Coronary Artery Disease / Dietary Goals of the United States

submitted by Dr. Gary Farr Last Updated December, 4, 2001

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INTRODUCTION
During this century, the composition of the average diet in the United States has changed radically. Complex carbohydrates-fruit, vegetables and grain products-which were the mainstay of the diet, now play a minority role. At the same time, fat and sugar consumption have risen to the point where these two dietary elements alone now compromise at least 60 percent of total calorie intake, up from 50 percent in the early 1900's.1

1 Statistics from reports and testimony to the Select Committee's National Nutrition Policy hearings, June 1974, appearing in National Nutrition Policy Study, 1974, Pt. 6 June 21, 1974, heart disease, p. 2633, high blood pressure, p. 2529, diabetes, p. 2523.

In the view of doctors and nutritionists consulted by the Select Committee, these and other changes in the diet amount to a wave of malnutrition-of both over and under consumption-that may be as profoundly damaging to the Nation's health as the widespread contagious diseases of the early part of the century.

The over-consumption of fat, generally, and saturated fat in particular, as well as cholesterol, sugar, salt and alcohol have been related to six of the ten leading causes of death: Heart Disease, Cancer, Cerebrovascular Disease, Diabetes, Arteriosclerosis and Cirrhosis of the Liver.

In his testimony at the Select Committee's July 1976 hearings on the relationship of diet to disease, Dr. D. Mark Hegsted of Harvard School of Public Health, said:

Even such a simple question as whether one should severely limit his consumption of butter and eggs can be a subject of endless scientific debate.

Faced with conflicting scientific opinions of this kind, it would be easy for health educators to sit on their hands; it certainly makes it easy for those who abuse their health to find a real "scientific" excuse.

But many of our health problems are sufficiently pressing that action has to be taken even if all scientific evidence is not in.

Based on (1) the Select Committee's July 1976 hearings on the relationship of diet to disease and its 1974 National Nutrition Policy hearings, (2) guidelines established by governmental and professional bodies in the United States and at least eight other nations, (Appendix)

B) and (3) a variety of expert opinions, the following dietary goals are recommended for the United States. Although genetic and other individual differences mean that these guidelines may not be applicable to all, there is substantial evidence indicating that they will be generally beneficial.

UNITED STATES DIETARY GOALS

1. Increase carbohydrate consumption to account for 55 to 60 percent of the energy (caloric) intake.

2. Reduce overall fat consumption from approximately 40 to 30 percent of energy intake.

3. Reduce saturated fat consumption to account for about 10 percent of total energy intake; and balance that with poly-unsaturated and mono-unsaturated fats, which should account for about 10 percent of energy intake each.

4. Reduce cholesterol consumption to about 300 mg. A day.

5. Reduce sugar consumption by about 40 percent to account for about 15 percent of total energy intake.

6. Reduce salt consumption by about 50 to 85 percent to approximately 3 grams a day.

The Goals Suggest the Following Changes
in Food Selection and Preparation

1. Increase consumption of fruits and vegetables and whole grains.
2. Decrease consumption of meat and increase consumption of poultry and fish.
3. Decrease consumption of foods high in fat and partially substitute poly-unsaturated fat for saturated fat.
4. Substitute non-fat milk for whole milk.
5. Decrease consumption of butterfat, eggs and other high cholesterol sources.
6. Decrease consumption of sugar and foods high in sugar content.
7. Decrease consumption of salt and foods high in salt content.