Dietary Guidelines for Chronic Disease Prevention

James M. Shikany, DrPH, Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine; George L. White Jr., MSPH, PhD, Department of Family and Preventive Medicine, University of Utah College of Medicine, Salt Lake City

South Med J. 2000;93(12) 

In This Article

Abstract and Introduction

In developed nations, diet is related directly or indirectly to the most prevalent chronic diseases. Research has helped clarify diet-disease relationships and enabled the promulgation of dietary recommendations for chronic disease prevention. We reviewed epidemiologic study results, clinical trial data, and general dietary recommendations from various agencies to develop a set of overall dietary guidelines for the prevention of the most common chronic diseases in the United States, including coronary heart disease, hypertension, cancer, and osteoporosis. Intake of monounsaturated fats, fiber, calcium, vegetables and fruits, and whole grains should be promoted. Consumption of saturated and trans fats, sodium, and refined grains should be minimized. Moderation in alcohol and caloric intake should be encouraged. Although research into associations between diet and disease is constantly in flux, our guidelines are based on replicated findings and provide a starting point for assisting patients in improving their diets.

Most leading causes of adult deaths in developed nations -- including coronary heart disease (CHD), cancer, and stroke -- are influenced by diet. Other diseases associated with significant morbidity, including hypertension, diabetes mellitus, obesity, and osteoporosis, are also closely linked with dietary intake, as an etiologic or exacerbating factor.

One of the seminal reports on the association between diet and disease was a review by Doll and Peto[1] in 1981, in which the authors estimated that at least 35% of cancer deaths might be attributable to diet. Since that time, countless descriptive and analytic epidemiologic studies have attempted to clarify the link between diet and CHD, cancer, and a variety of other chronic diseases, with varying degrees of success. While nutritional epidemiology is an inexact science, certain findings have been consistently reproduced in multiple studies and serve as the foundation for formulating dietary recommendations for the general population.

Dietary recommendations to promote health and prevent disease are summarized by the US Departments of Agriculture and Health and Human Services in Nutrition and Your Health: Dietary Guidelines for Americans.[2] The fourth edition of these guidelines was published in 1995 (Table 1). These guidelines, as well as other official recommendations (Table 2), attempt to distill years of research into the association between diet and disease into recommendations that can be readily implemented. Although rather vague, they provide a starting point for assisting patients in making healthful changes in their diets, with the goal of preventing or postponing the most common chronic diseases affecting Americans. More specific recommendations (which are more useful in a clinical setting), and the evidence supporting them, are presented here.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.