Q: WHAT NUTRITIONAL UPDATES ARE AVAILABLE IN THE 2010 DIETARY GUIDELINES FOR AMERICANS?
A: Staying up-to-date with all areas of health and wellness can be a real challenge. Fortunately, a set of scientifically based nutritional guidelines is regularly updated, providing the busy fitness professional with a current and accurate resource for practical use. The 2010 Dietary Guidelines for Americans was released on January 31, 2011, a joint publication by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services. The Dietary Guidelines for Americans (DGA) are published at least every 5 years, and the 2010 DGA is the seventh edition; the first edition was released in 1980 (3).
The 2010 DGA differs from previous editions in a number of ways, including the target audience. Previous editions were intended for healthy Americans ages 2 years and older. Because of the increased concern regarding the health of Americans, along with the knowledge that poor diet and physical inactivity continue to contribute to overweight and obesity, the 2010 DGA is intended for everyone 2 years of age and older, including those at risk for chronic diseases as well as healthy individuals (1).
The 2010 DGA includes a number of key recommendations within four general categories, summarized in the following list (1):
* Balancing calories to manage weight:
○ preventing or reducing overweight and obesity with better eating and activity patterns
○ managing body weight by controlling total calorie intake
○ increasing physical activity and reducing time spent in inactivity
○ maintaining calorie balance throughout the life span
* Foods and food components to reduce:
○ sodium intake — reducing to less than 2,300 mg or even lower to 1,500 mg for those who are older (older than 50 years); African American; or who have high blood pressure, diabetes, or chronic kidney disease
○ saturated fat — reducing to less than 10% of calories (replace with monounsaturated and polyunsaturated fatty acids)
○ trans fatty acids — keeping as low as possible (limit foods containing hydrogenated oils and other solid fats)
○ calories from solid fats and added sugars — reducing number of calories from these sources
○ refined grains — reducing consumption of refined grain foods containing solid fats, added sugars, and sodium
○ alcohol — if consumed, this should be in moderation (no more than one drink per day for women and 2 drinks per day for men) by adults of legal drinking age
* Foods and nutrients to increase (these recommendations should be met as part of an overall healthy pattern of eating, which stays within the number of needed calories)
○ fruits and vegetables — including a variety
○ whole grains — consuming at least half of grains as whole grains
○ fat-free and low-fat milk and milk products — consuming items such as milk, yogurt, and fortified soy beverages
○ protein foods — consuming a variety of protein sources (e.g., fish, lean meat and poultry, eggs, beans and peas, soy products, unsalted nuts, and seeds) and replacing high solid fats with choices that are lower in fat/calorie or are sources of oils
○ seafood — increasing the amount and variety of seafood, replacing some meat and poultry intake
○ oils — replacing solid fats with oils
○ potassium, dietary fiber, calcium, vitamin D — selecting foods high in these nutrients (e.g., vegetables, fruits, whole grains, milk, and milk products)
* Building healthy eating patterns:
○ meeting nutrient needs at an appropriate calorie intake
○ accounting for food and beverages consumed within a healthy eating pattern
○ reducing risk of foodborne illnesses by following safety recommendations when preparing and eating foods
Note that additional guidance is provided for women who may become pregnant (encouraging foods supplying heme iron as well as 400 µg per day of synthetic folic acid in addition to dietary folate) or who are pregnant or breast-feeding (encouraging weekly consumption of 8 to 12 oz of seafood, although limiting or avoiding some types of fish with high methyl mercury content, and suggesting iron supplementation if recommended by an obstetrician or health care provider). In addition, for individuals aged 50 years and older, ensuring consumptions of foods fortified with vitamin B12 (e.g., fortified cereals, supplements) is recommended.
Over the upcoming months, additional consumer-focused materials will be released. In the mean time, the DGA provides expanded information on each of these key recommendations, a very helpful source for health and fitness professionals with dietary questions (1). In addition, the Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines (DGA) for Americans provides a very detailed review of the scientific and medical knowledge that served as the basis for the 2010 DGA (2).
