Steps to a HealthierUS - PREVENTION Report
Volume 19: Issue 3  Spring 2005

Focus

Exercising Good Judgment in Choosing Your Diet

Americans of all ages can improve their health by making wise choices about eating and physical activity. This is the primary message of the Dietary Guidelines for Americans 2005, published by the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) in January 2005. Based on the most up-to-date and authoritative scientific information, the Dietary Guidelines provides specific recommendations on what constitutes a healthful diet to reduce risk of chronic diseases and to lead longer, healthier lives. The complete document can be downloaded for free at www.healthierus.gov/dietary guidelines or purchased from the U.S. Government Printing Office at http://bookstore.gpo.gov.

Both diet and physical activity play crucial roles in health. A healthful diet provides the nutrients your body needs while staying within your daily calorie needs. Regular physical activity contributes to your health, sense of well-being, and maintenance of a healthy body weight.

Many Americans eat too many calories and are inactive. Nearly a third of adults are obese (defined as having a body mass index of 30 or greater), and millions more are overweight (a body mass index of 25 or greater). The rate of overweight and obesity among children also has risen. Eating right and being physically active aren’t just a diet or a program—they are keys to a healthy lifestyle. With healthful habits, Americans can reduce their risk of overweight and obesity, as well as chronic diseases such as type 2 diabetes, high blood pressure, high blood cholesterol, cardiovascular disease, osteoporosis, and certain cancers.

The food and physical activity choices you make every day affect your health and how you feel today, tomorrow, and for the rest of your life.

How the Dietary Guidelines Are Developed

The Dietary Guidelines for Americans provides Americans with the best scientific information on what makes a healthful diet. First published in 1980, the guidelines, by law, undergo a review every 5 years to determine whether revisions are needed. If changes are necessary, a new edition of the Dietary Guidelines is published through the joint efforts of HHS and USDA.

The process started with the appointment by HHS and USDA of an external scientific advisory committee. This group of recognized experts analyzed current scientific and medical knowledge and summarized their findings in a detailed scientific report intended to form the basis for the Dietary Guidelines.

Using findings from the Dietary Guidelines Advisory Committee, as well as Government and public comments, HHS and USDA developed key recommendations for diet and physical activity, releasing the sixth edition of the Dietary Guidelines for Americans in January 2005. Targeting policymakers, healthcare providers, and nutrition educators, this document summarizes the preponderance of scientific knowledge and forms the basis for Federal food and nutrition education and information programs.

Finally, HHS and USDA created messages and materials to motivate Americans to adopt better patterns of eating and physical activity and to show how to incorporate the Dietary Guidelines recommendations into daily life.

Making Wise Food Choices

The right balance of calories and physical activity is not in itself sufficient to achieve good health. It is also necessary to get the right amount of nutrients within your daily calorie intake. The best way to give your body the nutrition it needs is by eating a variety of foods packed with nutrients. (The Dietary Guidelines recommends that, wherever possible, nutrients should come from foods rather than supplements.)

A healthful diet is one that

  • Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and other dairy products

  • Includes lean meats, poultry, fish, beans, eggs, and nuts

  • Is low in saturated and trans fats, cholesterol, added sugars, and salt (sodium)

The Dietary Guidelines also discusses two specific, well-designed eating plans for meeting those goals—the Dietary Approaches to Stop Hypertension (DASH) eating plan developed by the National Heart, Lung, and Blood Institute (NHLBI) and the USDA Food Guide. Although comprehensive, the Dietary Guidelines recommendations are flexible enough to suit a wide range of cuisines and food traditions.

Using Alcohol Sensibly

People who choose to consume alcohol should do so in moderation. Men should have no more than two drinks a day, and women should have no more than one drink a day. A drink is defined as 12 ounces of regular beer, 5 ounces of wine, or 1½ ounces of 80-proof distilled spirits.

