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Rebuilding the Food Guide Pyramid


Selected Food Groups ... Separating raw, cooked, and ready-to-eat foods while shopping, preparing, or storing. ... Food Safety ... – PowerPoint PPT presentation

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Title: Rebuilding the Food Guide Pyramid

The 2005 Dietary Guidelines for Americans
Benjamin Caballero, MD, PhD Center for Human
History of Dietary Guidelines
  • 1977 Dietary Goals for the U.S. (Senate)
  • 1979 Healthy People Surgeon Generals Report
  • 1980 First Edition of Dietary Guidelines (HHS and

1980 1985 1990 1995
(No Transcript)
Dietary Guidelines For Americans
  • Science-based advice for ages 2 (gold standard)
  • Promote health
  • Prevent chronic disease
  • Federal nutrition policy/programs
  • Vehicle to speak with one voice
  • Jointly developed by HHS/USDA

What the Guidelines Do
  • Provide dietary advice to consumers
  • Set policy for food assistance programs (e.g.,
    school lunches, elderly nutrition)
  • Establish overarching goals for
  • National health objectives
  • Nutrition monitoring
  • Nutrition research
  • Set framework for standards in
  • Food labeling/ fortification
  • Food product development

Legislated Mandate for the DGA
  • National Nutrition Monitoring and Related
    Research Act of 1990
  • Dietary guidelines must be issued every 5 years
  • Dietary guidance issued by the Federal government
    for the general public is to be reviewed by the
    Secretaries of Agriculture, and Health and Human
    Services. (Departments alternate the lead role.)

2005 DGA Committee
  • Vay Liang W. Go, MD
  • University of California at Los Angeles, Los
    Angeles, CA
  • Penny M. Kris-Etherton, PhD, RD
  • Penn State University, University Park, PA
  • Joanne R. Lupton, PhD
  • Texas AM University, College Station, TX
  • Theresa A. Nicklas, DrPH, MPH, LN
  • Baylor College of Medicine, Houston, TX
  • Russell R. Pate, PhD
  • University of South Carolina, Columbia, SC
  • F. Xavier Pi-Sunyer, MD, MPH
  • Columbia University College of Physicians and
  • New York, NY
  • Janet King, PhD, RD (Chair)
  • Childrens Hospital Oakland Research Institute,
    Oakland, CA
  • Lawrence J. Appel, MD, MPH
  • Johns Hopkins Medical Institutions, Baltimore, MD
  • Yvonne L. Bronner, ScD, RD, LD
  • Morgan State University, Baltimore, MD
  • Benjamin Caballero, MD, PhD
  • Johns Hopkins University Bloomberg School of
    Public Health, Baltimore, MD
  • Carlos A. Camargo, MD, DrPH
  • Harvard University, Boston, MA
  • Fergus M. Clydesdale, PhD,
  • University of Massachusetts, Amherst, Amherst, MA

Systematic Review of Scientific Literature
  • Identification of research questions
  • Questions were prioritized by
  • Publication/availability of recent systematic
    reviews by an authoritative source (e.g. IOM,
    CDC, NIH)
  • Preliminary literature search to determine if
    there were enough data (from peer-reviewed
    sources) to examine the research question
  • Iterative process

Systematic Review of Scientific Literature
  • All literature examined was peer-reviewed
  • Human studies were primary focus
  • Committee assessed study quality and the strength
    of the evidence
  • Priority was given to
  • trials with well-accepted, clinically relevant
    outcomes (e.g., incidence of cancer and
    myocardial infarction) and well-accepted risk
    factors (e.g., systolic blood pressure,
    low-density lipoprotein cholesterol, and weight)
  • longitudinal, cohort studies

Opportunities for Public Comments
  • Over 400 public comments submitted to the
  • Written comments were accepted throughout the
    Committees deliberations
  • Oral presentations were made at the January 2004

Content of Science Base
  • Aiming to Meet Nutrient Intake Recommendations
  • Energy
  • Discretionary Calories
  • Fats
  • Carbohydrates
  • Selected Food Groups
  • Fluid and Electrolytes
  • Ethanol
  • Food Safety

Key Scientific Recommendations
  • Consume a variety of foods within and among the
    basic food groups while staying within energy
  • Control calorie intake to manage body weight
  • Be physically active every day
  • Increase daily intake of fruits and vegetables,
    whole grains, and reduced-fat milk and milk
  • Choose fats wisely for good health
  • Choose carbohydrates wisely for good health
  • Choose and prepare foods with little salt
  • If you drink alcoholic beverages, do so in
  • Keep food safe to eat

Nutrient Adequacy
Consume a variety of foods within and among the
basic food groups, while staying within energy
  • Basic food groups
  • Fruits
  • Vegetables
  • Grains
  • Milk, yogurt and cheese
  • Meat, poultry, fish, dry beans, eggs, and nuts

Nutrient Adequacy
Nutrient Density
  • Nutrient-dense foods are those that provide
    substantial amounts of vitamins and minerals in
    relatively few calories. Foods of low nutrient
    density are those that supply calories but little
    or no amounts of vitamins and minerals.
  • The greater the consumption of foods or beverages
    that are low in nutrient density, the more
    difficult it is to consume enough nutrients
    without gaining weight, especially for sedentary
  • The consumption of added sugars, solid fats, and
    alcohol provides calories while providing little,
    if any, essential nutrients.

Nutrient Adequacy
Nutrient Intake
  • Adults do not consume enough vitamins A, C, and
    E calcium magnesium potassium and fiber.
  • Children do not consume enough vitamin E,
    calcium, magnesium, potassium, and fiber.
  • At the same time, in general, Americans consume
    too many calories and too much saturated and
    trans fat, cholesterol, added sugars, and salt.

Nutrient Adequacy
Special Groups
  • Iron For adolescent females and women of
    childbearing age
  • Folic Acid For women capable of becoming
    pregnant and in the first trimester of
  • Vitamin B12 For those over age 50
  • Vitamin D For the elderly, persons with dark
    skin, and persons exposed to insufficient UVB

Energy Balance
  • Discretionary calories
  • Total estimated daily energy
    requirement minus essential calories.
  • To make discretionary calories available or to
    increase their amount, individuals need to
  • increase their physical activity AND/OR
  • consume nutrient-rich foods that are relatively
    low in energy density.

Discretionary calories
Energy Balance       
Control calorie intake to manage body weight
  • Most Americans need to reduce the calories they
  • For weight control, calories do countnot
    proportions of carbohydrate, fat, and protein.
  • The healthiest way to reduce calorie intake is to
    reduce intake of added sugars, solid fat, and
    alcoholthey all provide calories, but they do
    not provide essential nutrients.
  • Controlling portion sizes helps limit calorie
    intake, especially when eating energy-dense
  • For most people, a reduction of 50 to 100
    calories per day will prevent weight gain.

Physical Activity and Health
Be physically active every day
  • Adults
  • Thirty minutes of at least moderate physical
    activity on most days provide important health
    benefits and reduces the risk of chronic disease.
    More than 30 minutes of moderate to vigorous
    physical activity on most days provide even more
    health benefits.
  • Participating in up to 60 minutes of moderate to
    vigorous physical activity on most days is
    recommended to prevent unhealthy weight gain.
  • After losing weight, adults who perform 60 to 90
    minutes of moderate physical activity daily are
    more successful at maintaining their reduced
    weight than those who rely only on limiting
    calorie intake.

Physical Activity and Health
Be physically active every day
  • Children and Adolescents
  • At least 60 minutes of moderate to vigorous
    physical activity on most days to maintain good
    health and fitness and for healthy weight during
    growth. Increasing physical activity can lower
    the BMI of overweight children
  • During leisure time, it is advisable for all
    individuals to limit sedentary behaviors, such as
    television watching and video viewing, and
    replace them with activities that require more

Physical Activity
Additional Health Benefits
  • Exercise that loads the skeleton has potential to
    reduce the risk of osteoporosis.
  • Resistance training (8 to 10 exercises twice or
    more per week) increases muscular strength and
    endurance and maintains or increases lean body

Fats and Fatty Acids
Choose fats wisely for good health.
  • Total fat 20 and 35 of energy for adults
  • Intakes as low as possible of
  • Saturated fats Less than 10 of calories
  • Trans fats About 1 of calories or less
  • Cholesterol Less than 300 mg of cholesterol per

Fatty Acids
Omega-3 fatty acids
  • Consuming two servings of fish per week
    (approximately 8 ounces total) may reduce the
    risks from cardiovascular disease, especially
    mortality from coronary heart disease.
  • Other sources of EPA and DHA may provide similar
    benefits however, more research is needed.

NOTE Caution for pregnant or lactating women
and children to avoid fish with high mercury
  • Choose carbohydrates wisely for good health.
  • Total carbohydrates Intake 45 to 65 of energy
  • Dietary Fiber Intake 14 grams per 1000
  • Added Sugars Reducing intake of added sugars
    (especially sugar-sweetened beverages) can lower
    calorie intake, and may be helpful in achieving
    recommended nutrient intakes and weight control.
  • Dental caries Reducing frequency of consuming
    sugars and starches and optimizing oral hygiene
    practices is advised
  • Glycemic index/load Few advantages in using
    these for dietary guidance

Selected Food Groups
  • Increase daily intakes of fruits and vegetables,
    whole grains, and reduced-fat milk and milk
  • Fruits and Vegetables At 2000 kcal/day, 9
    servings (4 ½ cups)
  • Whole Grains At least three servings (3 ounces)
    per day
  • Milk At 1600 kcal/day or more, 3 cups of
    non-fat or low-fat
  • milk or the equivalent

Sodium and Potassium
  • Choose and prepare foods with little salt.
  • Nearly all Americans consume substantially more
    salt than they need.
  • The general goal for adults is to consume less
    than 2,300 mg of sodium per day. Many persons
    will benefit from reducing salt intake even more.
  • At the same time, individuals are encouraged to
    increase their consumption of foods rich in
    potassium. Potassium lowers blood pressure and
    blunts the effects of salt on blood pressure.
  • Increasing potassium to at least 4,700 mg daily
    is advised.

  • If you drink alcoholic beverages, do so in
  • Moderation is up to one drink per day for women
    and up to two drinks per day for men.
  • One drink is defined as 12 ounces of regular
    beer, 5 ounces of wine (12 percent alcohol), or
    1.5 ounces of 80-proof distilled spirits.
  • Drinking alcoholic beverages should be avoided
    before or when driving, or whenever it puts
    anyone at risk.
  • Studies suggest adverse effects even at moderate
    alcohol consumption levels in specific
    individuals and situations.

Food Safety
  • Keep food safe to eat.
  • Behaviors in the home most likely to prevent
    microbial foodborne illnesses
  • Clean, Separate, Cook, Chill
  • Cleaning hands, contact surfaces, and fruits and
    vegetables (but not meat and poultry, which
    should not be washed)
  • Separating raw, cooked, and ready-to-eat foods
    while shopping, preparing, or storing.
  • Cooking foods to a safe temperature.
  • Chilling (refrigerating) perishable foods

Food Safety
  • An important protective measure against foodborne
    illness is avoiding higher-risk foods.
  • In the case of listeriosis, high-risk groups such
    as the very young, pregnant women, the elderly
    and those who are immunocompromised, should avoid
    higher-risk foods (e.g. frankfurters and deli
    meats which have not been heated to a safe

change in current intake needed to meet the
2005 DG - Main food groups
change in current intake needed to meet the
2005 DG - Subgroups, solid fats and added sugars
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