Too much milk, not enough fish
BY SUSAN STEVENS Daily Herald Health Writer
3/14/2005

Later this spring the USDA will try to sell its new dietary guidelines
to the American public.

Dietitians like many features of the 2005 recommendations. The new
diet encourages more variety in fruits and vegetables, specifies whole
grains rather than refined and better defines "good" fats vs. bad
fats. 

The guidelines also advocate stricter limits on added sugars and
for the first time encourage daily exercise to balance caloric intake.

But some dietitians aren't buying. While acknowledging the 2005
guidelines are a step above previous recommendations, nutrition experts
say they still fall short in some areas:

* They recommend too much dairy. 

The Dietary Guidelines Advisory Committee was charged with creating
a diet that provides all the recommended nutrients from food - no
vitamin pills allowed. Lots of foods contain calcium, but dairy has
the most, and the committee recommends three servings a day to get
your 1,000 milligrams.

"The problem is those recommended intakes are much higher than the
data really support," said Dr. Meir Stampfer, a professor of epidemiology
and nutrition at the Harvard School of Public Health. "I don't think
it's especially healthy to be getting that much dairy."

In other parts of the world, countries that consume less calcium
actually have lower rates of bone fracture than populations who get
a lot of calcium, Stampfer says. And a fair number of studies have
associated high calcium intakes with higher rates of prostate cancer,
he said.

* They don't emphasize the benefits of fish enough.

The guidelines suggest 5 1/2 ounces of protein each day, advising
people choose "lean" meats. Stampfer and other experts say the document
should go a step further.

"There's clear data promoting fish and fish oils as being healthy,
and there's lots of data showing limiting red meat intake is a good
idea," he said. "They just say 'limit saturated fat,' as though lean
meat were risk-free, and that's not true. Even a lean red meat is
associated with a risk of certain illnesses."

* They overemphasize grains.

Americans might not eat enough fruits and vegetables, but we make
sure we empty the bread bowl. The new emphasis on whole grains is
important, but some dietitians say six servings a day is still too
much.

"Most people have been sticking to at least six grains a day, and
they're getting sicker and fatter," said Bonnie Minsky, a dietitian
and spokeswoman for the American College of Nutrition.

* They're too generous with the calories.

If you've been reading food labels, you're attuned to the 2,000-calorie
diet. For many people - including most women - that's too many calories.
The guidelines include charts that vary calorie levels based on age,
but it's still easy to err on the side of generosity.

"There's not enough explanation here," said Kristen Fahnoe, a dietitian
at the Alexian Nutrition & Disease Prevention Center in Schaumburg.
"There needs to be more information based on the weight and health
status of the individual."

The guidelines also could go further to address the real factors
that affect how and what people eat, like stress, emotions, even busy
schedules, said Dr. Charles Baum, medical director of the Alexian
Nutrition & Disease Prevention Center.

"This does not take into account there's this whole environmental
influence on the way we eat," Baum said. "There's a tradition in the
federal government to believe education is the solution to the problem,
but that doesn't necessarily translate into behavior."

The guidelines are written by the U.S. Department of Agriculture,
which poses a quandary when good nutrition doesn't mesh with industry
interests. Some in the nutrition arena blame industry influence for
the predominance of animal products and grains in the recommendations

"The whole food pyramid, all the dietary guidelines, are a compromise
between nutrition advocates and food and agriculture lobbyists," Minsky
said. "I think we're going to get even sicker and fatter because of
it."


How well the guidelines succeed in managing America's waistline
might depend on how the message is conveyed, experts said. The USDA
is expected to update its 12-year-old food pyramid this spring.

Some of the recommendations - such as the 30 to 90 minutes of exercise
- will appear daunting to many typical Americans.

In many cases, however, incremental changes have benefit. Thirty
minutes of exercise is good, though 60 is better. Replacing a third
of your refined grains with whole grains is a good choice, even if
you can't get to half. 

No matter how many servings you manage in the end, eating more fruits
and vegetables means you'll benefit from the disease-fighting antioxidants
these foods contain and possibly control your total calories.

Toby Smithson, community dietitian for the Lake County Health Department,
appreciates the new guidelines because they incorporate messages she
had to add on to the old food pyramid, which didn't mention whole
grains or the importance of choosing low-fat and lean foods.

"There are a couple of components I'm very happy about," she said.
"It highlights physical activity as well as consumption. Those are
the two components I talk about every time I do a presentation."