Heart disease, stroke, cancer, diabetes

Dallas - Four of the nation's top health organisations have banded together to support an eating plan designed to help stave off the diseases that kill most people: heart disease, stroke, cancer and diabetes.

Each health agency has its own nutritional recommendations, but by joining forces under the American Heart Association's leadership, they hope to make it easier for the public to heed their combined dietary message and to understand exactly what "eating right" really means. The eating plan was developed following a national conference of experts including members of the American Heart Association's Nutrition Committee with the co-operation of the American Cancer Society, American Academy of Paediatrics and National Institutes of Health. Their report will be published in the July 27 issue of Circulation: Journal of the American Heart Association.

Richard J. Deckelbaum, M.D., co-author of the journal article, who is a member of the American Heart Association Nutrition Committee and professor of paediatrics and nutrition at Columbia University in New York City and attending paediatrician at New York Presbyterian Hospital, says, "A single healthy dietary concept cuts across disease categories to lower the risk of many chronic conditions."

Edward A. Fisher, M.D., Ph.D., a co-author of the article on behalf of the American Heart Association and director of lipoprotein research at New York's Mount Sinai Cardiovascular Institute in New York City, says, "By following a healthy diet, you gain a measure of protection against all the biggest killers."

Abby Blotch, Ph.D., R.D., chair of the American Cancer Society's Nutrition and Physical Activity Advisory Board, agrees. "The American Cancer Society publishes nutrition guidelines to give the public advice about the healthy eating and physical activity choices that will reduce their risk for cancer. The work of the American Heart Association demonstrates that the recommendations for preventing cancer are consistent with those for preventing heart disease, stroke, diabetes and obesity.
This will allow us to send a unified message to the American people that the healthful choice - a diet with a variety of plant foods including fruits and vegetables, and low in fat - is the right choice for an overall healthy lifestyle."

Under this eating plan, a typical day's healthy diet would include no more than 10 percent of total calories from saturated fat, and no more than 30 percent of total calories from all types of fat. The diet also recommends that 55 percent or more of an individual's total daily calories come from complex carbohydrates, such as cereals, grains, fruits and vegetables, and that dietary cholesterol be limited to 300 milligrams or less each day. Also the panel recommend that people consume no more than six grams of salt per day (one teaspoon), and eat only enough calories to maintain a desirable body weight.

The easiest ways to accomplish these goals are to:

1. Eat a variety of foods.
2. Choose most of what you eat from plant sources.
3. Eat five or more servings of fruits and vegetables each day.
4. Eat six or more servings of bread, pasta and cereal grains each day.
5. Eat high-fat foods sparingly, especially those from animal sources.
6. Choose a diet moderate in simple sugars.
7. Choose a diet moderate in salt.

The eating plan closely follows the U.S. Department of Agriculture's Food Pyramid and ensure that the diet contains enough of vitamins, minerals, fibre and other essential nutrients. Too much fat, especially saturated from meat or dairy products, too much sugar and salt, too many calories, and not enough whole grains, fruits, vegetables and low-fat or non-fat dairy products are the primary dietary problems challenging the U.S. population.
We need more of the green, leafy vegetables that are high in antioxidants, nutritional elements that delay or prevent atherosclerosis, the disease process that leads to heart attacks and strokes, and may protect against diabetes and some forms of cancer, says Fisher.

Recent statistics show that average overall fat consumption is down to about 34 percent of total calories compared to about 40 percent a few years ago. But the real problem, he says, is that saturated fat makes up half or more of that total on average - well above the one-third or less stipulated by the guidelines. "The other big problem is that we simply consume too many calories - more than we burn during physical activity," he adds. "As a result, the prevalence of obesity has skyrocketed - one third of the U.S. population is significantly overweight."
The eating plan is designed to meet the special nutritional needs of children, women, the elderly and minorities, as well as the general public.
Obesity increases a woman's risk for at least five of the leading causes of death, including heart disease, stroke, diabetes, atherosclerosis and some types of cancer. About 35 percent of all American women over age 20 are overweight, and among black women, the figure is over 50 percent. Women also need more calcium than men -- hence more low-fat dairy products -- to retard osteoporosis, the brittle-bones disease that affects millions of older women. Folate-rich foods are essential during pregnancy to prevent birth defects.
The authors cite data from surveys showing that nearly a quarter of young children get less than two-thirds of the calcium, iron and zinc they need. "The concepts bring together important dietary information that can benefit millions of people," Fisher concludes, "but they aren't an end in themselves. They also point to the tremendous need for research into how the food we eat affects our lifelong patterns of health and disease."