HIGHLIGHTS OF THE 6th EDITION OF THE DIETARY GUIDELINES FOR AMERICANS
2005 Key Recommendations For The General Public
The fifth edition (2000) of the Dietary Guidelines provided 10 guidelines under three basic messages called the "ABCs for good health": Aim for fitness; Build a healthy base; Choose sensibly (3). In contrast, the new evidence-based 2005 Dietary Guidelines provides 41 "key recommendations," 23 for the general public and 18 targeted to specific population groups (e.g., children, the elderly), under the following nine general topic areas or chapters: adequate nutrients within calorie needs; weight management; physical activity; food groups to encourage; fat; carbohydrates; sodium and potassium; alcoholic beverages; and food safety (1).
The following are key recommendations for the general public under the nine topic areas (1).
ADQUATE NUTRIENTS WITHIN CALORIE NEEDS
• Consume a variety of nutrient-dense foods and beverages within and among the basic food groups while choosing foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol.
• Meet recommended intakes within energy needs by adopting a balanced eating pattern, such as the USDA Food Guide or the DASH Eating Plan.
Two basic premises of the Dietary Guidelines are that food guidance should recommend diets that will provide all the nutrients needed for growth and health and that the nutrients consumed should come primarily from foods (1). Included for the first time are two examples of eating patterns that exemplify the Guidelines, specifically the USDA Food Guide and the DASH (Dietary Approaches to Stop Hypertension) Eating Plan. Both these plans include more low-fat milk and milk products, vegetables, fruits, and whole grains and less refined grains, total fats, added sugars, and calories than food consumption patterns typically consumed in the U.S. (1).
The newly released Dietary Guidelines encourages Americans to eat more nutrient-rich foods such as fruits, vegetables, whole grains, and low-fat and fat free milk and milk products each day.
The recommendations emphasize intake of a variety of foods among and within food groups and nutrient dense foods such as those that provide substantial amounts of vitamins and minerals with relatively fewer calories. Also encouraged is the intake of foods high in nutrients found in low amounts in the diets of adults (e.g., calcium, potassium, fiber, magnesium, and vitamins A, C, and E) and children and adolescents (e.g., calcium, potassium, fiber, magnesium, and vitamin E). For example, increasing the intake of milk and milk products can help meet children’s and adults’ calcium, potassium, and other nutrient needs (1).
WEIGHT MANAGEMENT
• 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.
Recognizing the significant increase in the prevalence of overweight and obesity among adults and children over the past two decades (5), the Dietary Guidelines encourages Americans to eat fewer calories while increasing their physical activity (1).
PHYSICAL ACTIVITY
• Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being, and a healthy body weight. To reduce the risk of chronic disease in adulthood, engage in at least 30 minutes a day of moderate-intensity physical activity on most days of the week; to help manage body weight and prevent gradual, unhealthy body weight gain during adulthood, engage in approximately 60 minutes of moderate-to vigorous-intensity activity on most days of the week; and to sustain weight loss in adulthood, participate in at least 60 to 90 minutes of daily moderate-intensity physical activity while not exceeding caloric intake requirements.
• Achieve physical fitness by including cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises or calisthenics for muscle strength and endurance.
Compared to the previous (2000) Dietary Guidelines which encouraged at least 30 minutes of physical activity for adults and 60 minutes for children on most, preferably all, days of the week to achieve health benefits (2), the new Dietary Guidelines, for the first time, also focuses on physical activity (60 to 90 minutes/day) to maintain weight loss (1). Time spent being physically active can be broken up into short bouts over the course of a day. It is the total amount of time during the day being physically active that is important.
FOOD GROUPS TO ENCOURAGE
• Consume a sufficient amount of fruits and vegetables while staying within energy needs. Two cups of fruit and 2 1/2 cups of vegetables per day are recommended for a reference 2,000-calorie intake, with higher or lower amounts depending on the calorie level.
