Q: What are the latest recommendations from the government on good dietary practices?
A: New recommendations were released in 2015, and some are different from the 2010 Dietary Guidelines with some surprises and reversals. There is also common sense and good judgment.
We all know that dietary practices are multifaceted and driven by ethnic backgrounds, personal experience, upbringing, acquired tastes, easy access, food allergies, food prices, myths and fads, natural and local seasonal foods, gluten-free diets, weight gain and weight loss desires, lack of knowledge about benefits and risks, and just lack of interest. Cultures have health differences, including risks for cardiovascular disease and cancer types and rates that can, at least partially, be attributed to dietary factors. However, lifestyle and population genetics can be at least as significant an influence as diet with respect to longevity and health statistics.
Even though interest in cooking and cuisine seems to be at an all-time high, as indicated by the multitude of cooking-related TV shows and farmers markets that are back in vogue, a serious question still remains as to whether most Americans are eating smartly, well and healthfully. The U.S. government, through the Department of Health and Human Services and the Department of Agriculture, periodically assembles nutritional and medical experts to provide guidelines to educate us on a consensus of positive and negative aspects of diet. The most recent Dietary Guidelines for 2015-2020 were released in December 2015. This is the eighth iteration of the Dietary Guidelines, the last was 2010. They provide a lot of good common sense advice, but they also differ in some significant respects from prior Dietary Guidelines.
The 2015-2020 Dietary Guidelines
Although many diseases are declining and lifespans are increasing, about half of all Americans have preventable lifestyle-related chronic diseases and disorders such as
cardiovascular disease, Type 2 diabetes, excessive weight and obesity. Lack of appropriate diet and exercise are important contributors. The general summary of the guidelines is:
1. Follow a healthy lifetime eating pattern.
All food and beverage choices matter. Choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy and reduce the risk of chronic disease.
2. Focus on variety, nutrient density and amount. To meet nutrient needs within calorie limits, choose a variety of nutrient-dense foods across and within all food groups in recommended amounts.
3. Limit calories from added sugars and saturated fats and reduce sodium intake. Consume foods low in added sugars, saturated fats and sodium. Cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns.
4. Shift to healthier food and beverage choices. Choose nutrient-dense foods and beverages across and within all food groups in place of less healthy choices. Consider cultural and personal preferences to make these shifts easier to accomplish and maintain. (Surprisingly, the Guideline has very little to say about drinking water consumption, the value of proper hydration and its essential contribution to good health, let alone survival. Many nutritionists, seem to treat water as a baseline commodity without specific health contributions, and also not as a source of beneficial nutrients like calcium and magnesium in some cases.)
5. Support healthy eating patterns for all. Everyone has a role in helping to create and support healthy eating patterns in multiple settings nationwide including homes, schools, businesses and communities.
A healthy eating pattern includes:
- A variety of vegetables from all the subgroups — including dark green, red and orange, legumes (beans and peas), and starch
- Fruits, especially whole fruits
- Grains, at least half being
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
Healthy eating pattern limits saturated fats and trans fats, added sugars, and sodium. Quantitative recommendations are to do the following:
- 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.
Sugar and low-calorie sweeteners
The guidelines recommend limiting added sugar intake to 10 percent of daily calories. Numerous natural sugars are available — including sucrose (table sugar), fructose (fruit sugar), honey, maple sugar and molasses. Sugar alcohols, such as xylitol and sorbitol, have fewer calories than true sugars. Numerous no-calorie sugar substitutes — including aspartame, sucralose and saccharine — are safe.
Cholesterol
Cholesterol from the diet is not a significant contributor to blood cholesterol. The prior guideline recommended limits on daily intake of cholesterol-containing foods, such as eggs. This one concludes that dietary cholesterol is not very important, and it has withdrawn the daily intake limit recommendation. Actually, this has been known for many years, including when the original recommendation was issued, but only now has it been acknowledged by the dietary nutrition establishment. It will probably take some time to undo the anti-egg misperception that has been implanted in the public psyche by previous "expert" advice and repetition by the press.
Brown eggs and white eggs are identical, brown eggs just cost more now.
Dietary fat
The distinction between fat and oil is whether it is solid or liquid at room temperature. Hydrogenation is a process that adds two hydrogen atoms to an unsaturated chemical to make it saturated.
The focus of primary concern is on trans fats that are produced by partial hydrogenation of cis oils. Cis and trans refer to the configuration of an unsaturated bond in the chemical. Cis bonds have a C shape, and trans bonds have a Z shape. Trans fats or oils are formed during the hydrogenation of a cis oil (soybean oil, for example) when it is not hydrogenated but isomerized. Animal fats usually contain trans fat.
