Last week the United States Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) released the new Dietary Guidelines for Americans, 2015-2020. (1) This publication contains important information that affects all of us so let’s take a quick look to see what it’s all about.
Every 5 years our government reviews and revises the Dietary Guidelines for Americans based on new research findings or “evidence” as well as new information collected about the current health and health habits of people like you and me from across America. This is an enormous task requiring a 2-year commitment (unpaid!) by a select committee of nutrition and health professionals who scour massive amounts of data, examine a vast number of health databases and review the latest scientific findings to identify and present potential revisions or new recommendations to the existing guidelines. The committee’s final report is sent to the Secretaries of the USDA and the HHS where the findings help guide development of the Dietary Guidelines that will be used over the next 5 years.
Now, what do the guidelines mean for us as Americans, and importantly for breast cancer survivors? First let’s see what the Guidelines have to say about the current health and health habits of our population. I think we can all agree that the following statements based on current evidence, are probably true and they point to specific areas where changes can be made to improve health and reduce risk of chronic disease.
- Our population faces significant health challenges related to a history of poor eating habits and decreased levels of activity.
- As described in the Dietary Guidelines, about half of all American adults – 117 million individuals – have one or more preventable chronic diseases, many of which are related to poor diet and low levels of physical activity. These chronic diseases include Type 2 diabetes, high blood pressure, cardiovascular disease, some types of cancer, and poor bone health.
- Over two-thirds of adults and close to one-third of children and youth in the U.S. are overweight or obese.
- The high rate of overweight, obese and chronic disease has persisted for more than 2 decades and comes with not only increased risk to health but also at high medical expense.
- The trends above indicate that most Americans are not following healthy eating patterns and are not participating in regular physical activity.
With this in mind what do we do about it? Based on the above findings, here are the recommendations from the 2015-2020 Dietary Guidelines for Americans.
- Follow a healthy eating pattern across the lifespan.
- Eat more of some foods (vegetables, fruits, whole grains, non-fat and low-fat dairy, lean protein) and less of others (saturated fats, added sugars, sodium, alcohol) over your lifetime.
- Focus on variety, nutrient density and amount.
- Within calorie limits, eat a variety of foods from all food groups in the appropriate amount. Remember – PORTION CONTROL!
- Limit calories from added sugars, and saturated fats and reduce sodium intake.
- Reduce the amount of foods and beverages consumed that are high in these components. Don’t add so much sugar, saturated fat and salt to your daily eating plan.
- Shift to healthier food and beverage choices.
- When developing your healthy eating pattern choose healthy, nutrient dense foods across all food groups in place of less healthy choices.
- Support healthy eating patterns for all.
- We all have a role in creating and supporting healthy environments for ourselves, our families, and our communities. Together we can make a difference.
What about physical activity? In addition to encouraging us to develop healthy eating patterns, the 2015-2020 Dietary Guidelines recommend that all Americans (children, adolescents, adults and older adults) should meet the Physical Activity Guidelines for Americans. (2) This, in tandem with the Dietary Guidelines, will promote good health by helping individuals to achieve and maintain a healthy body weight, and reduce risk of chronic disease. Below are select recommendations for adults from the Physical Activity Guidelines.
- All adults should avoid inactivity. Some physical activity is better than none.
- Adults should engage in a minimum of 150 minutes (2 hours & 30 minutes) of moderate-intensity exercise every week.
- Include muscle-strengthening activities 2 or more days every week.
You may be wondering how the new Guidelines specifically address breast cancer survivors. The 2015-2020 Dietary Guidelines are designed to be used as building blocks to help guide all individuals to healthier lifestyles through creation of healthy eating patterns and increased physical activity. The Guidelines are developed for chronic disease prevention; they are not intended to be used to treat disease.
The complex relationships between diet, physical activity and breast cancer risk are not specifically addressed in the Dietary Guidelines, however we know much from recent research that shows poor diet and low levels of activity can increase risk of breast cancer and other chronic disease. Here’s what the current research says:
- Being overweight or obese can increase the risk of being diagnosed with breast cancer compared to women who maintain a healthy weight, especially after menopause.
- Being overweight can increase risk of breast cancer recurrence in some studies by as much as 5-fold as compared to women who maintain a healthy weight.
- Eating a more Mediterranean-style meal pattern may play a role in reducing breast cancer risk. This kind of meal pattern includes lots of vegetables and fruits, whole grains, olive oil, fish and nuts, seeds and legumes.
- Regular physical exercise is associated with decreased risk of breast cancer and breast cancer recurrence.
- People who are physically active tend to have lower blood sugar, lower levels of insulin-like growth factor, less fat stores, are more likely to maintain a healthy body weight and tend to be healthier overall.
- Breast cancer patients are at increased risk for bone loss and fracture due to reduced hormone levels, chemotherapy and because of the cancer itself. Physical activity is good for bone health.
As a Registered Dietitian Nutritionist at Breastlink it is my role to promote health and wellness by helping patients and families make changes and develop new patterns to live healthy, active lifestyles. I rely on a variety of resources to guide the education and recommendations including results from recent research studies, professional, scientific and health-related publications including the Dietary Guidelines for Americans. These are all good resources, and when combined they provide the most current and comprehensive building blocks available to help patients reduce risk of chronic diseases including breast cancer and breast cancer recurrence, cardiovascular disease, Type 2 diabetes, high blood pressure, some other types of cancer and poor bone health.
And now my recommendations for you!
- Make small changes to your current eating pattern to start, like adding an apple to your lunch every day. Remember, a series of small changes add up to big changes over the course of weeks, months or a year.
- Shift your eating pattern to focus more on healthier choices. Eat more vegetables and fruits, whole grains, fat-free or low-fat dairy, lean protein, and healthy oils like olive, canola, corn, peanut, sunflower or soybean.
- Eat less added sugar, salt, saturated fats and alcohol.
- Watch portion sizes – PORTION CONTROL makes a difference!
- At your next lab appointment ask your healthcare provider to include serum vitamin D level to your blood work, if you have not already done so. Be sure to follow-up on the results and ask if a daily vitamin D supplement is right for you to help keep your bones healthy.
- Get active. I often suggest that my patients walk their way to fitness. Choose a sensible walking plan and stick with it, there are many wonderful programs available on the internet for all age groups and fitness levels. Consider getting a pedometer if you don’t already have one and most importantly – wear it!
Take a moment to quickly evaluate your own health and fitness. Look in the mirror; do any of the risk factors mentioned in this article apply to you? Are you carrying more weight than you should, particularly around your middle? Do you have high blood pressure, insulin resistance, Type 2 diabetes, or osteoporosis or have you been told you are borderline for a chronic condition? Do you follow a regular physical activity program every week? How about the other members of your family?
After completing the evaluation if you determined that a healthier lifestyle is right for you, then it’s time to make some changes. As the saying goes ‘don’t kick this can down the road’ by planning to make healthful changes next week or next month or even 6 months from now. Make the decision and start now to become as healthy and physically fit as you possibly can and remember to utilize the numerous resources available to help you succeed!
Dietary Guidelines for Americans, 2015-2020: http://health.gov/dietaryguidelines/2015/guidelines/
Physical Activity Guidelines for Americans: http://health.gov/dietaryguidelines/2015/guidelines/appendix-1/