• Choose a variety of fruits and vegetables each day. In particular, select from all five vegetable subgroups (3 cups/week of dark green vegetables, 2 cups/week of orange vegetables, 3 cups/week of legumes, 3 cups/week of starchy vegetables, and 6 1/2 cups/week of other vegetables).
• Consume 3 or more ounce-equivalents of whole-grain products (e.g., cereals, breads, pasta, rice) per day, with the rest of the recommended grains coming from enriched or whole-grain products. In general, at least half the grains consumed each day should come from whole grain products.
• Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products (e.g., cheese, yogurt).
For the first time, the Dietary Guidelines recommends 3 cups/day of fat-free or low fat milk or equivalent milk products (e.g., cheese, yogurt). The Guidelines recognizes dairy products as nutrient dense foods associated with overall diet quality, nutrient adequacy, and health promotion.
For the first time, the 2005 Dietary Guidelines includes the recommendation to consume 3 cups per day of fat-free or low-fat milk or equivalent milk products for ages 9 years and up (1). The previous (2000) Guidelines recommended consuming 2-3 servings from the dairy group a day (3). Also, for the first time, a specific number of servings of whole grain foods (i.e., 3 or more ounce-equivalents per day) is recommended and the recommendation for fruits and vegetables is given in cups as well as in servings (1).
Unlike the previous Guidelines (3) which made a more general recommendation to eat plenty of fruits, vegetables, and whole grains to help protect against chronic diseases, the new Guidelines (1) identifies individual food groups with disease prevention. For example, the 2005 Dietary Guidelines states that diets rich in milk and milk products can reduce the risk of low bone mass throughout the life cycle; that diets rich in fruits, vegetables, and whole grains may reduce the risk of coronary heart disease; and that diets rich in fruits and vegetables may reduce the risk of stroke, type 2 diabetes, and certain kinds of cancer (1).
FATS
• Consume less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep trans fatty acid consumption as low as possible.
• Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.
• When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free.
• Limit intake of fats and oils high in saturated and/or trans fatty acids, and choose products low in such fats and oils.
The new Guidelines (1) provides more specific advice and more information on trans fatty acids compared to the previous edition of the Guidelines (3).
CARBOHYDRATES
• Choose fiber-rich fruits, vegetables, and whole grains often.
• Choose and prepare foods and beverages with little added sugars or caloric sweeteners, such as amounts suggested by the USDA Food Guide and the DASH Eating plan.
• Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar- and starch-containing foods and beverages less frequently.
The new Guidelines encourages an increase in fiber intake to 14g/1000 kcal from fiber-rich foods because of the number of health benefits associated with dietary fiber, and discourages the consumption of foods containing large amounts of added sugars because of the difficulty in meeting nutrient needs without gaining weight (1).
SODIUM AND POTASSIUM
• Consume less than 2,300mg (approximately 1 tsp of salt) of sodium per day.
• Choose and prepare foods with little salt. At the same time, consume potassium-rich foods, such as fruits, vegetables, and dairy foods. Milk is ranked as the top food source of potassium among U.S. adults, according to USDA national food intake surveys (4,6).
Compared to the previous edition of the Dietary Guidelines (2000) (3), the new Guidelines emphasizes a diet adequate in potassium-rich foods to help lower the risk of high blood pressure (1).
ALCOHOLIC BEVERAGES
• Those who choose to drink alcoholic beverages should do so sensibly and in moderation – defined as the consumption of up to one drink per day for women and up to two drinks per day for men.
• Alcoholic beverages should not be consumed by some individuals, including those who cannot restrict their alcoholic intake, women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions.
• Alcoholic beverages should be avoided by individuals engaging in activities that require attention, skill, or coordination, such as driving or operating machinery.
FOOD SAFETY
To avoid microbial foodborne illness:
• Clean hands, food contact surfaces, and fruits and vegetables. Meat and poultry should not be washed or rinsed.
• Separate raw, cooked, and ready-to-eat foods while shopping, preparing, or storing foods.
• Cook foods to a safe temperature to kill microorganisms.
• Chill (refrigerate) perishable food promptly and defrost foods properly.