Exercising Good Judgment About Activity

When astronaut Neil Armstrong landed on the moon, he spoke of “one small step for man; one giant leap for mankind.” In the realm of physical activity, small steps also add up to big changes when people increase the amount of physical activity in their lives. Increasing physical activity does not require a gym, special equipment, or joining a team. Some people find a sport or formal exercise program that they enjoy, and participation provides a new source of fun, along with regular, healthful activity. Fortunately, ordinary, inexpensive activities such as walking, gardening, mowing the lawn, washing the car, doing home repairs, and cleaning the house also burn calories, exercise muscles, and can contribute to better health.

Adults need at least 30 minutes of moderate-intensity exercise above their regular activities on most days to reduce their risk of chronic disease. Moderate-intensity exercise, for example, requires some physical effort, but still permits the individual to carry on a conversation while exercising. Up to 60 minutes may be needed to prevent the weight gain that often accompanies aging. Approximately 60 to 90 minutes of daily exercise may be needed to sustain weight loss. Children and adolescents should engage in 60 minutes of physical activity on most days.

The number of minutes spent exercising need not occur in a single block of time, but can accumulate in 10-minute increments throughout the day. The accumulative total is what is important both for health and for burning calories. No one approach to physical activity is right for everyone. The specific activity (e.g., sports, exercise programs, recreational activities) is less important than whether it fits into an individual’s daily life and becomes part of his or her regular routine.

All Americans, regardless of their weight, need to choose a diet and a level of physical activity that will lead to better health. Attaining a healthy body weight greatly cuts the health risks facing obese adults and young people. Preventing gradual weight gain is important for those not presently overweight or obese because maintaining a healthy weight is far easier than losing excess fat. Efforts to lose weight should focus on slow, steady, and sustained success through a lifestyle that incorporates a healthful diet and increased physical activity rather than one that resorts to drastic fad diets.

Eating Safely

Healthful eating also means avoiding the illnesses caused by the foodborne pathogens that sicken some 76 million people and cause 5,000 deaths in the United States each year. Americans can take the following steps to greatly reduce these risks when buying, storing, and preparing foods:

  • Clean hands, the surfaces where foods are prepared, and fruits and vegetables. Do not wash fresh meat and poultry because it is unnecessary and tends to spread bacteria to other surfaces.

  • Separate raw, cooked, and ready-to-eat foods at the food market, and keep them separate in the kitchen and the refrigerator to help prevent cross-contamination.

  • Cook foods—especially eggs, meats, and poultry—to proper temperatures for safety. Avoid undercooked or raw meats, poultry, or eggs as well as unpasteurized milk or any product made with unpasteurized milk.

  • Chill perishable foods promptly, and thaw foods properly.

Safe Food Temperatures

Safe temperature is a key to safe food. Bacteria multiply in the danger zone between 40°F and 140°F. To avoid the risk of illness, keep food out of this zone, either colder in a refrigerator or freezer or warmer in an oven, in a chafing dish, or on a burner. Always cook poultry and meats to temperatures high enough to ensure safety. To make sure, use a meat thermometer.

180°F Whole poultry
170°F Poultry breasts
165°F Stuffing, ground poultry, reheated leftovers
160°F Meats (medium), egg dishes, pork, and ground meat
145°F Beef steaks, roasts, veal, and lamb (medium rare)
140°F Hold hot foods
  DANGER ZONE
40°F Refrigerator temperature
0°F Freezer temperature

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Spotlight

Finding Your Way to a Healthier You

The Dietary Guidelines for Americans 2005 is a 70-page book consisting of 9 focus areas and 41 recommendations (18 targeted to specific populations).

Finding Your Way to a Healthier You, a 12-page pamphlet for consumers, helps Americans apply the Dietary Guidelines to their daily lives. Produced by HHS and USDA, it outlines which foods Americans should choose, foods to limit, and examples and specific amounts. The pamphlet also explains the importance of physical activity and finding a healthful balance between food intake and activity.

