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Issue 121 Item 4 New Report Emphasizes Activity Over Calorie Restriction

May 5, 2002

Panel Urges Doubling Exercise from 30 minutes to 60 minutes a day and eating ‘Healthy’ Fats. The message is to Eat Less and Move More. Acknowledging that Americans are getting fatter, an independent panel of top nutritionists on Thursday recommended doubling the amount of exercise previously thought necessary to stay healthy while setting less rigid dietary guidelines.

The groundbreaking report, prepared for U.S. government health and nutrition agencies by the Institute of Medicine’s Food and Nutrition Board, urges people to eat more "healthy" fats and allows for significantly more added sugars in the diet, a recommendation that some critics say could discourage consumers from getting all the daily vitamins and nutrients they need.

The recommendations, last updated by the board in 1989, could lead to significant changes in food labeling, analysts said, and ultimately affect the U.S. Department of Agriculture’s closely followed list of recommended daily food requirements known as the food pyramid.

"I think it’s going to be difficult for USDA not to change the food pyramid [based on these recommendations]," said Dr. Walter Willett, nutrition and epidemiology professor at Harvard School of Public Health. "The top part of the pyramid is going to get bigger."

The report by the institute, which is part of the National Academy of Sciences, stressed physical activity over the restriction of calories, recommending an hour of moderate exercise every day, such as brisk walking. That’s double the amount recommended by the U.S. surgeon general and much more than what the majority of Americans accomplish.

More than 60% of Americans are not physically active on a regular basis and 25% aren’t active at all.

"We recognize that lifestyles of many in the United States … might make this goal seem difficult to achieve," panel chair Joanne Lupton, a professor of nutrition at Texas A&M University, said at a briefing.

The report spells out how many calories a person should eat based on weight and activity but avoids discussing what kinds of foods to eat. Instead the report set guidelines to accommodate a broad range of diets from low-fat Asian fare to Mediterranean, which is higher in good fats.

Specifically, the report said that in the average person’s diet, protein should make up 10% to 35%, carbohydrates 45% to 65% and fat should be between 20% and 35% of calories consumed.

These findings allow for people to consume a larger amount of "good" or monounsaturated and polyunsaturated fat than previously recommended.

"The main thrust of the pyramid has been the avoidance of fat. This is a big departure from that," Willett said.

Indeed, the report condemned the 1990s’ low-fat craze, warning that low levels of fat combined with very high levels of carbohydrates increased the risk of heart disease by lowering high-density lipoproteins or so-called good cholesterol.

The report also warned against eating foods that contain saturated fat and trans-fatty acids, often found in cookies, crackers, meat, full-fat dairy products and fast food. These fats play no role in a healthy diet, the report said, and increase the risk of heart disease by boosting levels of "bad" cholesterol. They should be avoided as much as possible while still getting the protein and fiber needed for a healthy diet, the report said.

Recommended daily levels of so-called good fats also were outlined in the report. They include Omega-3 and Omega-6 fatty acids.

Critics of Thursday’s report charged that it didn’t make it clear to consumers what foods they should be eating to get proper levels of nutrients.

The report also failed to settle the years-old debate about the healthiness of a high-protein diet such as the popular Atkins diet. The panel members said they did not set a maximum daily intake for protein because of conflicting or inadequate data on the subject.

The report did, however, recommend a cap on sugar consumption. It advised that sugars of the kind added to processed foods make up no more than 25% of all calories consumed, a level much higher than previously recommended by the USDA and much higher than many nutritionists felt was healthy.

But perhaps the most drastic changes in people’s lifestyle will have to come not from eating different kinds of food, but in their activity levels. The report calls for sedentary people, such as those working in an office, to get an hour of moderately intense activity, such as walking at 4 mph.

Despite the potential obstacles, Brooks and Carpenter said Americans can meet the one-hour exercise goal by breaking it up into smaller segments.

People can also choose to engage in a higher-intensity activity such as jogging for 20 to 30 minutes four to seven days a week.

Researchers at Brigham and Women’s Hospital in Boston reported in this week’s New England Journal of Medicine that brisk walking for 2.5 hours a week cut the risk of heart disease and stroke by about a third. In the study of 74,000 women, that level of activity reduced risk equal to doing 2.5 weekly hours of vigorous activity, such as jogging, swimming and playing tennis.

In general, Nestle said, "eat less and move more. Anything along that continuum is going to be helpful."