Combining the U.S. Dietary Guidelines and Physical Activity

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Figure 2. Average Daily Per Capita Calories from the U.S. Food Availability in 1970, 1990, and 2008, Adjusted for Spoilage and Other Waste Other dairy fats, 6 Added fats and oils, 403 Caloric sweeteners, 402 Dairy, 155 Flour and cereal products, 432 1970 2057 kcal Fruits, 71 Vegetables, 125 Meat, eggs, and nuts, 463 Added fats and oils, 446 Caloric sweeteners, 446 Other dairy fats, 15 Flour and cereal products, 573 1990 2405 kcal Dairy, 260 Fruits, 85 Vegetables, 126 Meat, eggs, and nuts, 453 Added fats and oils, 616 Caloric sweeteners, 446 Other dairy fats, 25 Dairy, 257 Flour and cereal products, 625 2008 2674 kcal Fruits, 87 Vegetables, 122 Meat, eggs, and nuts, 482 Adapted from the U.S. Dietary Guidelines Advisory Committee report. Data source: ERS Food Availability (Per Capita) Data System www.ers.usda.gov/Data/FoodConsumption/ at least in part, the accompanying weight gain in this country. Figure 2 shows the average daily per capita calories from the U.S. food availability in 1970, 1990, and 2008, and illustrates the average calorie increase over this time [6]. While there are many factors that appear to contribute to these extra calories, including larger portion sizes and more frequent fast food, snack food, and sugar-sweetened beverage intakes, the overarching goal to reduce overweight and enhance healthy lifestyle involves eating foods that are nutrient dense in order to meet nutrient needs without exceeding calorie needs. Because data show there is a range of energy intake that accompanies energy output across different age and gender groups, the exact number of calories needed may vary across individuals. This is where physical activity can offer some flexibility. While physical activity without reduced energy intake is usually inadequate to produce and sustain substantial weight loss, the inclusion of regular physical activity was the primary recommendation of the PAGAC report, and this is further reinforced by the U.S. Dietary Guidelines as well. Currently, grain-based desserts rank highest in mean energy intake among all persons constituting the U.S. population, followed by yeast breads, chicken and chicken dishes, soda, and pizza. Among boys ages 2–18 years, pizza, grain-based desserts, and sugar-sweetened soda represent the top three contributors [6]. Table 1 provides details by age for the top ten contributors. Table 1 illustrates the mean intake of energy and mean contribution (calories) of various foods among U.S. populations [6]. Physical Activity: The Benefits of Counterbalance The DGAC report summarized the evidence regarding relationships between physical activity, body weight, and other health outcomes. There was strong, consistent evidence that people who are physically active are at reduced risk of developing obesity. Even among overweight or obese people, those who are more active have less risk of chronic disease, similar to that of normal weight people [5, 6]. Similar to the DGAC, the PAGAC report was developed by 13 experts in physical activity who conducted a rigorous Research Digest June 2012 4
systematic review of the evidence regarding the role of physical activity and health across different age, gender, and special needs groups. The DGAC report noted that the PAGAC report highlighted four distinct points that were especially relevant to understanding physical activity and energy balance. 1. Achieving energy balance and a healthy weight depend on both energy intake and expenditure. 2. The effect of caloric deficit on weight does not depend upon whether the deficit is produced by reducing intake, increasing expenditure, or both; however, research studies that include the proportion of caloric deficit due to physical activity are rare. 3. Bouts of moderate- to vigorous-intensity aerobic physical activity that contribute to meeting physical activity guidelines are not the only source of physical activity energy expenditure. Any movement throughout the day that replaces seated activity contributes to the totality of energy expenditure. 4. Even among people at a healthy body weight, regular physical activity is required to maintain health and prevent disease. Regarding the last point, accumulating data document the fact that sedentary behavior is, in itself, a risk factor for all individuals [14, 15]. Table 1. Mean Intake of Energy and Mean Contribution (kcal) of Various Foods Among U.S. Population, by Age, NHANES 2005–06 All Age Age Age Age Age Age Age Age Age Age Persons 2–18 2–3 4–8 9–13 14–18 19+ 19–30 31–50 51–70 71+ Sample Size 8549 3778 497 899 1047 1335 4771 1310 1537 1224 700 Mean Intake of Energy (kcal) 2157 2027 1471 1802 2035 2427 2199 2407 2354 2020 1691 Rank Food Group 1 Grain-based desserts 138 138 68 136 145 157 138 128 145 134 141 2 Yeast breads 129 114 65 98 109 151 134 120 128 149 141 3 Chicken and chicken mixed dishes 121 113 59 92 122 143 123 154 141 97 67 4 Soda/energy/sports drinks 114 118 23 50 105 226 112 186 121 73 33 5 Pizza 98 136 47 95 128 213 86 129 108 48 21 6 Alcoholic beverages 82 6 - - - 18 106 120 135 82 40 7 Pasta and pasta dishes 81 91 86 97 101 78 78 92 81 75 50 8 Mexican mixed dishes 80 63 26 40 76 86 85 146 99 48 9 9 Beef and beef mixed dishes 64 43 19 23 42 70 71 81 78 58 55 10 Dairy desserts 62 76 40 93 86 64 58 48 58 59 78 Adapted from the National Cancer Institute (NCI). Food sources among U.S. populations, 2005–06. Risk factor monitoring and methods branch website. Applied Research Program. National Cancer Institute 2010a. Research Digest June 2012 5
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