Refreshed Dietary Guidelines Shift Focus to Healthy Eating Patterns

Americans need to adopt a healthy eating pattern focused on variety, nutrient density, and amount to reduce the risk of obesity and prevent chronic diseases like type 2 diabetes, hypertension, and heart disease, according to the latest update to the federal government’s dietary guidelines released this week.

Implications:  Refreshed Dietary Guidelines Shift Focus to Healthy Eating Patterns

The ideal diet includes greater amounts of vegetables, fruits, grains, fat-free or low-fat dairy, protein from a variety of sources, and oils, with restrictions on saturated fat, sodium, and added sugars, the new Dietary Guidelines for Americans state. To help people translate that advice, the document contains examples of 3 healthy patterns—a US-style pattern, a Mediterranean-style pattern, and a vegetarian-style pattern.

For the first time, the guidance, which is updated every 5 years by the US Department of Health & Human Services and the US Department of Agriculture, sets an explicit limit on intake of added sugars: keep them to less than 10% of daily calories.

That restriction joins limits on saturated fat (less than 10% of calories), trans fats (as low as possible), and sodium (less than 2,300 mg/day for people 14 years and older and even less for younger teens and children).

Support From Cardiology Societies

Both the American College of Cardiology (ACC) and American Heart Association (AHA) praised the new guidelines.

“We hope Americans will pay attention to this guidance, including limits on sugar intake, and incorporate it into their diets by focusing on consuming unprocessed foods, including fruits, vegetables and grains, and also replacing foods [containing] cholesterol and saturated fats with foods with healthier monounsaturated fats like olive oil and nuts,” ACC President Kim Allan Williams, MD, of Rush University Medical Center (Chicago, IL), said in a statement. Adhering to the guidance, he added, “will help improve the health of the American population.”

AHA President Mark Creager, MD, of Dartmouth-Hitchcock Medical Center (Lebanon, NH), was equally supportive, saying in a statement that “by providing a valuable source of nutrition information, the standards continue to help build a ‘culture of health’ that will reduce our risk for heart disease and stroke.”

But more efforts are needed, Creager indicated.

“In order to support these new science-based guidelines, the [AHA]  urges our nation’s political leaders to pursue broader policy changes such as improved nutrition labels [and] production of healthy foods with less salt, sugar, and fat and to continue consumer education,” he said. “A more comprehensive approach will go a long way in helping Americans adhere to these guidelines and stay on a path to better health.”

No More Cholesterol Limit

In the 2010 dietary guidelines, there was a limit on the consumption of dietary cholesterol to less than 300 mg/day. That restriction is not found in the current version, but “this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns,” the authors point out. “As recommended by the [Institute of Medicine], individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern. In general, foods that are higher in dietary cholesterol, such as fatty meats and high-fat dairy products, are also higher in saturated fats.”

Robert Eckel, MD, of the University of Colorado School of Medicine, a past president of the AHA, told TCTMD that there is not sufficient evidence to make a strong statement linking dietary cholesterol intake and LDL cholesterol levels but called for further research to clarify the issue.

He pointed to an editorial he wrote on the issue last year for the American Journal of Clinical Nutrition, in which he states: “Overall, some reservation is appropriate when claiming that dietary cholesterol is unimportant in modifying LDL cholesterol and the risk of [cardiovascular disease]. Yet, the primary emphasis should be placed on dietary patterns wherein the overall diet is heart healthy…. Despite > 50 years of science, a few better-done crossover studies to address the independent effect of dietary cholesterol in the setting of a heart-healthy lifestyle would be timely, with or without statin therapy on board.”

US Department of Health and Human Services and US Department of Agriculture. 2015-2020 Dietary Guidelines for Americans, 8th Edition. Published: January 7, 2016. Accessed: January 7, 2016. 

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Todd Neale is the Associate News Editor for TCTMD and a Senior Medical Journalist. He got his start in journalism at …

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