The Latest Word on What to Eat

By Anastasia Toufexis

Many Americans believe firmly in the notion of better health through better eating. What bothers them is the specifics: Just how much of what foods, for example, are they supposed to be consuming? Last week, in a massive new report by the National Research Council, the public received the best answer yet. The 1,300-page document, titled Diet and Health: Implications for Reducing Chronic Disease Risk, sets forth the most comprehensive and detailed set of dietary guidelines ever.

By following its recommendations, says the report, the American people could cut by at least 20% the risk of developing coronary heart disease, the top killer in the U.S. They could also "substantially" reduce the threat of a host of other ailments, including cancer, stroke, high blood pressure, obesity, osteoporosis and liver disease. Just how to do this is described in the guidelines, which were prepared by a 19-member panel after a review of more than 5,000 studies. The NRC group not only crystallizes the broad dietary goals laid down by earlier reports but also extends them to children.

Among the recommendations:

-- Limit fats to 30% of daily calories, with saturated fats making up less than 10% of the intake. Keep cholesterol consumption below 300 mg daily. Diets should emphasize fish, skinless poultry, lean meats and low- or non-fat dairy products, and cut back on fried and other fatty foods such as pastries, spreads and dressings. To reduce cholesterol, limit consumption of egg yolks, certain shellfish and organ meats.

-- Make carbohydrates account for at least 55% of daily calories, rather than the present average of 45%. Eat five or more servings daily of vegetables, preferably the green or yellow kind, and fruits, particularly citrus. In addition, eat six or more daily servings of starches, like rice and potatoes, and other complex carbohydrates, including pasta, whole-grain breads and cereals, and legumes. These are generally low in fats and rich in vitamins, minerals and fiber. Five or six servings may seem a lot, but a single serving is just half a cup of vegetables, a medium-size piece of fruit or a slice of bread. Observes the University of Toronto's Dr. Anthony Miller, who helped draft the report: "If you eat a mixed salad and have fruit for dessert, your meal might contain three servings."

-- Eat only moderate amounts of protein. Americans should meet the Recommended Daily Allowance -- 0.8 g per kg of ideal body weight for adults -- but not exceed twice that level. Since an ounce of lean ground beef has about 8 g of protein, a 120-lb. woman fulfills her entire protein requirement with a 5.6- oz. hamburger, and a 180-lb. man with an 8.4-oz. patty.

This is one of the report's surprises; many people have long believed the more protein the better. In fact, some popular weight-loss schemes have been based on high-protein intake. But the panel notes that diets rich in animal protein have no known benefits and may increase the risk of colon or breast cancer. Whether protein is the villain is not clear, however, since meats are typically loaded with fat.

The panel vehemently condemned the use of dietary supplements. Some 40% to 60% of Americans routinely swallow vitamins, mineral tablets, protein powders and the like. Yet most people do not need more than the RDAs for vitamins and minerals, and they get that easily through a varied diet. Megadoses have no benefits and can be toxic.

Similarly, the report says, there is no convincing evidence that calcium supplements help prevent osteoporosis, a crippling bone disease prevalent in older women. The calcium RDA is 800 mg; women now consume about three-quarters of that amount. They could make up the shortfall by drinking a 5-oz. glass of low-fat milk each day.

Fish-oil capsules got a thumbs down too. Eating marine fish one or more times a week is thought to help lower cholesterol, but proof that concentrated fish oil has the same result is lacking, and there is no information on its long-term effects. Nor are fiber supplements warranted as a hedge against cancer of the stomach, large intestine and lungs. Though the panel endorses eating more high-fiber foods, no one knows if the beneficial effects result from the fiber itself.

As for alcohol, the report advises those who drink to limit intake to less than 1 oz. daily, the equivalent of two cans of beer or two small glasses of wine. Though some researchers believe moderate drinking may have a protective effect against heart disease, the report finds that the risks of alcohol far outweigh any benefits. Women who are pregnant or trying to conceive should avoid alcohol. The panel also urged the public to limit salt consumption to 6 g -- about a teaspoon -- or less a day.

How difficult will it be for the U.S. to meet these goals? Americans are now on target for protein. But they still need to raise carbohydrates and lower total fats and saturated fats, salt and alcohol. Men now consume 45% more cholesterol than recommended.

The report stresses that the new guidelines are realistic and feasible, requiring adjustments but no real deprivations. Americans may still safely eat meat, provided it is "lean meat in smaller and fewer portions than is customary." Says Dr. DeWitt Goodman, a member of the panel from Columbia University: "The recommendations are compatible with gourmet, delicious eating." Some Americans may dispute that, but they will have to decide which is more important -- good taste or good health.

With reporting by Andrea Dorfman/New York and Dick Thompson/Washington