Tài liệu Dietary Guidelines for Americans 2005 pptx

iii
Contents
MESSAGE FROM THE SECRETARIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i
ACKNOWLEDGMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
EXECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v
CHAPTER 1 Background and Purpose of the Dietary Guidelines for Americans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
CHAPTER 2 Adequate Nutrients Within Calorie Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
CHAPTER 3 Weight Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
CHAPTER 4 Physical Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
CHAPTER 5 Food Groups To Encourage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
CHAPTER 6 Fats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
CHAPTER 7 Carbohydrates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
CHAPTER 8 Sodium and Potassium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
CHAPTER 9 Alcoholic Beverages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
CHAPTER 10 Food Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
APPENDIX A Eating Patterns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
APPENDIX A-1 DASH Eating Plan at 1,600-, 2,000-, 2,600-, and 3,100-Calorie Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
APPENDIX A-2 USDA Food Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
APPENDIX A-3 Discretionary Calorie Allowance in the USDA Food Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
APPENDIX B Food Sources of Selected Nutrients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
APPENDIX B-1 Food Sources of Potassium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
APPENDIX B-2 Food Sources of Vitamin E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
APPENDIX B-3 Food Sources of Iron . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
APPENDIX B-4 Non-Dairy Food Sources of Calcium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
APPENDIX B-5 Food Sources of Calcium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
APPENDIX B-6 Food Sources of Vitamin A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
APPENDIX B-7 Food Sources of Magnesium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
APPENDIX B-8 Food Sources of Dietary Fiber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
APPENDIX B-9 Food Sources of Vitamin C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
APPENDIX C Glossary of Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
APPENDIX D Acronyms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
DIETARY GUIDELINES FOR AMERICANS, 2005
iv
LIST OF FIGURES
FIGURE 1. Percent Increase or Decrease
From Current Consumption (Zero Line)
to Recommended Intakes
FIGURE 2. Adult BMI Chart
FIGURE 3. Example of Boys’ BMI Growth Curve
(2 to 20 years): Boys’ Body Mass
Index-For-Age Percentiles
FIGURE 4. Sources of Dietary Sodium
FIGURE 5. Temperature Rules for Safe Cooking
and Handling of Foods
LIST OF TABLES
TABLE 1. Sample USDA Food Guide and the Dietary
Approaches to Stop Hypertension (DASH)
Eating Plan at the 2,000-Calorie Level
TABLE 2. Comparison of Selected Nutrients in the DASH
Eating Plan, the USDA Food Guide, and Nutrient
Intakes Recommended Per Day by the Institute
of Medicine (IOM)
TABLE 3. Estimated Calorie Requirements (in Kilocalories)
for Each Gender and Age Group at Three Levels
of Physical Activity
TABLE 4. Calories/Hour Expended in Common Physical
Activities
TABLE 5. Fruits, Vegetables, and Legumes (Dry Beans)
That Contain Vitamin A (Carotenoids), Vitamin C,
Folate, and Potassium
TABLE 6. Comparison of 100 Grams of Whole-Grain
Wheat Flour and Enriched, Bleached, White,
All-Purpose Flour
TABLE 7. Whole Grains Available in the United States
TABLE 8. Maximum Daily Amounts of Saturated Fat
To Keep Saturated Fat Below 10 Percent
of Total Calorie Intake
TABLE 9. Differences in Saturated Fat and Calorie
Content of Commonly Consumed Foods
TABLE 10. Contribution of Various Foods to Saturated
Fat Intake in the American Diet
(Mean Intake = 25.5 g)
TABLE 11. Contribution of Various Foods to Trans Fat
Intake in the American Diet
(Mean Intake = 5.84 g)
TABLE 12. Relationship Between LDL Blood Cholesterol Goal
and the Level of Coronary Heart Disease Risk
TABLE 13. Major Sources of Added Sugars
(Caloric Sweeteners) in the American Diet
TABLE 14. Names for Added Sugars That Appear
on Food Labels
TABLE 15. Range of Sodium Content for Selected Foods
TABLE 16. Calories in Selected Alcoholic Beverages
DIETARY GUIDELINES FOR AMERICANS, 2005
v
Executive Summary
The
Dietary Guidelines for Americans [Dietary Guidelines]
provides science-based advice to promote health and to
reduce risk for major chronic diseases through diet and
physical activity. Major causes of morbidity and mortality
in the United States are related to poor diet and a seden-
tary lifestyle. Some specific diseases linked to poor diet
and physical inactivity include cardiovascular disease,
type 2 diabetes, hypertension, osteoporosis, and certain
cancers. Furthermore, poor diet and physical inactivity,
resulting in an energy imbalance (more calories consumed
than expended), are the most important factors contrib-
uting to the increase in overweight and obesity in this
country. Combined with physical activity, following a diet
that does not provide excess calories according to the
recommendations in this document should enhance the
health of most individuals.
