Thursday, June 30, 2011

Dietary Guidelines for Americans, 2010 - What YOU Need to Know - pt 3 of 3

This is it!  Hang in there and read the last post - after all, if you are one of my USA readers, these recommendations are for you and you should take responsibility for knowing what they are... read on and tomorrow we will have a new topic...

21. Protein is ample in the American diet and therefore is not a nutrient of concern.  Animal protein is often high in SFA and is energy dense so portion size must be “appropriate.” 

22. Interestingly the DGA is promoting dairy consumption even as some scientists (walter willett) do not feel this is warranted.  To be certain, the committee is stressing that the no fat low fat option is prefered.  Studies regarding weight loss or control by way of diary products are inconclusive.  The recommendations for consuming dairy based on the nutrient value of the food group.  The committee states that the calcium in milk is the most usable kind for the body and that milk products can also be a good source of protein.  Within total calories per day - it is suggested that we have 2-3 cups of milk or milk products a day.  I would add the caution on cheese, yogurt, milks and ice creams with regard to SoFAS J

23. Dietary fiber and whole grains are also highlighted and it is suggested that refined products be replaced by whole and that foods rich in fiber be consumed.  Most importantly, “consumption of naturally occurring plant based foods that are high in dietary fiber” are recommended and a point is made that products with “added fiber” do not procure the same health benefits - if any.  Whole grains and fiber protect against CVD, T2D, obesity and improve digestive health.

24. The increase in fruits and vegetables needs to occur with attention to the natural state of these foods such that they are not consumed with SoFASs, starches and sodium which would reduce their low density status.

25. The DGAC debunked the Glycemic Index and again referred to calories in the foods being more important than an index.  However, they noted that some carbohydrates do have higher energy density and should be limited - or that the carbs that are higher in nutrients and fiber be the first choice.  The report specifically noted calories per gram - i.e. LED  (low energy density) and Volumetrics, citing research studies similar to those I have read.

26. SSB were noted to increase weight if persons consumed more calories than are needed to balance their weight and because it is easy to over consume due to the energy density, these drinks should be limited in those who are overweight.

27. Non- caloric sweeteners were also reviewed and again, as long as calories are controlled, there is no evidence to support the assertion that diet sodas lead to weight gain.  There may be an association between overweight/obese persons and diet soda consumption, in that persons with higher BMIs are the ones drinking these beverages or using the sweeteners.  Again and again, however, this report notes that it is total amount of calories - an excess of them - that is the problem (for weight) not where they come from “calories are the issue in either case.”

28. The report notes that what they find in laboratory studies, (satiety) may not play out the same in the real world  where there is “a more complicated eating environment.”

29. Sodium, Potassium and Water are addressed and important statements pertaining to them include that when we reduce salt in peoples’ diets, their blood pressure comes down.  Potassium improves blood pressure in those who have hypertension and consuming foods that are low in one(sodium) and higher in the other(potassium) is wise.

30. Most importantly - the guidelines debunk another myth by stating that there is NO MINIMUM amount of water that we need to consume in a day.  We are not having trouble meeting our hydration needs as a whole.  Those who engage in MVPA should hydrate accordingly as should those who are exposed to extreme heat.  In other words, you do not need eight 8 oz glasses of water a day, but you need to not be thirsty.

DGAC (Dietary Guidelines Advisory Committee). 2010. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010. Washington, DC: U.S. Department of Health and Human Services, U.S. Department of Agriculture.

Wednesday, June 29, 2011

Let's Visit Europe

The part three synopsis of the Dietary Guidelines for American's is ready, but I think you need time to absorb the first two parts...

So for fun, click on this link which will take you to a web page that has information on the Food-Based Dietary Guidelines for European countries.  Scroll down several "page downs" worth (on the main page, you do not need to click any links for this part)- you will start seeing food pyramids from different countries, like Ireland, Spain, Switzerland... etc

Tuesday, June 28, 2011

Dietary Guidelines for American, 2010 - What YOU Need to Know - pt 2 of 3

DGAC (Dietary Guidelines Advisory Committee). 2010. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010. Washington, DC: U.S. Department of Health and Human Services, U.S. Department of Agriculture.

11. Calories in general are associated with weight, certain macro-nutrients (i.e. sat fat) are associated with disease and others health (omega 3 fats), while physical activity and decreases in sedentary behavior are related to overall health and well being.

12. In noting our over consumption, the report identifies likely culprits to be SoFAS, sodium, saturated fat (as well as cholesterol for males) and refined grains.  These issues need to be addressed and total EI (energy intake) decreased without compromising nutrition.  Therefore the suggestion is to decrease the above mentioned food types.  It is noted that sat fat be replaced with MUFA and PUFA and that refined grains be replaced with whole. (mono and poly unsaturated fats)

13. Note that the DGAC makes a point, several times, to say that adding positive food elements must be done with regard to TEI and that new components should be in PLACE of others, not in addition to them.

