Test Your Knowledge

The first three recommendations deal with calorie needs, weight management and the role of physical activity. Overweight and obesity are major problems in the United States, affecting about two-thirds of Americans. Being overweight substantially raises the risk of many different types of illness, including cancer, diabetes, heart attack, high blood pressure, high cholesterol, osteoporosis and stroke. The first three guidelines are intended to combat this trend.

A brief overview of these guidelines is as follows:

Adequate Nutrients Within Calorie Needs

• Consume a variety of nutrient-dense foods and beverages within and among the basic food groups while choosing foods that limit the intake of saturated fats and trans fats, cholesterol, added sugars, salt, and alcohol.
  
  
• Meet recommended intakes by adopting a balanced eating pattern, such as the U.S. Department of Agriculture (USDA) Food Guide or the Dietary Approach to Stop Hypertension (DASH) eating plan.

Many Americans consume too many calories and too much saturated fat, trans fat, cholesterol, added sugars and salt. According to the latest research, intake levels for calcium, potassium, fiber, magnesium and vitamin E may be a concern for children and adolescents. For adults, intake levels of the same nutrients and vitamin A and vitamin C are a concern.

In general, both the Food Guide Pyramid and the DASH diet encourage consuming vegetables, fruits, legumes, whole grains, and low-fat or fat-free milk products.

Dietary recommendations for population groups include the following:

• People over 50 should consume vitamin B12 in fortified foods or supplements.
  
  
• Women of childbearing age or who may become pregnant should eat foods high in heme iron (e.g., meats) and/or consume iron-rich plant foods (e.g., spinach) or iron-fortified foods with an enhancer of iron absorption (e.g., foods rich in vitamin C).
  
  
• Women of childbearing age who may become pregnant and those in the first trimester of pregnancy should consume adequate folic acid daily in the form of fortified foods or supplements. They also are encouraged to eat foods rich in folate.
  
  
• Older adults, people with dark skin, and people without enough exposure to ultraviolet radiation such as sunlight should consume extra vitamin D from vitamin D-fortified foods and/or supplements.

Weight Management

• Maintain weight in a healthy range, balance calories from foods and beverages with calories expended.
  
  
• In order to prevent gradual weight gain over time, small decreases in food and caloric beverages can be made along with increased physical activity.

The incidence of obesity in the United States has doubled in the past two decades. Achieving and maintaining a healthy weight can help to decrease a person’s risk for high blood pressure, high blood cholesterol, heart disease, stroke, type 2 diabetes, gallbladder disease, gout, respiratory disfunction, osteoarthritis and certain types of cancer.

Balancing calories consumed with calories expended through daily activities will help achieve and maintain a healthy weight. One way is by making sensible food choices and controlling portion sizes. Because most adults gain weight slowly over time, a reduction of 50 to 100 calories per day may prevent this gradual weight gain. For weight loss, reducing 500 calories a day while consuming a nutritionally adequate diet is a common goal. Also, people who are sedentary are urged to work toward increasing their level of activity.

Dietary recommendations for certain population groups include:

• People who need to lose weight should aim for a slow, steady weight loss by decreasing calories, maintaining an adequate nutrient intake and increasing physical activity.
  
  
• Overweight children should reduce the rate of weight gain while still eating enough to maintain growth and development. Consult a healthcare provider before placing a child on a weight-reduction diet.
  
  
• Pregnant women should ensure appropriate weight gain as specified by a healthcare provider. Pregnant women should neither gain too much or too little weight.
  
  
• Breastfeeding women can lose moderate amounts of weight safely, as long as this does not compromise the weight gain of the infant.
  
  
• Overweight adults, people with chronic diseases and/or on medication should consult a healthcare provider about weight loss strategies prior to starting a reduction program. This helps ensure appropriate management of other health conditions.

Physical Activity

• Engage in regular physical activity to promote health, psychological well-being and a healthy weight.
  
  
• Achieve physical fitness by performing cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises or calisthenics for muscle strength and endurance.

People who take in more calories than they expend gain weight. However, those who expend more calories than they take in usually lose weight. Regular exercise can help people expend more calories, or strike a better balance between consuming and expending calories. Exercise also has other benefits, including reducing the risk of chronic disease, increasing bone density and muscle size and strength.

Healthy adults who want to improve fitness and reduce the risk of chronic disease are encouraged to exercise for 30 minutes or more at a moderate to intense level on most days of the week. However, individual needs may vary. For most people, additional health benefits can be obtained by engaging in physical activity of more vigorous intensity or for longer duration.

Up to 60 minutes of moderate- to vigorous-intensity physical activity per day may be needed to prevent gradual, unhealthy weight gain in adulthood. Overweight people are urged to engage in 60 to 90 minutes of moderate-intensity physical activity per day as a way to sustain weight loss, but should consult with a healthcare provider before participating in an activity of this level. Men older than 40, women older than 50, and any adult with a chronic disease or at risk for a chronic disease should consult their healthcare provider prior to starting an exercise program.

Exercise recommendations for certain population groups include:

• Children and adolescents should engage in at least 60 minutes of physical activity on most – or preferably all – days of the week.
  
  
• Pregnant women should incorporate 30 minutes or more of moderate-intensity physical activity on most or all days of the week. This should only be done in the absence of medical or obstetric complications and activities with a high risk of falling or abdominal trauma should be avoided.
  
  
• Breastfeeding women can safely exercise without affecting the ability to successfully nurse.
  
  
• Older adults should participate in regular physical activity to reduce functional declines associated with aging and to promote health, emotional well being and appropriate weight.