An important component of each 5-year revision of the
Dietary Guidelines
is the analysis of new scientific informa-
tion by the Dietary Guidelines Advisory Committee (DGAC)
appointed by the Secretaries of the U.S. Department of
Health and Human Services (HHS) and the U.S. Department
of Agriculture (USDA). This analysis, published in the DGAC
Report (http://www.health.gov/dietaryguidelines/dga2005/
report/), is the primary resource for development of the
report on the Guidelines by the Departments. The
Dietary
Guidelines
and the report of the DGAC differ in scope and
purpose compared to reports for previous versions of the
Guidelines.
The 2005 DGAC report is a detailed scientific
analysis. The scientific report was used to develop the
Dietary Guidelines
jointly between the two Departments
and forms the basis of recommendations that will be used
by USDA and HHS for program and policy development.
DIETARY GUIDELINES FOR AMERICANS, 2005
vi
Thus it is a publication oriented toward policymakers,
nutrition educators, nutritionists, and healthcare providers
rather than to the general public, as with previous
versions of the
Dietary Guidelines
, and contains more
technical information.
The intent of the
Dietary Guidelines
is to summarize and
synthesize knowledge regarding individual nutrients and
food components into recommendations for a pattern
of eating that can be adopted by the public. In this publi-
cation, Key Recommendations are grouped under nine
inter-related focus areas. The recommendations are based
on the preponderance of scientific evidence for lowering
risk of chronic disease and promoting health. It is impor-
tant to remember that these are integrated messages that
should be implemented as a whole. Taken together, they
encourage most Americans to eat fewer calories, be more
active, and make wiser food choices.
A basic premise of the
Dietary Guidelines
is that nutrient
needs should be met primarily through consuming foods.
Foods provide an array of nutrients and other compounds
that may have beneficial effects on health. In certain cases,
fortified foods and dietary supplements may be useful
sources of one or more nutrients that otherwise might be
consumed in less than recommended amounts. However,
dietary supplements, while recommended in some cases,
cannot replace a healthful diet.
Two examples of eating patterns that exemplify the
Dietary Guidelines
are the USDA Food Guide (http://
www.usda.gov/cnpp/pyramid.html) and the DASH
(Dietary Approaches to Stop Hypertension) Eating Plan.
1
Both of these eating patterns are designed to integrate
dietary recommendations into a healthy way to eat for
most individuals. These eating patterns are not weight
loss diets, but rather illustrative examples of how to eat
in accordance with the
Dietary Guidelines
. Both eating
patterns are constructed across a range of calorie levels
to meet the needs of various age and gender groups. For
the USDA Food Guide, nutrient content estimates for
each food group and subgroup are based on population-
weighted food intakes. Nutrient content estimates for
the DASH Eating Plan are based on selected foods
chosen for a sample 7-day menu. While originally devel-
oped to study the effects of an eating pattern on the
prevention and treatment of hypertension, DASH is one
example of a balanced eating plan consistent with the
2005
Dietary Guidelines
.
Throughout most of this publication, examples use a
2,000-calorie level as a reference for consistency with the
Nutrition Facts Panel. Although this level is used as a
reference, recommended calorie intake will differ for indi-
viduals based on age, gender, and activity level. At each
calorie level, individuals who eat nutrient-dense foods
may be able to meet their recommended nutrient intake
without consuming their full calorie allotment. The remain-
ing calories—the
discretionary calorie allowance
—allow
individuals flexibility to consume some foods and beverages
that may contain added fats, added sugars, and alcohol.