• Avoid raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs or foods containing raw eggs, raw or undercooked meat and poultry, unpasteurized juices, and raw sprouts.
In addition to the above key recommendations for the general public, recommendations are also provided for special population groups such as pregnant or lactating women, children and older adults. For example, for children ages 2 to 8 years, 2 cups of fat-free milk or low-fat milk or equivalent milk products per day are recommended, whereas for children 9 years of age or older, 3 cups of fat-free or low-fat milk or equivalent milk products per day are recommended (1). Individuals with hypertension, blacks, and middle-aged and older adults should consume no more than 1,500mg of sodium per day compared to the 2,300mg/day limit for the general healthy population (1).
NEW RECOMMENDATIONS REGARDING DAIRY FOODS
The newly released Dietary Guidelines (1) acknowledges the important role of dairy foods in the diet and recommends that Americans 9 years of age and older consume 3 cups/day of fat-free or low-fat milk or equivalent milk products as part of a healthful diet. This recommendation is consistent with other recent reports such as one issued by the National Medical Association (7) and the Surgeon General’s Report on Osteoporosis and Bone Health (8). A recent analysis of government food and nutrient consumption data determined that 3 to 4 servings of dairy foods a day for all individuals 9
years of age and over is the optimal level to ensure adequate intake of calcium (9).
Health professionals can play a key role in promoting the Dietary Guidelines, tailoring the recommendations to different racial/ethnic groups, vegetarians, and other groups, and encouraging consumers to make healthful lifestyle choices.
Dairy foods provide 72% of the calcium available in the nation’s food supply (10). The Dietary Guidelines not only recognizes dairy products as an important source of calcium, but also as nutrient dense foods associated with overall diet quality and nutrient adequacy (1). The Guidelines identifies seven nutrients low in the diets of adults and five for children. Dairy foods, such as milk, cheese, and yogurt, supply four of these seven nutrients for adults: calcium, potassium, magnesium, and vitamin A. Similarly, dairy foods provide three of the five nutrients low in the diets of children: calcium, magnesium, and potassium (1,10,11).
In addition to improving overall diet quality and nutrient adequacy, dairy food consumption is associated with health benefits (1). The Guidelines points out that intake of milk, cheese, and yogurt is positively associated with bone mineral content or bone mineral density (1). Although the Guidelines does not mention the emerging body of research supporting dairy foods’ beneficial role in weight management (12,13), it states that "adults and children should not avoid milk and milk products because of concerns that these foods lead to weight gain" (1). Dairy foods’ beneficial role in health has long been established by the nutrition and science community (14,15). According to a recent analysis of approximately 100 studies published between 1980 and 2002, consuming 3 to 4 servings of dairy foods a day as part of a healthful diet could lead to a reduction in healthcare costs of $26 billion in the first year and more than $200 billion over five years (16).
For the first time, the Dietary Guidelines recommends dairy products as the primary strategy for individuals who are lactose intolerant (1). The Guidelines states "if a person wants to consider milk alternatives because of lactose intolerance, the most reliable and easiest way to derive the health benefits associated with milk and milk product consumption is to choose alternatives within the milk food group, such as yogurt or lactose-free milk, or to consume the enzyme lactase prior to the consumption of milk products" (1).
EFFECTIVELY COMMUNICATING THE DIETARY GUIDELINES TO CONSUMERS
A major challenge facing nutrition and other health professionals is to effectively communicate the Dietary Guidelines to consumers so that they will take appropriate actions to improve their lifestyles and overall health. Meeting this challenge is critical given that poor diet and a sedentary lifestyle contribute to about 15% of total deaths in the U.S. (17).
To help the public understand the science-based recommendations presented in the Dietary Guidelines (1), the government has produced a consumer-oriented brochure, Finding Your Way to a Healthier You (18). The brochure translates the Guidelines into actionable, easy to understand, language for consumers. Another initiative to make the Guidelines consumer-friendly is USDA’s new Food Guidance System, which replaces USDA’s Food Guide Pyramid (19).
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