Dietary Guidelines for Healthy American Adults

Krauss, Ronald M.; Deckelbaum, Richard J.; Ernst, Nancy D.; Fisher, E A; Howard, Barbara V.; Knopp, Robert H.; Kotchen, Theodore A.; Lichtenstein, Alice H.; McGill, Henry C.; Pearson, Thomas A.; Prewitt, T. Elaine; Stone, Neil J.; Horn, Linda Van; Weinberg, Richard B.

doi:10.1161/01.cir.94.7.1795

Cited by 389 publications

(100 citation statements)

References 50 publications

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“…Due to the positive linear trend between saturated fat intake and LDL cholesterol, there is a consensus among international nutrition panels that saturated fat intakes should be kept as low as possible while consuming a nutritionally adequate diet (31,44) . In the present evaluation, all but one of the average daily intakes based on Ireland's food pyramid advice exceeded the previous international recommendations for saturated fat (#10 % energy from saturated fat) (45)(46)(47) . The National Food Consumption Surveys have found that only 6 % of children (5-12 years), 11 % of teenagers (13-17 years) and 21 % of adults (18-64 years) reached this #10 % saturated fat goal (42) , which is less stringent than the current recommendation to keep saturated fat intakes 'as low as possible' (31) .…”

Section: Discussioncontrasting

confidence: 53%

Revision of food-based dietary guidelines for Ireland, Phase 1: evaluation of Ireland's food guide

Flynn

O'Brien

Faulkner

et al. 2011

Public Health Nutr.

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Objective: To evaluate Ireland's food-based dietary guidelines and highlight priorities for revision. Design: Evaluation with stakeholder input. Energy and nutrient intake goals most appropriate for Ireland were determined. Advice from Ireland's food guide was translated into 4 d food intake patterns representing age and gender groups from 5 to 511 years. Nutritional content of the food patterns was compared with identified goals and appropriateness of food advice was noted. Feedback from stakeholders was obtained on portion size of foods within the Bread, Cereal and Potato group and of portion descriptors for meat and cereal foods. Setting: Government agency/community. Subjects: General population aged 51 years, dietitians/nutritionists (n 44) and 1011 consumers. Results: Goals were identified for energy, macronutrients, fibre, Fe, Ca and vitamin D. Goals not achieved by the food patterns included energy, total fat, saturated fat, fibre and vitamin D. Energy content of food portions within the Bread, Cereal and Potato group varied widely, yet advice indicated they were equivalent. Dietitians/nutritionists agreed with the majority of consumers surveyed (74 %, n 745) that larger portion sizes within the Bread, Cereal and Potato group were more meaningful. 'Palm of hand' as a descriptor for meat portions and a '200 ml disposable cup' for quantifying cereal foods were preferred. Conclusions: Revision of the guidelines requires specific guidance on energy and vitamin D intakes, and comprehensive advice on how to reduce fat and saturated fat and increase fibre intakes. Advice should use portion descriptors favoured by consumers and enlarged portion sizes for breads, cereals and potatoes that are equivalent in terms of energy.

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Section: Discussioncontrasting

confidence: 53%

Revision of food-based dietary guidelines for Ireland, Phase 1: evaluation of Ireland's food guide

Flynn

O'Brien

Faulkner

et al. 2011

Public Health Nutr.

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Section: Dietary Carbohydratementioning

confidence: 73%

“…The values within this range (22 -40%) are considerably lower than average values (49% energy) in Western diets (McDowell et al, 1994), or recommended (55 -60% or more of total energy) healthful values (Krauss et al, 1996). Although current advice to reduce risk of CVD is, in general, to replace saturated fats with carbohydrate (Krauss et al, 1996), there is mounting evidence to indicated that low-fat, high-carbohydrate diets may elicit undesirable blood lipid changes, including reductions in HDL cholesterol and apolipoprotein A-1, while concurrently elevating TG, VLDL cholesterol and small dense LDL cholesterol (Denke & Breslow, 1988;Dreon et al, 1995;Jeppesen et al, 1997;Mensink & Katan, 1992). Because of these untoward blood lipid changes, substitution of MUFA for saturated fats has been suggested as a more effective strategy than substitution of carbohydrate for saturated fats in order to lower total and LDL serum cholesterol concentrations without adversely influencing HDL, VLDL, TG and apoprotein A-1 (Grundy, 1986;Mensink & Katan, 1987;Wahrburg et al, 1992).…”