The recommendations in the
Dietary Guidelines
are for
Americans over 2 years of age. It is important to incorporate
the food preferences of different racial/ethnic groups, vege-
Taken together, [the
Dietary Guidelines
]
encourage most
Americans to eat
fewer calories, be
more active, and make
wiser food choices.
1
NIH Publication No. 03-4082, Facts about the DASH Eating Plan, United States Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute,
Karanja NM et al. Journal of the American Dietetic Association (JADA) 8:S19-27, 1999. http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/.
DIE TARY G UID E LIN E S FO R AM E RIC AN S, 2005
vii
tarians, and other groups when planning diets and devel-
oping educational programs and materials. The USDA Food
Guide and the DASH Eating Plan are flexible enough to
accommodate a range of food preferences and cuisines.
The
Dietary Guidelines
is intended primarily for use
by policymakers, healthcare providers, nutritionists, and
nutrition educators. The information in the
Dietary
Guidelines
is useful for the development of educational
materials and aids policymakers in designing and imple-
menting nutrition-related programs, including federal
food, nutrition education, and information programs. In
addition, this publication has the potential to provide
authoritative statements as provided for in the Food
and Drug Administration Modernization Act (FDAMA).
Because the
Dietary Guidelines
contains discussions
where the science is emerging, only statements included
in the Executive Summary and the sections titled “Key
Recommendations,” which reflect the preponderance
of scientific evidence, can be used for identification of
authoritative statements. The recommendations are inter-
related and mutually dependent; thus the statements
in this document should be used together in the context
of planning an overall healthful diet. However, even
following just some of the recommendations can have
health benefits.
The following is a listing of the
Dietary Guidelines
by chapter.
ADEQUATE NUTRIENTS WITHIN
CALORIE NEEDS
Key Recommendations
• Consume a variety of nutrient-dense foods and bever-
ages within and among the basic food groups while
choosing foods that limit the intake of saturated and
trans
fats, cholesterol, added sugars, salt, and alcohol.
• Meet recommended intakes within energy needs by
adopting a balanced eating pattern, such as the USDA
Food Guide or the DASH Eating Plan.
Key Recommendations for Specific Population Groups
•
People over age 50.
Consume vitamin B
12
in its
crystalline form (i.e., fortified foods or supplements).
•
Women of childbearing age who may become pregnant.
Eat foods high in heme-iron and/or consume iron-rich
plant foods or iron-fortified foods with an enhancer of
iron absorption, such as vitamin C-rich foods.
•
Women of childbearing age who may become pregnant
and those in the first trimester of pregnancy.
Consume
adequate synthetic folic acid daily (from fortified foods
or supplements) in addition to food forms of folate from
a varied diet.
•
Older adults, people with dark skin, and people exposed
to insufficient ultraviolet band radiation (i.e., sunlight).
Consume extra vitamin D from vitamin D-fortified foods
and/or supplements.
WEIGHT MANAGEMENT
Key Recommendations
• To maintain body weight in a healthy range,
balance calories from foods and beverages with
calories expended.
• To prevent gradual weight gain over time, make
small decreases in food and beverage calories and
increase physical activity.
Key Recommendations for Specific Population Groups
•
Those who need to lose weight.
Aim for a slow, steady
weight loss by decreasing calorie intake while main-
taining an adequate nutrient intake and increasing
physical activity.
•
Overweight children.
Reduce the rate of body weight
gain while allowing growth and development. Consult
a healthcare provider before placing a child on a
weight-reduction diet.
•
Pregnant women.
Ensure appropriate weight gain
as specified by a healthcare provider.
•
Breastfeeding women.
Moderate weight reduction
is safe and does not compromise weight gain of the
nursing infant.
•
Overweight adults and overweight children with
chronic diseases and/or on medication.
Consult a
healthcare provider about weight loss strategies prior
to starting a weight-reduction program to ensure
appropriate management of other health conditions.
DIETARY GUIDELINES FOR AMERICANS, 2005
viii
PHYSICAL ACTIVITY
Key Recommendations
• Engage in regular physical activity and reduce
sedentary activities to promote health, psychological
well-being, and a healthy body weight.
