Dietary guidelines for Americans: An historical perspective

Since 1980, Dietary Guidelines for Americans have been published jointly, every 5 years, by the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (DHHS). They benefit from the recommendations of a formally appointed Dietary Guidelines Advisory Committee. The Guidelines are an example of public health recommendations that are based upon published original research and analysis of that data by expert panels. The Guidelines are intended for healthy adults, so they might reduce their risks for certain diet-related chronic conditions. They are suggestions; they do not serve-and should not be used-as regulations. Greater individualization of dietary recommendations, for both major subgroups of the population and for individual patients, can improve our effectiveness in preventing and treating specific diet-related chronic conditions. To accomplish this objective, vie need to move beyond the use of "indicators" (e.g., body mass index or blood cholesterol levels) as if they were "diagnostic," and focus on dietary and pharmacologic interventions (Or, in some cases, no intervention) based on more specific diagnostic criteria (e.g., lipid patterns, fat distribution patterns, evidence of insulin resistance, and family history). Better targeting of dietary recommendations should improve their effectiveness, while reducing costs.