June 24, 2010

Digesting the 2010 Dietary Guidelines

USDA Dietary GuidelinesOn June 15, 2010 the Dietary Guidelines Advisory Committee (DGAC) Report was published online for all to see – that’s the good news. The bad news: it’s likely that not nearly enough people will take even a few minutes to scan the DGAC Report Executive Summary (but I encourage you to do so). Far fewer people will heed the dire warnings coated with practical advice.

What is this 2010 DGAC Report? It’s the evidence-based backgrounder, or expert review, used to formulate the 2010 Dietary Guidelines for Americans. This Report came together over the last two years (and many meetings) with a group of nationally known and respected nutrition academics/experts and a big assist by USDA staff. The guidelines are mandated by Congress to be reviewed, updated and released by USDA and HHS every five years (last updated 2005). The Dietary Guidelines offer dietary guidance for the general public, federal nutrition education and promotion programs and food assistance programs.

What happens next? The DGAC Report and findings are now open for public comment. Yes, you can send in comments or ask to provide oral comments by July 8th or offer then at a public hearing (I'll be there). Then they’ll be formulated into the Dietary Guidelines for Americans. Oh yes, they’ll be some sausage-making (lobbying by commodity groups, food manufacturer’s and their trade associations, elected representatives and concerned consumers) between now and the final wording, expected in December. Then, the guidelines will be used to re-jigger the Food Guide Pyramid and other U.S. government nutrition education resources.

What's the DGAC Report good for? If you want to get the latest evidence (research) on many a nutrition topic, you’ll find it in the DGAC Report with a conclusion that synthesizes the evidence to date. Yes, there are hundreds of pages and hundreds of references. If you aren’t up for reading the whole document (and that’s understandable), just read the executive summary – it’s a well-written overview.

Is there any new news, will there be changes?

  • For starters I was pleased to see the honest voice of these nutrition experts, who in so many words said: to eat healthyfully today in our country today is damn difficult. However, they more tactfully said: “The daunting public health challenge is to accomplish population-wide adoption of healthful dietary patterns within the context of powerful influences that currently promote unhealthy consumer choices, behaviors, and lifestyles.” When discussing the obesity epidemic they stated: “The American environment is conducive to this epidemic, presenting temptation to the populace in the form of tasty, energy-dense, micronutrient-poor foods and beverages.”
  • On a sad note about the state of our health and nutrition status, they essentially say, these guidelines are aimed at the majority of Americans who are “overweight or obese and yet under-nourished in several key nutrients.” The so-called shortfall nutrients are: vitamin D, calcium, potassium, and dietary fiber.
  • A strong message is to focus on our children to prevent obesity starting...actually from prior to conception noting: “This is the single most powerful public health approach to combating and reversing America’s obesity epidemic over the long term.” It’s clear that a woman who gets pregnant at a desirable weight has the best chance of having a healthy baby and providing them with the least risks of obesity and related diseases later in life. This statistic is mind-blowing and downright scary: “One-fifth of American women are obese when they become pregnant, often put on much more weight than is healthy during pregnancy, and have trouble losing it after delivery, placing their offspring at increased risk of obesity and type 2 diabetes (T2D) later in life.”
  • A total diet approach is promoted meaning, an eating plan that is energy balanced and nutrient dense. Studies reveal that what Americans are eating, on average, isn’t pretty: “Americans of all ages consume too few vegetables, fruits, high-fiber whole grains, low-fat milk and milk products, and seafood and they eat too much added sugars, solid fats, refined grains [often high in fat and sodium], and sodium.” Believe it or not, added sugars and solid fats contribute approximately 35 percent of our calories and that’s true across all ages.
  • To eat the nutrients you need and limit the added sugars and solid fats, they suggest you: “Shift food intake patterns to a more plant-based diet that emphasizes vegetables, cooked dry beans and peas, fruits, whole grains, nuts, and seeds. In addition, increase the intake of seafood and fat-free and low-fat milk and milk products and consume only moderate amounts of lean meats, poultry, and eggs.” And the fewer calories you get to eat, the more important it is to make every morsel as nutrient dense as possible.
  • - Unhealthy lifestyle behaviors are identified which lead to “a greater propensity to gain weight”: too much TV watching, too little physical activity, eating out frequently (especially at fast food restaurants), snacking on food and drinks [with excess added sugars and solid fats which equals excess calories], skipping breakfast, and consuming large portions.
  • When it comes to the lengthy debate about carbohydrate and whether the glycemic index or load offers an assit with weight loss, the DGAC Report states: “there is no need for concern with their [sources of carbohydrate] glycemic index or glycemic load. What is important to heed: their [carbohydrates] calories, caloric density, and fiber content.”
  • The sodium recommendation is headed downwards, even further than the 2005 figure of 2,300 milligrams a day. The Report concludes that because nearly 70% of U.S. adults are African American, middle-aged and beyond (and many of these people are at risk of or have high blood pressure), the sodium goal should be 1,500 mg per day for the general population. That’s near to impossible for most people. Keep in mind the average sodium consumption is 4,000 – 6,000 milligrams a day. The DGAC encouraged food manufacturers and restaurants to work on cutting sodium….as processed and restaurant foods are the main sources of our sodium.

So what do you think? Have these nutrition recommendations from this illustrious panel gone far enough? Too far? and on which particular issues? Please let me hear from you.