It’s designed to be simple—calories in, calories out.
Eat foods with high nutritional content (calories in) and get regular exercise (calories out) and ensure the two are in balance. This is the logic behind the 2010 Dietary Guidelines for Americans (DGA). This federal nutrition policy, released January 31, serves as the federal government’s way of encouraging better health and nutrition for everyone in the U.S. Presented at a news conference by Department of Agriculture Secretary Tom Vilsack and Secretary of the Department of Health and Human Services Kathleen Sebelius, these evidenced-based nutritional recommendations are designed to promote health, encourage physical activity, reduce the risk of chronic diseases, and address the obesity epidemic that currently exists in our nation.
DGA is designed to condense current knowledge about individual nutrients and food components into an interrelated set of recommendations to promote healthier eating patterns that can be implemented by the public. Once every five years, the U.S. Department of Agriculture and the Department of Health and Human Services are required to update the Dietary Guidelines to reflect current evidenced-based research and medical literature. These Dietary Guidelines are the national standards for which all federal nutrition programs and policies must conform. Therefore, nurses can anticipate seeing possible changes to nutrition or food guidelines from other federal programs, such as the Women, Infants and Children (WIC) program or guidelines put out by the Food and Drug Administration.
The DGA contains 23 key recommendations for the general public and six additional recommendations for specific population groups. One of the most dramatic is the recommendation to reduce daily sodium intake to less than 2,300 milligrams (mg), with an even further reduction to 1,500 mg for individuals who are 51 and older, have hypertension, diabetes, chronic kidney disease, or are an African American. According to the DGA, this 1,500 mg recommendation applies to about half of the U.S. population, including most adults and even children. Additional key recommendations for reduction in foods and food components include:
- Consume less than 10 percent of calories from saturated fatty acids daily.
- Consume less than 300 mg per day of dietary cholesterol.
- Reducing the intake of trans fatty acids, solid fats, and added sugars.
- Limit the amount of foods that contain refined grains.
While restricting some foods and food components is essential in maintaining healthy eating patterns and reducing the risk of developing chronic diseases, the DGA also recommends increasing certain foods and nutrients in our daily diet. The following is a list of those recommendations:
- Increase the daily intake of fruits and vegetables.
- Consume a variety of dark-green vegetables, red and orange vegetables, beans, and peas.
- Replace refined grains with whole grains.
- Increase the daily intake of fat-free or low-fat milk.
- Select a variety of protein foods that include lean meat, poultry, eggs, beans, soy products, peas, unsalted nuts and seeds.
- Consume more seafood.
- Use oils to replace solid fats.
DGA encourages the consumption of nutrients primarily through foods and beverages instead of with dietary supplements. Preference is also given to plant (fruits and vegetables) based diets.
DGA identifies potassium, dietary fibers, calcium, and vitamin D as nutrients that are inadequately consumed in American diets.
Recommendations that address specific population groups are those for women of childbearing age who are capable of becoming pregnant, women who are pregnant or are breastfeeding, and individuals aged 50 years and older. Women who are pregnant are encouraged to consume eight to 12 ounces of seafood per week from a variety of seafood types, but to avoid tilefish, shark, swordfish, and king mackerel due to their high methyl mercury content. Individuals who are 50 years of age or older should consume foods fortified with vitamin B12.
Chronic disease, especially those conditions that are caused or exacerbated by obesity, are one of the greatest public health threats to our nation. These include hypertension, diabetes, heart disease, cancer, stroke, and arthritis. The financial cost of treating these conditions poses an immense financial burden to both the public and private health payers. But beyond cost, obesity threatens to shorten the average American’s life span for the first time in almost a century, and could even pose a national security threat if not enough Americans are fit for military or other defense duties.
To address looming financial and social threats, the DGA places a strong emphasis on calorie control and regular physical activity. DGA suggests that maintaining a caloric balance over time will assist in achieving and sustaining optimal weight through consuming only enough calories to meet your needs and by remaining physically active. To assist with portion control, DGA also suggests filling half of your plate of food with fruits and vegetables.
From the federal policy perspective, Sebelius mentioned that as part of the Affordable Care Act, there would be greater emphasis on nutrition labeling for packages, and on menus in restaurants. This could be in the form of regulation, but the agency is also working with manufacturers to improve package labeling, in particular putting some of the key information on the front of the package instead of the back.
Vilsack acknowledged that the recommended decrease in sodium was the biggest challenge for consumers, especially with the sometimes large amounts of “hidden” sodium in processed or packaged foods. That is, foods that have high amounts of sodium, but don’t necessarily taste salty, so the consumer is unaware of how much sodium is actually in a product. Vilsack called on manufacturers to voluntarily reduce the amount of sodium used in food processing.
Audience members at the news conference also raised the experience of regulating tobacco in the early 1990s as a comparison to the obesity epidemic. While the federal officials cautioned that the guidelines were not meant to be prescriptive in terms of telling Americans what to eat, and they acknowledged that moderation is key in proper eating, they said the success of regulating tobacco in reducing smoking and tobacco-related disease may be a strategy that can be used in the obesity epidemic.
The 2010 DGA guidelines also provide information on food safety. To prevent the spread of foodborne illnesses, the DGA has developed four safety principles: clean, separate, cook, and chill all foods. DGA also recommends avoiding foods that have not been pasteurized and undercooked foods.
Nurses will need this information as they help counsel their patients or clients on proper nutrition, but also for their own health. Eating well can be difficult, especially for such a busy job as nursing—one that often entails shift work. To maintain their own health and wellness, nurses are encouraged to follow the guidelines and support each other in their efforts.
To read the 2010 Dietary Guidelines for Americans in its entirety, go to www.dietaryguidelines.gov. More information on dietary guidelines is available at www.health.gov/dietaryguidelines and www.healthfinder.gov/prevention.
Katie Brewer is a senior policy analyst at ANA. Karen Siska is a graduate student intern at ANA and deputy family health bureau chief of the Anne Arundel County (Md.) Health Department.