Dairy products are a leading source of saturated fat in the American diet. In fact, the guidelines recommend people avoid saturated fat because of its link to heart disease.
Scientific evidence also shows that milk and other dairy products increase the risk of asthma, breast, ovarian, and prostate cancers, cognitive decline, and early death, and offer little if any protection for bone health.
Dairy products also cause bloating, diarrhea, and gas in the tens of millions of Americans who have lactose intolerance, the natural progression of not breaking down sugar in milk. The National Institutes of Health estimates that 30 million to 50 million American adults are lactose intolerant, including 95 percent of Asians Americans, 60-80 percent of African Americans and Ashkenazi Jews, 80-100 percent of Native Americans, and 50-80 percent of Hispanics.
In July 2018, the American Medical Association passed a resolution calling on the USDA and HHS to recognize that lactose intolerance is common among many Americans, especially African Americans, Asian Americans, and Native Americans, and to clearly indicate in the guidelines and other federal nutrition guidelines that dairy products are optional.
Canada’s latest food guide recommends that Canadians make water their “drink of choice.”
Calcium is plentiful in beans, leafy green vegetables, tofu, breads, and cereals. Oranges, bananas, potatoes, and other fruits, vegetables, and beans are rich sources of potassium. Legumes and green leafy vegetables are excellent sources of magnesium. The natural source of vitamin D is sunlight, and fortified cereals, grains, bread, orange juice, and plant milks are dietary options.
Every 5 years since 1980, a new edition of the Dietary Guidelines for Americans has been published. Its goal is to make recommendations about the components of a healthy and nutritionally adequate diet to help promote health and prevent chronic disease for current and future generations. Although many of its recommendations have remained relatively consistent over time, the Dietary Guidelines has evolved as scientific knowledge has grown. These advancements have provided a greater understanding of, and focus on, the importance of healthy eating patterns as a whole, and how foods and beverages act synergistically to affect health. Therefore, healthy eating patterns is a focus of the 2015-2020 Dietary Guidelines.
Key Recommendations: Components of Healthy Eating Patterns
The Dietary Guidelines’ Key Recommendations for healthy eating patterns should be applied in their entirety, given the interconnected relationship that each dietary component can have with others.
Key Recommendations
Consume a healthy eating pattern that accounts for all foods and beverages within an appropriate calorie level.
A healthy eating pattern includes:
- A variety of vegetables from all of the subgroups—dark green, red and orange, legumes [beans and peas], starchy, and other
- Fruits, especially whole fruits
- Grains, at least half of which are whole grains
- Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages
- A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes [beans and peas], and nuts, seeds, and soy products
- Oils [such as olive and canola oil]
A healthy eating pattern limits:
- Saturated fats and trans fats, added sugars, and sodium
Key Recommendations that are quantitative are provided for several components of the diet that should be limited. These components are of particular public health concern in the United States, and the specified limits can help individuals achieve healthy eating patterns within calorie limits:
- Consume less than 10 percent of calories per day from added sugars
- Consume less than 10 percent of calories per day from saturated fats
- Consume less than 2,300 milligrams [mg] per day of sodium
- If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age
Implementation of the Dietary Guidelines Through MyPlate
Click here to compare MyPlate to the Harvard Healthy Eating Plate.
