New AHA Guidelines Focuses on Big-Picture Approach to Diet

      The American Heart Association issued new dietary guidelines to help consumers Thursday, saying people should aim for a healthy overall pattern of foods rather than overemphasizing nutrient numbers at every meal.

      This big-picture approach is designed to be easier to use than past guidelines, allowing people to choose dishes they like from different food groups rather than calculating percentages of nutrients in the items they''re eating.

      The new recommendations, a tweaking of guidelines issued in 1996, continue to promote fruits, vegetables, and grains over meat and dairy products as a step toward reducing heart disease risk.

      And they show no letup in the effort to get Americans to slim down, eat fewer calories, and consume less saturated fat.

      However, the heart association for the first time recommends two helpings a week of fish such as tuna or salmon, based on the latest research findings that fatty acids in fish can reduce heart disease risk.

      Dr. Ronald M. Krauss, a University of California scientist who chaired the association''s dietary guidelines committee, said the recommended proportions from different food groups are similar to the US Department of Agriculture''s much-publicized food pyramid, but differs because it seeks to achieve certain goals.

      ``We don''t think a diet is effective if it hasn''t lowered cholesterol or blood pressure,'' Krauss said. For the first time, the heart association guidelines are adaptable to people with different levels of heart disease risk, such as high cholesterol or elevated blood pressure.

      Despite improved health habits and medical advances, heart disease is still the number one killer in the United states, causing more than 950,000 deaths a year - one every 33 seconds. And nearly 60,000,000 Americans have one or more forms of cardiovascular disease.

      The centerpiece of eating to avoid heart disease, say the recommendations, is a diet rich in fruits, vegetables, whole grains, fish, lean meats, and poultry. Five servings of fruits and vegetables and six servings of grains should make up the bulk of daily menus.

      The Heart Association calls for limiting saturated fats (found in animal products and tropical oils) to 10 percent or less of daily calories. So-called trans fatty acids, a component of hard margarine and some baked goods and commercially prepared foods, should be drastically eliminated.

      Intake of salt and cholesterol should be kept low, alcoholic drinks should be limited to one per day for women and two per day for men, and people should generally decrease the size of portions of high-calorie foods to prevent weight gain, say the recommendations.

      As for slimming down, the guidelines discourage extremely high-protein or low-fat diets, and instead urge striking a balance between calories eaten and calories burned through exercise. Weight loss should be gradual, not more than 1 or 2 pounds a week.

      Meier Stampfer, a professor of epidemiology and nutrition at the Harvard School of Public Health, applauded the retooled guidelines. ``This represents a major step forward toward balancing the guidelines with the current science,'' he said.

      In particular, he said, the new recommendations recognize that unsaturated fats, the kind in vegetable oils, nuts, and fish, for example, are good to have in the diet. Eating unsaturated fats is preferable to loading up on carbohydrates as a dietary strategy, he said.

      ``There had been this repeated mantra of `fat is bad'' and an emphasis on omitting total fat, and there was never a good scientific basis for that,'' Stampfer said.

      He lightly criticized the guidelines on a few points. ``I was disappointed they didn''t distinguish the quality of the carbohydrates enough,'' he said, indicating that some starches, like potatoes, quickly are broken down into glucose in the body, raising blood sugar too quickly. Other carbohydrates, like whole wheat and very coarse bread, take longer to break down and raise blood sugar more slowly.

     

c.2000 The Boston Globe