14. We do not consume adequate amounts of fruits and vegetables which are nutrient rich low calorie foods.  We are also deficient on whole grains, good oils (noted above) and low/no fat milk and milk products.

15. On page E1-7 it is noted that nutrients should come from our foods on a plate and not in pills.  They go so far as to suggest that a daily multi vitamin is not needed.   “A fundamental premise of the DGAC is that nutrients should come from foods”….  “For the general, healthy population, there is no evidence to support a recommendation for the use of multivitamin/mineral supplements in the primary prevention of chronic disease.”

16. The only concern for the general population in regard to nutrient deficiency is for vitamin D, potassium and fiber. These can be consumed through a balance diet, with attention to overall caloric intake.

17. As indicated in this blog post, SFA is associated with disease markers and adverse health outcomes.  If replaced with MUFA and PUFA while holding calories even with need and total fat percent below 10% this could have a significant positive impact on cardiovascular health and T2D incidence and management.

18. This same indication applies to children for which the intermediate markers of disease are also present. 

19. Understanding the committee’s concerns on the different fats and that the public is confused by the term total fat, makes the IOM FOP suggestion of SFA on front of pack labels make good sense.

20. Though discussed separately in the report, intake of seafood, alcohol , nuts and chocolate was addressed.  The benefit of seafood is related to the type of fat that it contains which may be associated with lowering inflammation (a marker of disease), as well as it being a low calorie high nutrient food (when cooked wisely).  That is to be balanced by attention to the type of seafood - avoiding or limiting intake according to MeHg and POP - Persistent Organic Pollutants. Chocolate got a relatively small nod of favor, due to its high caloric properties and nuts received special attention - first due to their often being salted and second because of a lack of understand in the general public that - “nuts should be consumed in small portions as they are high in calories and can contribute to weight gain.”  Alcohol is protective of heart disease and can be consumed in moderation without leading to weight gain, if calories are controlled and of course, the drinks aren’t high calories ones.

Monday, June 27, 2011

Dietary Guidelines for American, 2010 - What YOU Need to Know - pt 1 of 3

You can view your own copy of the guidelines as well as some summary sheets by visiting this website
 SOURCE: DGAC (Dietary Guidelines Advisory Committee). 2010. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010. Washington, DC: U.S. Department of Health and Human Services, U.S. Department of Agriculture.

1. The main theme of the guidelines is that we have over consumed and should now strive to meet our daily nutritional needs with constant attention to our energy needs.  We are encouraged to eat only as much as we need if not less.

2. The food environment does have an impact on individual behavior.  For example, the increased consumption of high calorie foods which are poor in nutrients (frequency and total volume) is based on the availability of them (physical and financial) where as the inverse is true for fruits and vegetables.

3. Because it has been found to be helpful, people should monitor their intake of calories and certain nutrients.

4. There should be efforts made to increase the availability and consumption of foods that are nutrient dense, in appropriate portions, with lower saturated fat, sugar and sodium content. 

5. SoFAS - stands for solid fats and added sugars - it is quite interesting then - the DGAs are focusing on added sugars but the IOM in its report on FOP labeling did not recommended their quantification!

6. Children are consuming too many calories as well and we should reduce this surplus especially in regards to SoFAS and empty calories often found in SSBs (sugar sweetened beverages).  We can replace these items with fruits and vegetables for which the country as a whole is in need.  Similar foods that are energy dense and low in calories should be consumed.

7. The type of calorie and its food source is less important in regards to weight loss than the amount of calories that one consumes. In other words, there is no strong evidence on the amount of protein vs carbohydrates that is best for weight loss, however there is concern about some adverse health effects and discomfort experienced in persons who eat a high protein diet.  Thus the DGA recommends the avoidance of high protein diets.

8. The diet (our day to day intake of foods and beverages) that is recommended is very much like the one that I both promote and adhere to.  It is on page E1-5 of the DGAC and reads…. “a relatively high intake of vegetables, fruit and total fiber, and a relatively low intake of total fat, saturated fat and added sugars.”  Boy - there is that added sugars thing again - you would think it important!  [sorry I am still upset with the IOM]

9. The DGAC [dietary guidelines for Americans committee]suggests that all overweight persons, regardless of age or health status, be encouraged to lose weight if they are overweight. This is related especially to older adults who were once thought unhealthy at low weights, but that was due to population research that did not capture that the low weight was weight loss from illness, not healthy weights from diet and exercise.