The Dietary Guidelines for Americans and the Healthy People 2020 program, which aim to promote healthy behavior in Americans during the next decade, recommend consumption of at least three portions of whole grains a day to reduce the risk of suffering cardiovascular diseases, type 2 diabetes, and certain types of cancer. From:
Wheat and Rice in Disease Prevention and Health, 2014
DIANE RIGASSIO RADLER, RIVA TOUGER-DECKER, in
Prevention in Clinical Oral Health Care, 2008 The Dietary Guidelines for Americans and the Food Guidance System replaced the Food Guide
Pyramid, which was first introduced in 1992.5,7 Key recommendations of the Dietary Guidelines are presented in an easy to use format that can be customized for the consumer. Depending on individual energy needs, specific quantities of foods from each food group are used to define potential optimal health. Furthermore, the current Food Guidance System includes physical activity assessment and recommendations for activity for the first time in the history of the Pyramid
graphics. The Center for Nutrition Policy and Promotion [CNPP], a branch of the USDA, is ultimately responsible for the promotion of the Dietary Guidelines for Americans. The “MyPyramid” [Figure 14-2], a tool designed to translate the Food Guidance System to a graphic and interactive representation, allows each person to monitor his or her food and physical activity to achieve optimum health. “MyPyramid” illustrates six recommendations
including personalization, gradual improvement, physical activity, variety, moderation, and proportionality. The interactive technology afforded by the government website allows each consumer to enter his or her own age, gender, and physical activity for personal recommendations and to compare individual food intakes to the Dietary Guidelines for Americans.5Disease Prevention and Health Promotion
The Food Guidance System
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Nutritional Approaches for Cardiovascular Disease Prevention
Alison M. Hill, ... Penny M. Kris-Etherton, in Preventive Cardiology: Companion to Braunwald's Heart Disease, 2011
Federal Government
•
Dietary Guidelines for Americans, 2005. The Dietary Guidelines for Americans is published jointly every 5 years by the Department of Health and Human Services and the USDA. The guidelines provide authoritative advice for people 2 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. Visit //www.health.gov/DietaryGuidelines/dga2005/document/default.htm.
•Dietary Guidelines for Americans, 2010. Provides the most recent dietary guidelines for Americans. Visit //www.cnpp.usda.gov/dietaryguidelines.htm
MyPyramid.gov. MyPyramid offers personalized eating plans and interactive tools that help plan and assess healthy food choices based on the Dietary Guidelines for Americans. Visit //www.mypyramid.gov/.
•Health and Human Services Small Step Adult and Teen program. Information is presented about steps to take to improve health and well-being. Visit //www.smallstep.gov/.
•National Heart, Lung, and Blood Institute [NHLBI]
•National Cholesterol Education Program. The goal of the NCEP is to reduce illness and death from CHD in the United States by reducing the percentage of Americans with high blood cholesterol. Through educational efforts directed at health professionals and the public, the NCEP aims to raise awareness and understanding about high blood cholesterol as a risk factor for CHD and the benefits of lowering cholesterol levels as a means of preventing CHD. Visit //www.nhlbi.nih.gov/about/ncep/.
•Hearts N’ Parks program is a national, community-based program supported by the NHLBI and the National Recreation and Park Association that is designed to encourage heart-healthy lifestyles in communities. Visit //www.nhlbi.nih.gov/health/prof/heart/obesity/hrt_n_pk/index.htm.
•Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Updated guidelines for hypertension for the health care professional. The report provides new evidence for treating high blood pressure. Visit //www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.htm.
•Centers for Disease Control and Prevention
•Healthy weight program is designed to help individuals achieve and maintain a healthy weight. Visit //www.cdc.gov/healthyweight/index.html.
•Nutrition program helps individuals follow a healthy diet. Visit //www.cdc.gov/nutrition/index.html.
•Physical activity program helps individuals learn about recommendations for active living. Visit //www.cdc.gov/physicalactivity/index.html.
•Cholesterol website provides information about blood cholesterol levels and risk of heart disease. Visit //www.cdc.gov/cholesterol/.
•Food and Drug Administration, food labeling and nutrition programs. Information is presented about labeling requirements for foods under the Federal Food Drug and Cosmetic Act and its amendments. Included in this is information about the nutrition facts panel, health claims/qualified health claims, and nutrient content claims. Visit //www.fda.gov/Food/LabelingNutrition/default.htm.
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Nutritional Considerations for the Pediatric Dental Patient
Laura Romito, James L. McDonaldJr., in McDonald and Avery Dentistry for the Child and Adolescent [Ninth Edition], 2011
The Dietary Guidelines for Americans [the ABCs] promulgated by the U.S. Department of Agriculture [USDA] support the objectives in Healthy People 2010 and include the following recommendations:
•Aim for fitness.
•Aim for a healthy weight.
•Be physically active each day.
•Build a healthy base.
•Let the Food Guide Pyramid guide your food choices.
•Choose a variety of grains daily, especially whole grains.
•Choose a variety of fruits and vegetables daily.
•Keep food safe to eat.
•Choose sensibly.
•Choose a diet low in saturated fat and cholesterol and moderate in fat.
•Choose beverages and foods so as to moderate your intake of sugars.
•Choose and prepare foods with less salt.
