Five Shades of Grey: New Dietary Guidelines for Americans

Every five years the Dietary Guidelines for Americans is released by the U.S. Departments of Agriculture and Health and Human Services. The document itself is actually not intended for the general public, but rather designed specifically for use by health professionals and policy makers who can incorporate the recommendations into nutrition practices and food programs.

This 2015-2020 version provides five overall guidelines that are designed so people can make healthy choices that still fit within their individual preferences. They’re not revolutionary – I’ve been teaching most of these principles for a while, and they do leave some room for interpretation.

  1. Follow a healthy eating pattern across the lifespan.

The first guideline is to eat “a healthy eating pattern,” or in other words, a diet that will provide all the nutrients needed for good health, the reduction of disease risk, and that will be an appropriate number of calories for maintaining a healthy weight. While previous editions of the Dietary Guidelines have focused more on individual nutrients and their impact on health, this edition has shifted the focus to overall eating patterns, believing the patterns to be more predictive of overall health status.

Healthy Eating pattern

  1. Focus on variety, nutrient density, and amount.

The guidelines function on the belief that our nutritional needs should be met primarily through foods. However, in order to get everything we need through food without over consuming calories, we need to focus on nutrient-dense foods from a variety of food groups. The majority of Americans are not currently consuming a diet that falls in line with recommendations (i.e. not eating enough fruit and vegetables while eating too many grains and proteins). They are likely replacing those healthier foods with high calorie foods containing little nutritional value.

Variety Nutrient Density

  1. Limit calories from added sugars and saturated fats and reduce sodium intake.

In addition to the things we want to eat more of, it is also important to note what we should be eating less of. The guidelines say we should shoot for less than 10 percent of our total calories coming from added sugars and less than 10 percent from saturated fats (both averaging over that currently). Current sodium intakes reach as high as almost double the recommendation of 2,300mg or less per day, so naturally, it’s recommended we decrease that as well.

Limit Calories from sugar and fat

  1. Shift to healthier food and beverage choices.

The authors of the Dietary Guidelines are under no illusion that making some of these changes will be easy – they suggest making a number of small shifts in food choices over time to create an overall healthier eating pattern. Examples include the following:

  • Replace high fat proteins and refined starches with smaller portions of lean protein, whole grains, and more vegetables.
  • Include more vegetables and fruits as side dishes, snacks, and desserts.
  • Use more seafood, nuts, seeds, and legumes to replace some meat, poultry and eggs in the diet.
  • Exchange some solid fats, like butter, with more oils.
  • Drink fewer sugary beverages and instead drink mainly water.
  • Decrease sodium intake by cooking at home more often and using fresh ingredients instead of pre-prepared foods.

Seafood Nuts Legumes

  1. Support healthy eating patterns for all.

We all have a role in helping establish healthy eating patterns in our society, from the individual making better food choices, to health professionals educating the public, to policy makers who create the structure for government food programs (i.e. school food programs).

In addition to these five guidelines, there was also some controversy over what was left OUT of the guidelines. One of which is dietary cholesterol. The old recommendation of staying under 300mg per day was removed in favor of the advice to “eat as little dietary cholesterol as possible.” Some find this confusing. I actually don’t mind this change, as many dietitians (myself included) have been taking the focus off of dietary cholesterol for years. Our body makes the cholesterol it needs, and there is little evidence showing that dietary cholesterol itself is directly correlated to blood cholesterol levels.

Healthy Eating for all

When the first draft was released in 2015 for public commenting, it included more specific recommendations on other topics. For example, they suggested eating less red and processed meats for health and sustainability (a topic that didn’t even make it into the final draft). It also suggested taxing sugary beverages and eliminating artificial sweeteners out of concern for long-term health, but those didn’t make it either (changes potentially due to backlash from the meat and sugar industries).

The Dietary Guidelines might seem too vague for some, but when it’s all said and done, recommendations are moving in a good direction. The ambiguity doesn’t bother me, it allows for individualization. Nutrition science has never been a black and white issue, but rather full of grey areas. The best thing we can do is take the advice offered and turn it into a plan that involves real foods and is realistic for our individual lifestyles.

Contributed by Rebekah Blakely, RD (Nutrition Director, Wellfit Malibu)


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