Dietary Guidelines For Healthy Adults
Preamble to note:
For taking it more seriously we shall have a look at some research extracts of the American Heart Association (AHA).
- In 1957 the American Heart Association projected that alteration of dietary fat intake would be able to reduce the frequency of coronary heart disease (CHD), which had become the ground source of disability and death in the United States and other industrialized countries.
- Since then the AHA has issued seven policy statements on diet and CHD as consistent new information has become accessible.
- In each of these statements prominence was placed on expenditure of total fat, saturated and certain unsaturated fatty acids, dietary cholesterol, and sodium because of their significant contribution to risk of CHD.
- Later, excessive alcohol intake was considered because of its association with hypertension, stroke, and other diseases. Such knowledge has encouraged other health organizations and the federal government to make similar recommendations.
- In May 1989 representatives of nine health organizations and governmental bodies met under the aegis of the AHA, reviewed the scientific evidence, and concluded that most Americans can improve their overall health and maintain it with a few specific but fundamental dietary changes.
The following guidelines are consistent with those promoted by each organization:
- Scoff a nutritionally satisfactory diet consisting of a variety of foods.
- Reduce consumption of fat, especially saturated fat, and cholesterol.
- Achieve and preserve a suitable body weight.
- Increase consumption of complex carbohydrates and dietary fiber.
- Trim down the intake of sodium.
- Consume alcohol in moderation, if at all. Children, adolescents, and pregnant women should abstain.
Current AHA recommendations regarding dietary guidelines for adults and related lifestyle practices for the general population are based on evidence indicating that modification of specific risk factors will decrease incidence of CHD.
These risk factors include
- Cigarette smoking;
- Elevated levels of plasma cholesterol,
- Particularly low-density lipoprotein (ldl) cholesterol;
- Low levels of high-density lipoprotein (hdl) cholesterol;
- increased blood pressure;
- Diabetes mellitus;
- Obesity, especially visceral adiposity; and
- Physical inactivity.
To reduce the impact of these risk factors on the occurrence of CHD in the general population, in 1996 the AHA recommends the following population-wide lifestyle and dietary guidelines for adult goals:
- Exclusion of cigarette smoking
- Appropriate levels of caloric ingestion and physical activity to prevent obesity and reduce weight in those who are overweight
- Consumption of 30% or less of the day's total calories from fat
- Consumption of 8% to 10% of total calories from saturated fatty acids
- Consumption of up to 10% of total calories from polyunsaturated fatty acids
- Consumption of up to 15% of total calories from monounsaturated fatty acids
- Consumption of less than 300 mg/d of cholesterol
- Consumption of no more than 2.4 g/d of sodium
- Consumption of 55% to 60% of calories as complex carbohydrates
- For those who drink and those for whom alcohol (ethanol) is not contraindicated, consumption should not exceed 2 drinks (1 to 2 oz of ethanol) per day
Dietary Guidelines for Americans:
In devising the following dietary recommendations, the AHA Nutrition Committee endeavored to make them consistent with those issued by the US Dietary Guideline Committee. Although the AHA dietary guidelines for adults were developed specifically for avoidance of heart and blood vessel disease, they can have a say to prevention of other diseases, including some forms of cancer, renal disease, and osteoporosis.
The AHA dietary guidelines for adults are also consistent with current recommendations for prevention and management of diabetes. These chronic diseases account for the majority of the morbidity and mortality in the population, highlighting the importance of providing the public with scientifically based lifestyle and dietary guidelines for adults. So if you are going to follow the below points, you can surely make your health safe and sound.
Eat a diversity of foods
- The AHA strongly approves consumption of a variety of foods and believes that all dietary recommendations should enable individuals to adopt eating patterns consistent with their own lifestyles and that will supply the calories, protein, essential fatty acids, carbohydrates, vitamins, minerals, and fiber needed for good health.
- This prototype can be achieved by eating foods from all the food groups, including fruits and vegetables; nonfat and low-fat dairy products; whole-grain breads, cereals, pasta, starchy vegetables, and beans; and lean meat, skinless poultry, and fish.
- The AHA recommends that healthy individuals obtain an sufficient nutrient intake from foods eaten in variety, balance, and moderation.
- Vitamin and mineral supplements are not a substitute for a balanced and nutritious diet designed to emphasize intake of fruits, vegetables, and whole-grain foods. Excessive intake of calories, sugar, and salt should be avoided.
Balance food ingestion with physical activity and preserve or reduce weight.
