The latest set of national dietary guidelines acknowledges that many Americans are unhealthy and emphasizes efforts to battle the obesity epidemic.
In addition to lower sodium and saturated and trans fat goals, the recommendations from the U.S. Department of Agriculture and the Department of Health and Human Services also call for policymakers and the food industry to become engaged in the fight.
"The most important issue is that this set of guidelines is addressing an unhealthy American public for the first time," said Linda Van Horn of Northwestern University, chair of the Dietary Guidelines Advisory Committee. "The obesity epidemic is priority number one, and every single thing in this report is focused on addressing that problem up front."
Yet in terms of intake recommendations, there are not many changes from the last guidelines update in 2005.
Fat and Salt Intake Top Changes
The changes in fat consumption are among the biggest new recommendations. The new guidance urges that saturated fat intake be cut from 10 percent of total daily energy consumption to just 7 percent, with more emphasis on calories from the more healthful mono- and poly-unsaturated fats.
And the transfat intake recommendation has been cut in half -- from 1 percent to 0.5 percent, with the idea being to eat as few of these fatty acids as possible, Van Horn told MedPage Today in an interview.
Another key change is in the sodium intake recommendation. The 2005 guidelines put it at 2,300 mg per day for the general population. However, since 70 percent of Americans have diabetes, heart disease, obesity, or some other risk factor, the new recommended daily allowance is 1,500 mg. That was the number set in the old guidelines only for the high-risk group.
The advisory also encourages increased potassium intake, since this element helps cut the effects of sodium on blood pressure.
Still, there are no new recommendations in terms of cholesterol consumption, which stands at 300 mg per day for healthy adults, and less than 200 mg daily for high-risk individuals.
USDA Guidelines Target Unhealthy Lifestyle
And recommendations for protein and carbohydrate intake have remained relatively unchanged, although the new guidelines call for a shift to a more plant-based diet that focuses on nutrient-rich rather than energy-dense foods.
"Recognizing underconsumption of key nutrients like dietary fiber will go a long way toward helping people consume the nutrients they are missing by shifting intake toward lower energy but higher nutrient-dense foods," Van Horn said.
That means eating more vegetables, fruits, whole grains, seafood, and low-fat milk and dairy products while cutting back on refined grains, added sugars, and solid fats -- particularly those found in sugar-sweetened beverages and desserts, the researchers said.
Specifically, recommended seafood intake is two, four-ounce servings per week, to accrue 250 mg per day of omega-3 fatty acids including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).
Van Horn says the changes in diet and nutrient intake "won't happen overnight," and expects the process to be gradual.
Nutrition experts say one of the most challenging changes will be the sodium recommendations.
"No one made it down to only the 2005 recommended max of 2,300 mg of sodium daily," said Keith Ayoob of Albert Einstein College of Medicine. "If people have trouble reaching [that] mark, then 1,500 mg will be even tougher."
Connie Diekman of Washington University in St. Louis said that most Americans eat 3,000 to 8,000 mg of sodium per day: "Why not develop better ways to get them to 2,300 and then see how that impacts the incidence of hypertension?"
Ayoob added that the earlier recommendations "allow people a condiment here and there, and even a bowl of soup, especially if it's a reduced sodium one. That would be more realistic for consumers, and it would still require some changes to how people eat."
Van Horn said meeting the goals will also require the cooperation of policy makers and the food industry.
Adjusting the American Diet
The idea is to provide incentives to offer healthier products, she said. Ideally, companies should take "key products and gradually but deliberately reduce [for example] the sodium contents of those foods."
"As the American palate gradually adjusts," she said, "those food products can remain front and center in the American diet but not contribute the excessive amounts of sugar, fats, and salt.
Diekman said the key will be "helping consumers change their taste palate so that the shift in food choices is achievable."
The guidelines also recommend against a daily multivitamin and encourage moderate alcohol intake, at no more than a drink a day for women and two for men.
They also address food safety issues, outlinine four key steps to prevent foodborne illness: "clean, separate, cook, and chill."
In a prepared statement, Margo G. Wootan, nutrition policy director for the Center for Science in the Public Interest, applauded the committee for recognizing that "what is most needed is an unprecedented effort to help people follow the Dietary Guidelines, including changes in policy and the food environment."
"The report wisely recommends that USDA and HHS develop a national strategy to help people eat better, including ramping up nutrition education, expanding access to fruits and vegetables, and getting industry to provide more-healthful products."
National dietary guidelines were first published in 1980 and are reviewed every five years. They new set of guidelines is open for public comment until July 15.