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   Because of new scientific information related to nutrient requirements, the Dietary Guidelines are revised every 5 years to promote health and reduce chronic diseases. The Dietary Guidelines address diet, physical activity, and other issues related to food intake and energy expenditure. They reflect the preponderance of scientific evidence and summarize information regarding individual nutrients and food components into recommendations for eating patterns that can be adopted by the public. Government nutrition programs use the Dietary Guidelines to determine funding for research, nutrition labeling, and to develop nutrition education information for the public. The Dietary Guidelines contain technical information involved in key issues, such as energy balance. They are primarily oriented toward policymakers, nutrition educators, nutritionists, and healthcare providers, rather than the general public. The Dietary Guidelines are translated into a consumer-friendly form through the MyPyramid Food Guidance System to implement the Dietary Guidelines recommendations.  The Dietary Guidelines for 2005 include nine focus areas with 23 key recommendations. In general, the message is simple: monitor portion size, be more active, and eat a variety of foods. The guidelines support healthy eating habits to improve health and quality of life. Unique nutrient needs of specific population groups, such as people older than age 50, pregnant women, and children and adolescents, are addressed in Key Recommendations for Specific Population Groups.

Dietary Guidelines for Americans 2005

Focus on fruits

Eat a variety of fruits-whether fresh, frozen, canned, or dried-rather than fruit juice for most of your fruit choices. For a 2,000-calorie diet, you will need 2 cups of fruit each day (for example, 1 small banana, 1 large orange, and ¼ cup of dried apricots or peaches).

Make half your grains whole

Eat at least 3 ounces of whole-grain cereals, breads, crackers, rice, or pasta every day. One ounce is about 1 slice of bread, 1 cup of breakfast cereal, or ½ cup of cooked rice or pasta. Look to see that grains such as wheat, rice, oats, or corn are referred to as “whole” in the list of ingredients.

Vary your veggies

Eat more dark green veggies, such as broccoli, kale, and other dark leafy greens; orange veggies, such as carrots, sweet potatoes, pumpkin, and winter squash; and beans and peas, such as pinto beans, kidney beans, black beans, garbanzo beans, split peas, and lentils.

Go lean with protein

Choose lean meats and poultry. Bake it, broil it, or grill it. And vary your protein choices-with more fish, beans, peas, nuts, and seeds.

Get your calcium-rich foods

Get 3 cups of low-fat or fat-free milk- or an equivalent amount of low-fat yogurt and/or low-fat cheese (1½ ounces of cheese equals 1 cup of milk)-every day. For kids aged 2 to 8, it’s 2 cups of milk. If you don’t or can’t consume milk, choose lactose –free milk products and/or calcium-fortified foods and beverages.

The Healthy People 2000 report, issued in 1990 by the U.S. Department of Health and Human Services (USDHHS), identified public health goals to improve the overall health of the United States. It promoted health and disease prevention and addressed disparities in health status and health outcomes between diverse population groups. To help meet these goals within 10 years, specific objectives involving nutrition were identified in 21 different priority areas. The goals for Healthy People 2010 focus on (1) increasing the quality and years of healthy life, and (2) eliminating health disparities among racial and ethnic groups. The report emphasizes that public and private organizations must share responsibility for improving Americans’ health. Healthy People 2010 targets many objectives related to nutrition, weight, and oral health.

Healthy People 2010: Nutrition Priority Areas

• Reduce the proportion of children, adolescents, and adults who are overweight or obese.
• Increase the proportion of adults who are at a healthy weight.
• Reduce growth retardation among low-income children younger than age 5 years.
• Increase the proportion of all individuals who consume desirable levels of fruits, vegetables (at least one serving of dark green or orange), and grain products (at least six daily servings including three whole grain).
• Increase the proportion of individuals older than age 2 years who consume less than 10% of kilocalories from saturated fat and no more than 30% of kilocalories from total fat.
• Increase the proportion of individuals 2 years and older who consume 2400 mg or less of sodium.
•  Increase the proportion of individuals 2 years and older who meet dietary recommendations for calcium.
• Reduce iron deficiency among young children, women of childbearing age, and pregnant women.
• Increase the proportion of children and adolescents whose intakes from meals and snacks at school contribute proportionally to overall dietary quality.
• Increase the number of worksites that offer nutrition or weight management classes or counseling.
• Increase the number of physician office visits that include counseling or education related to diet and nutrition for patients with cardiovascular disease, diabetes, and hyperlipidemia.
• Achieve food security and reduce hunger in U.S. households.
• Increase the number of mothers who breastfeed their infants.
• Reduce the number of low-birth-weight and very-low-birth-weight infants.
• Increase the proportion of mothers who achieve a recommended weight gain during their pregnancy.
• Increase the proportion of pregnancies that begin with an optimum folic acid level.
• Reduce the proportion of children and adolescents who have dental caries in their primary or permanent teeth.
• Increase the numbers of community water systems containing optimal amounts of fluoride.