To help Americans choose wisely when shopping for groceries, Finding Your Way to a Healthier You shows how to use the Nutrition Facts label printed on food packages to determine which nutrients a food contains, whether the nutrition is reasonable for the calories, and whether any ingredients should be limited. It outlines the principles of safe food handling and storage and provides a chart of safe food temperatures to help consumers avoid foodborne illnesses. Finally, the pamphlet suggests how those who choose to consume alcohol can do so in a safe and healthful way.

Finding Your Way to a Healthier You can be viewed and downloaded for free at http://www.healthierus.gov/ dietaryguidelines/ or purchased from the U.S. Government Printing Office at http://bookstore.gpo.gov or by calling toll free at 866-512-1800.

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Resources

The President’s Challenge program offers awards to people who become active and stay involved in a sport or physical activity of their choice, either on their own or with a group. The free program is suitable for all ages and levels of fitness. Resources for getting started, setting goals, tracking progress, and obtaining awards are available at http://www.presidentschallenge.org.

The Small Step Web site offers resources for eating right and getting active. An interactive meal planner and an activity tracker plus menus, inspiring success stories, and more are available at http://www.smallstep.gov/.

The DASH eating plan, developed by NHLBI, is clinically proven to reduce blood pressure. The complete plan—including recipes, meal-planning tips, hints for reducing sodium intake, plus a discussion of high blood pressure and its dangers—is available at http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/.

Active at Any Size offers resources and information, including appropriate activities and safety tips, to help overweight individuals get involved in physical activity. Materials are available at http://win.niddk.nih.gov/ publications/active.htm#activeat.

Exercise: A Guide from the National Institute on Aging addresses the health benefits of physical activity for older persons; how to exercise safely to improve or maintain endurance, strength, balance, and flexibility; how to stay motivated; and nutrition. A downloadable booklet and online video demonstrations are available at http://www.niapublications.org/exercisebook/index.asp.

Choosing a Safe and Effective Weight-loss Program—developed by the Weight-control Information Network (WIN), a program of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)—offers advice on how to evaluate a weight-loss plan. This publication is available at http://win.niddk.nih.gov publications/choosing.htm.

How to Understand and Use the Nutrition Facts Label, prepared by the Food and Drug Administration (FDA), provides detailed information on understanding the Nutrition Facts label on packaged foods. This document is available at http://www.cfsan.fda.gov/~dms/foodlab.html.

Measuring Physical Activity Intensity shows how to judge the physical intensity of a wide range of sports, exercises, and activities. Prepared by the Centers for Disease Control and Prevention (CDC), this chart is available at http://www.cdc.gov/nccdphp/dnpa/physical/measuring/index.htm.

www.FoodSafety.gov offers advice from FDA and other Government agencies on handling food safely in a variety of situations—while shopping, at home or away, when cooking for a crowd, or even after a power outage, hurricane, or flood. Several Web pages on food safety are available at http://www.foodsafety.gov/ ~fsg/fsgadvic.html.

Color Your Way to 5 a Day!—a Web page from CDC—explains that the color of a fruit or vegetable tells a lot about the nutrients it contains, and each color (such as red tomatoes, white onions, and blueberries) adds something special to a healthful diet. Find out more at http://www.cdc.gov/nccdphp/dnpa/5ADay/campaign/ color/index.htm.

The National Healthy Babies, Healthy Mothers Coalition presents nutrition news and information for pregnant women, new mothers, and their babies at http://www.hmhb.org/.

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Activities

JumpSTART offers fun activities for elementary school teachers to encourage and promote physical activity and healthful eating among their students. A component of the Cardiovascular Health Promotion Project and developed collaboratively by NHLBI and the National Recreation and Park Association, JumpSTART recommends 10 specific field-tested activities that can be easily incorporated into existing educational curricula. The program emphasizes the importance of learning about physical activity and healthful eating at a young age and promotes healthy habits not only at school but also at home. JumpSTART acknowledges the importance of parental involvement and includes activities and materials that children can share at home with their parents. More information is available at www.nhlbi.nih.gov/health/prof/heart/other/jumpstrt.htm.

