A poor diet is responsible for a number of chronic illnesses such as high cholesterol, obesity, hypertension, and diabetes, resulting in as much as 75% of the cost of medical care in the United States. Several new articles in the NEJM points out the difficulties in how best to achieve a change in the US diet, presently containing large amounts of salt, high-calorie sweeteners, and unhealthful fats.
The 2010 Dietary Guidelines emphasize:
- Eat more vegetables, beans, fruits, whole grains, and nuts and highlight healthful plant-based eating patterns, including vegetarian and vegan diets,
- Replace some red meat and poultry with fish,
- Replace trans fats and saturated fats with unsaturated fats,
- Limit total calorie intake.
However, recommendations like this are unlikely to have much of an impact on improving people’s diets and healthy physical activities.
The original Food Guide Pyramid, which encouraged substituting grain products for dietary fat (irrespective of their nutritional quality), may have inadvertently contributed to epidemics of metabolic syndrome and related chronic diseases by increasing refined-starch consumption. The current administration, motivated by First Lady Michelle Obama’s campaign against childhood obesity, has replaced MyPyramid with MyPlate. This image improves on its immediate predecessors, especially with advice to cover half the plate with vegetables and fruits: