On January 31, 2011, U.S. Department of Agriculture Secretary Tom Vilsack and Secretary of the Department of Health and Human Services Kathleen Sebelius announced the release of the 2010 Dietary Guidelines for Americans. These guidelines are described as “the federal government's evidence-based nutritional guidance to promote health, reduce the risk of chronic diseases, and reduce the prevalence of overweight and obesity through improved nutrition and physical activity."

University of Vermont Professor of Medicine Naomi Fukagawa, M.D., Ph.D., was one of 13 prominent researchers with expertise in dietary intake, human metabolism, behavioral change, and health appointed in 2008 to serve on the 2010 Dietary Guidelines Advisory Committee (DGAC) that developed the recommendations for this policy. A board-certified pediatrician and expert in nutritional biochemistry and metabolism, Fukagawa, who served as DGAC’s vice chair, recently answered some questions about the new guidelines.

Q: It appears that the salt intake recommendation is the most remarkable element of the new guidelines. What findings supported that committee recommendation?

“The DGAC Report recommended a gradual reduction to 1,500 milligrams of salt per day. The 2010 Dietary Guidelines for Americans policy recommends 2,300 milligrams per day, which was the goal of the 2005 recommendations. The Institute of Medicine, World Health Organization and other large organizations recommend 2,000 milligrams per day, so we are not so out of line with the world view. The recommendation is geared toward blood pressure control. Perhaps most compelling among the data was the rise in blood pressure in children in the last decade that tracks with salt intake as well as increased calorie intake. There’s no real threshold for the effect of salt on blood pressure, but the literature suggests that less than 2,300 milligrams per day can be applied to children and adults up to age 50. However, certain groups are more susceptible to the blood pressure-raising effects of salt and for those, the recommendation is to try to reduce intake to 1,500 milligrams per day. These groups comprise about half of the U.S. population and include those over age 51, African Americans of all ages and people with hypertension, diabetes or chronic kidney disease. The challenge is changing the food supply and behavior to realistically meet the goal in five years. It’s difficult to dissect out the ‘chicken or the egg’ phenomenon, because increased calories can lead to obesity and blood pressure often rises with obesity. However, it is clear that we probably consume more salt than we need.”

Q: Another important change is the addition of another serving of seafood per week. Can you comment on the research the committee did that led to that recommendation?

“Data support the value of omega-3 fatty acids in all age groups. The DGAC reviewed evidence examining the relationship between the consumption of seafood, omega-3 fatty acids and the risk of cardiovascular disease, excluding studies using dietary supplements, and found that consumption of two 4-ounce servings of seafood per week was associated with reduced cardiac mortality from coronary heart disease or sudden death in persons with or  without cardiovascular disease. Unfortunately, due to fear of mercury and Persistent Organic Pollutants (POPs) — chemical compounds that persist in the environment, bioaccumulate through the food web, and pose a risk of causing adverse effects to human health and the environment — as well as difficulties with access in some parts of the country, intake has been less than recommended.  Although supplement use is common, the DGAC believed that whole foods provided more than just the fatty acids and hence, seafood as a whole was encouraged. The challenge is finding ecologically friendly and efficient ways to allow for greater consumption. Unfortunately, there was little evidence to suggest that plant sources of omega-3 fatty acids were equally effective. There was moderate evidence that increased maternal intake of omega-3 fatty acids during pregnancy was associated with higher levels of DHA – or docosahexaenoic acid – in breast milk and improved health infant outcomes, such as visual acuity and cognitive development.”

Q: What exactly are “whole foods” and what are the potential roadblocks to people having access to whole food?

“Whole foods are minimally processed and nutrient — but not calorie — dense and can be packaged or frozen. The term ‘nutrient dense’ indicates that the nutrients and other beneficial substances in a food have not been diluted by the addition of calories from added solid fats, added sugars, or added refined starches, or by solid fats naturally present in a food, such as the fat in meats, poultry, fluid milk, and other milk products, such as cheese. Supplements or individual components extracted from the ‘raw’ food would not be considered ‘whole.’ Roadblocks to access are obvious — it’s difficult to transport large quantities and to maintain freshness. People are often too busy to cook or don’t know how to cook with ‘whole’ ingredients. Hence the challenges are a combination of availability and willingness of the consumer to choose ‘whole foods.’”

Q: How critical is accurate nutritional labeling to helping ensure compliance with the guidelines? What are the current requirements for food manufacturers regarding food labeling?

“Labeling is important as a guide to those who read them, but ensuring that people understand their individual dietary needs and use the labels to help make wise choices is more important. Labeling requirements are changing, both because of consumer demands and because of proposed legislation.”

Q: What are the top five most important dietary recommendations in the new guidelines?

  • Balance calories to maintain a healthy weight: enjoy your food, but eat less and avoid oversized portions; stay physically active.
  • Increase intake of fruits and vegetables.
  • Reduce sodium intake and drink water instead of sugary drinks.
  • Consume nutrient-dense foods and beverages and establish a healthy eating pattern.
  • Encourage behavior change to set the stage for lifelong healthy eating, physical activity and weight management.

For more information about the 2010 Dietary Guidelines, visit http://www.cnpp.usda.gov/dietaryguidelines.htm.

PUBLISHED

03-09-2011
Jennifer Nachbur