The USDA Center for Nutrition and Promotion is providing the Interactive Healthy Eating Index and the Physical Activity Toll. The Interactive Healthy Eating Index is an online dietary assessment tool that analyzes information regarding diet, nutrition, and physical activity status. This interactive tool evaluates users’ dietary or physical activity information and provides recommendations based on the Dietary Guidelines for Americans and the Food Guide Pyramid. By providing a total score that includes total fat, saturated fat, cholesterol, and sodium consumption, users can evaluate their physical activity level with relation to eating habits. For more information, visit http://www.usda.gov, and click on Food and Nutrition.

The 5 A Day for Better Health Program was founded by a partnership between the National Cancer Institute and the Produce for Better Health Foundation. One of the largest public/private partnerships for nutrition, the 5 A Day campaign provides consumers with information on how to include five to nine servings of fruits and vegetables in their daily diet. It also offers information and activities for various age ranges, genders, and ethnic groups. Wellness programs—such as Body & Soul, a wellness program for African American churches—encourage church members to eat five to nine servings of fruits and vegetables every day and provide information on how to live healthier lives by taking care of their bodies and their spirits. More information is available at http://5aday.gov/about/index.html.

Sisters Together: Move More, Eat Better, an initiative sponsored by NIDDK’s Weight-control Information Network, primarily promotes healthy weight, physical activity, and healthy eating among African American women age 18 and older. The program works with national and local newspapers, magazines, radio stations, schools, and other organizations to raise awareness among African American women about the benefits of physical activity and healthful eating. A brochure and more information are available at http://win.niddk.nih.gov/ sisters/index.htm or by telephone at 1-877-946-4627.

Hearts N’ Parks, a community-based program sponsored by NHLBI and the National Recreation and Park Association, promotes healthy weight, heart-healthy diets, and physical activity to tackle the growing trend of obesity in the United States. The program provides science-based information about lifestyle changes that can improve and reduce the risk of heart disease by promoting healthy recreational activities offered by park and recreation departments and other agencies. For more information about this initiative, visit http://www.nhlbi.nih.gov/health/prof/heart/obesity/hrt_n_pk.

Slim For Life is an effective 10-week program for nutrition education and weight management offered by the American Heart Association, Utah Office. The program emphasizes healthy lifestyle changes such as diet and exercise. The classes encourage healthy food choices, reduction in fat intake, understanding food labels, daily exercise, and weight loss. The registration fee is $60, and the classes run quarterly—beginning in January, March, June, and September. For more information, call 800-AHA-USA1 (800-242-8721) or visit http://www.americanheart.org/presenter.jhtml?identifier=10420.

Heart Walk, a noncompetitive event sponsored by the American Heart Association, together with several other organizations, that promotes physical activity and a heart-healthy lifestyle. This event also serves as a fundraiser for lifesaving research and educational programs. More than 1 million Americans participate in the walk each year, and more than 600 Heart Walks are held across the nation. This event is a celebration of life, especially for those who have been affected by heart disease. For more information, visit http://www.americanheart.org/presenter.jhtml?identifier=3028374.

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In the Literature

Effects of Comprehensive Lifestyle Modification on Blood Pressure Control by L.J. Appel et al. Journal of the American Medical Association 289:2083–2093, April 23, 2003.
Research conducted by the PREMIER Collaborative Research Group concluded that a combination of lifestyle interventions—such as weight loss, reduced sodium intake, increased physical activity, and limited alcohol intake—could significantly reduce blood pressure for those individuals with above-optimal blood pressure and stage 1 hypertension. Researchers also found that NHLBI’s DASH eating plan improves physical fitness, reduces cardiovascular risk, and lowers blood pressure.