- Loss of excess weight and long-term maintenance of a healthy weight can improve blood lipid levels and blood pressure and reduce risk for heart disease, the most common form of diabetes, stroke, and certain cancers.
- In many individuals with increased abdominal or visceral fat, even modest weight reduction may result in improvement in many metabolic CHD risk factors, particularly those associated with insulin resistance, including low HDL level, elevated triglyceride level, and small dense LDL.
- Successful long-term upholding of a healthy body weight can be promoted by regular physical activity in combination with a diet that is limited in calories, particularly those derived from fat, and relatively rich in complex carbohydrates and fiber.
Choose a diet low in fat, saturated fatty acids, and cholesterol.
- The AHA's population-wide recommendation to consume no more than 30% of total calories as fat is aimed at reducing saturated fatty acid intake and maintaining a healthy body weight. This dietary guideline for adults applies to the average of total calories consumed over a period of 1 week. A common false impression is that the total calories must be consumed in one day, which can limit the variety of food choices in the diet.
- Diets with very low total fat intake have been tested with favorable results in studies of persons at high risk, but such diets have not been demonstrated to be of value for the general population and may have adverse consequences, including potential nutrient deficiencies in certain subgroups such as children, pregnant women, and the elderly. For this reason, the AHA endorses the recommendation of the World Health Organization for a lower limit of 15% of calories as total fat.
- Moreover, the AHA advises that for the general population, the level of fat intake in the diet should be guided by emphasis on adequate consumption of fruits, vegetables, and grains; a healthy weight goal; and, as described below, dietary intake of saturated fatty acids and cholesterol appropriate to individual risk for CHD.
- The AHA emphasizes restriction of saturated fatty acid intake because this is the strongest dietary determinant of plasma LDL cholesterol levels. Different saturated fatty acids have varying abilities to raise blood cholesterol.
- Total plasma and LDL cholesterol levels are mainly affected by lauric (12 carbon atoms), myristic (14 carbon atoms), and palmitic (16 carbon atoms) acids. Reduced intake of these cholesterol-raising saturated fatty acids has resulted in a reduction in plasma LDL cholesterol levels in well-controlled dietary studies. Short-chain (less than 10 carbon atoms) fatty acids and stearic acid (18 carbon atoms) have little effect on cholesterol levels.
- Currently the AHA recommendation for the general population is that less than 10% of total calories come from saturated fatty acids. Equations developed from carefully controlled clinical studies indicate that reducing saturated fat intake from the current average intake of 12% to 14%of calories can lead to an average reduction of 3% to 5% in CHD risk in the population as a whole. There is,
- Inter-individual variation in plasma LDL cholesterol retort to reduced intake of saturated fatty acids, partially influenced by genetic factors. For this reason and also because of varying CHD risk status, population-wide guidelines do not deal with the specific needs of all individuals. In particular, persons with elevated LDL cholesterol levels that are responsive to diet can benefit from even greater limitation of dietary saturated fatty acids, such as 7% or less of total calories.
- Foods contain fatty acids in varying types and amounts, it is not practical to design an eating pattern that selectively eliminates or replaces one fatty acid with another. For example, food labels list total fat by category. For the idea of designing an eating pattern, all saturated fatty acids are considered alike.
- Diminution in caloric intake resulting from limitation of total saturated fatty acids may be beneficial for achieving and maintaining a healthy body weight. When it is appropriate to reduce plasma lipid and lipoprotein levels while maintaining caloric intake, saturated fatty acids in the diet can be replaced by either polyunsaturated or monounsaturated fatty acids, carbohydrates, or protein, all of which have differing effects on plasma serum lipids and lipoproteins.
- High intakes of Ω-6 polyunsaturated fatty acids, however, have been reported to increase risk of formation of gallstones. In addition, results of animal studies suggest that high intake of polyunsaturated fatty acids (more than 10% of calories) may promote cancer. The AHA currently recommends that intake of Ω-6 fatty acids be no more than 10% of total calories. Ω-3 polyunsaturated fatty acids, derived primarily from fish, can also be substituted for dietary saturated fatty acids and as discussed below may have beneficial effects beyond those associated with lowering LDL cholesterol levels.
In recent years there has been an interest in monounsaturated fatty acids as a suitable replacement for saturated fatty acids. Although their net effect on serum lipids and lipoproteins is not much different from that of polyunsaturated fatty acids, they may have some advantages. Unlike polyunsaturated, monounsaturated are not as susceptible to oxidation, which may play a role in atherogenesis.
The AHA therefore recommends a monounsaturated fatty acid intake in the range of 10% to 15% of total calories.