• To reduce the risk of chronic disease in adulthood:
Engage in at least 30 minutes of moderate-intensity
physical activity, above usual activity, at work or
home on most days of the week.
• For most people, greater health benefits can be
obtained by engaging in physical activity of more
vigorous intensity or longer duration.
• To help manage body weight and prevent gradual,
unhealthy body weight gain in adulthood: Engage in
approximately 60 minutes of moderate- to vigorous-
intensity activity on most days of the week while
not exceeding caloric intake requirements.
• To sustain weight loss in adulthood: Participate in
at least 60 to 90 minutes of daily moderate-intensity
physical activity while not exceeding caloric intake
requirements. Some people may need to consult
with a healthcare provider before participating in
this level of activity.
• Achieve physical fitness by including cardiovascular
conditioning, stretching exercises for flexibility, and
resistance exercises or calisthenics for muscle strength
and endurance.
Key Recommendations for Specific Population Groups
•
Children and adolescents
. Engage in at least 60
minutes of physical activity on most, preferably all,
days of the week.
•
Pregnant women.
In the absence of medical or obstetric
complications, incorporate 30 minutes or more of
moderate-intensity physical activity on most, if not all,
days of the week. Avoid activities with a high risk of
falling or abdominal trauma.
•
Breastfeeding women.
Be aware that neither acute nor
regular exercise adversely affects the mother’s ability
to successfully breastfeed.
•
Older adults
. Participate in regular physical activity to
reduce functional declines associated with aging and
to achieve the other benefits of physical activity identi-
fied for all adults.
DIETARY GUIDELINES FOR AMERICANS, 2005
FOOD GROUPS TO ENCOURAGE
Key Recommendations
• Consume a sufficient amount of fruits and vegetables
while staying within energy needs. Two cups of fruit
and 2
1
/2 cups of vegetables per day are recommended
for a reference 2,000-calorie intake, with higher or
lower amounts depending on the calorie level.
• Choose a variety of fruits and vegetables each day.
In particular, select from all five vegetable subgroups
(dark green, orange, legumes, starchy vegetables, and
other vegetables) several times a week.
• Consume 3 or more ounce-equivalents of whole-grain
products per day, with the rest of the recommended
grains coming from enriched or whole-grain products.
In general, at least half the grains should come from
whole grains.
• Consume 3 cups per day of fat-free or low-fat milk or
equivalent milk products.
Key Recommendations for Specific Population Groups
•
Children and adolescents.
Consume whole-grain prod-
ucts often; at least half the grains should be whole
grains. Children 2 to 8 years should consume 2 cups
per day of fat-free or low-fat milk or equivalent milk
products. Children 9 years of age and older should
consume 3 cups per day of fat-free or low-fat milk or
equivalent milk products.
FATS
Key Recommendations
• Consume less than 10 percent of calories from
saturated fatty acids and less than 300 mg/day
of cholesterol, and keep
trans
fatty acid consumption
as low as possible.
• Keep total fat intake between 20 to 35 percent of
calories, with most fats coming from sources of polyun-
saturated and monounsaturated fatty acids, such as
fish, nuts, and vegetable oils.
• When selecting and preparing meat, poultry, dry beans,
and milk or milk products, make choices that are lean,
low-fat, or fat-free.
• Limit intake of fats and oils high in saturated and/or
trans
fatty acids, and choose products low in such fats
and oils.
ix
Key Recommendations for Specific Population Groups
•
Children and adolescents
. Keep total fat intake between
30 to 35 percent of calories for children 2 to 3 years of age
and between 25 to 35 percent of calories for children and
adolescents 4 to 18 years of age, with most fats coming
from sources of polyunsaturated and monounsaturated
fatty acids, such as fish, nuts, and vegetable oils.
CARBOHYDRATES
Key Recommendations
• Choose fiber-rich fruits, vegetables, and whole
grains often.
• Choose and prepare foods and beverages with little
added sugars or caloric sweeteners, such as amounts
suggested by the USDA Food Guide and the DASH
Eating Plan.
• Reduce the incidence of dental caries by practicing
good oral hygiene and consuming sugar- and starch-
containing foods and beverages less frequently.