10. As noted in the above bulleted section (previous post) - physically active people may be less inclined to become overweight and all persons who are physically active have better health outcomes than those who are not.  The conclusions do not promote physical activity as a way to lose weight, but as a way to be healthy and contribute to the expenditure of calories.  It is noted in the chapter on energy balance that significant amounts of MVPA are needed to lose weight and that a majority of persons do not achieve the minimal recommendations. [moderate to vigorous physical activity]

Sunday, June 26, 2011

Odds and Ends

No Stir - Trickery:  First - the use of the term All Natural is not regulated by a clear definition - according to the FDA labeling law, it only has to mean minimally processed.  This is not news to you, I have said it in the past.  It is also not news to most of you that I am a devout fan of Smucker's All Natural Peanut Butter which actually IS all natural in that it is peanuts and salt - period.  This means it does not stay solid at room temperature - it separates.  That is a VERY good sign - the fat in that peanut butter is the good kind.  It requires stirring.  So this weekend I saw brands that said "natural peanut butter - no stirring required."  I turned the jar over to the NFP and read the ingredients, which included palm oil and ADDED SUGAR.  Don't be tricked!  The stirring is what makes it healthy - and don't be afraid to stir - I even You Tubed the stirring  - to help you out.

Age of Diagnosis:  A story that I glanced over this week regarded breast cancer in older women.  I believe that the women were over aged 65 when they received a diagnosis of breast cancer (and I believe that the study referred to a specific type of BCA - a more common type).  In these women, the cause of death, when they died, was not breast cancer but heart disease. Again, heart disease is the number one killer of Americans and it is related more often to saturated fat intake and being overweight.

What's Your Doctor Prescribing?  This blurb regards a supreme court decision that was made this week.  It has been awhile since I blogged about my disdain for drug companies but my disdain is very much alive.  Still, I was not really aware of the practice that the Supreme Court defended this week.  Pharmacies keep records of what medicines are prescribed by each physician - (physicians have a number - a DEA number maybe- that they have to write on the Rx form).  After removing all patient information, the drug stores can sell these lists to drug companies who use them to target doctors.  Here is an example this practice in action.  One state, Vermont, outlawed the transfer of information and the supreme court overturned their law.  Medical organizations are upset about this as they profess to not want  direct to doctor marketing. Perhaps it is less fun now that they cannot also receive free meals and greens fees.

Why I am Anti Craisons:  I may not have gotten to this in my Dietary Guidelines for Americans (DGA) overview, but it supports my advocacy for low energy dense foods.  Actually, I am pretty sure I discussed LED foods last night.  Well, Craisons - a dried fruit snack that keeps ending up as a free sample in my high fiber, low sugar cereal, are NOT a low energy dense food.  They have 3.6 calories per gram, where as melons have 0.37 per gram, apples 0.51, and much the same with most fresh, whole fruit.

National Prevention Strategy - Yes We Have One:  Actually, I think I will give this a separate blog day, but so you know, the focus of our strategy is prevention of disease and  promotion of wellness.  In this report, the latest numbers on obesity are given - adults  34% and children 16%.  How can children be obese?

Forget the Carrots, Your Eyes Need D:  The information I am sharing with you here is NOT to be taken as fact as I heard only a smidgen of the story.  The gist of it was that children have vitamin D deficiency (which the DGA supports as true) and that the lack of D is leading to increased cases of near sightedness.  An eye doctor and or researcher was saying that kids needed to spend more time in the sunlight.  I am sure that the show went on to cover sun protection.  What I want to add is the importance of protecting the EYEs themselves - are eyes, selves?  Well, remember the pinguecula post?  Put shades on those kids!

The Dirt on Grapes:  EEK- literally dirt.  I clean my grapes by placing them in a strainer that is inside a bowl of water.  I swish them around vigorously and then lift out the grapes and water my plants with the liquid (if they need it) and then do it again, and then rinse them just in the basket - after all that,  I eat them.  Both batches of rinse water are dirty, but the first is remarkably so.  Why am I telling you this?  In case you are one of the people who tastes grapes or any produce while shopping. (unless you are at the fancier stores that have washed and cut samples in a covered dish with toothpicks even).

Added Sugar:  Just to be clear, when the DGA suggest that we limit added sugar, they are not necessarily talking about table sugar.  Instead they mean sugar in processed foods and beverages.  So sugar in an actual orange (with its naturally occurring fiber) is the intrinsic kind - sugar is natural in whole pieces of fruit.  Sugar in a orange flavored snack - is added sugar.  (and as I was saying above, sugar in your peanut butter is ADDED)

Saturday, June 25, 2011

Dietary Guidelines for Americans 2010

I am breaking this into a few different posts because my Mom says that people get tired when the blog is too long :)  I will tell more about the guidelines in a day or two from now.

