The U.S. Department of Agriculture is coming out with a new version of dietary guidelines for Americans. These guidelines, which are quite similar to the former ones, recommend decreasing the consumption of meat and increasing intake of vegetables, non-fat dairy products and fruit. It is hoped that if we let these guidelines influence our food choices, Americans will stop eating cheeseburgers, sodas and sweetened fruit juices, fat-filled junk foods like potato chips and chocolate chip cookies, and instead consume fat-free cottage cheese, apples and Swiss chard. We might even decrease our portion sizes when we realize that the 16-ounce steak we were thinking of ordering contains enough protein for our entire family.
The recommendations make good medical sense. If followed, they will increase the intake of whole grains, fiber, vitamins and minerals and decrease the intake of foodstuffs that may be associated with cardiovascular disease, diabetes and even cancer. These are all important health objectives, regardless of whether a person needs to lose weight or not. However, they are not new. Health professionals have been telling us for decades that we have to pay attention to what we are eating not only to meet our body's needs for specific nutrients, but also to decrease the likelihood of developing debilitating or even terminal illnesses.
But who is going to follow these recommendations? Is the Department of Agriculture just preaching to the converted?
Around the time the dietary guideline report was released, there were press releases describing a new wondrous delicacy at this year's Texas State Fair: fried butter. Friends of mine went to the fair and described the area devoted to deep-fried foods with the same amazement as if they had just seen people eating roasted slugs. The deep-fried butter was the main attraction but people were also eating the fried tequila topped with whipped cream, the chicken fried steak, fried chocolate bars, fried ice cream and of course that traditional feature of most state fairs, the deep fried corn dog. In all fairness, it should be stated that the fried butter was actually coated with batter and not unique to the fair. One of the "Food Network's" popular chefs, Paula Dean, has made fried butter. Her recipe, which includes cream cheese in the batter, probably doesn't have more calories than many of the other southern delicacies prepared on her show.
State fair food is, of course, not a staple for any of us, so perhaps we will be motivated to follow the guidelines and improve our food intake. But it is unlikely that as a country we will be shifting to a healthier eating style anytime soon unless the country goes into a sort of food lockdown. As the report describes, most of our meals are eaten away from home and only rarely meet these guidelines.
In 1977 we consumed 18 percent of our daily calories from restaurant foods. In l996, 77 percent of our calories came from food eaten away from home and that number has probably increased by now.
Portion sizes in restaurants and of prepared foods have increased immensely. According to the information in the dietary guidelines report, in 2002 the average serving of steak was 224 percent larger and a chocolate cookie was 700 percent larger than a 1996 USDA food guide serving. We have become so accustomed to these larger sizes that when we see food portions of 30 years ago, they look child-sized to us.
The USDA report confirms that eating away from home increases our intake of calories, fat, sugar and sodium and deceases our consumption of vegetables. Thus, how can a new set of dietary guidelines change this?
In an ideal world, restaurants could alter their menus and portion sizes to meet the dietary guidelines. Some, catering to a specially health conscious customer base, have done so by offering options for vegetarians, vegans and people who want to limit their consumption of saturated fats and sugars. But the trend in fast food restaurant chains is to offer ever more egregiously caloric meals to attract customers who want to get the most calories, fat and salt for their money. And this trend is not limited to fast food restaurants. Watch an advertisement of the typical moderately priced chain restaurant and you will see the same emphasis on oil, butter, cheese, cream and bacon as ingredients or sauces. Will these foods be replaced by brown rice, lentil salad and arugula salad? It seems unlikely.
Perhaps an effective way to shift food consumption patterns is to make the foods we should be eating cost less. This is true in restaurants where a plate of pasta will cost less than a chicken breast or steak tips. But there are few bean, lentil, whole grain pasta or vegetable options, especially in places where people go for lunch, such as food courts or local lunchtime restaurants. And sometimes food that looks healthy, such as the prepared foods sold in warming trays in large supermarkets, really isn't. These foods tend to be very high in fat as the added oil keeps them moist and fresh tasting. They may be cheaper than foods sold in restaurants but often are just as unhealthy because of their fat and salt content.
Another difficulty in getting people to change is the disconnection between what they are eating today and the health problems they may confront years from now. Calcium intake is an example. Women are told to make sure their calcium intake is adequate when they are young adults so they won't develop osteoporosis (fragile bones). When do they actually increase their calcium intake? After their first bone scan.
An epidemiologist/nutritionist who works on the association between diet and cancer told me that it is very common for a patient to seek dietary advice after the diagnosis. She told me that patients always say the same thing: "Now I understand how important it is to eat right."
Despite the obstacles in getting people to change their eating habits, it can be done. Years ago people wouldn't touch skim milk, grimaced when they saw yogurt and were revolted by sashimi. The popularity of these food items in supermarkets indicate that food habits do shift. In part it is because the foods taste better these days. Yogurt is no longer the astringent watery product it was in the early days. Sashimi seems to have overcome the antipathy people have toward raw fish and children think whole milk is now disgusting because it is so creamy.
We just have to think of ways of making lentils, whole grain pasta and kale tasty without deep frying them.