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What's new about the 1990 dietary guidelines for Americans?
REPORT What's New About the 1990 Dietary Guidelines for Americans? BETTY B. PETERKIN
Human Nutrition Information Service, U. S. Department of Agriculture, Federal Building, Hyattsville, Maryland 20782
INTRODUCTION
Departmental reviewers of the Committee's recommendations concluded that the basic messages of the seven guidelines, as presented on the cover of the 1985 bulletin, remain sound and of priority importance to Americans in choosing food for a healthful diet. However, some changes to the wording of the guidelines were made (see Table 1) for the following reasons:
The Third Edition of Nutrition and Your Health: Dietary Guidelines for Americans (1) was jointly published by the U. S. Departments of Agriculture (USDA) and Health and Human Services (HHS) in late 1990 (2). It replaces the 1985 edition of the Dietary Guidelines bulletin (3) as the statement of Federal nutrition policy. As such, this bulletin contains the central set of priority dietary guidance messages the government gives to healthy Americans through its nutrition education programs. The 1990 Dietary Guidelines bulletin reflects recommendations of a Dietary Guidelines Advisory Committee of nine nationally-recognized nutrition scientists and physicians. The Committee, at the request of the Departments, reviewed the 1985 bulletin for its soundness with respect to the current scientific evidence about diet as it relates to health. In its review, the Committee drew heavily on two recent major reports on this topic by the National Academy of Sciences (4) and the Surgeon General (5). The Committee's review also considered the utility of the bulletin to the public, drawing on USDA-sponsored research on use of the guidelines by professionals and consumers. Invited comments to the Committee from numerous individuals and groups also provided useful perspectives on the guidelines. The Committee's report to the two Departments (6) includes its recommendations, a discussion of the changes it proposed to the 1985 edition, summaries of the research on the uses of the guidelines, and information on public comments received (7).
• "Healthy" weight replaces "desirable" weight, to reflect the more health-oriented weight assessment method presented in the bulletin. This method is based on advances in the science of how the amount and location of body fat relate to health problems and mortality. • The guidance on fats is reworded to make it clear on the bulletin's cover that fat in the total diet is the focus. The guideline is worded more positively, removing the term "avoid" and the possible misunderstanding it conveyed to some that fats are to be eliminated from the diet. • The adequacy of complex carbohydrates and fiber in the diet is assured through the selection of vegetables, fruits, and grain products. The guideline is based on current scientific evidence on the need for Americans to eat more of and a variety of these foods and on research that found guidance on the selection of foods to be more popular with guideline users than guidance on the use of food components. • The term "sugars" replaces "sugar," to more accurately define the foods of concern, table sugar and other caloric sweeteners, listed in the bulletin's text. "Use---only in moderation" replaces "Avoid too much ---" in both the sugars and the salt/sodium guidelines to remove the misunderstanding that the "avoid" phrase conveys to some. • The terms salt and sodium are used in the guideline that previously referred only to sodium, because salt provides most of the sodium in American diets and is better understood than sodium.
THE SEVEN DIETARY GUIDELINES The Dietary Guidelines Advisory Committee and the 0022-3182/91/2304-0183$03.00/0 © 1991 SOCIETY FOR NUTRITION EDUCATION 183
184
Peterkin / 1990 DIETARY GUIDELINES
Table 1.
Dietary Guidelines: 1985 and 1990.
