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Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy (2013)

Chapter: Appendix G: Key Recommendations of the *Dietary Guidelines for Americans*

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Suggested Citation:"Appendix G: Key Recommendations of the *Dietary Guidelines for Americans*." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Appendix G

Key Recommendations of the
Dietary Guidelines for Americans

The Dietary Guidelines for Americans, 2010 (USDA and HHS, 2011) provide U.S. consumers with information and guidance on how to follow a healthy eating pattern, emphasizing nutrient density over energy density, as well as physical activity to help achieve and maintain a healthy weight. The Dietary Guidelines are designed to be used in developing educational materials and to serve as a resource for policy makers in the design and implementation of nutrition-related programs, including federal nutrition assistance and education programs. The Dietary Guidelines also serve as the basis for consumer information intended to facilitate and promote healthy eating and physical activity so as to support normal growth and development and reduce the risk for diet-related chronic disease.

KEY REVISIONS IN THE 2010 GUIDELINES

The 2010 Dietary Guidelines recognize that a major obstacle to meeting nutritional needs among a growing proportion of American households (nearly 15 percent) is the inability to acquire adequate foods to meet their needs, while other Americans consume too few of certain nutrients even though they have the resources to obtain a healthy diet. The 2010 Dietary Guidelines further identify a concurrent issue: food components commonly consumed in excess by individuals across life stages that may increase the risk of chronic disease. These components include sodium, solid fats, added sugars, and refined grains. Replacing nutrient-dense foods with these components creates a challenge to achieving recommended nutrient intake and calorie control.

Suggested Citation:"Appendix G: Key Recommendations of the *Dietary Guidelines for Americans*." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×

Evidence cited in the Dietary Guidelines shows that more than half the added sugars in the American diet come from a handful of foods: sugar-sweetened soft drinks, energy drinks, and sports drinks (37.5 percent); fruit drinks (10.5 percent); candy (6.1 percent); and sugars and honey (3.5 percent). Unlike other food components that contribute excess calories, these products contribute to intake of calories but provide no essential nutrients. Thus the Dietary Guidelines strongly recommend reducing consumption of calories from added sugars.

KEY RECOMMENDATIONS IN THE 2010 GUIDELINES

Balancing Calories to Manage Weight

•   Prevent and/or reduce overweight and obesity through improved eating and physical activity behaviors.

•   Control total calorie intake to manage body weight. For people who are overweight or obese, this will mean consuming fewer calories from foods and beverages.

•   Increase physical activity and reduce time spent in sedentary behaviors.

•   Maintain appropriate calorie balance during each stage of life—childhood, adolescence, adulthood, pregnancy and breastfeeding, and older age.

Foods and Food Components to Reduce

•   Reduce daily sodium intake to less than 2,300 milligrams (mg), and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease. The 1,500 mg recommendation applies to about half of the U.S. population, including children and the majority of adults.

•   Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids.

•   Consume less than 300 mg per day of dietary cholesterol.

•   Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats.

•   Reduce intake of calories from solid fats and added sugars.

•   Limit the consumption of foods that contain refined grains, especially refined-grain foods that contain solid fats, added sugars, and sodium.

Suggested Citation:"Appendix G: Key Recommendations of the *Dietary Guidelines for Americans*." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×

•   If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and two drinks per day for men—and only by adults of legal drinking age.

Foods and Nutrients to Increase

Individuals should meet the following recommendations as part of a healthy eating pattern while staying within their caloric needs:

•   Increase fruit and vegetable intake.

•   Eat a variety of vegetables, especially dark-green and red and orange vegetables and beans and peas.

•   Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains.

•   Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages.

•   Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds.

•   Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry.

•   Replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oils.

•   Use oils to replace solid fats where possible.

•   Choose foods that provide more potassium, dietary fiber, calcium, and vitamin D, which are nutrients of concern in American diets. These foods include vegetables, fruits, whole grains, and milk and milk products.

Women capable of becoming pregnant should

•   Choose foods that supply heme iron, which is most readily absorbed by the body; additional iron sources; and enhancers of iron absorption, such as vitamin C–rich foods.

•   Consume 400 micrograms (mcg) per day of synthetic folic acid (from fortified foods and/or supplements) in addition to food forms of folate from a varied diet.

Women who are pregnant or breastfeeding should

•   Consume 8 to 12 ounces of seafood per week from a variety of seafood types.

•   Because of their high methyl mercury content, limit white (alba-

Suggested Citation:"Appendix G: Key Recommendations of the *Dietary Guidelines for Americans*." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×

     core) tuna to 6 ounces per week, and do not eat the following four types of fish: tilefish, shark, swordfish, and king mackerel.

•   If pregnant, take an iron supplement, as recommended by an obstetrician or other health care provider.

Individuals aged 50 and older should

•   Consume foods fortified with vitamin B12, such as fortified cereals, or dietary supplements.

Building a Healthy Eating Pattern

•   Select an eating pattern that meets nutrient needs over time at an appropriate calorie level.

•   Account for all foods and beverages consumed and assess how they fit within a total healthy eating pattern.

•   Follow food safety recommendations when preparing and eating foods to reduce the risk of foodborne illness.

REFERENCE

USDA and HHS (U.S. Department of Agriculture and U.S. Department of Health and Human Services). 2010. Dietary Guidelines for Americans, 2010. 7th ed. Washington, DC: Government Printing Office. http://www.health.gov/dietaryguidelines/2010.asp (accessed June 11, 2012).

Suggested Citation:"Appendix G: Key Recommendations of the *Dietary Guidelines for Americans*." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×
Page 213
Suggested Citation:"Appendix G: Key Recommendations of the *Dietary Guidelines for Americans*." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×
Page 214
Suggested Citation:"Appendix G: Key Recommendations of the *Dietary Guidelines for Americans*." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×
Page 215
Suggested Citation:"Appendix G: Key Recommendations of the *Dietary Guidelines for Americans*." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×
Page 216
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For many Americans who live at or below the poverty threshold, access to healthy foods at a reasonable price is a challenge that often places a strain on already limited resources and may compel them to make food choices that are contrary to current nutritional guidance. To help alleviate this problem, the U.S. Department of Agriculture (USDA) administers a number of nutrition assistance programs designed to improve access to healthy foods for low-income individuals and households. The largest of these programs is the Supplemental Nutrition Assistance Program (SNAP), formerly called the Food Stamp Program, which today serves more than 46 million Americans with a program cost in excess of $75 billion annually. The goals of SNAP include raising the level of nutrition among low-income households and maintaining adequate levels of nutrition by increasing the food purchasing power of low-income families.

In response to questions about whether there are different ways to define the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, USDA's Food and Nutrition Service (FNS) asked the Institute of Medicine (IOM) to conduct a study to examine the feasibility of defining the adequacy of SNAP allotments, specifically: the feasibility of establishing an objective, evidence-based, science-driven definition of the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, as well as other relevant dimensions of adequacy; and data and analyses needed to support an evidence-based assessment of the adequacy of SNAP allotments.

Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy reviews the current evidence, including the peer-reviewed published literature and peer-reviewed government reports. Although not given equal weight with peer-reviewed publications, some non-peer-reviewed publications from nongovernmental organizations and stakeholder groups also were considered because they provided additional insight into the behavioral aspects of participation in nutrition assistance programs. In addition to its evidence review, the committee held a data gathering workshop that tapped a range of expertise relevant to its task.

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