National Nutrition Month: New Changes Ahead for the Dietary Guidelines for Americans

It's National Nutrition month, and what better way to celebrate than to get excited about the upcoming changes to the Dietary Guidelines? I know, it might sound a little dry, but there really is reason to take an interest. Some BIG and much needed revisions are on the horizon.

As you know, the various food industries fight tooth and nail to make sure any new recommendations continue to posit them in a positive light. Any reduction in intake is a reduction in sales, and despite the effect on the health of Americans, companies want those dollars to keep rolling in. That is why these new proposed changes are such a breath of fresh air. Finally, it seems, someone has listened to common sense (ie science) over big business.

First on the chopping block? Sugar! Finally we are, hopefully, going to make some drastic reductions in how much sugar we eat. The average American consumes 150 - 170 pounds of refined sugar per year. Yikes! The proposed changes would recommend limiting sugar to no more than 10% of total calories for the day. For someone eating a 2,000 calorie diet, that would mean no more than 200 calories from sugar. What does that look like? Well, that's about 12 tsp of sugar. A 12oz can of Coke has just over 9 tsp of sugar, so you can see how quickly this adds up. Even if you don't drink soda (and I hope you don't), remember that little bits of sugar here and there add up. A little in your latte, a little more in the jam on your toast, some honey in your oatmeal, a few bites of candy... it adds up quick.

What likely has finally pushed these recommendations forward is the mountains of evidence linking refined carbohydrate intake to elevated triglycerides and high cholesterol. The studies repeatedly support it (1). This stuff is dangerous when consumed in excess and it's great that our recommendations are finally coming in line with science. Time to find a new career sugar lobbyists.

Next up? No more low fat diets! About time. We now know a low-fat diet is not the answer to reducing heart disease. In fact, these new recommendations are acknowledging the growing pile of scientific research showing that dietary cholesterol does not affect your LDL ("bad" cholesterol) levels. Poor eggs took a lot of heat for that, but now they are vindicated. The thing is we need fats, but the right fats. The problem with a blanket reduction in fat is that we also end up limiting "healthy" fats (and typically end up increasing carbs to replace it). Thankfully that recommendation is no more. The committee now urges people to eat more fats from fish, nuts, olives, avocados, and healthy oils. Yeah, we should still back off the saturated fat a bit (but no need to eliminate entirely) and trans fats are still a big no-no, but overall the focus is now on the quality of fats consumed rather than outright reduction.

This whole discussion on fats goes back to what I mentioned previously. We've seen again and again in research that excessive carbohydrate consumption is one of the factors that raises LDL and most notably raises the dense LDL particles in the bloodstream which are particularly dangerous in terms of heart disease. If we decrease fat while increasing carbohydrate consumption, we've done nothing to solve cardiovascular disease in this country, and the numbers prove it (2).

The other huge push in these new proposed recommendations is to encourage diets higher in plant foods and less reliant on animal products. This is definitely what we need in this country. We consume a lot of meat, which in and of itself is not bad, but we need a generous dose of fruits, vegetables, legumes and whole grains (preferably non-wheat based) in there as well. It's what we Dietitians call a "balanced diet." Crazy idea, I know. It's so common sense, but the lobbyists have pushed for so long to keep this sort of wording out of our legislation that it's almost unbelievable to see it in writing. It validates what many of us whole-food proponents have been preaching for so long. And it's the key to reducing disease in this country!

If instead we urge Americans to decrease sugar (and carbs in general) while improving the quality of fats in their diet, I think we can finally make some progress in reducing the risk for cardiovascular disease. Couple that with recommendations to increase fruit and vegetable consumption along with daily physical activity, I think soon enough the numbers will speak for themselves.

This is why these new recommendations are so exciting. If we do this right, we can save millions of lives. Crossing my fingers that the final report comes out strong and bold on these key areas.

1. http://www.ncbi.nlm.nih.gov/pubmed/16256003
Abstract
Variations in the size and density distributions of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) particles have been related to risk for cardiovascular disease. In particular, increased levels of small, dense LDL particles, together with reduced levels of large HDL and increases in small HDL, are integral features of the atherogenic dyslipidemia found in patients with insulin resistance, obesity, and metabolic syndrome. Increased dietary carbohydrates, particularly simple sugars and starches with high glycemic index, can increase levels of small, dense LDL and HDL, primarily by mechanisms that involve increasing plasma triglyceride concentrations. Low-carbohydrate diets may have the opposite effects. Diets with differing fatty acid composition can also influence LDL and HDL particle distributions.

2. http://www.ncbi.nlm.nih.gov/pubmed/16467234
Conclusion: Over a mean of 8.1 years, a dietary intervention that reduced total fat intake and increased intakes of vegetables, fruits, and grains did not significantly reduce the risk of CHD, stroke, or CVD in postmenopausal women and achieved only modest effects on CVD risk factors, suggesting that more focused diet and lifestyle interventions may be needed to improve risk factors and reduce CVD risk.