Post on 20-Dec-2015
Nutrition and Your Health:Dietary Guidelines for Americans
2005 Dietary Guidelines Advisory Committee Report*Healthy Hawai‘i Initiative Provider Training
Nine Key Messages Consume a variety of food Control calorie intake to manage body
weight Be physically active every day Fruits/vegetables/whole grains/low-fat milk Choose fats wisely Choose carbohydrates wisely Cut down on salt If you drink, use alcohol in moderation Keep food safe to eat
1. Consume a variety of foods
within and among the basic food groups
while staying within energy needs Promote intake of vitamin E,
calcium, magnesium, potassium, and fiber by children and adults
Promote intake of vitamins A and C by adults
2. Control calorie intake to manage body weight Calories do count - not the
proportion of carbohydrates, fat, and protein in diet*NEJM 2003 May 22
A calorie deficit of 50 to 100 calories a day allows weight maintenance in adults
Monitor weight regularly Limit portion size
3. Be physically active every day Moderate physical activity at least 30
mins. every day reduces risk of obesity, HTN, DM, CAD*Start Living Healthy message: 30 minutes, most days.
Many adults need up to 60 mins. to prevent weight gain
60 to 90 minutes to prevent weight regain
Children and adolescents need 60 mins. on most days*role for pedometers?
4. Choose fats wisely Limit animal fats & cholesterol Limit trans fats (partially
hydrogenated vegetable oils) Reduced risk of sudden/CHD death
associated with 2 servings of fish/week (pregnant, lactating women, children need to avoid mercury)
5. Choose carbohydrates wisely Choose whole fruits rather than
juices Choose whole grains rather than
refined grains Reduce added sugars, especially
sugar-sweetened beverages
6. Fruits & vegetables, whole grains, reduced-fat milk products
2½ to 6½ cups of fruits and vegetables daily
*Provider Training: children 5 servings, adult women 7, adult men 9
Brown rice over white rice Whole wheat over white bread Adults: 3 cups skim or low-fat milk
per day (Ca, Mg, K, vit D)
7. Choose and prepare foods with little salt to lower blood pressure Potassium-rich diets blunts effect
of salt Goal: < 2,300 mg sodium per day
8. If you drink alcohol, do so in moderation Mortality reduction primarily seen in
Men > 45 years Women > 55 years
Moderation Men: up to two drinks per day Women: up to one drink per day
Beer 12 oz., wine 5 oz., spirits 1.5 oz.
9. Keep food safe to eat Foodborne diseases yearly toll in
U.S. 76 M illnesses 325,000 hospitalizations 5,000 deaths
Putting it all together Dietary Approaches to Stop
Hypertension DASH diet (N Engl J Med. 1997 Apr 17;336(16):1117-24)
High fruits and vegetables High in low-fat dairy In hypertensives, reduced systolic BP by
11.4 mm Hg and diastolic BP by 5.5 mm Hg DASH Sodium: Low salt
+ 30 mins. physical activity
*Idaho Plate Method
Healthy meal: 9 inch plate: 1/2 vegetables 1/4 carbohydrates 1/4 protein fruit and dairy on the sideFor Type 2 DM, for low-literacy, ESL
Microeconomics diets based on refined grains,
added sugars, and added fats are more affordable
diets based on lean meats, fish, fresh vegetables, and fruit are not
Drewnowski A. Obesity and the food environment. Am J Prev Med 2004;27(3S):154–162.
Control of lives is related to control of land, systems of productions, and the formal political and legal structures in which lives are embedded.
-Paul Farmer. Infections and Inequalities.
Microconomics Supersizing phenomenon Main cost of fast-food industry:
labor Marginal cost of additional food
insignificant Consumer feels he’s getting a
better deal
Economics 3,800 calories of food a day
produced for every American 500 calories more than 30 years
ago Drives agribusiness imperative to
induce consumers to eat more
The Supply Side Meat-packing plants: Nebraska;
Greeley, Colorado Migrant workers Work conditions reminiscent of The
Jungle Marshallese: agribusiness in
Oklahoma, chicken processing in Arkansas
Marketing the Product Marketing to children
McDonald’s Playlands A good parent gives his children what
they like School cafeterias & vending
machines