1985 Edition
1990 Edition
Eat a variety of foods Maintain desirable weight Avoid too much fat, saturated fat, and cholesterol
(same) Maintain healthy weight Choose a diet low in fat, saturated fat, and cholesterol Choose a diet with plenty of vegetables, fruits, and grain products Use sugars only in moderation Use salt and sodium only in moderation (same)
Eat foods with adequate starch and fiber Avoid too much sugar Avoid too much sodium If you drink alcoholic beverages, do so in moderation
TEXT OF THE BULLETIN The content and emphasis of the 1990 text accompanying the seven gUidelines differs considerably from the 1985 text. Differences reflect advances in research relating diet and health and the greater consensus on some issues that has developed since the early 1980s, when the text for the 1985 edition was written. For example, new prominence is given to recommendations to decrease the intake of fat, especially saturated fat, and to increase consumption of vegetables, fruits, and grain products because of their contributions of complex carbohydrates, including dietary fiber, and other food components important to health. This coincides with conclusions of both the National Academy of Sciences and the Surgeon General's reports (4, 5). The text of the 1990 bulletin is organized to allow readers to easily choose and refer to the information they want about each of the guidelines listed on the cover: brief "advice for today," highlighted boxes with tips on implementation, and remaining text that tells briefly about health implications of the guidelines. The bulletin's back cover references some of the scientific reports used as the basis for the bulletin's content, and states where to get more information on applying the guidelines. The bulletin's audience is specified as healthy Americans two years of age and over. The guidelines, and advice about their implementation, emphasize enjoyable and healthful eating through variety and moderation, rather than dietary restriction. They recognize that the content of the total diet over a day or more is a key concept in healthful eating, and that any food that provides energy andlor nutrients can be part of a nutritious diet. Eat a variety of foods. This advice in earlier editions of the guidelines remains sound. In response to requests by some users of the earlier bulletins for more specific food selection guidance, a varied diet is described in the
1990 bulletin using USDA's Food Guide (8,9). Reference is made to the text of the bulletin for the guidelines on fats and on vegetables, fruits, and grain products, where more specific tips are given. Special concerns about food selection by certain groups in the population are noted: People who eat little food are cautioned to choose lowcalorie, high-nutrient foods from the food groups; women and adolescents are advised to eat more calcium-rich foods; and young children, teenage girls, and women of childbearing age are cautioned about their special need for iron-rich foods. Maintain healthy weight. New, yet interim, advice on how to assess body weight and shape is introduced with this guideline. Adults are asked to assess their weight using three criteria: • Your weight falls within the suggested range for persons of your height and age in Table 2. These weights are derived from a National Academy of Sciences report (4) and differ considerably from those in the table in the 1985 edition that were based on 1959 Metropolitan Insurance Company data. In the new table, suggested weights for height are the same for men and women; however, the higher weights in the ranges are noted as more appropriate for people with more bone and muscle, i.e., usually men. The new table presents weight by age category, recognizing that people can be a little heavier as they grow older without facing an additional risk to health. • Your waist-to-hip ratio is below one (0.80 for women and 0.95 for men). If not, your abdominal fat may be a health risk, even if your weight falls within the suggested range in the table. To find your waist-to-hip ratio, measure your waist near the navel while standing relaxed; then measure around your hips over the buttocks where they are the largest; and divide the waist measure by the hip measure. • You have no special health problems for which your doctor suggests weight loss or weight gain? If any of these criteria are not met, it may be wise to check with a doctor on how weight might affect health and what to do about it. Research on the relation of body weight and shape to mortality and morbidity continues. The basis for more precise guidance on what constitutes healthy weight is expected by the next edition of the guidelines, if not before. Reduce weight slowly. Being either too thin or too fat can be a health risk, but being too fat is a problem for more Americans. People who are overweight are advised to set realistic weight goals and strive for long-term success through better habits of exercise and eating. Information on calories expended during different activities and general advice on reducing calorie intake are given. When trying to lose weight, a steady loss of 1/2 to 1 pound a week (a change from 1 to 2 pounds in the 1985 edition)
J. of
August 1991
Nutr. Educ. Vol. 23, No.4
Table 2.
Suggested weights for adults.