Is a Calorie a Calorie? by A.C. Buchholz and D.A. Schoeller. American Journal of Clinical Nutrition 79:899S–906S, May 2004.
This study compared and analyzed metabolized energy expenditure in diets high in protein and low in carbohydrates versus diets low in fat. Research data indicated that, regardless of the macronutrient composition of a particular diet, the amount of energy to burn calories remains constant.

How to Understand and Use the Nutrition Facts Label by the U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, November 2004.
People look at food labels, specifically the Nutrition Facts, for innumerable reasons. This useful article advises consumers how to make educated choices that can contribute to a healthier diet and discusses topics such as serving size, calories, calories from fat, nutrition, and the Percent Daily Values.

Chronicle of the Institute of Medicine Physical Activity Recommendation: How a Physical Activity Recommendation Came To Be Among Dietary Recommendations by G.A. Brooks et al. American Journal of Clinical Nutrition 79:921S–930S, May 2004.
A multidisciplinary expert panel assessed scientific literature regarding macronutrients and energy and concluded that physical activity and good nutrition provide protection against diseases and assist in the balance of energy expenditure and intake. The dietary recommendations strongly encourage that adult's daily energy intake should not be greater than their daily energy expenditure. Consequently, the physical activity recommendation for adults and children was doubled to 60 minutes per day.

Physical Activity, Including Walking, and Cognitive Function in Older Women by J. Weuve et al. Journal of the American Medical Association 292:1454–1461, September 22–29, 2004.
Researchers examined the relationship between physical activity and cognitive functions in older adults. Some of the tests included general cognitive memory, category fluency, and attention. The study concluded that physical activity, including walking, significantly improved cognitive functions in older women.

Sugars, Energy Metabolism, and Body Weight Control by W.H. Saris. American Journal of Clinical Nutrition 78:850S–857S, October 2003.
This study concluded that the sources of energy are irrelevant as long as there is energy balance. Although evidence identified the determinant of weight gain as the ratio of fat to carbohydrate as well as the macronutrient composition of diets, little evidence suggests that sugars have a negative impact on body weight control. The review contains meticulously analyzed data from various reliable sources and focuses on the assessment of recommended lifestyle factors that affect weight control, such as increasing levels of physical activity and reducing fat and sugar intakes.

Importance of Potassium in Cardiovascular Disease by D.A. Sica et al. Journal of Clinical Hypertension 4:198–206, 2002.
This study assessed the critical role of a balanced level of potassium, particularly in the maintenance of cardiovascular health and in the prevention of at-risk cardiovascular patients. Special interest is placed in the promotion of potassium retention for cardioprotective and renoprotective therapies.

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Meetings

2005 FDA Science Forum. “FDA Science Advancing Public Health Through Innovative Science.” Washington, DC. Visit http://www.fda.gov/scienceforum/. April 27–28, 2005.

“Food for Thought: Sustaining the Global Population.” National Institutes of Health, Bethesda, MD. Visit http://videocast.nih.gov/FutureEvents.asp. May 10, 2005.

2nd European Symposium on Dietary Fatty Acids and Health. Frankfurt, Germany. Visit http://www.eurofedlipid.org/meetings/frankfurt/. May 19–20, 2005.

Global Health Summit. Philadelphia, PA. Visit http://www.globalhealthsummit.org. June 5, 2005.

4th Annual Meeting of the International Society for Behavioral Nutrition and Physical Activity. Amsterdam, The Netherlands. Visit http://www.isbnpa.org/meeting.cfm. June 16–18, 2005.

Second National Nutrition Education Conference. Arlington, VA. Visit http://www.fns.usda.gov/ nutritionconference. September 12–14, 2005.

American Dietetic Association Food and Nutrition Conference and Expo. St. Louis, MO. Visit http://www.eatright.org/Public/ConferencesAndEvents/96.cfm. October 22–25, 2005.

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