If you drink alcoholic beverages, do so in moderation.
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Obesity therapy
Jahangir Moini, ... Mohtashem Samsam, in Global Health Complications of Obesity, 2020
Low-fat diets
The Dietary Guidelines for Americans and the MyPlate program provide examples of low-fat diets. Eating a diet that consists of 20%–35% fats helps manage weight, promote health, and reduce risks of chronic disease. Foods to reduce include saturated and trans fats, cholesterol, sodium, added sugar, refined grains, and alcohol. Foods to increase include fruits, vegetables, whole grains, low-fat dairy and protein foods, and oils. This helps maximize nutrient content and the health promotion potential of the diet. Additional low-fat diets include the DASH diet and the diets recommended by the American Diabetes Association, American Heart Association, and American Cancer Society. The commercial Weight Watchers program is also a low-fat diet.
Focus on the Dietary Guidelines for Americans
The Dietary Guidelines for Americans is now in its eighth edition and consists of five suggestions that should be followed. They are as follows:
1.Follow a healthy eating pattern across the life span. Maintain a healthy weight, support nutrient adequacy, and reduce risks of chronic disease.
2.Focus on variety, nutrient density, and amount. Meet nutrient needs, but stay within calorie limits.
3.Limit calories from added sugars and saturated fats, and reduce sodium intake. These include sodas, snacks, desserts, sandwiches, and pizza.
4.Shift to healthier food and beverage choices. For example, instead of fried chicken, eat chicken baked with herbs. Instead of canned peaches in syrup, eat fresh or frozen peaches without added sugars.
5.Support healthy eating patterns for all. Work with others to encourage better diet at home, at school, or in the workplace.
Focus on MyPlate
The US government’s MyPlate program suggests that each meal should consist of the following:
•50%—approximately 20% fruits and 30% vegetables—vary your vegetables, and focus on whole fruits. Whole fruits can be fresh, frozen, dried, or canned in 100% juice. Eat colorful fruits and vegetables because they provide more vitamins and minerals and are usually lower in calories. Fruits can be eaten with meals, as snacks, or as desserts. Fresh, frozen, or canned vegetables are acceptable, and they can be steamed, sautéed, roasted, or raw.
•50%—approximately 20% proteins and 30% grains—mix up protein foods to include seafood, beans, peas, unsalted nuts and seeds, soy products, lean meats, and poultry. Make half your grains whole grains, which should be listed first or second on the ingredients list—such as oatmeal, whole-grain bread, and brown rice. Limit grain-based desserts and snacks, such as cakes, cookies, and pastries.
•Drink low-fat or fat-free milk, or eat similar types of yogurt. Soymilk is also great. Replace sour cream, cream, and regular cheese with low-fat yogurt, milk, and cheese. Drink beverages that have less sodium, saturated fat, and added sugars. For oils, use vegetable oils instead of butter, and oil-based sauces and dips instead of those with butter, cream, or cheese. Drink water as much as possible, and avoid nondiet soda, energy or sports drinks, and other sugar-sweetened drinks.
There has been more in-depth study of low-fat diets than on any other type of diet. In many studies, low-fat diets have shown significantly greater weight loss than people who did not follow these diet plans. Low-fat diets also provided improvements in hemoglobin A1c [HbA1c], blood pressure [BP], high-density lipoprotein [HDL], and triacylglycerides [TAG]. The Women’s Health Initiative Dietary Modification Trial revealed that a low-fat diet without any instructions for calorie restriction helped maintain weight loss slightly better than following a diet that was higher in fat. Therefore it can be stated that a low-fat diet is an effective weight control strategy over any length of time, as long as it is followed correctly.