Another factor deserving attention is the use of Transfatty acids. Transfatty acids found primarily in hydrogenated vegetable oils tend to raise cholesterol levels relative to their non-hydrogenated counterparts. This increase appears to be less than occurs with similar amounts of saturated animal fat or highly saturated vegetable oils, e.g., coconut and palm kernel oils. Among the few data available, analyses using plasma or tissue levels of Transfatty acids as a measure of intake suggest that CHD risk is associated with transfatty acids derived from animal products but not with those from hydrogenation of oils. In addition, there is no clear dose-response effect for Transfatty acid intake and CHD risk. Based on this limited information, the AHA recommends limiting Transfatty acid intake, for example, by substituting soft margarine for hard. The AHA also encourages the food industry to develop more products with reduced Transfatty acid content.
Opt a diet with abundance of vegetables, fruits, and whole-grain products.
- These foods should contribute the majority of daily energy intake—between 55% and 60% of total calories. Fruits, vegetables, whole grains, and legumes provide important vitamins, minerals, fiber, and complex carbohydrates as part of a diet moderate in total fat and low in saturated fat content.
- Diets high in unrefined carbohydrates also tend to be high in both soluble and insoluble fiber. Foods rich in soluble fiber, including oats, barley, beans, soy products, guar gum, and pectin found in apples, cranberries, currants, and gooseberries can help maximize a reduction in plasma total and LDL cholesterol levels as part of a fat-modified diet.
- Total dietary fiber intake of 25 to 30 g/d from foods, not supplements, will help ensure an eating pattern high in complex carbohydrates and low in fat.
Choose a diet judicious in sugar.
- The AHA encourages consumption of complex carbohydrates in the form of grains, vegetables, and legumes.
- Sugar intake has not been directly related to risk for cardiovascular disease, but diets high in refined carbohydrates are often high in calories and low in complex carbohydrates, fiber, and essential vitamins and minerals.
Make use of salt and sodium in moderation.
- The AHA recommends that the general public consume no more than 6 grams of sodium chloride per day. This recommendation is based on the evidence for an association between dietary sodium chloride intake and blood pressure derived from a substantial number of epidemiological observations and clinical trials of salt restriction.
- Results of therapeutic trials of sodium chloride restriction in hypertensive individuals also document modest but significant reductions in blood pressure. However, there is considerable variation among blood pressure responses to sodium chloride restriction, and there is no simple, reliable test to accurately predict salt sensitivity.
- Although there is general agreement in the scientific community that salt restriction can improve blood pressure in hypertensive individuals, there are no clear data that allow definition of a desirable upper limit for salt intake. In the United States most current estimates of average sodium chloride intake range from 7.5 to 10.0 g/d. The AHA has elected to support the recommendation of the US Dietary Guideline Committee to limit sodium chloride intake to 6 g/d.
- However, slightly higher intakes (6.0 to 7.5 g/d) have not been verified to increase cardiovascular risk or raise blood pressure in normotensive persons without other cardiovascular risk factors. Based on the entirety of the evidence, the AHA has concluded that the recommendation that the general public limit daily sodium chloride intake to 6 g/d is prudent and safe, will not restrict intake of other nutrients, and may have a significant impact on prevention of cardiovascular disease.
- Reduced sodium intake should be only one component of a comprehensive nutritional approach to blood pressure lowering, which should also include prevention and treatment of obesity, limitation of alcohol intake, and strategies that ensure adequate intake of potassium, magnesium, and calcium.
If you drink, do so in temperance.
- Incidence of heart disease in those who consume moderate amounts of alcohol (an average of 1 to 2 drinks per day for men and l drink per day for women) is inferior to in nondrinkers.
- However, with increased consumption of alcohol, there are increased public health dangers, such as alcoholism, hypertension, obesity, stroke, and cardiomyopathy, a number of cancers, liver disease, accidents, suicides, and fetal alcohol syndrome. In addition, some persons with an inherited predisposition to a variety of metabolic conditions, such as hypertriglyceridemia, pancreatitis, and porphyria should not consume alcohol at all.
- For the person beginning to drink alcohol, alcohol addiction and alcoholism is a real danger, heightened by a familial inclination to alcoholism. In consideration of these risks, the AHA wraps up that it is not sensible to issue guidelines to the general population that may lead some persons to increase their intake of alcohol or start drinking if they do not already do so.
- The advisability of consuming alcohol in moderation (no more than 2 drinks per day) is best determined in consultation with the individual's primary care physician.