IS NUTRIENT DENSITY ONLY IMPORTANT FOR WEIGHT LOSS?
Nutrient-dense foods and beverages provide the greatest number of nutrients with the least number of calories. In other words, the nutrients have not been diluted by nonbeneficial calories from added sugars, solid fats, refined starches, or by solid fats naturally within the item (1). The higher the nutrient density, the better the food or beverage is with regard to a healthy diet. Examples of nutrient-dense foods, when prepared without adding solid fats or sugars, include vegetables, fruits, whole grains, seafood, eggs, beans and peas, unsalted nuts and seeds, fat-free and low-fat milk and milk products, and lean meats and poultry (1).
Nutrient density is of benefit when weight loss is a goal. To help visualize this, see the Figure for a comparison of the number of calories in nutrient-dense and non‐nutrient-dense forms of particular foods (1). Clearly, the focus on nutrient-dense options provides individuals with the needed energy-producing macronutrients along with vitamins and minerals without the added calories from fat and added sugars. Selecting nutrient dense foods allows for needed nutrients to be supplied without excessive calories.
Keeping emphasis within the diet on nutrient-dense foods can be of benefit for everyone, not just individuals desiring weight loss. Focusing on nutrient density provides optimal nutrition. Consuming excessive amounts of sodium, solid fats, added sugars, and refined grains may increase the risk of some chronic diseases regardless of overweight or obesity (1).
As an example, consider the quality of fat within the American diet, which is considered a critical health issue (2). Saturated fat intake is associated with increased total and low-density lipoprotein cholesterol and increased risk of cardiovascular disease. In addition, there is strong evidence for an association between saturated fat intake and markers of insulin resistance as well as increased risk of type 2 diabetes. A potential dietary modification is to replace saturated fat with monounsaturated fatty acids or polyunsaturated fatty acids to decrease risk for cardiovascular disease and type 2 diabetes (2).
Intake of nutrient-dense foods is not optimal for many people. Consider the four top sources of calories among Americans (1):
1. grain-based desserts (cake, cookies, pie cobbler, sweet rolls, pastries, and donuts)
2. yeast breads (white bread or rolls, mixed-grain bread, flavored bread, whole-wheat bread, and bagels)
3. chicken and chicken mixed dishes (fried or baked chicken parts and chicken strips/patties, chicken stir-fries, chicken casseroles, chicken sandwiches, chicken salads, stewed chicken, and other chicken mixed dishes)
4. sweetened beverages (soda, energy drinks, sport drinks, and sweetened bottled water including vitamin water)
Numbers 1 and 4 are not nutrient dense, and numbers 2 and 3 are rather broadly defined, thus potentially either high or low nutrient density depending on the selection (e.g., whole-wheat bread versus white bread; baked chicken versus fried chicken). Health and fitness professionals can support the selection of nutrient-dense choices as part of an overall healthy eating pattern — both for weight loss as well as for health.
IS PHYSICAL ACTIVITY INCLUDED AS PART OF THE DIETARY GUIDELINES FOR AMERICANS?
Health and fitness professionals can be encouraged by the continued support provided in the DGA for physical activity. Specifically, one of the key recommendations states “Increase physical activity and reduce time spent in sedentary behaviors” (1). Although the main focus of the DGA is the food and beverage selections on the calorie intake side of caloric balance, the importance of caloric expenditure is clearly highlighted. By expending more calories with lifestyle physical activity as well as regular planned exercise, Americans can better manage body weight as well as reap the many health benefits associated with nonsedentary behavior. Unfortunately, few Americans actually meet the weekly goal of at least 150 minutes of activity as recommended in the Physical Activity Guidelines for Americans (4), and as a result, fitness professionals have the opportunity to make a major impact. Healthy eating patterns along with regular physical activity provide the winning combination for all Americans.
Be sure to check out the Nutritionist’s View column in this issue about how to use the 2010 Dietary Guidelines for Americans as a guide when recommending a healthy diet to clients.