Choose a diet that is low in saturated fat and cholesterol and moderate in total fat: subtle changes to a familiar message.
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"Choose a diet that is low in saturated fat and cholesterol and moderate in total fat," issued in Nutrition and Your Health: Dietary Guidelines for Americans in the year 2000, has an interesting and lengthy history. The first guideline, for which there was extensive scientific data to show that dietary excess increased chronic disease risk, prompted much scientific discussion and debate when implemented as dietary guidance. Three major changes in the guideline are noted since it was issued in 1980, i.e., numerical goals for dietary fats; the applicability of recommended fat intakes for all individuals > or =2 y old; and rewording to emphasize reducing saturated fat and cholesterol intakes. The shift in emphasis includes the terminology moderate fat, which replaces the phrasing low fat. National data about the food supply, the population's dietary intake, knowledge, attitudes and behaviors, and nutritional status indicators (e.g., serum cholesterol levels) related to dietary fats help to monitor nutrition and health in the population. Experts consider that national data, although not without limitations, are sufficient to conclude that U.S. intakes of fats, as a proportion of energy, have decreased. The lower intakes of saturated fat and cholesterol are consistent with decreases in blood cholesterol levels and lower rates of coronary mortality over the past 30 years. Strategies are needed and some are suggested, to further encourage the population to achieve a dietary pattern that is low in saturated fat and cholesterol and moderate in total fat. Other suggestions are offered to improve national nutrition monitoring and surveillance related to the guideline. (+info)
Choose beverages and foods to moderate your intake of sugars: measurement requires quantification.
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The Dietary Guidelines for Americans, which form the basis of federal nutrition policy, have changed in subtle, but important ways with regard to sugars since they were first introduced in 1980; one might say they have become "sweeter" over time. Nonetheless, they have continued to maintain that there is a concern with overconsumption of sugars in the diets of Americans. Although the Dietary Guidelines themselves have never quantified how much constitutes overconsumption vs. moderation, the Food Guide Pyramid provides some guidance on that subject. The Pyramid's recommendations for added sugars, which vary by total energy level, are posed as a benchmark for gauging the appropriateness of the population's intakes. Data from the Food Supply series and from the Continuing Surveys of Food Intakes by Individuals are used to assess recent intakes. The population is consuming added sugars at levels far in excess of recommendations; this is generally true for all population subgroups examined, but especially for adolescents. Soft drinks are the major source of added sugars in the diet. Suggestions are given to facilitate correction of these dietary imbalances. (+info)
Choose and prepare foods with less salt: dietary advice for all Americans.
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The Nutrition and Your Health: Dietary Guidelines for Americans have included dietary guidance on salt and sodium since they were first released in 1980. This paper briefly reviews the impetus for including sodium guidelines, changes in them over time and factors influencing these changes. Although guidance appears to have changed little over the five editions, differences in wording reflect changes in knowledge of the link between sodium and blood pressure, a shift in public health policy toward prevention and increased consumption of processed and prepared foods. We examine methods to monitor sodium intake and assess whether Americans are following these guidelines. Available data indicate that American adolescents and adults are consuming more sodium than recommended and are unable to judge whether the amount of sodium in their diet is appropriate. Although Americans avoid adding salt to food at the table, their efforts may have little effect given that the majority of salt consumed is added during commercial processing and preparation. Thus, changes to the Dietary Guidelines that emphasize the major sources of sodium in U.S. diets and advice to "choose and prepare foods with less salt" may help all Americans meet recommended sodium intake levels in the future. (+info)
If you drink alcoholic beverages do so in moderation: what does this mean?
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The changes in content of the alcohol guideline of the various editions of the Dietary Guidelines for Americans from 1980 to 2000 are discussed. This is followed by a capsule summary of the history and evolution of the discipline of alcohol epidemiology compared with that of nutrition epidemiology. Methods of assessment are discussed, and issues surrounding the validity and reliability of self-report of alcohol consumption are then outlined. Relevant objectives from Healthy People 2010 are discussed. Surveillance of the alcohol guideline discloses that, at present, very few American drinkers follow the recommendations of the alcohol guideline. Indications for future research needs to address this issue conclude the discussion. (+info)
Community involvement at what cost?--local appraisal of a pan-European nutrition promotion programme in low-income neighbourhoods.
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In the UK, government has committed itself to improving health and reducing inequalities in health. For the first time, issues such as food poverty will be addressed by tackling the causes of poverty and wider determinants of ill health. The time has never been better, therefore, for health and local authorities to work collaboratively to promote and improve health. Community involvement is also paramount to sustainable programmes. However, such a dramatic shift in policy and greater emphasis on public health requires health professionals themselves to adopt a different approach. The World Health Organization (WHO) recommends a health promotion approach as a framework for action. But despite the existence of this framework there is little evidence that a wider understanding of health promotion and the necessary practical experience has been achieved. This has weakened the potential impact of health promotion and has possibly encouraged inappropriate use of health promotion principles in practice. The European Food and Shopping Research Project (SUPER project) was established under the WHO European network of Healthy Cities to help local projects implement the principles of health promotion (WHO, 1986). This paper describes the SUPER project and its implementation in Liverpool (1989-1997), where levels of unemployment, deprivation and ill health are amongst the highest in the UK. Participation in SUPER is appraised to identify the various benefits and obstacles involved and to identify links with progress at the local level. This appraisal is discussed and the use, and potential misuse, of participatory appraisal techniques to elicit information and mobilize communities is examined. (+info)
National nutrition and public health policies: issues related to bioavailability of nutrients when developing dietary reference intakes.