SODIUM AND POTASSIUM
Key Recommendations
• Consume less than 2,300 mg (approximately
1 tsp of salt) of sodium per day.
• Choose and prepare foods with little salt. At the same
time, consume potassium-rich foods, such as fruits
and vegetables.
Key Recommendations for Specific Population Groups
•
Individuals with hypertension, blacks, and middle-aged
and older adults.
Aim to consume no more than 1,500
mg of sodium per day, and meet the potassium recom-
mendation (4,700 mg/day) with food.
ALCOHOLIC BEVERAGES
Key Recommendations
• Those who choose to drink alcoholic beverages should
do so sensibly and in moderation—defined as the
consumption of up to one drink per day for women
and up to two drinks per day for men.
• Alcoholic beverages should not be consumed by some
individuals, including those who cannot restrict their
alcohol intake, women of childbearing age who may
become pregnant, pregnant and lactating women, chil-
dren and adolescents, individuals taking medications
that can interact with alcohol, and those with specific
medical conditions.
• Alcoholic beverages should be avoided by individuals
engaging in activities that require attention, skill, or
coordination, such as driving or operating machinery.
FOOD SAFETY
Key Recommendations
• To avoid microbial foodborne illness:
• Clean hands, food contact surfaces, and fruits
and vegetables. Meat and poultry should
not
be washed or rinsed.
• Separate raw, cooked, and ready-to-eat foods
while shopping, preparing, or storing foods.
• Cook foods to a safe temperature to kill
microorganisms.
• Chill (refrigerate) perishable food promptly and
defrost foods properly.
• Avoid raw (unpasteurized) milk or any products
made from unpasteurized milk, raw or partially
cooked eggs or foods containing raw eggs, raw
or undercooked meat and poultry, unpasteurized
juices, and raw sprouts.
Key Recommendations for Specific Population Groups
•
Infants and young children, pregnant women, older
adults, and those who are immunocompromised.
Do
not eat or drink raw (unpasteurized) milk or any products
made from unpasteurized milk, raw or partially cooked
eggs or foods containing raw eggs, raw or undercooked
meat and poultry, raw or undercooked fish or shellfish,
unpasteurized juices, and raw sprouts.
•
Pregnant women, older adults, and those who are
immunocompromised:
Only eat certain deli meats and
frankfurters that have been reheated to steaming hot.
DIETARY GUIDELINES FOR AMERICANS, 2005
1
chapter
11
Background and Purpose of the
Dietary Guidelines for Americans
The Dietary Guidelines for Americans [Dietary Guidelines],
first published in 1980, provides science-based advice to
promote health and to reduce risk for chronic diseases
through diet and physical activity. The recommendations
contained within the Dietary Guidelines are targeted to the
general public over 2 years of age who are living in the
United States. Because of its focus on health promotion and
risk reduction, the Dietary Guidelines form the basis of
federal food, nutrition education, and information programs.
By law (Public Law 101-445, Title III, 7 U.S.C. 5301 et seq.),
the Dietary Guidelines is reviewed, updated if necessary,
and published every 5 years. The process to create the
Dietary Guidelines is a joint effort of the U.S. Department
of Health and Human Services (HHS) and the U.S.
Department of Agriculture (USDA) and has evolved to
include three stages.
In the first stage, an external scientific Advisory Committee
appointed by the two Departments conducted an analysis
of new scientific information and prepared a report summa
rizing its findings.
2
The Advisory Committee’s report was
made available to the public and Government agencies for
comment. The Committee’s analysis was the primary
resource for development of the Dietary Guidelines by the
Departments. A significant amount of the new scientific
information used by the Dietary Guidelines Advisory
Committee (DGAC) was based on the Dietary Reference
Intake (DRI) reports published since 2000 by the Institute
of Medicine (IOM), in particular the macronutrient report
and the fluid and electrolyte report.
During the second stage, the Departments jointly devel-
oped Key Recommendations based on the Advisory
Committee’s report and public and agency comments.

-


2
For more information about the process, summary data, and the resources used by the Advisory Committee, see the 2005 Dietary Guidelines Advisory Committee Report
(2005 DGAC Report) at http://www.health.gov/dietaryguidelines.
