I was also very pleased to see the guidelines name specific types of foods as foods that we need to limit. The label SoFAS [shorthand for solid fats and added sugars] will be useful if people can really understand what it means. Last time, the USDA talked about "discretionary calories," which seem to now be called SoFAS. I never felt that the American public figured out what discretionary calories were and how few they were supposed to eat in a day. My worry with SoFAS is that foods don't come labeled with their calories from SoFAS specified. So, some foods are all SoFAS (candy, cake, sugar sweetened beverages and butter), but most SoFAS are consumed along with other types of calories (like pizza, high-fat cheeses), so it will be hard for people to know how many SoFAS calories they have used up. I would like to see some educational materials that show exactly where these calories come from and how few you can consume within a day and still stay within these guidelines.
DR. DEAN ORNISH
The Preventive Medicine Research Institute (Sausalito, Calif.)
This report is an improvement over the previous guidelines. There seems to be a convergence about what constitutes a healthy way of eating for most people that is reflected in the new dietary guidelines. That's encouraging. There's a growing awareness that a healthy diet is plant-based, low in red meat and higher in seafood; low in refined carbohydrates, such as refined sugar and white flour; lower in sodium, trans fats, saturated fat and processed foods; and higher in unrefined carbohydrates, such as whole grains, fruits and vegetables in natural forms.
Although it recommends seafood in general, it doesn't distinguish between types of seafood in particular. For example, it would have been helpful to distinguish between seafood such as salmon that is rich in beneficial omega-3 fatty acids from seafood such as tuna and swordfish that is higher in harmful mercury.
Finally, it would have been helpful to discuss more fully that what we include in our diet is as important as what we exclude. There are literally hundreds of thousands of protective substances that are found primarily in fruits, vegetables, whole grains, legumes and soy products. Instead of thinking about diet primarily in terms of reducing risk of illness and premature death, I find it much more useful to talk about how much better you look and feel when you eat and live more healthfully. Joy of living is much more sustainable than fear of dying.
Director, Cardiovascular Nutrition Lab
Tufts University School of Medicine (Medford, Mass.)
Having served in the drafting of the 2000 Dietary Guidelines for Americans, I don't think we're seeing a radical shift in what has been proposed. What we are seeing is a strengthening of some of the recommendations and more specificity in others. The proposal to shift toward a dietary pattern containing plant-based foods represents an actionable way to comply with earlier versions of the guidelines that emphasized limiting intakes of animal fats.
From the perspective of Americans adhering to the dietary guidelines, the more concrete the advice is, the better. This report makes what we should do more explicit, which I think is going to be particularly helpful. From the perspective of controlling calorie intake, which the majority of Americans needs to do, the report emphasizes substituting better choices within categories. For example, in choosing a dietary fat, say, to put on vegetables, it's better to use this than that.
The report also focuses on what should be reduced in the diet: sugar, solid fats, sodium and refined grains. Again, these are not new concepts, but as a population we have not been particularly successful in achieving them. The report puts considerable emphasis on these components of the diet.
Regardless of diet quality, the most critical issue for Americans is body weight. Even an ideal diet in excess of caloric needs is going to result in weight gain. That is, too much of a good thing can also be bad, and that's a concept that can get lost in translation. We need to talk about what foods should displace other foods, not that you should be adding whole wheat muffins to what you're already eating in the morning.
DR. RICHARD DECKELBAUM
Director, Institute of Human Nutrition
Columbia University ( New York City)
I'm very impressed by the guidelines. These recommendations are definitely going to be right for most Americans.
They have changed in useful ways. The advisory committee has done a huge and comprehensive job in evaluating the strength of the evidence across the field of nutrition. Where the evidence is not clear, they say so.
They've also done a good job by bringing other sectors into the process — business, agriculture, aquaculture. That approach really conveys an important message: that you can't solve the obesity crisis singly; everyone has got to be involved.