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Dietary reference intakes (DRI), like its predecessor, the recommended dietary allowances (RDA) and the Recommended Nutrient Intakes (RNIs), are reference values, based on the best scientific evidence available. They serve as reference amounts of specific nutrients and food components for use in assessing the adequacy of and in planning for nutritious diets. They have been used for over 50 y as the basis for national nutrition monitoring and intervention programs in the United States, Canada, and other countries and as the basis for dietary guidance developed for both individuals and for targeted groups of people. Thus, although not developed for specific policy applications, they have represented the best scientific perspectives regarding what should be the basis for nutrition and public health policy related to foods and supplements. In determining DRIs, as was the case with the RDA, significant attention must be paid to the form of the nutrient or food component that is evaluated. Research conducted to determine how much of a nutrient is needed must evaluate the chemical form provided, the matrix in which it is given and the effect of other food components on absorption and/or utilization. Because the DRI recommendations will be used in population-wide policy development, assumptions must be made explicitly about what is expected for all of these factors in a typical diet. At the same time, where data exist relative to nontypical but potentially very significant effects on bioavailability, these must also be delineated to be of use in a variety of settings. Finally, one of the most important aspects of determining bioavailability in developing reference intakes is that as new information emerges, new complexities enter into the process. As more chemical complexes of nutrients and food components become available in the marketplace, new bioavailability factors may need to be established. Examples of such changes exist in the DRI reports already published for vitamin B-12 and folate and in previous RDA for iron and protein. It is often the different assumptions related to bioavailability that alter the reference intakes used as the basis for public health policy in different countries, rather than the basic science from which the recommendation is derived. (+info)
Using the national nutrition monitoring system to profile dietary supplement use.
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The National Nutrition Monitoring and Related Research Program (NNMRRP) was defined by Congress in 1990 as "the set of activities necessary to provide timely information about the role and status of factors that bear on the contribution that nutrition makes to the health of the people of the United States" (7 U.S.C. section sign5302). The NNMRRP includes nearly 100 components at both the national and state level; the keystone components are the National Health and Nutrition Examination Surveys (conducted by the National Center for Health Statistics) and the Continuing Surveys of Food Intakes by Individuals (conducted by the Agricultural Research Service). These surveys were designed to measure individuals' consumption of foods and beverages and the nutrient intakes resulting from this consumption; expansion of these surveys to include dietary supplements and their nutrient contributions has been and continues to be a significant challenge. This article identifies the data needs regarding consumer use of dietary supplements in terms of the analytical demands to address the contribution dietary supplements make to "the health of the people of the United States." Important gaps in the data currently available are discussed. Current efforts to address dietary supplements are described along with recommendations regarding efficient use of the keystone surveys as well as other components of the NNMRRP. (+info)
Contribution of lead from calcium supplements to blood lead.
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We conducted a case-control study to determine the contribution of lead to blood from consumption of calcium supplements approximating the recommended daily intakes over a 6-month period. Subjects were males and females ages 21 to 47 years (geometric mean 32 years) with a geometric mean blood lead concentration of 2.5 microg/dL. They were subdivided into three groups. One treatment group (n = 8) was administered a complex calcium supplement (carbonate/phosphate/citrate) and the other treatment group (n = 7) calcium carbonate. The control group (n = 6) received no supplement. The lead isotopic compositions of the supplements were completely different from those of the blood of the subjects, allowing us easily to estimate contribution from the supplements. The daily lead dose from the supplements at 100% compliance was about 3 microg Pb. Three blood samples were taken at 2-month intervals before treatment to provide background values, and three were taken during treatment. Subjects in the treatment group were thus their own controls. Lead isotopic compositions for the complex supplement showed minimal change during treatment compared with pretreatment. Lead isotopic compositions in blood for the calcium carbonate supplement showed increases of up to 0.5% in the (206)Pb/(204)Pb ratio, and for all isotope ratios there was a statistically significant difference between baseline and treatment (p < 0.005). The change from baseline to treatment for the calcium carbonate supplement differed from that for both the control group and the group administered the complex supplement. Blood lead concentrations, however, showed minimal changes. Variations in blood lead levels over time did not differ significantly between groups. Our results are consistent with earlier investigations using radioactive and stable lead tracers, which showed minimal gastrointestinal absorption of lead in the presence of calcium (+/- phosphorus) in adults. Even though there is no discernible increase in blood lead concentration during treatment, there are significant changes in the isotopic composition of lead in blood arising from the calcium carbonate supplement, indicating a limited input of lead from diet into the blood. Because calcium carbonate is overwhelmingly the most popular calcium supplement, the changes we have observed merit further investigation. In addition, this type of study, combined with a duplicate diet, needs to be repeated for children, whose fractional absorption of lead is considerably higher than that of adults. (+info)