Components of a Healthful Diet. Nutrition Objectives for the Nation

Guidelines have been published that advise Americans on the components of a healthful diet. In 1977 the Senate Select Committee on Nutrition and Human Needs issued “Dietary Goals for the United States,” based on concerns that overnutrition may cause obesity, coronary heart disease, cancer, and stroke. This report recommended that Americans should consume less food, fat (especially saturated fat), cholesterol, refined sugar, and salt, and should increase consumption of fruits, vegetables, grain products, and unsaturated oils.

A. Nutrition Objectives for the Nation. National nutrition goals and objectives in relation to health promotion and disease prevention were first published in 1979 in the Surgeon General’s Report on Health Promotion and Disease Prevention, titled “Healthy People.” The 17 specific nutrition objectives to be attained by 1990 included reducing iron deficiency anemia in pregnant women; eliminating diet- induced growth retardation of infants and children; decreasing significant overweight by weight-loss regimens; reducing serum cholesterol and sodium ingestion; increasing breastfeeding; educating the population on diet-related diseases and food composition; providing nutrition information in labels, via employee and school cafeterias, in state school systems, and in health contacts; and improving the national nutrition status monitoring system.

Only the objective of reducing sodium was achieved by 1990; there was no progress in decreasing overweight, which actually increased, and the remaining objectives were partially achieved.

The 21 nutrition objectives for the year 2000 are measurable and include intervention strategies. They are: reduce coronary heart disease deaths; reverse the rise in cancer deaths; reduce overweight; reduce growth retardation among children; reduce dietary fat intake; increase complex carbohydrate and fiber- containing foods (5+ servings of vegetables and fruits, 6+ grain products); increase the proportion of overweight who exercise; increase calcium intake; decrease salt and sodium intake; reduce iron deficiency; increase breastfeeding; prevent baby bottle tooth decay; use food labels to make nutritious food selections; achieve useful and informative nutrition labeling for processed, fresh, and ready-to-eat foods; increase the number of brand items reduced in fat and saturated fat and the proportion of restaurants and institutions offering low-fat, low-calorie food choices consistent with the Dietary Guidelines (see the following), children’s food services consistent with the Dietary Guidelines, and home food services to the elderly; increase nutrition education in schools and worksites; and increase the proportion of primary care providers who provide nutrition services and referral. Annual tracking data will be provided throughout the decade.

B. USDA/HEW Dietary Guidelines. In 1980, the USDA and the Department of Health, Education, and Welfare (HEW) published “Dietary Guidelines” (updated in 1985, 1990, and 1995). These recommended that we: (1) eat a variety of foods to provide energy (calories), protein, vitamins, minerals, and fiber needed for good health; (2) balance the food you eat with physical activity; maintain or improve your weight to reduce incidence of high blood pressure, heart disease, stroke, certain cancers and the most common kind of diabetes; (3) choose a diet with plenty of grain products, vegetables, and fruits, that provide needed vitamins, minerals, fiber and complex carbohydrates; (4) choose a diet low in fat, saturated fat, and cholesterol to reduce risk of heart disease and certain types of cancer and to help maintain a healthy weight; (5) choose a diet moderate in sugars to help reduce caloric intake and tooth decay; (6) choose a diet moderate in salt and sodium to help reduce risk of high blood pressure; and (7) if you drink alcoholic beverages, do so in moderation as alcoholic beverages supply empty calories and can cause many health problems and accidents and lead to addiction.

C. Diet and Cancer Report. The National Research Council and the American Cancer Society have presented guidelines aimed at cancer prevention that are similar to those just listed. Recommendations that are specific for cancer prevention are: reduce fat intake to 30% or less of calories; increase fiber intake to 20-30 g/day; eat five or more servings of vegetables and fruits daily; and minimize consumption of foods preserved by salt curing (including salt pickling) or smoking. Additional cautions are to minimize contamination of foods with carcinogens from any source; identify mutagens in food; and remove or minimize their concentration unless the nutritive value of foods is jeopardized or other potential hazard is introduced.

D. Surgeon General’s “Report on Nutrition and Health”. In 1988, dietary changes were recommended in the Surgeon General’s “Report on Nutrition and Health” in order to improve the health of Americans. The highest priority is to reduce intake of foods high in fats and increase intake ,of foods high in complex carbohydrates and fiber. The specific recommendations for most people (Table I) deal with fats and cholesterol, energy and weight control, complex carbohydrates and fiber, sodium and alcohol. Other is sues for some people are fluoride, sugars, calcium, and iron. As of this writing, the next report was due in 1996. The new format will discuss specific topics, for example, dietary fat and health, and new reports will be issued every two years.