Height without Shoes
5/0" 5/1" 5/2" 5/3" 5/4" 5/5" 5/6" 5'7" 5/8" 5/9" 5/10" 5/11" 6/0" 6/1" 6/2" 6/3" 6/4" 6/5" 6/6"
Wei9"ht (in Pounds) without Clothes' Ages 35 and over Ages 19 to 34
97-128 101-132 104-137 107-141 111-146 114-150 118-155 121-160 125-164 129-169 132-174 136-179 140-184 144-189 148-195 152-200 156-205 160-211 164-216
108-138 111-143 115-148 119-152 122-157 126-162 130-167 134-172 138-178 142-183 146-188 151-194 155-199 159-205 164-210 168-216 173-222 177-228 182-234
, The higher weights in the ranges generally apply to men, who tend to have more muscle and bone; the lower weights more often apply to women, who have less muscle and bone. Source: Derived from National Academy of Sciences' Diet and Health (1989)
is suggested. The change was made because a 2-pound loss represents about a 1,000 calorie deficit per day-an excessive and possibly dangerous deficit for some people. The bulletin cautions about the use of other extreme and dangerous approaches to weight loss, such as severely restricting the variety of foods eaten, inducing vomiting, or using medications-laxatives, amphetamines, and diuretics, for example. Choose a diet low in fat . . . the issue of numerical goals. Whether or not numerical goals should be introduced into the guidelines was carefully considered. It was concluded that if a broad scientific consensus exists on a numerical goal for a food component important to health, such as fat, such a goal should be presented. Thus, goals are presented for total fat and saturated fat, the two food components believed to be of most current significance to the health of Americans. Adopted for use are the same goals as recommended by the National Academy of Sciences (4) and an expert panel for the National Cholesterol Education Program: 30% or less of calories from total fat and less than 10% from saturated fat. Use of numerical goals for fats. Such a numerical goal will be useful to professionals and others with enough interest and information to assess diets for lipid content. Also, numerical goals will help counteract the incorrect assumption by some that fat should be eliminated from the diet. The way to figure the grams of fat represented by 30 and 10% of calories and the grams of fat in a few commonly used foods are shown. However, people who
185
want to assess diets for fat content will need additional information from supplemental materials and food labels about the fat in foods they eat. Goals are to be applied to diets over several days, not to a meal or a food. These goals for fats are not for children under two years, who have special dietary needs. Older children are encouraged to choose diets that are lower in fats, but that also provide calories and nutrients children need for normal growth. It is suggested that both children and adults with established food habits may need to change their diets gradually toward the goals. Get blood cholesterol checked. Risk for heart disase is increased among people with elevated blood cholesterol levels. Thus, adults are urged to get their blood cholesterol checked; and, if it is above 200 mg/dl, to follow the advice of health professionals about diet and, if necessary, medication. Choose a diet with plenty of vegetables, fruits, and grain products. This guideline emphasizes the dietary pattern that replaces calories from fat with calories from foods containing carbohydrates, a pattern recommended in both the National Academy of Sciences and Surgeon General's reports (4, 5). Also noted is the importance of fiber in proper gastrointestinal functioning, and of the importance of getting dietary fiber from a variety of foods, rather than from supplements. Advice on the selection of vegetables, fruits, and grain products is expanded and made more specific than the advice to eat foods with adequate starch and fiber, which was found to be confusing by some users of the 1985 edition. Use sugars only in moderation. This guideline calls for using sugars only in moderation for two main reasons: sugars and foods that contain large amounts of them supply calories but are limited in nutrients; and sugars and starches, which break down into sugars in the mouth, can contribute to tooth decay. The importance of fluoride and dental hygiene in the prevention of tooth decay is also noted. Use salt and sodium only in moderation. This guideline calls for using salt and sodium only in moderation, because Americans need much less of these substances than they now consume and eating less will benefit those people whose blood pressure goes up with salt intake. Adults are encouraged to get their blood pressure checked, and, if it is high, to consult a health professional about diet and possible medications.
If you drink alcoholic beverages, do so in moderation. With this guideline comes the caution that alcoholic beverages provide calories but little or no nutrients, and that drinking them is linked to health problems, accidents, and addiction. Some groups of people who
186
Peterkin / 1990 DIETARY GUIDELINES
should not drink are identified: women who are pregnant or trying to conceive, people who plan to drive or engage in other activities that require attention and skill, people who are using medications, people who cannot keep their drinking moderate, and children and adolescents. For people who elect to drink alcoholic beverages, moderate drinking is defined as no more than one drink a day for women and no more than two drinks a day for men. Women should drink less because they are usually smaller than men and have proportionately less water in their bodies to dilute the alcohol. Also, new research indicates that women have about one-half as much as men of the enzyme that breaks down alcohol in the stomach, before it enters the blood stream (10). The geometric designs on the 1985 bulletin's cover and centerfold have been retained for the 1990 edition. However, the new bulletin will be immediately recognized as different because the background on the cover is black, rather than white as in 1985. With each edition, the Dietary Guidelines for Americans have gained in acceptance and use by both professionals and consumers. USDA and DHHS acknowledge the role that nutrition educators have played in this greater acceptance and use, and look forward to their continued 0 support.