By 2004, some objectives showed positive results, whereas several objectives showed negative results. In particular, negative outcomes included decreasing numbers of people with a healthy weight, increasing prevalence of overweight people (adults, children, and adolescents), and children with dental caries and untreated dental decay.

  The dental hygiene profession continues to grow and rapidly move into the forefront of health care. To function as valuable members of today’s healthcare team, the dental hygienist must be knowledgeable in various aspects of health care. Because of the lifelong synergistic bidirectional relationship between oral health and nutritional status, dental hygienists and registered dietitians and nutritionist need to be competent in assessing and providing basic education to patients, and provide referral to each other to effect comprehensive patient care.

  All registered dietitians and some nutritionists are considered experts in the field, but their training prepares them for slightly different areas. A nutritionist has at least a 4-year degree in foods and nutrition and usually works in a public health setting assisting people on the community, such as pregnant teenagers or older individuals, with diet-related health issues. In many states, a nutritionist is legally defined and is licensed or certified. Nutritionist work in local or state health departments and in the extension service of a land-grant university. A registered dietitian (RD) has completed a minimum of a bachelor’s degree in foods and nutrition with training in normal and clinical nutrition, food science, and food service management, and advanced training in medical nutrition therapy. A registered dietitian must pass a national registration examination and receive continuing education. Registered dietitians work in hospitals, long-term care facilities, healthcare providers’ offices, pharmaceutical companies, schools, community and research settings, wellness and fitness centers, and many other settings.

  Dental professionals typically see patients on a more regular basis than other healthcare professionals; this allows observation of many physical signs, particularly oral signs, of a nutrient deficiency or medical condition that affects nutritional status before it is diagnosed. Recognition of abnormal conditions and early referral to an appropriate healthcare professional can lead to positive health outcomes for patients. Assessment of dietary information obtained from a patient can also uncover habits detrimental to oral health that can be addressed in the dental office. Additionally, compromised oral health may affect food choices. For example, patients who lose their teeth may avoid foods that are hard to chew and reduce the quality and variety of their diets.

  Finally, dental hygienists can follow up on the goals established by patients to evaluate their understanding and compliance. Overall, the dental hygienist is committed to prevention of oral disease along with promotion of health and wellness. All healthcare professionals must work together to enhance patient care.

 Abundance of food and lack of physical activity make maintaining healthy weight quite difficult for a number of Americans. Body Mass Index (BMI) is considered a preferred current method of defining healthy weight (it is not appropriate for children younger than 2).

BMI can be determined by dividing weight (in lbs) by the height (in inches), dividing that number by the height (in inches) again, and then multiplying the answer by 703. A BMI of less than 25 is considered the upper limit of healthy weight.

A BMI of 25 is considered overweight. A BMI of 30 and more is considered as obesity.   

To prevent excessive weight most people have to eat more fruits and vegetables, be physically more active, reduce intake of high-calorie foods and sugar sweetened drinks. Portion size can also do a trick. According to studies, controlling portion size might reduce energy intake. 

Physical activity is important factor for maintaining healthy weight for all age groups. Different intensities and types of exercise have different effect. Vigorous physical activity is better for body fitness than moderate activity. Resistance exercise increases muscular strength. To reduce the risk of osteoporosis weight-bearing exercise is the best – it maintains the peak bone mass during adulthood and prevents bone loss among aging people. Regular physical activity reduces the risk of early death, coronary heart disease, stroke, hypertension, type 2 diabetes, colon and breast cancer, and depression.

 For substantial health benefits, adults should do at least 150 minutes (2.5 hours) a week of moderate – intensity, or 75 minutes (1.5 hours) weekly of vigorous – intensity exercise aerobic physical activity. Preferably adults should increase their physical activity to get more health benefits, and work on muscle strengthening activities as well.

 Many Americans consume excessive kilocalories but inadequate amounts of some nutrients. Meeting nutrient recommendations must be balanced with keeping caloric levels under control. In the other words, food choices need to change when caloric intake levels are decreased to include foods containing more nutrients. 

Dietary intake data and evidence of public health problems indicate that adults consume inadequate amounts of calcium, potassium, dietary fiber, magnesium, and vitamins A,C, and E. In addition, older men, women, and adolescent girls fail to consume adequate amounts of zinc, and older women are not getting enough vitamin B6 from their diets. 

The Dietary Guidelines promote the use of foods to meet physiological nutrient needs. In addition to the array of nutrients provided by food, hundreds of other naturally occurring substances present may protect against chronic health conditions. In some cases, fortified foods are advisable sources of nutrients that otherwise might be consumed in less that recommended amounts (e.g., folic acid). Supplements, recommended if a specific nutrient cannot or is not otherwise being met by food intake, cannot replace a healthful diet. A high-quality diet that does not provide excess kilocalories, in addition to physical activity, should enhance the health of most Americans. 

♦         Consume a variety of nutrient-dense foods and beverages within and among the basic food groups, while choosing foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol.   

♦         Meet recommended intakes with energy needs by adopting a balanced eating pattern, such as My Pyramid or the DASH (Dietary Approach to Stop Hypertension) Eating Plan.

