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Your 2015 Dietary Guidelines Primer

Since 1980, the Dietary Guidelines Americans (DGA) have been published every five years, so right on cue were the 2015 DGA released in January.  According to the DGA, about half of all American adults have one or more preventable, diet-related chronic diseases, including cardiovascular disease, type 2 diabetes, and obesity. Although infectious diseases have practically vanished in the U.S., there is no end in site for chronic disease – which are mainly related to poor diet quality and inactivity. So let’s get down to the bottom line. What’s the difference between these DGA from the previous and is it really going to help Americans?

First, to understand the future of the DGA we must first look at the past. Previously, the DGA focused on nutrients in isolation and dietary food groups but people don’t consume nutrients in isolation. So the 2015 DGA focus more on healthy eating patterns over the lifetime and making ‘shifts’ to consume healthier food options. For example, shifting from white bread to 100% whole grain bread, from coconut oil (solid fat) to olive oil. I’m sure I won’t completely blindside anyone when I say that the current eating patterns of Americans don’t align with the recommendations of the DGA. Three-fourths of the population has an eating pattern low in fruits, vegetables, dairy, and oils. Roughly 70% of Americans exceed the recommended added sugar and saturated fat intake per day (<10% of calories/day) and 89% exceed the recommend sodium intake (2,300 mg healthy individuals, 1,500 mg hypertension or prehypertension).  Again, most of us probably aren’t surprised by these statistics. Let’s take a closer look at the major updates in the 2015 DGA – cholesterol, the Mediterranean/vegetarian diet, and sodium.

In 1980, emerging research implicated dietary and serum cholesterol in the development of heart disease and cholesterol became the nutrient that everybody loved to hate. More recent research suggests that cholesterol-rich foods (such as eggs) don’t actually increase serum cholesterol levels like previously thought. So the 2015 DGA Advisory Committee did something that they have never done in the past. They removed the restriction of 300 mg of cholesterol per day. Now, the DGA make it clear, it is not recommending you go out and eat all the cholesterol you possibly can since they restricted you all these years. The DGA are simply stating that there is no adequate evidenced for a quantitative limit for dietary cholesterol at this time.  A recent article published in the Food & Nutrition Magazine, titled The Cholesterol Conundrum, stated that the key to understanding LDL cholesterol’s risk and reward may lie in the size and density of its particles which range from large, buoyant, cholesterol-rich particles, to small, dense particles low in lipids.

In 2010, the DGA mentioned the Mediterranean diet but the 2015 DGA took it a step further and created a healthy Mediterranean-style eating pattern, recommending amounts of food from each food group at 12-calorie levels. Similar, the DGA created a 12-calorie level for the vegetarian-style of healthy eating. It should be noted that the healthy vegetarian-eating pattern was created based on self-identified vegetarians and therefore, includes eggs and dairy because the overall consensus of vegetarians was that the majority consume these foods.

There seemed to be a lot of disappointment around a topic that the 2015 DGA did not address, the sodium debate. While there is no dispute on restricting 1.5 grams (1,500 mg) of sodium for those individuals with prehypertension or hypertension, some research has shown that restricting sodium too much can have adverse side effects on healthy individuals. Some health professionals say that there is no health benefit to consuming less than 2,500mg per day, while the American Heart Association still sticks by the 1,500mg sodium limit for all individuals. Clearly, more research is needed to understand the affects of dietary sodium and whether we should be restricting or liberating sodium.

What can we expect for the 2020 DGA? After all, it is only five short years away. The 2015 DGA state that they plan on expanding the DGA to include toddlers and infants, as well as providing additional guidance for pregnant women. In my opinion, I think that cholesterol will be returning into the picture. Not necessarily saying that there will be a quantitative limit for cholesterol but rather focusing more on the cholesterol particle in the development of heart disease. Also, I expect dietary sodium recommendation to remain stagnant or liberated for healthy individuals.

For more information on the 2015 Dietary Guidelines visit http://health.gov/dietaryguidelines/2015/.

Alli Bokenkotter is a University of Cincinnati Dietetic Intern.  She is also the diversity and National Nutrition Month Chair of the Greater Cincinnati Dietetic Association. 

SCAN Symposium Session 2016: Ethics of Food, Sustainability and the Environment

This week’s blog post features Christopher Gardner, PhD Professor of Medicine at Stanford University.  This session is titled: Ethics of Food, Sustainability and the Environment.  Ideally the system that provides the food we eat should be both ethical and support environmental sustainability. In addition, ideally, food should be nutritious, pleasing to the palate, safe, convenient, and affordable. None of these characteristics are dichotomous; they all involve a continuum. Unfortunately, in some cases increasing one characteristic results in decreasing another. Our current food production and consumption practices are less than ideal, with room for improvement. This presentation will address the disturbingly unethical treatment of livestock raised for food and the human labor force that plants, raises, tends, harvests, and slaughters our food. Strategies for increasing the environmental sustainability of our food choices will be discussed. Finally, it will be proposed that engaging your clients and patients in the topics of food ethics and environmental sustainability may be a useful tool in helping some of them to make sustained healthful behavior modifications in their eating habits.   

