Articulatory Loop

Today marks the release of the 2005 US Government Dietary Guidelines Advisory Committee Report. It doesn't contain anything that regular readers here haven't heard before, but is nonetheless a big step forward in terms of our government's handling of dietary and health issues. First off, the Committee broke from precedent this round, not simply updating its 2000 report, but conducting "an evidence-based review of diet and health." Literature was reviewed, experts testified, et cetera, et cetera, and now we have a bright shiny new report. The report is organized around answering a set of 34 key questions, yielding nine key Messages, about which I shall briefly write:

1. Consume a variety of foods within and among the basic food groups while staying within energy needs.

This is something that's been a message for some time, but weakly heard. Americans love their fad diets, and in rushing off to eat all one type of food and none of another, miss the point entirely. The key message here is variety: Americans are suffering from a critical lack of basic nutrients, particularly vitamins C, E, and potassium, in part because we just don't eat enough variety.

2. Control calorie intake to manage body weight.

Here's a big ole' duh, but apparently many people seem to have missed this message: you need to consume, in a day, at most the number of calories you expend in a day. If you consume fewer calories, you will lose weight, and if you consume more you will gain weight. Regardless of what type of food provided those calories!

The key bit here is portion control: the Committee recommends substituting lower calorie-density, nutrient-rich foods for higher-density, lower-nutrient ones as a way to both get more vitamins and control weight.

3. Be physically active every day.

They recommend at least 30 minutes of physical activity a day, and more like 60-90 for people who want to lose or keep off weight. We all know this, but again, some just don't seem to get it.

4. Increase daily intake of fruits and vegetables, whole grains, and nonfat or low-fat milk and milk products.

Take-home messages are again to eat a variety of foods, but specifically to have 3 cups worth of low/non-fat milk products a day, and replace as much processed grain food with whole grains. Sounds good to me...except I cannot stand the taste of anything below 2% milk or yoghurt. Low/non-fat cheese is abomination.

5. Choose fats wisely for good health.

Eat less saturated and trans fats, and eat fish high in n-Omega-fatty acids twice a week, unless you're pregnant, nursing, or a kid, in which case you have to worry more about mercury levels. They recommend just checking with "consumer guides" to identify lower-mercury fish, but to be honest, the kinds of things these acids are good for can probably wait till you're older, or not with child.

6. Choose carbohydrates wisely for good health.

We know about the debate on carbs, and how inconclusive data so far has been. The Committee reiterates that it's relative calorie intake and expenditure that will determine weight loss/gain, but it is clear that too much sugar, especially of the processed/refined variety, is bad. They recommend getting more fiber too. And drinking less soda (and other sugar sweetened beverages).

7. Choose and prepare foods with little salt.

Less NaCl, more KCl. Unless of course you're like me and have dangerously low blood pressure, in which case you probably should just drink more water.

8. If you drink alcoholic beverages, do so in moderation.

They recommend 1 serving per day for women and 2 for men starting at middle age, and none in adolescence and not much in between. Yeah, riiiiiiiight.

9. Keep food safe to eat.

This bit is about all those nasty things you can get from bad food and how there are about 76 million illnesses due to bad food in the US each year, including about 5,000 deaths. Yuck.

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The New York Times reports that the Center for Science in the Public Interest has found that, big shocker!, parents are fighting a losing battle against food marketers in getting their kids to eat healthily. If SpongeBob were hocking broccoli instead of Lunchables (or, contrarily, if Lunchables contained anything that occurs in nature), kids would be more likely to eat healthy. Kraft and others have made some gestural movement in the direction of addressing these concerns, but it still boils down to spin.

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After you eat, you poop; this fact is not in contention. However, new research questions conventional wisdom about constipation: fiber and water may not help, and regular laxatives may not be harmful or habit-forming. This is all stuff I'd thought had been worked out long ago, but it seems there's a bit of a gap in the research, apparently due (in part) to patients' unwillingness to discuss such matters with their doctor.