Section: Dietary Carbohydratementioning

confidence: 73%

The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic

et al. 2002

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Objective: Field studies of twentieth century hunter-gathers (HG) showed them to be generally free of the signs and symptoms of cardiovascular disease (CVD). Consequently, the characterization of HG diets may have important implications in designing therapeutic diets that reduce the risk for CVD in Westernized societies. Based upon limited ethnographic data (n ¼ 58 HG societies) and a single quantitative dietary study, it has been commonly inferred that gathered plant foods provided the dominant energy source in HG diets. Method and Results: In this review we have analyzed the 13 known quantitative dietary studies of HG and demonstrate that animal food actually provided the dominant (65%) energy source, while gathered plant foods comprised the remainder (35%). This data is consistent with a more recent, comprehensive review of the entire ethnographic data (n ¼ 229 HG societies) that showed the mean subsistence dependence upon gathered plant foods was 32%, whereas it was 68% for animal foods. Other evidence, including isotopic analyses of Paleolithic hominid collagen tissue, reductions in hominid gut size, low activity levels of certain enzymes, and optimal foraging data all point toward a long history of meat-based diets in our species. Because increasing meat consumption in Western diets is frequently associated with increased risk for CVD mortality, it is seemingly paradoxical that HG societies, who consume the majority of their energy from animal food, have been shown to be relatively free of the signs and symptoms of CVD. Conclusion: The high reliance upon animal-based foods would not have necessarily elicited unfavorable blood lipid profiles because of the hypolipidemic effects of high dietary protein (19 -35% energy) and the relatively low level of dietary carbohydrate (22 -40% energy). Although fat intake (28 -58% energy) would have been similar to or higher than that found in Western diets, it is likely that important qualitative differences in fat intake, including relatively high levels of MUFA and PUFA and a lower o-6=o-3 fatty acid ratio, would have served to inhibit the development of CVD. Other dietary characteristics including high intakes of antioxidants, fiber, vitamins and phytochemicals along with a low salt intake may have operated synergistically with lifestyle characteristics (more exercise, less stress and no smoking) to further deter the development of CVD.

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“…Although there is no clear evidence demonstrating that salt restriction reduces the incidence of hypertension in normotensive people, there is general agreement that it can improve blood pressure in hypertensive individuals, particularly those aged more than 44 y (Midgley et al, 1996;Fodor et al, 1999). The American Heart Association (AHA) recommends 6 g/day (2400 mg of sodium) as a 'prudent and safe' limit for the daily intake of sodium chloride (Krauss et al, 1996), but this is abundantly exceeded in all of our clusters, particularly the 'big eaters', whose diet is also highly atherogenic and highly caloric (greater risk of obesity). These subjects should therefore be the primary target for interventions aimed at lowering blood pressure and preventing coronary heart disease.…”

Section: Discussionmentioning

confidence: 99%

Dietary and nutritional patterns in an elderly rural population in Northern and Southern Italy: (II). Nutritional profiles associated with food behaviours

et al. 2003

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Objective: To describe the nutritional profiles of the food consumption patterns identified in an elderly Italian rural population. Design: Cross-sectional study. Setting: Population-based study. Subjects: A total of 847 men and 1465 women aged 65 y or older, resident in rural areas in the province of Pavia (Northern Italy) and near Cosenza (Southern Italy) in 1992-1993. Interventions: A cluster analysis segregated the subjects into six groups for men and seven for women on the basis of similarities in their food intake (see companion paper). The mean daily energy, macronutrient, mineral and vitamin intakes were calculated for the sample as a whole and for each cluster, and then compared with the age-and gender-specific recommended daily allowances for the Italian population. Results: The largest cluster ('small eaters', which included about half of the population) had an insufficient intake of essential fatty acids, calcium, potassium, zinc (men), iron (women), thiamin, riboflavin, niacin, b-carotene, and vitamins A, D and E. The most noticeable characteristics of some of the other clusters were a high intake of fats, a high proportion of total energy provided by sugars, a high intake of vitamin C, folic acid and b-carotene, and a high alcohol consumption. Furthermore, sodium intake was too high in all of the clusters and vitamin D intake was generally inadequate. Conclusions: The dietary habits of elderly Italians living in rural areas combine elements of the Mediterranean and 'wealthy' diets.

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Dietary Guidelines for Healthy American Adults

Cited by 389 publications

References 50 publications

Revision of food-based dietary guidelines for Ireland, Phase 1: evaluation of Ireland's food guide

Revision of food-based dietary guidelines for Ireland, Phase 1: evaluation of Ireland's food guide

The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic

Dietary and nutritional patterns in an elderly rural population in Northern and Southern Italy: (II). Nutritional profiles associated with food behaviours

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