DIE TARY G UID E LI N E S FO R AM E RIC AN S, 2005
2
The Dietary Guidelines details these science-based policy
recommendations. Finally, in the third stage, the two
Departments developed messages communicating the
Dietary Guidelines to the general public.
Because of the three-part process used to develop and
communicate the 2005 Dietary Guidelines, this publication
and the report of the DGAC differ in scope and purpose
compared to reports for previous versions of the Guidelines.
The 2005 DGAC report is a detailed scientific analysis that
identifies key issues such as energy balance, the conse-
quences of a sedentary lifestyle, and the need to emphasize
certain food choices to address nutrition issues for the
American public. The scientific report was used to develop
the Dietary Guidelines jointly between the two Departments,
and this publication forms the basis of recommendations
that will be used by USDA and HHS for program and
policy development. Thus it is a publication oriented
toward policymakers, nutrition educators, nutritionists
and healthcare providers rather than to the general public,
as with previous versions of the Dietary Guidelines, and
contains more technical information.
New sections in the Dietary Guidelines, consistent with
its use for program development, are a glossary of terms
and appendixes with detailed information about the
USDA Food Guide and the Dietary Approaches to Stop
Hypertension (DASH) Eating Plan as well as tables listing
sources of some nutrients. Consumer messages have
been developed to educate the public about the Key
Recommendations in the Dietary Guidelines and will be
used in materials targeted for consumers separate from
this publication. In organizing the Dietary Guidelines for
the Departments, chapters 2 to 10 were given titles that
characterize the topic of each section, and the Dietary
Guidelines itself is presented as an integrated set of Key
Recommendations in each topic area.
These Key Recommendations are based on a preponder-
ance of the scientific evidence of nutritional factors that
are important for lowering risk of chronic disease and
promoting health. To optimize the beneficial impact of
these recommendations on health, the Guidelines should
be implemented in their entirety.
IMPORTANCE OF THE DIETARY GUIDELINES
FOR HEALTH PROMOTION AND DISEASE
PREVENTION
Good nutrition is vital to good health and is absolutely
essential for the healthy growth and development of
children and adolescents. Major causes of morbidity and
mortality in the United States are related to poor diet and
a sedentary lifestyle. Specific diseases and conditions
linked to poor diet include cardiovascular disease, hyper-
tension, dyslipidemia, type 2 diabetes, overweight and
obesity, osteoporosis, constipation, diverticular disease,
iron deficiency anemia, oral disease, malnutrition, and
some cancers. Lack of physical activity has been associ-
ated with cardiovascular disease, hypertension, overweight
and obesity, osteoporosis, diabetes, and certain cancers.
Furthermore, muscle strengthening and improving balance
can reduce falls and increase functional status among
older adults. Together with physical activity, a high-quality
diet that does not provide excess calories should enhance
the health of most individuals.
Poor diet and physical inactivity, resulting in an energy
imbalance (more calories consumed than expended), are
the most important factors contributing to the increase
in overweight and obesity in this country. Moreover, over-
weight and obesity are major risk factors for certain chronic
diseases such as diabetes. In 1999–2002, 65 percent of
U.S. adults were overweight, an increase from 56 percent
in 1988–1994. Data from 1999–2002 also showed that 30
percent of adults were obese, an increase from 23 percent
in an earlier survey. Dramatic increases in the prevalence
of overweight have occurred in children and adolescents
of both sexes, with approximately 16 percent of children
and adolescents aged 6 to 19 years considered to be over-
weight (1999–2002).
3
In order to reverse this trend, many
Americans need to consume fewer calories, be more
active, and make wiser choices within and among food
groups. The Dietary Guidelines provides a framework to
promote healthier lifestyles (see ch. 3).
Given the importance of a balanced diet to health, the
intent of the Dietary Guidelines is to summarize and
synthesize knowledge regarding individual nutrients and
3
Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among U.S. children, adolescents, and adults, 1999-2002. Journal of the American Medical
Association (JAMA) 291(23):2847-2850, 2004.
DIE TARY G UID E LI N E S FO R AM E RIC AN S, 2005
3
food components into recommendations for an overall
pattern of eating that can be adopted by the general public.
