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Thursday, January 7, 2016

New Dietary Guidelines: Less Sugar, Salt; Coffee OK


Watch your sugar, use caution with the salt shaker, and limit those saturated fats.

That’s the advice from the updated U.S. nutritional guidelines, released Thursday by the Department of Agriculture and the Department of Health and Human Services. The guidelines are published every 5 years and aim to reflect the latest science-based evidence about what we eat.

“Diet is one of the most powerful tools we have to take control of our own health,” Health and Human Services Secretary Sylvia Burwell told reporters at a briefing Thursday. “There are many ways to stay healthy, but nutrition will always be at the foundation of good health.”

While some groups like the American Medical Association praise and support the guidelines, critics say the recommendations don't go far enough -- And they've accused the government of playing politics with Americans' health.

"It really is a betrayal of science to politics," says David Katz, MD, founding director of the Yale Prevention Research Center, a federally funded program that studies how changes to lifestyle can prevent disease. "Public health, which means the lives of real people, is being thrown under the political bus."

Some of the biggest controversy centered on what wasn't in the guidelines -- a recommendation to eat less red and processed meat. The Dietary Guidelines Advisory Committee, a panel of independent experts, called eating large amounts of red and processed meat “detrimental.”

The guidance does recommend we eat lean meats and poultry, and it notes that eating less meat, including processed meat and processed poultry, has been linked to a lower risk of heart disease. But it doesn’t offer specific instructions or limits around red and processed meats. Choices can include processed meats and processed poultry, as long as eating patterns stay within the limits for sodium, saturated fats, added sugar, and calories recommended by the new guidelines.

"The science on the link between cancer and diet is extensive," says Richard Wender, MD, chief cancer control officer for the American Cancer Society. "By omitting specific diet recommendations, such as eating less red and processed meat, these guidelines miss a critical and significant opportunity to reduce suffering and death from cancer."

The Center for Science in the Public Interest says in a statement that after the advisory committee made that recommendation, “the scientific report was attacked by the meat industry and its allies in Congress.”

But the CSPI says the recommendation in the guidelines to eat less meat indicates the Agriculture and Health & Human Services departments “partially resisted the political pressure.”

The National Cattlemen’s Beef Association praised the guidelines, though.

“Lean beef is a wholesome, nutrient-rich food that helps us get back to the basics of healthy eating, providing many essential nutrients such as zinc, iron, protein, and B vitamins, with fewer calories than many plant-based sources of protein,” says Richard Thorpe, identified as a physician and Texas cattle producer, in a statement issued by the association.

At Thursday's news briefing, officials from the agencies defended the meat guideline as it stands, saying the recommendations reflect the best evidence, although men and teen boys still eat too much meat, poultry, and eggs.

Katz doesn’t agree. In a social media post, he calls the guidelines “a national embarrassment.”

“This is a sad day for nutrition policy in America,” he writes. “It is a sad day for public health. It is a day of shame.”

Compared to the advisory committee’s report, Katz says, the guidelines “represent a disgraceful replacement of specific guidance with the vaguest possible language.

“A term that recurs often, clearly intended to say something while saying next to nothing, is ‘nutrient dense foods,’” he writes. “That replaces reference to specific foods that populate the original document. It might mean broccoli ... I guess it might even mean pepperoni. We can’t tell, and that is clearly by design.”

For the first time, the 2015 guidelines tackle added sugars, recommending they make up less than 10% of Americans’ diets. Those do not include naturally-occurring sugars, like those in milk or fruit.

The guidance also recommends that we get less than 10% of our calories per day from saturated fats. Those include butter, whole milk, meats that are not lean, and tropical oils such as coconut or palm oil.

It suggests you eat no more than 2,300 milligrams of sodium if you're 14 or older -- less for those younger than 14. Almost 90% of Americans eat more than the recommended daily amount of sodium, Burwell says.

In a change from past guidelines, eggs are now included among recommended protein foods. Also included are seafood, lean meats and poultry, legumes (beans and peas), and soy products, along with nuts and seeds.

The CSPI says it’s disappointed the recommendations "downplayed the importance of consuming less dietary cholesterol, especially from eggs." It pointed out, though, that the guidelines don't recommend an unlimited quality of eggs, instead advising Americans to eat "as little dietary cholesterol as possible" as part of a healthy eating pattern.

Also for the first time, the guidelines do not propose restricting how much total fat we eat. Over the past decade, research has shown health benefits for eating plans such as the Mediterranean diet, which is high in unsaturated fats like olive oil, nuts, and fatty fish. The decision to drop the total fat limit was hailed earlier this year.

And there’s good news if you like your cup of java: The guidelines mention coffee for the first time and say that having a moderate amount of it can be part of a healthy eating plan.

The guidelines urge Americans to focus on eating:

· A variety of vegetables (dark green, red, and orange)

· Fruits, especially whole fruits

· Grains, at least half of them whole grains

· Fat-free or low-fat dairy, including milk, yogurt and cheese

· Protein foods and oils, especially plant- or nut-based oils

The CSPI says the recommendations are “sound, sensible and science-based” overall.

“If Americans ate according to that advice, it would be a huge win for the public’s health,” says Michael Jacobson, PhD, CSPI president. “That said, the federal government’s basic nutrition advice has remained largely unchanged for the past 35 years. The problem is that the food industry has continued to pressure and tempt us to eat a diet of burgers, pizzas, burritos, cookies, doughnuts, sodas, shakes, and other foods loaded with white flour, red and processed meat, salt, saturated fat, and added sugars, and not enough vegetables, fruit, and whole grains.”

http://www.medscape.com/viewarticle/856872

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