NOTES AND REFERENCES 1 U. S. Department of Agriculture, and U. S. Department of Health and Human Services. Nutrition and your health: Dietary guidelines for Americans. 3rd ed. Home and Garden Bull. No. 232. Washington. DC: U. S. Government Printing Office, 1990, 28 pp. 2 Single copies of Reference 1 are available free from the Consumer Information Center, Department 514-X, Pueblo, Colorado 81009. For information about hulk orders or ohtaining negatives, contact the Superintendent of Documents, U.S. Government Printing Offlce, Washington. D.C. 20401, (202) 275-3343. 3 U.S. Department of Agriculture, and U.S. Department of Health and Human Services. Nutrition and your health: Dietary guidelines for Americans. 2nd ed. Home and Garden, Bull. No. 232. Washington, DC: U.S. Government Printing Office, 1985, 24 pp. 4 National Academv of Sciences. National Research Council. Food and Nutrition Bo·ard. Diet and health: Implications for reducing chronic disease risk. Washington, DC: National Academy Press, 1989, 749 pp. 5 U.S. Department of Health and Human Services. Public Health Service. The Surgeon General's report on nutrition and health. Washington, DC: U.S. Government Printing Office, 1988,712 pp. 6 Dietary Guidelines Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 1990. HyattSVille, MD: Human Nutrition Information Service, U.S. Department of Agriculture, 1990, 48 pp. 7 Single copies of Reference 6 are available, while supplies last, from the Human Nutrition Information Service, Federal Building, Room 325-A, HyattSVille, Maryland 20782. 8 Cronin. F., A. Shaw, S. Krehs-Smith, P. Marsland, and L. Light. Developing a food guidance system to implement the Dietary Guidelines. joumal of Nutrition Education 19:281-302, 1987. 9 U. S. Department of Agriculture, Human Nutrition Information Service. Preparing foods and planning menus using the dietary guidelines. Home and Garden Bull. No. 232-8. Washington. DC: U.S. Government Printing Office, 1989, 32 pp. lO Frezza. M., C. DiPadova, G. Pozzato. M. Terpin, E. Baraona, and C. Lieber. High blood alcohol levels in women: Role of decreased gastric alcohol dehydrogenase activity and first pass metabolism. NetL' England joumal of Medicine, 322:95-99, 1990.
CHILD HEALTH 2000 World Congress and Exposition on Child Health, to be held February 19-22, 1992 at the Vancouver Trade & Convention Centre, Vancouver, B. C., Canada. Meeting for specialists in the field of child health to come together to exchange information, introduce technological advancements, and explore ways of reducing mortality and improving the health of children around the world. Themes: "Preventive Health Care"; "Child Health Related to Social Change"; "Biotechnology"; and "Advanced Science and Technology." For further information, please contact: Child Health 2000, Suite 200, 1190 Melville Street, Vancouver, B.C. V6E 3Wl, CANADA; tel: (604) 684-3663, fax: (604) 689-4806. EXERCISE, CALORIES, FAT & CANCER Annual Research Conference, sponsored by The American Institute for Cancer Research, to be held September 4-5, 1991 at the Ritz Carlton Hotel, Pentagon City, Virginia (Metropolitan Washington, D.C.). The Conference has been approved for 9 CE hours for RDs and DTs by the American Dietetic Association and for 8.5 hours of AMA CME Category I credit by Georgetown University School of Medicine. For further information, please contact Rita Taliaferro, Director, Conference Management Division, Associate Consultants, Inc., 1726 M Street, NW, Suite 400, Washington, D.C., tel: (202) 737-8062.