What’s the Scoop on Protein?

In the 1980s we focused on fat, in the early 2000s we focused on carbohydrates, and now the hot topic has been protein. Most Americans today want to lose weight while building muscle and if it were easy it wouldn’t be the number one New Year’s resolution each year.  Here is the 101 on protein.

If you are the “average Joe” who engages in recreational exercise the recommended dietary allowance is 0.8 grams of protein per kilogram of body weight. If you engage in resistance training, weight training, and/or are trying to build muscle, it is recommended 1.4-1.6 gm/kg of protein per day.  To figure out how much you need, divide your body weight in pounds by 2.2.  This turns your weight into kilograms.  From here simply multiply your weight in kilograms by the amount of protein you need based off your goals or lifestyle.  

If you weigh 142 lbs. (divide by 2.2= 64.5 kg).  Maybe you want to get into body building and use 1-1.4 g/kg, this translates to: 65 to 90.3 g of protein per day.

So where should this protein come from? If you’ve stepped into a GNC or Vitamin Shoppe lately, looking for a protein powder can be simply overwhelming. Don’t get me wrong, I’m not throwing GNC or the Vitamin Shoppe under the bus, I have been a customer with both companies but ask any dietitian and they’ll tell you consume protein from food first, supplements second. Specifically, high-quality protein, such as eggs, dairy, poultry, seafood, and nuts and seeds. 

While most people focus on protein to build lean muscle mass, protein also plays an important role in preventing chronic disease. There is growing evidence that high-protein foods sources such as fish, beans, nuts, and chicken in place of red meats can reduce risk of cardiovascular disease, improve diabetes management, and promote weight maintenance.

Bottom line, while protein is important for our fitness goals. The amount and quality of the protein source is just as important to achieve our fitness goals and prevent chronic disease.

Thanks for reading!

Your Intern,

Alli Bokenkotter

For more information:

The Nutrition Source: Protein. Retrieved from http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/protein/

Phillips, S. M. (2013). Http://www.gssiweb.org/en/Article/sse-107-protein-consumption-and-resistance-exercise-maximizing-anabolic-potential. Sports Science Exchange, 26, 1-5. Retrieved February 25, 2016, from https://secure.footprint.net/gatorade/stg/gssiweb/pdf/107_Phillips_SSE.pdf.

SCAN Symposium Session 2016: When "Being Healthy" Goes Too Far: Assessment and Treatment for Orthorexia and Pathological Exercise

This week’s blog post features Edward Tyson, MD, a physician in private practice, and Jessica Setnick, MS, RD, CEDRD, Senior Fellow at Remuda Ranch.  Their session is titled: When "Being Healthy" Goes Too Far: Assessment and Treatment for Orthorexia and Pathological Exercise.  In our wellness-focused society, our clients are constantly bombarded with messages to “eat well and exercise.” Taken to the extreme when used as a response to emotional stress or a recent medical scare or diagnosis, or combined with the drive to excel and a tendency toward perfectionism, these otherwise healthy behaviors can cause illness, injury, and worse. Where is the line between healthy and appropriate versus detrimental and dangerous? And how do we lead our clients back from the danger zone? This presentation will provide answers to both questions so that RDNs can identify and manage orthorexia and pathological exercise in any area of practice.

SCAN Symposium Session 2016: SCAN Symposium Session 2016: How Sustainability is Shaping the Shopping Cart

This week’s blog post features Kate Geagan, MS, RD Nutrition Communicators Consultant.  Her session is titled: “How Sustainability is Shaping the Shopping Cart.”  Consumer interest about what’s in our food and how it’s produced has grown exponentially, driven by a number of factors and concerns including animal welfare, worker conditions, degree and type of processing, ingredient sourcing, desire to buy locally, and the local and global environmental impact of our food choices as well as access to more information than ever before. However, the integration of guidance to reduce the environmental impact of the diet and dietary recommendations for optimal health is complex, highly regionalized and a young discipline without strong consensus or integration to date. Where and to what extent do sustainability and health converge, and what advice can we give to consumers looking to eat more sustainably?  This session will provide insights on the latest evidence and initiatives from the fields of nutrition, food systems, and environmental science as well as strategies for helping consumers navigate this complex landscape to make food choices that deliver on nutrition, taste and sustainability to promote a positive health culture that extends to the environment.