Tuesday, February 15, 2011

Updated USDA Dietary Guidelines Released C

From Medscape Education Clinical Briefs

News Author: Emma Hitt, PhD
CME Author: Laurie Barclay, MD

Clinical Context

Achieving and maintaining a healthy weight require eating and physical activity patterns focused on consuming fewer calories, making informed food choices, and increasing participation in physical exercise. Benefits of such a program also include lower a risk for chronic disease and improvements in overall health.

The Dietary Guidelines for Americans, 2010 discusses these strategies and issues recommendations for Americans 2 years and older, including those at increased risk for chronic disease.
The guidelines are tailored to the food preferences, cultural traditions, and customs of the many and diverse groups residing in the United States and also offer specific recommendations for groups based on age, sex, and special considerations such as pregnancy.

Study Highlights

* Overweight and obesity can be prevented and/or reduced through improved eating and physical activity behaviors.
* Body weight can be managed by controlling total calorie intake.
* For overweight or obese individuals, management of body weight requires consuming fewer calories from foods and beverages.
* Physical activity should be increased, and time spent in sedentary activities should be reduced.
* Appropriate caloric balance needs to be maintained during each life stage, including childhood, adolescence, adulthood, pregnancy and breast-feeding, and older age.
* Daily sodium intake should be reduced to less than 2300 mg in the general population and to less than 1500 mg for those 51 years and older; African Americans; or individuals with hypertension, diabetes, or chronic kidney disease.
* Less than 10% of calories should come from saturated fatty acids; these should be replaced with monounsaturated and polyunsaturated fatty acids.
* Dietary cholesterol intake should not exceed 300 mg per day.
* Trans-fatty acid intake should be minimized by limiting foods containing partially hydrogenated oils and other solid fats.
* Calorie intake should be reduced from solid fats, added sugars, and foods containing refined grains, especially those containing solid fats, added sugars, and sodium.
* If alcohol is consumed, it should be limited to 1 drink per day or less for women and 2 drinks per day or less for men, and only by adults of legal drinking age.
* Within daily caloric needs, vegetable and fruit intake should be increased, especially dark-green, red, and orange vegetables; beans; and peas.
* At least half of all grains consumed should be whole grains, and refined grains should be replaced with whole grains whenever possible.
* Intake of fat-free or low-fat milk and milk products (eg, milk, yogurt, cheese, or fortified soy beverages) should be increased.
* Protein foods should include a variety of sources (eg, seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds), with seafood replacing some meat and poultry when feasible.
* Protein foods higher in solid fats should be replaced with those that are lower in solid fats and calories and/or are sources of oils.
* Oils should replace solid fats when possible.
* Because American diets may be lacking in potassium, dietary fiber, calcium, and vitamin D, dietary sources of these should be increased by eating proportionately more vegetables, fruits, whole grains, and milk and milk products.
* Women of childbearing potential should favor foods supplying heme iron and vitamin C-rich foods to enhance iron absorption.
* In addition, they should consider additional iron sources and consume 400 μg per day of synthetic folic acid from fortified foods and/or supplements as well as foods rich in folate.
* Women who are pregnant or breast-feeding should consume 8 to 12 ounces seafood per week from a variety of seafood types, excluding tilefish, shark, swordfish, and king mackerel because of their high content of methyl mercury.
* Similarly, white (albacore) tuna intake should not exceed 6 ounces per week.
* Pregnant women should take an iron supplement recommended by their physician.
* Persons 50 years and older should consume vitamin B12-fortified foods (eg, fortified cereals) or dietary supplements.

Clinical Implications

* To achieve and sustain a healthy weight, the USDA and the US Department of Health and Human Services guidelines stress the importance of maintaining calorie balance with time by consuming only enough calories from foods and beverages to meet their needs and by being physically active.
* The USDA and the US Department of Health and Human Services guidelines also emphasize the need to consume nutrient-dense foods and beverages, while avoiding calorie-dense foods and beverages low in nutritional value.

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