Thursday, June 22, 2006

New AHA Diet & Lifestyle Recommendations: The $1000 Challenge

This week, the American Heart Association (AHA) revised it's 2000 Dietary Guidelines with a new title and updated recommendations. The 2006 American Heart Association Diet and Lifestyle Recommendations include the following major changes:

  • including "lifestyle" in the title to emphasis the importance of diet and lifestyle
  • minimizing the intake of food and beverages with added sugars;
  • emphasizing physical activity and weight control;
  • eating a diet rich in vegetables, fruits and whole-grain foods;
  • avoiding use of and exposure to tobacco products;
  • achieving and maintaining healthy cholesterol, blood pressure and blood glucose levels; and
  • further reducing saturated and trans fatty acids in the diet

The media has focused its attention on the stricter limit for trans-fats to less than 1% of total calories in the diet. None in the mainstream media seem to be asking about the new stricter guideline for saturated fat - the new recommendation is to limit saturated fat intake to less than 7% of total calories. And let's be clear, it's not 7% or less saturated fat - it's a very clear recommendation to consume less than 7% of energy from saturated fat. The omission of the little "equal sign" under the "less than" sign makes this a "less than" recommendation, not an "equal to or less than" proposition.

To achive this, one must strictly limit consumption of animal foods and regular dairy. There is no way around it when we consider that every liquid oil provides some saturated fatty acids along with the monounsaturated and polyunsatured fats. Basically, this particular guideline is establishing a population-wide recommendation to move to a vegetarian diet without stating it as such.

What's very troubling with the recommendation is that there is no clear, convincing evidence that reducing saturated fat intake to less than 7% of daily energy will prevent chronic disease, improve quality of life in the long-term or increase life expectancy.

After pondering how to communicate how the new stricter limit on saturated fat is dangerous, I concluded I could write, write, write and bore you to death with statistics, data and decades of research findings - or - I could get to the point very quickly with some basic, public information and add a simple challenge to readers.

First some basic information:

On average, as the statistics from 1970-2000 highlight, we've increased our consumption of carbohydrates - significantly - along with our intake of overall calories; our intake of fat, saturated fat and protein has remained more or less stable. In fact, men actually reduced both fat and saturated fat as percentage of their daily calories and in absolute grams eaten each day.

As a nation, our dietary modifications have made us fatter, more have developed Type II Diabetes, and significantly more are taking one or more prescription drugs each day (in 2000, 44% of the population), and an alarming number require three or more prescription medications each day (in 2000, 17% of the population).

We have to ask, what will happen if we do manage to convince the population to reduce saturated fat even more?

Based on studies that have investigated the role of saturated fats in our metabolism, we must ready ourselves for larger numbers of people with nutrient deficiencies, especially the fat soluable vitamins; growing numbers suffering with obesity and insulin resistance, leading to more people with Type II Diabetes; a greater reliance on prescription medication to alleviate the chronic conditions caused by our diet; and more foods touting the benefits of their "low-fatness" to convince you to eat more of it instead of eating animal foods that have saturated fat.

The fact is, limiting saturated fat to less than 7% of calories will directly reduce intake of critical essential micronutrients, fatty acids and amino acids; reduce the absorption of essential fat soluble vitamins; and inhibit the absorption of important minerals. We know this - it's found in numerous studies and surveys. Data from nutritional surveys of people in the US continue to show nutrient deficiencies.

That will only be exacerbated even more if they strictly limit saturated fat to less than 7% of calories.

Now the challenge:

I contend, one simply CANNOT plan a day's menu for a eating and keep saturated fat at less than 7% of energy while at the same time meet essential nutrient-requirements for fatty acids, amino acids, vitamins, minerals and trace elements.

It can't be done.

Take a look at the AHA document, full-text this time - there is not one example of how to eat within the document. No example menu to show following their dietary recommendation will provide for all essential nutrients. No example menu to even show how to eat according to their new guidelines.

Why?

It can't be done and meet nutrient requirements.

So, my challenge is - if someone can prove me wrong - create a menu with about 2,000-calories (the IOM establishes a 30-year old female with a BMI of 24.99 who is "low-active" requires 1,956-calories per day), using common whole foods and that menu conforms to the new AHA recommendations, I'll eat my words, issue a public written apology and reward the person with $1000.00.

Yup, if someone can create a menu, I'm willing to pay to see it.

