To control your own weight and help bring the national obesity epidemic under control, eat less. Duh, Rick exclaims in this week's podcast. But hard as it is to believe, this is the first time the federal government has officially turned its back on the powerful food industry lobby (pork barrel, anyone?) and advocated for reducing consumption. That's in the just released 2010 Dietary Guidelines for Americans, a joint project of the USDA and Health and the Department of Health and Human Services (HHS).
The last time the guidelines were updated was five years ago, and they've undergone a few changes in this version. The basic rule of thumb for healthy eating is that half of the food on your plate should consist of fruits and vegetables. That's a reflection of one of the concepts the guidelines aim to emphasize: try to achieve caloric balance. The other concept is also apparent: consume foods that are high in nutrient density and avoid low density foods. The latter are those that are high in sugar and/or fat, or have been refined excessively. That includes most white breads, pasta, and cereals and absolutely puts the kabosh on sugar-containing sodas.
Rick lauds these guidelines as very practical and easy to understand, avoiding most measuring or even excessive reading of food labels, opting instead for simple rules that shouldn't present much of a barrier for anyone to understand or follow. Clearly, some of the old advice is still included: eating lean meats and seafood, consuming less than 10% of calories from saturated fat, limiting cholesterol to 300 milligrams per day, and choosing low fat or fat free dairy products.
The Darth Vader of the 2010 guidelines, though, is salt. Most of us consume way more than we should, and most of us should limit our consumption to 2300 milligrams a day. People who already have high blood pressure, kidney disease, diabetes, or are of African American heritage should be more conservative, opting for 1500 milligrams a day. That's not much salt, and the biggest problem in trying to reduce our intake is actually processed foods.
A quick read of the label of many prepackaged foods, especially soups, noodle mixes, frozen entrees, and snacks reveals that just two servings of many of them would meet or exceed the daily sodium allowance for many. (Fast food and even restaurant meals often exceed the sodium allowance, too). Now that the federal government has stepped into the fray, large manufacturers and retailers such as Walmart seem to have bought in. Walmart has announced its intention to decrease the price of fruits and vegetables, and food manufacturers are making efforts to voluntarily decrease sodium in their products.
Predictably, the guidelines also stress the importance of exercise and extol the virtues of drinking water instead of any sugar laden beverage. Alcohol in moderation is fine, with most women okay with one drink per day and most men with two.
So what's a health conscious person to do with these guidelines? Exercise more, eat less, avoid a lot of salt, sugar, fat and processed foods, and eat more fruits and veggies. If not duh, then yawn. Other topics this week include a new antibiotic for Clostridium difficile infection in NEJM, in the same journal the utility of vaccination against human papilloma virus in males, and a lack of benefit seen with imaging for low back pain in Annals of Internal Medicine. Until next week, y'all live well.