How dietary guidelines can help prevent disease

Most of the illnesses that occur today are chronic like diabetes, heart disease, cancer or kidney disease.

These stay with us for the rest of our lives, are debilitating, and are expensive to treat. But in many cases they are not all that difficult to prevent. Unfortunately, our dietary guidelines are of little or no help in this regard but could be.

In 1941, following studies that demonstrated that certain vitamin deficiencies caused specific diseases [thiamine and beriberi, niacin and pellagra, vitamin D and rickets, vitamin A and blindness, vitamin C and scurvy and iodine and thyroid disease], the US Department of Agriculture issued dietary guidelines for the minimum requirements for various vitamins along with those for protein, calcium, phosphorus and iron. These recommended dietary allowances, or RDAs, became the standard for nutrient targets to prevent deficiency diseases.

There followed the addition, for example, of vitamin D to milk and various vitamins like thiamine and niacin to prepared cereals in an attempt to avoid nutrient deficiencies. It was a successful approach but it is not adequate in today’s time for helping to prevent multiple serious chronic illnesses, many of which are beginning to develop in children and young adults.

An article in the Journal of the American Medical Association on August 11, 2010 by Mozaffarian and Ludwig urges that we think in terms of “food” and not in terms of “nutrients.” They point our that we know full well that a diet of fresh fruits, vegetables, whole grains and nuts is associated with a lower incidence of chronic illnesses just as certain fish reduce the risk of heart disease.

We also know that processed foods such as lunch meats, fast foods, salty snacks, and sugared beverages increase disease risk. They argue that our “nutrient-based” current approach “may foster dietary practices that defy common sense.” For example, many packaged, processed foods substitute refined carbohydrates for fat and market them as fat free or low fat which they are but they are certainly not healthy. Similarly, many packaged foods such as soups are very high in sodium. “Taking the nutrient approach to self serving extremes, the food industry “fortifies” highly processed foods, like refined cereals and sugar-sweetened beverages, with selected micronutrients and re-characterizes them as nutritious.”

The authors recommend that we not drop our attention to nutrients levels but that we concurrently lessen the focus on nutrients and emphasize food-based targets such as fruits, vegetables, low fat meats and fish. These foods are inherently healthy, are low in saturated fats, have no trans fats, are low in salt, high in fiber and high in nutrients. This approach would be consistent with scientific data on what is healthful, what is likely to help prevent chronic illnesses, would “mitigate industry manipulation” and help us all to understand what a healthy diet can be.

The Department of Agriculture should take these recommendations and put them into action.

Stephen C. Schimpff is a retired CEO of the University of Maryland Medical Center in Baltimore and is the author of The Future of Medicine — Megatrends in Healthcare. He blogs at Medical Megatrends and the Future of Medicine.

Submit a guest post and be heard.

Comments are moderated before they are published. Please read the comment policy.

  • Doc99

    Whenever I see articles with nutritional advice, I am reminded of THIS.

  • J.T. Wenting

    and tomorrow someone else has another “study” funded by another interest group that hails something else as the end-all of healthy eating and completely contradicts this one.

    Not saying the advise to “watch your nutrients” is bad, it isn’t, but there are so many mutually contradictory “food studies” and “diet plans” that people no longer believe any of them.

    • Mike

      J.T., while I agree that so many food studies are contradictory I am a firm believer, based on my personal experience, that diet plays a huge role in our overall health. I am convinced that the healthy diet and exercise regime I followed played a significant role in my own recovery from a ruptured cerebral aneurysm.

      Three years post rupture I had made little progress. I suffered terrible fatigue and depression and almost daily, it seemed, I felt myself growing weaker. Determined to regain my health I started a low-calorie, low-fat diet, choosing natural low-fat foods-leaner cuts of meat, vegetables, etc-and avoided processed and fast foods as well as all junk foods. A rule of thumb I tried to follow was to only eat things that I could catch, pick, or kill (not literally). This was combined with a strenuous exercise program and within 6 months I had dumped 69 pounds and felt great. My strength returned, the fatigue and depression was gone and my energy level skyrocketed.

      So, I am a big believer that what we put in our mouths plays a big role in our health. That being said, and being a country boy I do have some thoughts on some lesser known aspects of our food supply that I’ll comment on a bit later if I have time.

      • J.T. Wenting

        I’m not saying diet is no factor, I’m sure it is.
        But I’m exceedingly sceptical whenever I read some report (especially if it makes the newspapers or television talkshows) about how eating this or that can help prevent such or so or cause you to live longer.

  • Mary Brighton

    Eat as close to the earth as possible given your current budget, time constraints and food availability…using this philosophy makes us more “sane” eaters…

    Mary Brighton

  • Doc99

    “Eat as close to the earth as possible …”

    That recommendation sounds a lot like pica and stands on shaky ground.

Most Popular