaminant.

Dietary Guidelines for Americans

What should a person eat to stay healthy? The answers can be found in the Dietary Guidelines for Americans. These guidelines translate the nutrient recommendations of the DRI into food recommendations. The Dietary Guidelines for Americans 2010 provide evidence-based advice to help people attain and maintain a healthy weight, reduce the risk of chronic diseases, and promote overall health through diet and physical activity.

Below are the key recommendations of the Dietary Guidelines for Americans 2010, clustered into four major topic areas.

Balancing Calories to Manage Weight

  • Prevent and/or reduce overweight and obesity through improved eating and physical activity behaviors. 
  • Control total calorie intake to manage body weight. For people who are overweight or obese, this will mean consuming fewer calories from foods and beverages.
  • Increase physical activity and reduce time spent in sedentary behaviors.
  • Maintain appropriate calorie balance during each stage of life—childhood, adolescence, adulthood, pregnancy and breastfeeding, and older age.

Foods and Food Components to Reduce

  • Reduce daily sodium intake to less than 2300 milligrams, and further reduce intake to 1500 milligrams among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease. The 1500 milligrams recommendation applies to about half of the U.S. population, including children and the majority of adults.
  • Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids.
  • Consume less than 300 milligrams per day of dietary cholesterol.
  • Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats.
  • Reduce the intake of calories from solid fats and added sugars.
  • Limit the consumption of foods that contain refined grains, especially refined grain foods that contain solid fats, added sugars, and sodium.
  • If alcohol is consumed it should be consumed in moderation—up to one drink per day for women and two drinks per day for men—and only by adults of legal drinking age.

Foods and Nutrients to Increase

  • Increase vegetable and fruit intake.
  • Eat a variety of vegetables, especially dark-green and red and orange vegetables, and beans and peas. 
  • Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains.
  • Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages.
  • Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds.
  • Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry.
  • Replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oils.
  • Use oils to replace solid fats where possible.
  • Choose foods that provide more potassium, dietary fiber, calcium, and vitamin D, which are nutrients of concern in American diets. These foods include vegetables, fruits, whole grains, and milk and milk products.

Building Healthy Eating Patterns

  • Select an eating pattern that meets nutrient needs over time at an appropriate calorie level. 
  • Account for all foods and beverages consumed and assess how they fit within a total healthy eating pattern.
  • Follow food safety recommendations when preparing and eating foods to reduce the risk of foodborne illnesses.

Frome the key recommendations, the first area focuses on balancing calories to manage healthy body weight by improving eating habits and en- gaging in regular physical activity.

The second area advises people to reduce their intake of such foods and food components as sodium, solid fats (and the saturated fats, trans fats, and cholesterol they contain), added sugars, refined grain products, and alcoholic beverages (for those who partake).

The third area encourages consumers to select a variety of fruits and vegetables, whole grains, low-fat milk products, and protein foods (including seafood). The fourth area helps consumers build healthy eating patterns that meet energy and nutrient needs while reducing the risk of foodborne illnesses. Together, the Dietary Guidelines for Americans 2010 point the way toward longer, healthier, and more active lives.

Summary

A well-planned diet delivers adequate nutrients, a balanced array of nutrients, and an appropriate amount of energy.

A well-planned diet is based on nutrient-dense foods, moderate in substances that can be detrimental to health, and varied in its selections.

The Dietary Guidelines apply these principles, offering practical advice on how to eat for good health.

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