Human Nutrition Information Service, U. S. Department of Agriculture, Federal Building, Hyattsville, Maryland 20782
INTRODUCTION
Departmental reviewers of the Committee's recommendations concluded that the basic messages of the seven guidelines, as presented on the cover of the 1985 bulletin, remain sound and of priority importance to Americans in choosing food for a healthful diet. However, some changes to the wording of the guidelines were made (see Table 1) for the following reasons:
The Third Edition of Nutrition and Your Health: Dietary Guidelines for Americans (1) was jointly published by the U. S. Departments of Agriculture (USDA) and Health and Human Services (HHS) in late 1990 (2). It replaces the 1985 edition of the Dietary Guidelines bulletin (3) as the statement of Federal nutrition policy. As such, this bulletin contains the central set of priority dietary guidance messages the government gives to healthy Americans through its nutrition education programs. The 1990 Dietary Guidelines bulletin reflects recommendations of a Dietary Guidelines Advisory Committee of nine nationally-recognized nutrition scientists and physicians. The Committee, at the request of the Departments, reviewed the 1985 bulletin for its soundness with respect to the current scientific evidence about diet as it relates to health. In its review, the Committee drew heavily on two recent major reports on this topic by the National Academy of Sciences (4) and the Surgeon General (5). The Committee's review also considered the utility of the bulletin to the public, drawing on USDA-sponsored research on use of the guidelines by professionals and consumers. Invited comments to the Committee from numerous individuals and groups also provided useful perspectives on the guidelines. The Committee's report to the two Departments (6) includes its recommendations, a discussion of the changes it proposed to the 1985 edition, summaries of the research on the uses of the guidelines, and information on public comments received (7).
• "Healthy" weight replaces "desirable" weight, to reflect the more health-oriented weight assessment method presented in the bulletin. This method is based on advances in the science of how the amount and location of body fat relate to health problems and mortality. • The guidance on fats is reworded to make it clear on the bulletin's cover that fat in the total diet is the focus. The guideline is worded more positively, removing the term "avoid" and the possible misunderstanding it conveyed to some that fats are to be eliminated from the diet. • The adequacy of complex carbohydrates and fiber in the diet is assured through the selection of vegetables, fruits, and grain products. The guideline is based on current scientific evidence on the need for Americans to eat more of and a variety of these foods and on research that found guidance on the selection of foods to be more popular with guideline users than guidance on the use of food components. • The term "sugars" replaces "sugar," to more accurately define the foods of concern, table sugar and other caloric sweeteners, listed in the bulletin's text. "Use---only in moderation" replaces "Avoid too much ---" in both the sugars and the salt/sodium guidelines to remove the misunderstanding that the "avoid" phrase conveys to some. • The terms salt and sodium are used in the guideline that previously referred only to sodium, because salt provides most of the sodium in American diets and is better understood than sodium.
THE SEVEN DIETARY GUIDELINES The Dietary Guidelines Advisory Committee and the 0022-3182/91/2304-0183$03.00/0 © 1991 SOCIETY FOR NUTRITION EDUCATION 183
184
Peterkin / 1990 DIETARY GUIDELINES
Table 1.
Dietary Guidelines: 1985 and 1990.