The AHA didn't think it important to take the time to show anyone reading their recommendations HOW TO DO IT, so I'm willing to here if someone creates a one-day menu and sends it to me and it's within the AHA guidelines. Sad when you think about it - the AHA has the in-house experts on hand to do so!

Heck, they even have menus in their No-Fad Diet book...oh, wait, those menus don't conform to their new guidelines and have way too much trans-fats! But, I digress...

Anyone up for the challenge?

Here are the specifics the menu must include, to conform to the AHA guidelines:

  • 1,956-calories from food and beverages detailed with quantity to consume
  • No vitamin supplements may be included to meet essential nutrient DRI's, the AHA specifically recommends foods for meeting nutritional needs
  • Essential nutrients must provide atleat 98% of DRI: Recommended Intake for Individuals based on a female, 30 years old
  • Essential nutrients not to exceed established Upper Tolerable Limits for a female, 30 years old
  • Less than 7% of calories from Saturated Fat
  • Less than 1% of calories from Trans-fats (industrial and naturally occuring)
  • Total Fat - no specific limit
  • Whole Grain foods must be included as part of grains included
  • Vegetables must be included and may be fresh, frozen or canned
  • Fruits must be included and may be fresh, frozen or canned
  • Dairy must be included
  • Nuts, Seeds, Legumes, lean meats, poultry and fish allowed in menu
  • Added Fats and Oils - depends on what you can fit in with 1,956-calories
  • Added Sugars - allowed, but keep to a minimum, especially beverages
  • Cholesterol - no more than 300mg
  • Sodium - no more than 2300mg
  • Alcohol - no more than one serving (4-oz wine, 12-oz beer, 1.5-oz hard liquor)
  • July 18, 2006: Must comply with the AHA guideline to include a wide variety of foods

You can email your submissions for review and analysis. I'll maintain this challenge online through August 31, 2006. Foods included in the menu must have a nutrient profile available in the USDA Nutrient Database for analysis. Only one submission per person (or organization) allowed.

Over the next few weeks and months I'll present menus submitted along with analysis to determine if it meets nutrient requirements and conforms to the AHA recommendations. If anyone creates a menu that conforms to the above, you'll know when I make a public written apology here on my blog and cut a check to the person who created the menu.

Good Luck!

UPDATE: July 18, 2006

The American Heart Association has placed a page on their website with a general guideline of how many servings of each food group to eat daily (or weekly) as part of a diet that complies with their new 2006 Diet and Lifestyle Recommendations issued last month. Because my challenge requires those submitting menus to comply with the AHA guidelines, the foods included in the menu must comply with this additional information. This guideline is similar to the two dietary patterns the AHA pointed to in their full-text paper previously.

3 comments:

  1. While it's difficult to say the glass is half full, I offer the following. There is no limit on fats, only saturated fats. While as you point out, all fats and oils contain some saturated fat, it's still an improvement over the fat phobia days of 1980's and 90's. Also, sweetener consumption is finally starting to get some attention which is in my estimation and (others), is probably the single biggest contributor to the modern dgenerative diseases including heart disease and cancer. Sugars are no longer labeled as 'empty calories', a syllogism which seemed to imply that they didn't count as part of one's calories.

    On the other hand, it is clear that yet another pronouncement has come from the 'ivory tower' experts who don't apparently live in the real world. It is almost beside the point whether one can come up with a menu that manages to contains the proper nutrients. Is it practical in the real world? Can you eat this way day after day. This is, of course a challenge for any diet, low carb or fat although usually easier with low carb. The AHA diet would probably involve huge amounts of soy with limited amounts of fatty fish and some fruits and vegetables to get the required protein and vitamins.

    In an unrelated item, alcohol consumption is now reduced to a mximum of one drink per day when the evidence indicates that 2 per day had the greatest cardio benefit. See http//www.nhlbi.nih.gov/new/press/03-01-08.htm

    I guess it wasn't politically correct to allow that much alcohol.

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  2. On the other hand, it is clear that yet another pronouncement has come from the 'ivory tower' experts who don't apparently live in the real world. It is almost beside the point whether one can come up with a menu that manages to contains the proper nutrients. Is it practical in the real world? Can you eat this way day after day.

    Exactly!

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  3. Is this challenge still on? I sent you a menu by e-mail but you haven't replied to acknowledge it and I was wondering if you recieved it.

    ReplyDelete