The consensus is that foods such as margarine and shortenings that contain trans fats or oils should be avoided because of associations with bad cholesterol formation and increased risk of coronary heart disease. Saturated fats are present in many meat fats, and some are produced by complete hydrogenation of vegetable oils. The current health concern level is somewhat mixed. Olive, canola and peanut oils are monounsaturated and considered to be "good" fats or oils.
Polyunsaturated omega-3 and omega-6 oils — including corn, sunflower and safflower oils — are also considered "good." Foods containing omega-3 fats also include fatty fish such as salmon, mackerel and sardines; flaxseeds; walnuts; canola oil; and unhydrogenated soybean oil. Omega-6 fatty acids include linoleic acid and vegetable oils such as safflower, soybean, sunflower, walnut and corn oils.
Coffee & caffeine
The 2015-2020 Dietary Guidelines now recommend moderate coffee consumption of up to three to five cups of coffee per day. Brewed coffee has about 1,000 individual chemicals, so they are likely not all good for us, but apparently, on balance, coffee intake is beneficial. In addition to caffeine, which can be at 100 to 200 milligrams per typical 8-ounce cup or more in some brews, a few of the major chemicals with physiological activity in milligram amounts include theobromine (does not contain bromine or bromide) and numerous antioxidant phenolic chemicals. Tea and chocolate contain many of the same chemicals in lesser amounts. A 12-ounce cola can contain about 35 mg to 50 mg of caffeine. Caffeine is a stimulant vasodilator that widens blood vessels and improves blood flow and cognitive activity.
An old epidemiological study report from the Harvard School of Public Health concluded that coffee increased cancer risks. That caused significant consternation among the coffee-drinking American public. However, you can forget about that erroneous "epidemiological" report. Many studies now conclude that moderate coffee consumption actually reduces risks of liver, colon, oral and esophageal cancers, as well as Type 2 diabetes and even cardiovascular and Alzheimer’s diseases. So, don’t believe every non-validated premature epidemiological report you read.
Use common sense
The take-home messages are that expert recommendations change and science is not always correct, especially if it is not very good science from the start. Nutrition is a complex topic, and more objective research and observation will be necessary to hone in on the best understanding of how food patterns affect the health of the general public and subgroups within the population. Also, misinformation is often hyped by communicators (some TV physicians, for example) from one or some non-validated reports that lead to fads that are adopted by many, to the primary benefit of the sellers. In addition, all foods likely have both positive and negative components, so don’t overdo anything. For example, spinach has vitamins and minerals (some lost during cooking) but also oxalic acid and nitrate. Some people are allergic to some foods, and some people need special diets, so talk to your physician before making large dietary changes.
There is still much to be learned about diet and health. In the meantime, good judgment is important and sufficient, and exercising rational dietary judgment is not difficult. Moderation in all things is usually the best policy.
Chances are your grandmother’s common sense advice is just about as good as it gets. Eat a variety of good foods (you know what they are) to assure good nutrition. Vitamin and mineral supplements and megavitamins are not generally needed nor beneficial with a few exceptions. Do not consume too much meat (especially cured meats) or excessive amounts of fat, calories, salt and sugars. Approved low-calorie, synthetic sugar substitutes are safe. Ease up on carbohydrates (unless you exercise heavily), and eat more vegetables and fiber. Use iodized salt.
Avoid being seduced by fads. Less than 1 percent of the population is sensitive to gluten, so do not have anxiety and waste your money on gluten-free foods unless you are among the 1 percent. Limit fast foods, and light to moderate alcohol consumption along with food is probably better than OK. Consume dairy, seafood and eggs without worrying much about dietary cholesterol. Cholesterol is an essential physiological component, and cholesterol status is essential to good health, but if your body is producing an excess of the wrong kind, that is more important than the cholesterol that you ingest. Use butter and oil instead of margarine (which can have trans fat), and use non-hydrogenated vegetable oils, such as olive, peanut and safflower oils, but not partially hydrogenated trans oils and fats. Drink some coffee, and finally, drink plenty of water that meets standards, of course.
I know of no evidence that "natural" or "organic" foods are better for you than the normally produced foods, nor that genetically modified foods have any negatives compared to "normal" foods that are also genetically modified, just by a different process. Pesticides are tightly regulated and residues are minute when present.
Some of these suggestions are my common sense extrapolations with some backing. Most people can eat smartly, watch their weight and get some moderate exercise … and bon appétit, and buon appetito!
Dr. Joe Cotruvo is president of Joseph Cotruvo and Associates LLC, water, environment and public health consultants, and technical editor of Water Technology. He is a former director of the EPA Drinking Water Standards Division.
