The federal government has issued the first update in five years of its "Dietary Guidelines for Americans" — but despite broad recognition of the U.S. obesity crisis, the update left the major cornerstones of the guidelines largely intact.
The recommendations for salt intake are likely to be among the most controversial elements in the 2010 edition, but it's the absence of change that will be driving this controversy since the sodium recommendations hardly vary from the 2005 Dietary Guidelines for Americans.
The sole difference is that the 1,500-mg/day sodium limit for individuals with hypertension or its risk factors was a "suggestion" in 2005 — but has now been promoted to a full-fledged recommendation that the document notes "applies to about half of the U.S. population, including children, and the majority of adults."
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Earlier this month, the American Heart Association called for an across-the-board, 1,500-mg/day limit for everyone — including people without risk factors for hypertension.
Other groups and individual researchers have also argued that the government's 2,300-mg/day sodium target for the general population was too high.
The revision, a joint effort of the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS), was released today — although it carries a 2010 date.
Basic recommendations for maximum intake of fats and cholesterol, sodium, potassium, and fiber remain unchanged from the last edition.
Instead, the "Dietary Guidelines for Americans 2010" focused mainly on wording tweaks — reorganizing how some of the recommendations are presented.
For example, the recommendation to reduce calories from added sugar now gets separate emphasis. In the 2005 edition of the dietary guidelines, added sugar was lumped with other suggestions in a large section on carbohydrates.
The new edition of the dietary guidelines sets the following daily limits or targets: • Fat intake: 20 percent to 35 percent of total calories • Saturated fat: less than 10 percent of total calories (mono- and polyunsaturated fats may be substituted) • Trans-fats: less than 1percent of calories • Cholesterol: less than 300 mg • Fiber: 14 g per 1,000 calories • Potassium: 4,700 mg • Sodium: less than 1,500 mg for all African-Americans and those with hypertension, diabetes, and chronic kidney disease (including children), as well as persons older than 51; everyone else is advised to consume under 2,300 mg of sodium a day • Fruits and vegetables: at least 2.5 cups • Refined grains: less than 3 oz
More of the Same?
Although most of these basic numeric targets are the same as before, the 2010 revision expands on them in new ways.
For example, the new guidelines make numerous references to "solid fats" as an unhealthy food to be avoided. It also recommends substituting mono- and polyunsaturated fats and oils for solid and animal fats when possible.
The new edition also makes more suggestions of alternatives to refined grains and sugars and high-fat meats.
Some academic physicians contacted by MedPage Today and ABC News were skeptical about the guidelines' ability to change the average American's eating habits.
Dr. Goutham Rao of Children's Hospital of Pittsburgh stated his view of the likely impact in a single word: "Negligible."
Said Dr. David Katz, of Yale University, "If the many prior iterations are any indication, very little."
On the other hand, Dr. Eliana Perrin, of the University of North Carolina in Chapel Hill, told MedPage Today and ABC in an email that there are important secondary effects from the guidelines.
"While most Americans don't read the guidelines cover to cover, they become an important source of evidence-based and evidence-informed information and the basis for many federal programs. Their impact is wider because of this," she said.
The full 112-page USDA/HHS publication, "Dietary Guidelines for Americans 2010," also includes tips on kitchen hygiene, safe cooking and refrigeration temperatures — and other methods for avoiding food-borne diseases.
The kitchen and cooking tips were among the document's 16 appendices.
Those appendices also include dietary recommendations for specific population groups such as children, pregnant women, and people at high risk for metabolic diseases; suggestions on interpretation of food labels; vegetarian and vegan adaptations of the guidelines; and lists of common foods rich in nutrients that many Americans don't get enough of — including vitamin D, calcium, and fiber.