When it comes to preventing the #1 killer in America, the U.S. Government is too lenient. On January 31, the U.S. Department of Agriculture Secretary Tom Vilsack and Secretary of the Department of Health and Human Services Kathleen Sebelius announced the release of the 2010 Dietary Guidelines for Americans, the federal government's evidence-based nutritional guidance to promote health, reduce the risk of chronic diseases, and reduce the prevalence of overweight and obesity through improved nutrition and physical activity.
As a physician with a medical practice aimed at prevention and wellness, I was personally disappointed to see these lackluster recommendations have only a few minor adjustments from the previous 2005 guidelines.
U.S. Department of Agriculture Secretary Tom Vilsack and Secretary of the Department of Health and Human Services Kathleen Sebelius announced the release of the 2010 Dietary Guidelines for Americans, the federal government's evidence-based nutritional guidance to promote health, reduce the risk of chronic diseases, and reduce the prevalence of overweight and obesity through improved nutrition and physical activity.
Basic recommendations for maximum intake of fats and cholesterol, sodium, potassium, and fiber remain unchanged from the last edition. However, the recommendation for sodium intake was left too low as a result of little faith in Americans to do what is in their best interest. In short, the new USDA Dietary Guidelines say to Americans: don't aim too high, you'll probably fail anyway.
The 'revised' Guidelines recommend to limit daily intake of 2,300mg of sodium or less for most of us, and suggest less than 1,500 mg for all African Americans and anyone with hypertension, diabetes, and chronic kidney disease (including children), as well as persons older than 50.
To their credit, the Guidelines do acknowledge the current obesity epidemic and therefore they offer some of the tips that to help consumers translate the Dietary Guidelines into their everyday lives:
• Enjoy your food, but eat less
• Avoid oversized portions
• Make half your plate fruits and vegetables
• Switch to fat-free or low-fat (1%) milk
• Compare sodium in foods like soup, bread, and frozen meals - and choose the foods with lower numbers
• Drink water instead of sugary drinks
This is a good start. But what I find most disturbing is that at a time when high blood pressure and heart attacks, collectively known as 'heart disease,' kill more Americans than several cancers combined, you'd think that our government would take a stronger stance to protect us from the sodium lurking in processed foods. (The USDA is a government agency, after all.)
Previously the American Heart Association recommended that salt intake should be below 2,300 mg per day for American adults, but as of a recent article published in the journal Circulation and public call to action, the AHA suggests that consumption of less than 1,500mg should now be the goal for all Americans, particularly since those 'risk' categories may comprise up to 70% of the population.
One could argue that our health is supposed to be our own personal responsibility. And 'we don't need the government telling us how to eat', right? But shouldn't the government be motivated by saving money and isn't the USDA charged with protecting our health in respect to food safety?
Is it unreasonable to consider that since current health care spending is in excess of $24 billion per year for these PREVENTABLE conditions it might be wise to urge Americans to get over their dependence on salt and make some serious changes? After all, reducing sodium intake could save up to $24 billion in healthcare costs each year, the AHA noted.
Nope, apparently not. In a press conference, USDA Secretary Tom Vilsack said the government had to "respect consumers' ability to adhere to the recommendations." In a conference call with reporters, USDA Secretary Tom Vilsack said the government had to respect consumers' ability to adhere to the recommendations. Noting that the current average daily sodium intake is about 3,400 mg, he said many people would likely rebel against the change in the taste of food that large-scale reductions in salt content would entail. "It's important to us that the recommendations be practical and reasonable," he said.
Since the previous aim of reducing sodium intake was already perceived as difficult, the new goal is basically what the high recommendation was over five years ago.
One could argue that the general public pays no attention to the Guidelines when making food choices anyway. I mean, have you ever read these Guidelines? But when you consider that the Guidelines form the basis of nutrition education programs, Federal nutrition assistance programs such as school meals programs and Meals on Wheels programs for seniors, and dietary advice provided by health professionals it is critical to get the most accurate and helpful information out to prevent and manage heart disease. The people who benefit from these meal programs are not usually choosing their food, it is provided for them and salt the content in food is not necessarily easy to determine.
Clearly, processed foods are a main contributor, as these foods contain three-quarters of the sodium consumed by Americans. So while we physicians encourage individuals to consume low-salt foods, the overall level of salt in the food supply also must be lowered, such as through regulatory efforts.
When you consider that it will be another 5 years before we see another update to the Guidelines, complications from chronic diseases like high blood pressure and diabetes will continue to chip away at our national health and resources.
For your reference, here's a list of the "substantial" benefits of lowering sodium intake by 1,200 mg per day, according to the AHA:
- Up to 120,000 fewer coronary heart disease events
- As many as 66,000 fewer strokes
- Almost 100,000 fewer heart attacks
- Up to 92,000 fewer deaths
And, reducing salt consumption also can help prevent the blood pressure increases that come with age, ultimately affecting 90% of adults.
The updated edition of the dietary guidelines sets the following daily limits or targets:
- Fat intake: 20% to 35% of total calories
- Saturated fat: less than 10% of total calories. And mono- and polyunsaturated fats may be substituted for solid (animal-derived) fats
- Trans-fats: less than 1% of calories
- Cholesterol: less than 300 mg
- Fiber: 14 g per 1,000 calories
- Potassium: 4,700 mg
- Sodium: less than 1,500 mg for all African Americans and anyone with hypertension, diabetes, and chronic kidney disease (including children), as well as persons older than 50; everyone else is advised to consume under 2,300 mg of sodium a day
- Fruits and vegetables: at least 2.5 cups
- Refined grains: less than 3 oz
Primary source: Dietary Guidelines for Americans 2010
USDA, et al "Dietary Guidelines for Americans 2010," U.S. Government Printing Office 2010.
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About Dr. Pennington
Dr. Andrea Pennington is a respected medical doctor and a leading authority on wellness and prevention. She is the author of The Pennington Plan for Weight Success.
The former medical director for Discovery Health Channel, Dr. Pennington has appeared on the Oprah Winfrey Show, the Dr. Oz show, the Today Show, CNN and the Early Show on CBS.