1985 Edition
1990 Edition
Eat a variety of foods Maintain desirable weight Avoid too much fat, saturated fat, and cholesterol
(same) Maintain healthy weight Choose a diet low in fat, saturated fat, and cholesterol Choose a diet with plenty of vegetables, fruits, and grain products Use sugars only in moderation Use salt and sodium only in moderation (same)
Eat foods with adequate starch and fiber Avoid too much sugar Avoid too much sodium If you drink alcoholic beverages, do so in moderation
TEXT OF THE BULLETIN The content and emphasis of the 1990 text accompanying the seven gUidelines differs considerably from the 1985 text. Differences reflect advances in research relating diet and health and the greater consensus on some issues that has developed since the early 1980s, when the text for the 1985 edition was written. For example, new prominence is given to recommendations to decrease the intake of fat, especially saturated fat, and to increase consumption of vegetables, fruits, and grain products because of their contributions of complex carbohydrates, including dietary fiber, and other food components important to health. This coincides with conclusions of both the National Academy of Sciences and the Surgeon General's reports (4, 5). The text of the 1990 bulletin is organized to allow readers to easily choose and refer to the information they want about each of the guidelines listed on the cover: brief "advice for today," highlighted boxes with tips on implementation, and remaining text that tells briefly about health implications of the guidelines. The bulletin's back cover references some of the scientific reports used as the basis for the bulletin's content, and states where to get more information on applying the guidelines. The bulletin's audience is specified as healthy Americans two years of age and over. The guidelines, and advice about their implementation, emphasize enjoyable and healthful eating through variety and moderation, rather than dietary restriction. They recognize that the content of the total diet over a day or more is a key concept in healthful eating, and that any food that provides energy andlor nutrients can be part of a nutritious diet. Eat a variety of foods. This advice in earlier editions of the guidelines remains sound. In response to requests by some users of the earlier bulletins for more specific food selection guidance, a varied diet is described in the
1990 bulletin using USDA's Food Guide (8,9). Reference is made to the text of the bulletin for the guidelines on fats and on vegetables, fruits, and grain products, where more specific tips are given. Special concerns about food selection by certain groups in the population are noted: People who eat little food are cautioned to choose lowcalorie, high-nutrient foods from the food groups; women and adolescents are advised to eat more calcium-rich foods; and young children, teenage girls, and women of childbearing age are cautioned about their special need for iron-rich foods. Maintain healthy weight. New, yet interim, advice on how to assess body weight and shape is introduced with this guideline. Adults are asked to assess their weight using three criteria: • Your weight falls within the suggested range for persons of your height and age in Table 2. These weights are derived from a National Academy of Sciences report (4) and differ considerably from those in the table in the 1985 edition that were based on 1959 Metropolitan Insurance Company data. In the new table, suggested weights for height are the same for men and women; however, the higher weights in the ranges are noted as more appropriate for people with more bone and muscle, i.e., usually men. The new table presents weight by age category, recognizing that people can be a little heavier as they grow older without facing an additional risk to health. • Your waist-to-hip ratio is below one (0.80 for women and 0.95 for men). If not, your abdominal fat may be a health risk, even if your weight falls within the suggested range in the table. To find your waist-to-hip ratio, measure your waist near the navel while standing relaxed; then measure around your hips over the buttocks where they are the largest; and divide the waist measure by the hip measure. • You have no special health problems for which your doctor suggests weight loss or weight gain? If any of these criteria are not met, it may be wise to check with a doctor on how weight might affect health and what to do about it. Research on the relation of body weight and shape to mortality and morbidity continues. The basis for more precise guidance on what constitutes healthy weight is expected by the next edition of the guidelines, if not before. Reduce weight slowly. Being either too thin or too fat can be a health risk, but being too fat is a problem for more Americans. People who are overweight are advised to set realistic weight goals and strive for long-term success through better habits of exercise and eating. Information on calories expended during different activities and general advice on reducing calorie intake are given. When trying to lose weight, a steady loss of 1/2 to 1 pound a week (a change from 1 to 2 pounds in the 1985 edition)
J. of
August 1991
Nutr. Educ. Vol. 23, No.4
Table 2.
Suggested weights for adults.