These patterns are exemplified by the USDA Food Guide
and the DASH Eating Plan (see ch. 2 and app. A). The
Dietary Guidelines is applicable to the food preferences
of different racial/ethnic groups, vegetarians, and other
groups. This concept of balanced eating patterns should
be utilized in planning diets for various population groups.
There is a growing body of evidence which demonstrates
that following a diet that complies with the Dietary
Guidelines may reduce the risk of chronic disease.
Recently, it was reported that dietary patterns consistent
with recommended dietary guidance were associated
with a lower risk of mortality among individuals age 45
years and older in the United States.
4
The authors of the
study estimated that about 16 percent and 9 percent of
mortality from any cause in men and women, respectively,
could be eliminated by the adoption of desirable dietary
behaviors. Currently, adherence to the Dietary Guidelines
is low among the U.S. population. Data from USDA illustrate
the degree of change in the overall dietary pattern of
Americans needed to be consistent with a food pattern
encouraged by the Dietary Guidelines (fig. 1).
A basic premise of the Dietary Guidelines is that nutrient
needs should be met primarily through consuming foods.
Foods provide an array of nutrients (as well as phyto-
chemicals, antioxidants, etc.) and other compounds that
may have beneficial effects on health. In some cases, forti-
fied foods may be useful sources of one or more nutrients
that otherwise might be consumed in less than recom-
mended amounts. Supplements may be useful when they
fill a specific identified nutrient gap that cannot or is not
otherwise being met by the individual’s intake of food.
Nutrient supplements cannot replace a healthful diet.
Individuals who are already consuming the recommended
amount of a nutrient in food will not achieve any addi-
tional health benefit if they also take the nutrient as
a supplement. In fact, in some cases, supplements and
fortified foods may cause intakes to exceed the safe levels
of nutrients. Another important premise of the Dietary
Guidelines is that foods should be prepared and handled
in such a way that reduces risk of foodborne illness.
USES OF THE DIETARY GUIDELINES
The Dietary Guidelines is intended primarily for use by
policymakers, healthcare providers, nutritionists, and
nutrition educators. While the Dietary Guidelines was
developed for healthy Americans 2 years of age and older,
where appropriate, the needs of specific population groups
have been addressed. In addition, other individuals may
find this report helpful in making healthful choices. As
noted previously, the recommendations contained within
the Dietary Guidelines will aid the public in reducing their
risk for obesity and chronic disease. Specific uses of the
Dietary Guidelines include:
Development of Educational Materials and
Communications.
The information in the Dietary Guidelines is useful for the
development of educational materials. For example, the
federal dietary guidance-related publications are required
by law to be based on the Dietary Guidelines. In addition,
this publication will guide the development of messages
to communicate the Dietary Guidelines to the public.
Finally, the USDA Food Guide, the food label, and Nutrition
Facts Panel provide information that is useful for imple-
menting the key recommendations in the Dietary Guidelines
and should be integrated into educational and communi-
cation messages.
Development of Nutrition-Related Programs.
The Dietary Guidelines aids policymakers in designing
and implementing nutrition-related programs. The Federal
Government bases its nutrition programs, such as the
National Child Nutrition Programs or the Elderly Nutrition
Program, on the Dietary Guidelines.
Development of Authoritative Statements.
The Dietary Guidelines has the potential to provide
authoritative statements as provided for in the Food
and Drug Administration Modernization Act (FDAMA).
Because the recommendations are interrelated and mutu-
ally dependent, the statements in this publication should
be used together in the context of an overall healthful
diet. Likewise, because the Dietary Guidelines contains
discussions about emerging science, only statements
included in the Executive Summary and the highlighted
boxes entitled “Key Recommendations,” which reflect the
preponderance of scientific evidence, can be used for
identification of authoritative statements.
4
Kant AK, Graubard BI, Schatzkin A. Dietary patterns predict mortality in a national cohort: The national health interview surveys, 1987 and 1992. Journal of Nutrition (J Nutr) 134:1793-1799, 2004.
DIE TARY G UID E LI N E S FO R AM E RIC AN S, 2005

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