This information from the Dietary Guidelines for Americans Committee Report 2010, is not all inclusive.  I have reviewed the summary and main conclusions but focus here on ones that are most important to me as a researcher and health promoter and/or ones that I have mentioned in my blog (nee wellness weekly) over the last ten years.  Thus with only a few exceptions, I do not focus on children and I do not highlight conclusions regarding sub populations when the conclusions are different from the general public, i.e. pregnant women, infants and persons who have some frailty or nutritional limitations due to severe disease states. 

The DGA state that the majority of persons would need “total energy intakes range from 2000 to 3000 calories per day for men and 1600 to 2400 calories per day for women, depending on age and physical activity level.”  As you can see the range for women is wide and the upper end is based on baseline metabolic processes, body weight and the amount of physical activity.  The data presented in this report shows the average intake of Americans across all age groups.  From the age of 9 to 70, everyone is consuming more than 2000 a day on average (I would blame this on the highly caloric food options that we have and the fact that our food labels give daily values based on a 2000 calorie diet).

This report also provides the most current overweight and obesity numbers for our country.  When combining the two, 72% of women and 64% of men fall into this category. We determine overweight and obesity by BMI status.  For adults we have number categories and for children a percentile ranking.  For toddlers and infants we do not use BMI, but almost 10% of them are considered overweight.  It looks like about 12% of children aged 2-19 are obese, nearly 17% are overweight and 32% are at risk for overweight based on percentile rankings.  I am always stunned when I see these numbers and when we break this down ethnically or by SES - the numbers are higher for poorer persons and non-white persons - across ages.

I want to highlight some implications that are found in Part D Section 1.  This part of the report regards Energy Balance and Weight Management.  This, along with informed eating and access to healthy foods is why I do what I do.  The bulleted information below comes directly from the committee report.  It is available online and the reference is provided.  As the point of the recommendations is to promote the guidelines to all Americans, I feel confident they do not mind my sharing.  The last bullet involves physical activity.  As you know, my constant pronouncement is that caloric intake has the greatest impact on weight, while sedentary activity is related to all cause mortality and metabolic processes, and physical activity to overall health, wellbeing (absence of disease), and fitness.  As much as a fountain of youth physical activity is, it only contributes a small percentage to overall total energy expenditure.  I was very pleased to see that the DGAC gave this issue full attention.

For tonight I share this and in a day or two, I will share the important points I have gleaned from the full report:

·       Adults are encouraged to self-monitor body weight, food intake, and physical activity to improve outcomes when actively losing weight or maintaining body weight following weight loss. There is also evidence that self-monitoring of body weight and physical activity also improves outcomes when actively losing weight or maintaining body weight following weight loss (Butryn, 2007; Wing, 2006). In order to facilitate better self-monitoring of food intake, there needs to be increased availability of nutrition information at the point of purchase.
·       Children and adults are encouraged to follow a frequency of eating that provides nutrient-dense foods within daily caloric requirements periodically through the day. Caution must be taken such that the frequency of eating does not lead to excess calorie intake but does meet nutrient needs. 
 ·       Strong and consistent evidence indicates that dietary patterns that are relatively low in energy density improve weight loss and weight maintenance among adults. Consistent but limited evidence suggests that lower energy density diets may be associated with lower risk of T2D among adults.  (I have pasted this statement here because low energy density cooking is my signature and I make a point to purchase, prepare and consume low energy dense foods.  Recall the blog post where I equated calorie per gram to the price per unit shelf tags at the grocery store.  I am delighted to see that the DGAC is promoting low density food choices specifically. I was equally pleased to see some of the research that I have reviewed as part of the evidence in this summary, including the work of Barbara Rolls.  Here is a post about energy density) 
·       Strong, consistent evidence indicates that physically active people are at reduced risk of becoming overweight or obese. Furthermore, there is strong evidence that physically active adults who are overweight or obese experience a variety of health benefits that are generally similar to those observed in people of ideal body weight. Because of the health benefits of physical activity that are independent of body weight classification, people of all body weight classifications gain health and fitness benefits by being habitually physically active. In addition, strong and consistent evidence based on a wide range of well-conducted studies indicates that physically active people have higher levels of health-related fitness, lower risk of developing most chronic disabling medical conditions, and lower rates of various chronic diseases than do people who are inactive. (In reporting the research the DGAC focuses mostly on what the Physical Activity Guidelines say and a few important points are made.  The first is that to get weight off a substantial amount of physical activity is needed and that when looking at weight loss, the physical activity “expenditure of calories” is a very small fraction of the overall deficit - meaning that more is cut from the calories than from the extra burn.  Physical Activity is strongly recommended for health - and those who maintain a healthy weight moderate their  calories and exercise daily - as noted in the first bullet. However, the text in this section does not talk about physical activity as a strategy for weight loss - as you can see.)

DGAC (Dietary Guidelines Advisory Committee). 2010. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010. Washington, DC: U.S. Department of Health and Human Services, U.S. Department of Agriculture.