Height without Shoes
5/0" 5/1" 5/2" 5/3" 5/4" 5/5" 5/6" 5'7" 5/8" 5/9" 5/10" 5/11" 6/0" 6/1" 6/2" 6/3" 6/4" 6/5" 6/6"
Wei9"ht (in Pounds) without Clothes' Ages 35 and over Ages 19 to 34
97-128 101-132 104-137 107-141 111-146 114-150 118-155 121-160 125-164 129-169 132-174 136-179 140-184 144-189 148-195 152-200 156-205 160-211 164-216
108-138 111-143 115-148 119-152 122-157 126-162 130-167 134-172 138-178 142-183 146-188 151-194 155-199 159-205 164-210 168-216 173-222 177-228 182-234
, The higher weights in the ranges generally apply to men, who tend to have more muscle and bone; the lower weights more often apply to women, who have less muscle and bone. Source: Derived from National Academy of Sciences' Diet and Health (1989)
is suggested. The change was made because a 2-pound loss represents about a 1,000 calorie deficit per day-an excessive and possibly dangerous deficit for some people. The bulletin cautions about the use of other extreme and dangerous approaches to weight loss, such as severely restricting the variety of foods eaten, inducing vomiting, or using medications-laxatives, amphetamines, and diuretics, for example. Choose a diet low in fat . . . the issue of numerical goals. Whether or not numerical goals should be introduced into the guidelines was carefully considered. It was concluded that if a broad scientific consensus exists on a numerical goal for a food component important to health, such as fat, such a goal should be presented. Thus, goals are presented for total fat and saturated fat, the two food components believed to be of most current significance to the health of Americans. Adopted for use are the same goals as recommended by the National Academy of Sciences (4) and an expert panel for the National Cholesterol Education Program: 30% or less of calories from total fat and less than 10% from saturated fat. Use of numerical goals for fats. Such a numerical goal will be useful to professionals and others with enough interest and information to assess diets for lipid content. Also, numerical goals will help counteract the incorrect assumption by some that fat should be eliminated from the diet. The way to figure the grams of fat represented by 30 and 10% of calories and the grams of fat in a few commonly used foods are shown. However, people who
185
want to assess diets for fat content will need additional information from supplemental materials and food labels about the fat in foods they eat. Goals are to be applied to diets over several days, not to a meal or a food. These goals for fats are not for children under two years, who have special dietary needs. Older children are encouraged to choose diets that are lower in fats, but that also provide calories and nutrients children need for normal growth. It is suggested that both children and adults with established food habits may need to change their diets gradually toward the goals. Get blood cholesterol checked. Risk for heart disase is increased among people with elevated blood cholesterol levels. Thus, adults are urged to get their blood cholesterol checked; and, if it is above 200 mg/dl, to follow the advice of health professionals about diet and, if necessary, medication. Choose a diet with plenty of vegetables, fruits, and grain products. This guideline emphasizes the dietary pattern that replaces calories from fat with calories from foods containing carbohydrates, a pattern recommended in both the National Academy of Sciences and Surgeon General's reports (4, 5). Also noted is the importance of fiber in proper gastrointestinal functioning, and of the importance of getting dietary fiber from a variety of foods, rather than from supplements. Advice on the selection of vegetables, fruits, and grain products is expanded and made more specific than the advice to eat foods with adequate starch and fiber, which was found to be confusing by some users of the 1985 edition. Use sugars only in moderation. This guideline calls for using sugars only in moderation for two main reasons: sugars and foods that contain large amounts of them supply calories but are limited in nutrients; and sugars and starches, which break down into sugars in the mouth, can contribute to tooth decay. The importance of fluoride and dental hygiene in the prevention of tooth decay is also noted. Use salt and sodium only in moderation. This guideline calls for using salt and sodium only in moderation, because Americans need much less of these substances than they now consume and eating less will benefit those people whose blood pressure goes up with salt intake. Adults are encouraged to get their blood pressure checked, and, if it is high, to consult a health professional about diet and possible medications.
If you drink alcoholic beverages, do so in moderation. With this guideline comes the caution that alcoholic beverages provide calories but little or no nutrients, and that drinking them is linked to health problems, accidents, and addiction. Some groups of people who
186
Peterkin / 1990 DIETARY GUIDELINES
should not drink are identified: women who are pregnant or trying to conceive, people who plan to drive or engage in other activities that require attention and skill, people who are using medications, people who cannot keep their drinking moderate, and children and adolescents. For people who elect to drink alcoholic beverages, moderate drinking is defined as no more than one drink a day for women and no more than two drinks a day for men. Women should drink less because they are usually smaller than men and have proportionately less water in their bodies to dilute the alcohol. Also, new research indicates that women have about one-half as much as men of the enzyme that breaks down alcohol in the stomach, before it enters the blood stream (10). The geometric designs on the 1985 bulletin's cover and centerfold have been retained for the 1990 edition. However, the new bulletin will be immediately recognized as different because the background on the cover is black, rather than white as in 1985. With each edition, the Dietary Guidelines for Americans have gained in acceptance and use by both professionals and consumers. USDA and DHHS acknowledge the role that nutrition educators have played in this greater acceptance and use, and look forward to their continued 0 support.
