10 Ways U.S. Dietary Guidelines Should Change

Federal dietary guidelines are due for an update. Here's what an advisory panel thinks about it.

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The 13-member advisory committee that in June handed the federal government its recommendations for new dietary guidelines wants to wage all-out war on obesity—not simply suggest, as earlier guidelines have, that Americans eat more of this (veggies and whole grains) and less of that (salt and fat). Here are 10 of the key recommendations from the panel's report:

Think total diet. A concrete but flexible diet is more likely than one that is vague and rigid to succeed over time. Rather than saying that less than 10 percent of calories should come from saturated fat, for example, the panel's guidelines promote nutrient-dense foods that are also low in saturated fat, such as whole-grain bread, produce, skim milk, and poultry, and discourage but never impose a total ban on foods like full-fat cheese, pizza, french fries, ice cream, and bacon. "A healthful total diet is not a rigid prescription, but rather is a flexible approach that incorporates a wide range of individual tastes and preferences," the panel wrote.

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Salt is out, potassium in. To bring down the 70 percent of the adult population with hypertension, or high blood pressure, the recommended daily maximum for salt should be slashed to 1,500 milligrams from the current 2,300 mg. Hypertension raises the risk of heart attacks, stroke, and other cardiovascular problems. The lower number already is the suggested ceiling for Americans who are middle-aged or older or African-American, or who already have been diagnosed with high blood pressure. Raising the blood level of potassium is another way to lower blood pressure, and many Americans don't get enough from foods like raisins, figs, and bananas; the panel recommends more than doubling the currently suggested 2,000 mg. a day to 4,700 mg.

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All fats aren't evil. Mono- and polyunsaturated fats and omega-3 fats found in many cold-water fish are healthier substitutes for solid fats like butter, shortening, and animal fat. More fish and small quantities of unsalted nuts are recommended. So is dark chocolate, as evidence is building that it reduces blood pressure.

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Low carbs vs. low fat: no winner. A "moderate body of evidence" fails to demonstrate that one or the other was superior for losing weight and keeping it off, the panel concludes. Eating less, the advisors note, is the only tried and true way to lose weight. They do find that high-quality protein from sources such as lean meats, poultry, eggs, and seafood can initially help pounds come off by quelling hunger, but they cite studies showing that over time the amount of protein in different diets has no bearing on weight loss or maintaining it.

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Tofu and other veggie-based proteins aren't magic. Claims of unique health benefits of vegetable and soy protein aren't backed by good evidence, but the panel notes that these sources do add dietary fiber, and most Americans don't eat enough fiber-rich foods.

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Americans should know how much they should eat. "If you ask any American how many calories they need on a given day, most of them are clueless," says Linda Van Horn, chair of the advisory committee and professor of preventive medicine at Northwestern University. The panel believes that if people had a better sense of that, and of how many calories they take in, the obesity epidemic might be slowed. So the 2010 guidelines, says Van Horn, must offer effective, consumer-friendly tools to help individuals come up with reasonable estimates, personalized according to age, sex, and level of physical activity. The report does not propose a form for those tools.

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Treat kids and pregnant women as special groups. Previous guidelines lumped all children ages 2 and up with adults and didn't address pregnant women separately. The advisors want the dietary needs of infants, children ages 2 to 18, and pregnant women treated separately. While all groups need to eat less overall, pregnant women need to seek out foods rich in folate and iron, while kids should give up soda for milk to bolster levels of vitamin D and calcium, nutrients essential for healthy bones.