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Ok, let’s summarize how the basic science nutrition translates into the seven US dietary guidelines:
Community Based Research and Education Programs
- Eat a variety of foods - this guideline is based on the research that shows that there is no one food or food group that is complete - a variety of foods eaten ensures a healthy diet with an appropriate balance of nutrients and non-nutrient compounds that have health effects.
- Choose a diet with plenty of grain products, vegetables and fruits - this guideline is based on the epidemiologic and basic science research that shows the health effects of soluble and insoluble fibers, antioxidant vitamins and minerals, and the multitude of plant-based chemicals that are beneficial to health.
- IF you drink alcoholic beverages, do so in moderation - this guideline is based on research that shows some alcoholic beverages such as wine and beer do contain some flavonoid antioxidant compounds that may be beneficial to health but the positive health effects need to be balanced with the toxic effects of excessive alcohol intake. Moderation in this sense means < 2 drinks per day. One drink equals 1.5 oz distilled liquor, 5 oz. wine, 12 oz beer.
- Choose a diet moderate in sugars - this guideline is based on research that show very high simple carbohydrate diets may also be high in fat, especially saturated fat and may displace calories from more nutrient dense foods to empty calorie or junk foods that have lower nutrient density.
- Choose a diet moderate in salt and sodium - this guideline is based on research that shows there is a subpopulation of salt sensitive individuals in regard to development of hypertension and for general public health policy it seems appropriate to encourage moderation in salt and sodium intake.
- Balance the food you eat with the physical activity - maintain or improve your weight - this guideline is based on the newest obesity research regarding modest or moderate caloric restriction with increased physical activity to achieve healthy weight.
- Choose a diet low in fat, saturated fat, and cholesterol - this guideline is based on epidemiologic, basic science and clinical research showing that blood lipid profiles improve with a diet that contains no more than 30% of calories from fat.
Since the 1970’s a number of community based research and education programs aimed at reducing chronic disease risk, notably cardiovascular and cancer risk have been carried out in the US and other countries. There are a few notable ones you should be familiar with as a physician.
The Five A Day community intervention studies were conducted by grantees funded through the National Cancer Institute in the 1980’s and early 90’s. These programs focused on health behavior change regarding increasing the number of servings of fruits and vegetables from the mean of 3 per day to 5 per day. This recommendation is based on epidemiological, basic science, and clinical studies which show increased fruit and vegetable consumption is correlated with reduced cancer risk.
The Produce for Better Health Foundation is a public-private partnership formed from the early NCI community research studies and is responsible for the logo that you see on produce labels on fresh fruits and vegetables purchased in grocery stores throughout the US, public service advertising, and publications aimed at helping people increase consumption of fruits and vegetables. Check out their website at http://www.5aday.com for research news, recipes, tip sheets, and other information for health professionals and consumers.
The Stanford Heart Disease Prevention Program, started in the 1970’s, was the first community intervention program aimed at reducing cardiovascular disease risk on a population level. Programs included targeted populations of employees in worksites, church-based interventions, and schools. A number of studies followed over the years and now data are available to learn how these community intervention studies succeeded in lowering CVD risk. Researchers from Dartmouth Medical School reported that populationwide programs such as these are cost-effective and can achieve health benefits at a cost equivalent to that of many currently accepted medical interventions. Programs like this can also lengthen life and save resources, especially if the program affects people with pre-existing heart disease or other coronary risk factors.
In the next section, you will learn how to translate these public health nutrition guidelines into food consumption guidelines suitable for clinical patient care.
Content questions should be directed to: Marilyn.S.Edwards, Ph.D., R.D.
or Maggie McQuiggan, M.S.
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