The Public Health Implications of the 2010 Dietary Guidelines

An Expert Interview With David L. Katz, MD, MPH

Janet Kim, MPH

Disclosures

February 15, 2011

In This Article

Editor's Note:

Every 5 years since 1980, the US Department of Agriculture (USDA) and the US Department of Health & Human Services (HHS) jointly release a revised edition of the Dietary Guidelines for Americans (DGA) on the basis of a comprehensive review of the most current and best available medical and scientific evidence. The new 2010 DGA, unveiled on January 31, 2011, will provide authoritative guidance for government nutrition policy, programs, and education that aim to promote healthier dietary and physical activity patterns in Americans 2 years of age and older.

Several noteworthy changes from the 2005 policy document include recommendations that focus on all stages of life, expanded guidance for childhood nutrition, greater recognition of vegetarian dietary patterns or including more plant-based foods, the significance of eating behaviors on weight management, and a call for improving the overall food and physical activity environment.

David L. Katz, MD, MPH, is a board-certified specialist in both internal medicine and preventive medicine/public health. He is the founding Director of Yale University's Prevention Research Center; founder and Director of the Integrative Medicine Center at Griffin Hospital; founder and President of the nonprofit Turn the Tide Foundation in Derby, Connecticut; and the principal inventor of the Overall Nutritional Quality Index algorithm used in the NuVal™ Nutritional Scoring System.

Janet Kim, MPH, of Medscape spoke with Dr. Katz, an internationally renowned authority on nutrition, weight management, and chronic disease prevention, about the revised 2010 DGA, and he offers us his perspective on the strengths and weaknesses of the updated recommendations in terms of the public's health.

Medscape: What do you consider to be the most positive changes in the 2010 DGA?

Dr. Katz: It is certainly encouraging that the 2010 DGA are clearly focused on the prevailing interface of nutrition and public health. The guidelines talk about obesity, diabetes, and heart disease risk, and are attempting to deliver dietary guidance to fix what's broken. This has always been a theme that has been present in the dietary guidelines, but has never been quite as explicit as it is now. One example of this is a specific recommendation to eat less overall and consume fewer calories. This is clearly a response to a society that has epidemic or, perhaps more correctly now, hyperendemic obesity. I think that's very encouraging. In essence, the dietary guidelines have done the appropriate reality check, and I like that.

An explicit reference to a plant-based diet is also made, and I like that as well. There is a willingness to get into some subtleties that I think are important and timely, but have been left out of prior editions of the dietary guidelines, perhaps partly because they are subtleties. One of the things guidance intended for an entire population is to consider the kind of guidelines that people are actually ready to digest. If we give people information that they can't understand or can't use, it's not good even if the science behind it is strong.

An example of a subtlety that I think is important is the recognition that not all saturated fat is created equal. The guidelines specifically note that stearic acid, which predominates in dark chocolate, is not harmful. That carve out, I think, is appropriate and responsive to what is a growing public debate about the role of saturated fat in health. It's interesting to see how many people in the blogosphere or cyberspace have strong opinions of saturated fat as not being harmful. In fact, in my opinion, some saturated fatty acids certainly are harmful, but not all are. I was very pleased to see a willingness to take on that issue. Those are some of the salient changes that I particularly appreciated.

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