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Nutrition
Mark Mirabelli MD, Ramsey Shehab MD, in Clinical Men's Health, 2008
USDA/My Pyramid
The Dietary Guidelines for Americans56 are written to “promote good dietary habits, reserve health and reduce risk for major chronic diseases” [Table 19-3]. Like all low-fat diets, the emphasis in the USDA food guide diet is on fruits, vegetables, and whole grains. The Dietary Guidelines are explained in visual form as the USDA My Pyramid, an evolution from the previous USDA Food Guide Pyramid. In 2005, the USDA food guide pyramid was rebuilt with the food groups being represented by a rainbow of colored, vertical stripes and an illustration of a person climbing steps to emphasize the importance of exercise [Figure 19-2]. It was also individualized for age, gender, and activity level and simplified to make serving sizes and food choices easier to comprehend by the public. A Web site highlighting this diet [//www.mypyramid.gov] allows individuals to receive a personal, tailored diet regimen plan. This in turn creates an individualized approach to balancing nutrition and exercise, which is promoted to lead to a better lifestyle. Unfortunately, the basic pyramid contains no text and has an abstract illustration that limits its usefulness to individuals with access to it—persons with access to the Web site or a full copy.
The Diabetes Prevention Program57 examined the USDA diet in a 27-center, randomized, clinical trial that evaluated the effects of lifestyle intervention and pharmacotherapy on the incidence of type 2 diabetes in persons with impaired glucose tolerance. In this study, 3234 overweight participants [32% men] were randomly assigned to one of three groups: [1] placebo plus standard lifestyle recommendations, [2] metformin plus standard lifestyle recommendations, and [3] intensive lifestyle intervention. Participants in the medication and placebo groups were provided written information on the food guide pyramid and were seen annually in individual sessions. Patients in the intensive lifestyle group also followed the food guide pyramid but received closer follow-up. Participants in the intensive lifestyle group lost significantly more weight than those in the metformin and placebo groups. The intensive lifestyle group also had a significantly lower incidence of type 2 diabetes than the placebo or metformin group at 1 year.
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Supplementation: Dietary Supplements
S.S. Percival, in Encyclopedia of Human Nutrition [Third Edition], 2013
Potential Benefits of Dietary Supplements
The 2000 Dietary Guidelines for Americans [new release due 2005] emphasizes choosing foods sensibly, maintaining a healthy weight, and exercising regularly. It acknowledges that some people may need a vitamin–mineral supplement to meet specific needs. Similarly, the Food and Nutrition Board and the American Dietetic Association also recognize that dietary supplements may be desirable for some nutrients and for some individuals. The following is a compilation of recommendations by these groups:
•Folic acid supplements for women of childbearing age due to the risk of neural tube defects
•Vitamin B12 supplements for people older than age 50 years due to inefficient absorption
•Vitamin B12 supplements for vegans who eat no animal products
•Calcium for people who seldom eat dairy products
•Vitamin D for elderly people who do not consume fortified dairy products and for others with little exposure to sunlight
•Iron supplementation for pregnant women
•Multivitamin-mineral supplement for people who are following a severely restricted weight-loss diet.
Specifically for athletes, the position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine is that physical activity, athletic performance, and recovery from exercise are enhanced by optimal nutrition. These organizations recommend appropriate selection of food and fluids, timing of intake, and supplement choices for optimal health and exercise performance. In sports, athletes who are at greatest risk of micronutrient deficiencies are those who restrict energy intake or use severe weight-loss practices, eliminate one or more food groups from their diet, are sick or recovering from injury, or consume high-carbohydrate diets with low micronutrient density. In practice, athletes should consume diets that provide at least the Recommeded Dietary Allowances/Direct References Intakes for all micronutrients from food. It follows that, in general, no vitamin and mineral supplements are required if an athlete is consuming adequate energy from a variety of foods to maintain body weight. Supplementation may be necessary under conditions of inadequate food intake. Athletes, as for the general population, should follow supplementation recommendations unrelated to exercise, such as folic acid in women who may become pregnant.
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Cardiovascular Disease, Genes, and Nutrition: Gender Matters
JOSE M. ORDOVAS PhD, LI-MING LOH, in Principles of Gender-Specific Medicine, 2004
d. WHOLE GRAIN.
Although current dietary guidelines for Americans recommend increased intake of grain products to prevent CHD, epidemiologic data relating whole-grain intake to the risk of CHD are sparse. The investigators of the Nurses’ Health Study evaluated whether high whole-grain intake reduces risk of CHD in women. [53]. After adjustment for age and smoking, increased whole-grain intake was associated with decreased risk of CHD. For increasing quintiles of intake, the corresponding RRs were 1.0 [reference], 0.86, 0.82, 0.72, and 0.67 [95% CI comparing 2 extreme quintiles: 0.54, 0.84; P for trend