With 65 percent of Americans overweight and 30 percent obese, it's past overdue for most Americans to get off the couch, eat better and start exercising. Previous federal guidelines have served up a consistent message regarding diet and exercise, but the new Dietary Guidelines for Americans 2005 offer much more detail in terms of food choices and the levels of physical activity. Yet while experts generally agree that this new publication is a necessary step in addressing the country's problems with weight and exercise, basic questions remain: Are the guidelines reasonable? What can the public do with this new information? Is our government doing enough to battle this ongoing health crisis?
The dietary guidelines, first written in 1980, are a joint project by the United States Department of Health and Human Services and the United States Department of Agriculture (USDA). They are intended to summarize current nutritional information and make recommendations for patterns of eating. By law, the guidelines are reviewed and updated every five years by a panel of experts. Considering the vast amount of new nutritional information being produced, Diego Rose, associate professor and head of the nutrition section in the community health sciences department of Tulane University's School of Public Health and Tropical Medicine, believes these five-year reviews are necessary.
"Nutrition as a science is getting better -- there's a lot of researchers out there and the field is growing with a lot of federal funding available," Rose says. "When the science is better and there's a lot more information, it gets more complicated in some ways. It's good that they do this every five years because they update what they now know."
After culling together updated information, the Dietary Guidelines Advisory Committee (DGAC) makes its recommendations. In the case of the 2005 guidelines -- a document nearly twice as long as the 2000 guidelines -- the committee has gotten much more specific about just how Americans should eat. As the guidelines point out, a healthy diet is a key component in reducing the risk of chronic diseases such as diabetes and high blood pressure, so a couple of sample eating plans are now included. Plus, the panel has made fairly clear what to eat from various food groups and what to avoid.
Margo Wootan, director of nutrition policy for the Center for Science in the Public Interest, a public advocacy group, says this is an improvement from the previous guidelines. "They've made several changes to the guidelines, which strengthens them," Wootan says. "They increased the recommendations for fruits and vegetables; they made the advice about whole grains clearer and stronger . They provided an actual numerical target for sodium intake, which makes it clearer to the public.
"Plus, they provided stronger advice about trans-fat, encouraging people to eat them as little as possible. They didn't include a numerical target, which would have made the advice even stronger. And the same goes for sugar. While they didn't provide a numerical target for added sugar intake, they did say people should limit their intake."
Specifically, the guidelines state that for a 2,000-calorie diet (the calorie level on nutrition labels), a person should consume nine servings of fruits and vegetables. It might sound like an overwhelming number, but in actuality the amount translates to 2 cups of fruit and 2 1/2 cups of vegetables daily.
People are often mistaken about what a serving actually is, says Eve Dansereau, a dietician providing medical nutrition therapy to patients at the Ochsner Clinic Foundation. "If you had a large banana that would be two servings of fruit -- a lot of people don't know that. If it's a really large banana, it could be three."
Other food components to the dietary guidelines include daily servings of dairy products (3 cups); 6 to 8 ounces of grains; 5 1/2 to 6 ounces of meat; 4 to 5 servings per week of nuts, seeds and dry beans; and 3 to 6 teaspoons daily of oil. If you're still hungry, you can splurge your remaining 267 calories, according to the UDSA Food Guide Amount, on solid fats and added sugars. All of this is to be completed within a 2,000-calorie diet.
The simple reason why most Americans are overweight is that they consume too many calories. Of course, not everyone needs as many as 2,000 calories -- and some require more -- so the guidelines offer caloric estimates for various age groups, men and women, and levels based on how active an individual is.
Like the previous guidelines, the 2005 guidelines emphasize exercise as a vital component for weight management. This time around, they recommend a higher amount of exercise and base recommendations on an individual's needs rather than the generic 30 minutes a day suggested by the 2000 guidelines. For instance, in order to lower the risk of chronic disease, a person should exercise at least 30 minutes a day on most days of the week. And to ward off the gradual weight gain that usually occurs as we grow older, it is recommended that you work out approximately an hour a day most days of the week.
Stopping the weight gain associated with aging is a goal for many people, and one that Dansereau endorses. Still, she doesn't agree that everyone needs to work out 60 minutes a day to accomplish it.
"I ask my patients to try to shoot for 150 minutes of exercise per week. Most people if they would do that, they might stop the cycle of weight gain with aging. Some people will look at me and say, I can't believe that number,' and others will say they can do more. A lot of it has to come from within and how much they want to prevent gaining weight with age."
What if you want to go beyond that? What if you're determined to become one of the relatively few adult Americans who aren't overweight? Well, that determination will come in handy. The guidelines recommend that for sustained weight loss for those previously overweight/obese, you should work out 60-90 minutes daily. Even health experts find that recommendation a little demanding.
"I think they're challenging both personally and professionally, but they're honest," Wootan says. "I think people need to recognize that there are different levels of activity and different levels of activity have different benefits."
Will Americans follow the new guidelines? Due to the technical language and detail, the guidelines themselves aren't really geared toward the general public, but are the basis for more accessible government publications such as the Food Guide Pyramid and the brochure Finding Your Way to a Healthier You.
Tulane University's Rose says that the success of the recommendations will rely on how much the public is willing to listen and act now that science has spoken. "It's the reality of the gap between what scientists know and what people want to hear," Rose says. "I think they're realistic, but people are going to have to want to do it. Now you're not going to going to eat your standard New Orleans diet -- high fat, fried foods, etc. -- and get it under 2,000 calories. But there aren't a lot of calories in fruits and vegetables."
Dansereau agrees that in order to follow the guidelines, people will have to make changes in attitude and behavior. "People have to step up to the plate and take the responsibility of making time for exercise, preparing healthier foods or buying pre-packaged items that are healthier, and being accountable for their own health. The government can't do it for you, but I think we're very lucky that we have a government that's put a lot of funds into these types of programs."
But Wootan at Center for Science in the Public Interest thinks that the government hasn't done enough to get the message out.
"My biggest concern is what are they going to do with this good advice now that they've updated it? My fear is that they'll do what they've done in the past, which is cross their fingers and hope Americans eat better," Wootan says. "The Department of Health and Human Services and the USDA should coordinate a major national campaign to address obesity and unhealthy eating habits. They need to work with all agencies of the government and Congress to get junk food out of schools, strengthen nutritional education and physical education in schools, curb marketing of unhealthy foods to children, and require calorie labeling at fast food and other chain restaurants."
No matter what approach is taken, most people are resistant to change, and in this case, the changes can be pretty drastic. For example, according to the guidelines, the current average consumption of whole grains would have to increase as much as 300 percent in order to reach the new recommended intake level. Still, the switch doesn't have to be immediate. In fact, it might be better to take it slowly.
"I think if you can incorporate a few of the principles from the guidelines that it may impact your health in a positive way," Dansereau says. "Start small and work your way up. Don't let it overwhelm you -- when you do it enough, it becomes habit."
For more information about the Dietary Guidelines for Americans 2005, visit www.healthierus.gov/dietaryguidelines/.
- The guidelines state that for a 2,000-calorie diet, a person should consume nine servings of fruits and vegetables.