New diet guidelines try again to prod Americans toward better health

Andrew Zajac, Tribune Washington Bureau

WASHINGTON — In a new attempt to help an overweight nation slim down and improve its long-term health, the government released new dietary guidelines that called on Americans to eat less, cut down on salt, bulk up on fruits and vegetables, and try water instead of sugary soft drinks.

The guidelines, part of an every-five-years re-examination of the nation’s diet, generally paralleled past recommendations by the government and outside groups, but this time it put special emphasis on salt as a special dietary culprit.

It recommended reducing sodium intake by more than half for all people 51 and older, all African-Americans and everyone with high blood pressure, diabetes or kidney disease — all together about half of all Americans.

The guidance was addressed to a U.S. population in which one-third of children and a majority of adults are overweight or obese and seemingly impervious to warnings about the consequences of unhealthy eating.

Many of the new recommendations are stronger in tone than the 2005 guidelines, aimed at awakening the public to the links between unhealthy eating habits and such chromic killers as diabetes, cancer, stroke and heart disease.

And this time the government emphasized the economic as well as the medical price of unhealthy eating.

Health and Human Services Secretary Kathleen Sebelius, who unveiled the guidelines with Secretary of Agriculture Tom Vilsack, said three-quarters of every health care dollar is spent on chronic diseases related to diet — imposing a huge financial cost on business, governments and household budgets.

Past guidance has been “opaque … and there really has not been much debate focus on how this impacts us as a nation,” said Sebelius, whose department co-authored the guidelines with the Agriculture Department.

Some nutrition experts, while lauding the guidelines overall, said that their impact would be blunted because of an unwillingness to name specific foods to be avoided or consumed in smaller quantities. 

Vilsack underscored the magnitude of the communications challenge, saying, “I must admit personally I never read the dietary guidelines until I got this job.”

The advice on sodium was perhaps the most drastic recommended alteration.

Americans consume an average of about 3,400 mg of sodium daily, well above the 2,300 mg recommended daily upper limit.

The new guidelines recommend that the half of the U.S. population in a risk group lower intake to about 1,500 mg.

That likely will be hard to do even with willing consumers, because about 90 percent of a person’s sodium comes from restaurant or packaged food, not the salt shaker.

“You have to look at a label or a (food) company website,” said Margo Wotan, nutrition policy director for the nonprofit Center for Science in the Public Interest.

More generally, Wotan praised the guidelines for straightforwardness that she said will help consumers understand what they need to do.

For example, Wotan said, the guidance document may be the first in the series dating back to 1980 to state the obvious: “eat less” — and to offer an image rather than a measurement of a proper portion: “make half your plate fruits and vegetables.”

“It’s so clear,” Wotan said.

The guidelines also advocated switching to fat-free or low-fat milk and directly discouraged consumption of sugary beverages in favor of water.

Previous beverage guidance urged selection of “beverages with little added sugars or caloric sweeteners.” 

Nutritionist Marion Nestle said the new guidelines are a substantial improvement over earlier versions, but she said the government pulled punches by failing to name foods to be avoided, in deference to powerful food lobbies who don’t want their products passed over by consumers.

Nestle said the guidelines use the acronym “SoFAS”, which stands for solid fats and added sugars. “Why don’t they just say what they mean: eat less meat, sodas, snack foods?” said Nestle, who teaches at New York University. “The most useful thing they could do is name names.”

While purely advisory, the dietary guidelines influence decisions in school food programs, Meals on Wheels, and regulatory issues like food labeling and how foods are marketed to children.

Officials presented the guidelines as part of a mosaic of food-centered health initiatives aimed at persuading people to eat better and get more exercise.

They include a proposed USDA overhaul of federally subsidized school meals programs that would cut salt, add low-fat dairy products, increase whole grains and make other changes to menus.

And the Food and Drug Administration is working with food producers to improve nutrition information on food packaging and with restaurant chains to add nutrition information to menus.