NOTES AND REFERENCES 1 U. S. Department of Agriculture, and U. S. Department of Health and Human Services. Nutrition and your health: Dietary guidelines for Americans. 3rd ed. Home and Garden Bull. No. 232. Washington. DC: U. S. Government Printing Office, 1990, 28 pp. 2 Single copies of Reference 1 are available free from the Consumer Information Center, Department 514-X, Pueblo, Colorado 81009. For information about hulk orders or ohtaining negatives, contact the Superintendent of Documents, U.S. Government Printing Offlce, Washington. D.C. 20401, (202) 275-3343. 3 U.S. Department of Agriculture, and U.S. Department of Health and Human Services. Nutrition and your health: Dietary guidelines for Americans. 2nd ed. Home and Garden, Bull. No. 232. Washington, DC: U.S. Government Printing Office, 1985, 24 pp. 4 National Academv of Sciences. National Research Council. Food and Nutrition Bo·ard. Diet and health: Implications for reducing chronic disease risk. Washington, DC: National Academy Press, 1989, 749 pp. 5 U.S. Department of Health and Human Services. Public Health Service. The Surgeon General's report on nutrition and health. Washington, DC: U.S. Government Printing Office, 1988,712 pp. 6 Dietary Guidelines Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 1990. HyattSVille, MD: Human Nutrition Information Service, U.S. Department of Agriculture, 1990, 48 pp. 7 Single copies of Reference 6 are available, while supplies last, from the Human Nutrition Information Service, Federal Building, Room 325-A, HyattSVille, Maryland 20782. 8 Cronin. F., A. Shaw, S. Krehs-Smith, P. Marsland, and L. Light. Developing a food guidance system to implement the Dietary Guidelines. joumal of Nutrition Education 19:281-302, 1987. 9 U. S. Department of Agriculture, Human Nutrition Information Service. Preparing foods and planning menus using the dietary guidelines. Home and Garden Bull. No. 232-8. Washington. DC: U.S. Government Printing Office, 1989, 32 pp. lO Frezza. M., C. DiPadova, G. Pozzato. M. Terpin, E. Baraona, and C. Lieber. High blood alcohol levels in women: Role of decreased gastric alcohol dehydrogenase activity and first pass metabolism. NetL' England joumal of Medicine, 322:95-99, 1990.
CHILD HEALTH 2000 World Congress and Exposition on Child Health, to be held February 19-22, 1992 at the Vancouver Trade & Convention Centre, Vancouver, B. C., Canada. Meeting for specialists in the field of child health to come together to exchange information, introduce technological advancements, and explore ways of reducing mortality and improving the health of children around the world. Themes: "Preventive Health Care"; "Child Health Related to Social Change"; "Biotechnology"; and "Advanced Science and Technology." For further information, please contact: Child Health 2000, Suite 200, 1190 Melville Street, Vancouver, B.C. V6E 3Wl, CANADA; tel: (604) 684-3663, fax: (604) 689-4806. EXERCISE, CALORIES, FAT & CANCER Annual Research Conference, sponsored by The American Institute for Cancer Research, to be held September 4-5, 1991 at the Ritz Carlton Hotel, Pentagon City, Virginia (Metropolitan Washington, D.C.). The Conference has been approved for 9 CE hours for RDs and DTs by the American Dietetic Association and for 8.5 hours of AMA CME Category I credit by Georgetown University School of Medicine. For further information, please contact Rita Taliaferro, Director, Conference Management Division, Associate Consultants, Inc., 1726 M Street, NW, Suite 400, Washington, D.C., tel: (202) 737-8062.