Dietary Guidelines for Americans, 2010: The Cornerstone of Nutrition Policy

Nutrition has always been a key public health issue, although our nutritional focus has evolved over the years in response to societal changes in food availability and eating behaviors. While issues related to nutrient deficiencies were the focus of most early public health efforts, today's focus has shifted to the epidemic of overweight and obesity, as well as the role of nutrition in chronic disease. Nutrition, alongside physical activity, plays a crucial role in overall health. In addition to helping us maintain a healthy weight, good dietary habits are associated with reducing the risk of coronary heart disease, hypertension, type 2 diabetes, osteoporosis, some cancers, and other conditions such as iron-deficiency anemia, constipation, and dental caries.¹

The U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) recently issued the seventh edition of the Dietary Guidelines for Americans, 2010. These evidence-based guidelines, which are updated every five years to reflect the preponderance of current nutrition science, serve as the cornerstone of national nutrition policy and education efforts.

While the Dietary Guidelines have traditionally been written for healthy Americans aged 2 years and older, the recommendations in the seventh edition go much further, acknowledging that a majority of Americans do not meet a strict definition of “healthy.”

The Dietary Guidelines are still a primary prevention tool. For example, one of the six chapters of the new Dietary Guidelines is focused exclusively on balancing calories to achieve and maintain a healthy weight; this theme of caloric balance is also woven throughout the entire document. Other chapters outline information on the nutritional pros and cons of various types of food and how to build healthy eating patterns.

I believe strongly that, rather than constantly bombarding people with messages about what they can't eat, we should be telling them what they can eat that they'd enjoy. Like past versions of the Dietary Guidelines, this edition emphasizes the need for fruit, vegetables, whole grains, lean meats or plant-based protein sources, and low-fat/fat-free dairy products, while recommending reduced intake of saturated fats, trans fats, sodium, and added sugars. It also recommends consuming a diet that comprises mostly plant-based foods, and it emphasizes the importance of acquiring nutrients through food sources, thereby limiting dietary supplements and heavily fortified food products.

Although much of the science linking dietary habits to health outcomes has not changed dramatically since the last Dietary Guidelines were released in 2005, the prevalence of some diet-related morbidities has continued to increase. Because of these trends, thousands of lives are unnecessarily lost and quality of life is compromised for countless Americans each year. In response, the new Dietary Guidelines make an explicit call to action, highlighting the need for comprehensive and coordinated initiatives at all levels of society. The final chapter of the Dietary Guidelines charges Americans in all settings—individuals, families, workplaces, schools, governments, industries, and health care—with taking an active role to improve nutrition in the U.S. This chapter provides more of a bridge between individual-level and population-level advice.

Improving nutrition means not only improving an individual's or a family's eating behaviors, but also improving the environments in which food choices are made. As those of us in public health are keenly aware, the food environment has changed dramatically in the last few decades. For some Americans, unhealthy choices and behaviors have now become the norm. In turn, these new norms further increase the risk of the aforementioned chronic diseases and conditions.

The Dietary Guidelines challenge all sectors of the community to move toward making the healthy choice both the easy choice and the affordable choice for all Americans. The federal government realizes that scientific evidence and resulting recommendations aren't enough to dramatically change Americans' eating habits. A comprehensive, systemic public health approach is needed in every community, with the Dietary Guidelines serving as the foundation. Over the lifespan of the new Dietary Guidelines, HHS and USDA will be releasing more targeted, actionable communication tools to help with these efforts at multiple levels.

As “America's Doctor,” it is my responsibility to provide Americans with the best scientific information available on how to live a healthier life. I encourage you—the professional public health community—to likewise use your creativity, activism, and partnerships to bring the Dietary Guidelines to life in your circles of influence. Preparing healthy meals for your own family, advocating for healthier food options in your local schools and workplaces, incorporating nutrition education components into your programs and services, and advocating for policy changes at the institutional, local, state, or federal level are a few of the many ways that you can make a difference. Your collective efforts will truly benefit the health of current and future generations of Americans.