If you want to prevent cavities, how often you eat can be just as important as what you eat. That’s because food affects your teeth and mouth long after you swallow. Eating cookies with dinner will do less harm to your teeth than eating them as a separate snack. Of course, overall poor nutrition can contribute to periodontal (gum) disease. It also can have other long-term effects on your mouth. Learning how food affects your oral health is the first step toward mouth-healthy eating.

Immediate Effects of Food
Changes begin in your mouth the minute you start to eat certain foods. Bacteria in your mouth make acids. The acids start the process that can lead to cavities.

How does this happen?

All carbohydrate foods eventually break down into simple sugars: glucose, fructose, maltose and lactose. Fermentable carbohydrates break down in the mouth. Other foods don’t break down until they move further down the digestive tract.

It’s the fermentable carbohydrates that work with bacteria to form acids that begin the decay process and eventually destroy teeth. They include the obvious sugary foods, such as cookies, cakes, soft drinks and candy. But they also include less obvious foods, such as bread, crackers, bananas and breakfast cereals.

Certain bacteria on your teeth use the sugars from these foods and produce acids. The acids dissolve minerals inside the tooth enamel. The process is called demineralization. Teeth also can regain minerals. This natural process is called remineralization. Saliva helps minerals to build back up in teeth. So do fluoride and some foods.

Dental decay begins inside the tooth enamel when minerals are being lost faster than they are being regained.

The longer food stays near the bacteria on the tooth, the more acids will be produced. So sticky carbohydrates, such as raisins, can do more acid damage. But other foods that pack into crevices in the tooth also can cause decay. Potato chips are a terrific example. Eat a handful of chips and see how long you have to work to get all the stuck bits out from between your teeth. Teeth with a lot of nooks and crannies, such as molars, are more likely to trap food. That’s why they tend to have more decay.

To make matters worse, many of the foods that are unhealthy for teeth don’t just create acids while they are being eaten. The acids stick around for the next half-hour.

Depending on your eating and drinking patterns, it’s possible for the bacteria to produce acid almost constantly. This can happen if you sip soft drinks or sweetened coffee throughout the day. Eating many small sweet or starchy snacks can produce the same effect. The resulting acid damage adds up, so decay is more likely. Studies have shown that people who eat sweets as snacks between meals have higher rates of decay than people who eat the same amount of sweets with their meals.

On the brighter side, some foods actually help to protect teeth from decay. That’s because they increase saliva flow and neutralize the acids produced by bacteria. This makes it less likely that the enamel will lose minerals. For example, aged cheese eaten immediately after other food helps to buffer the acid.

Chewing sugarless gums also can help protect your teeth against cavities. Xylitol is an ingredient in some sugarless gums. This sweetener has been shown to reduce the amount of bacteria in the mouth. It also helps to buffer the teeth against the effect of acid. Most sugarless gums and sugarless candies increase the flow of saliva, which helps to protect your teeth against bacteria.

Long-Term Effects
Like the rest of your body, your mouth depends on overall good nutrition to stay healthy. In fact, your mouth is highly sensitive to poor nutrition. It can lead to tooth loss, serious periodontal (gum) disease and bad breath.

What To Eat
The current and best advice for overall good nutrition is found in the Dietary Guidelines for Americans. This document was developed by the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services.

The guidelines are simple in concept:

• Eat whole grains daily instead of refined grains. Whole grains include brown rice, oatmeal and whole wheat bread. Refined grains include white bread and white rice.
• Eat healthier vegetables, including dark green and orange vegetables.
• Eat a variety of fruits.
• Choose a diet with plenty of grain products, fruits and vegetables.
• Choose fish, beans, nuts and seeds for some of your protein needs.
• Choose beverages and foods to moderate your intake of sugars.
• Choose and prepare foods with less salt.
• If you drink alcoholic beverages, do so in moderation.
• Aim for a healthy weight and be physically active each day.

To help people understand these guidelines, the USDA has replaced the old Food Guide Pyramid. The new guide is an interactive tool called MyPyramid. It is actually many different pyramids, depending on a person’s age, gender and physical activity.

Your diet, like the pyramid, should have:

• A strong base of grains
• At least 2½ cups of vegetables a day
• At least 2 cups of fruits a day
• At least 3 cups of calcium-containing milk, yogurt and cheese
• Proteins such as meats, beans, eggs and nuts

Eat fats and sweets sparingly.

To prevent tooth decay, you should follow a few additional guidelines. This can help to keep the amount of acid created by the bacteria on your teeth to a minimum. Here are some tips:

1. Limit between-meal snacking. Fewer snacks mean less acid exposure for your teeth. If you snack, choose foods that are not fermentable carbohydrates.
   • Best choices — Cheese, chicken or other meats, or nuts. These foods actually may help protect tooth enamel. They do this by neutralizing acids or by providing the calcium and phosphorus needed to put minerals back in the teeth.
   • Moderate choices — Firm fruits such as apples and pears and vegetables. Firm fruits contain natural sugars. However, their high water content dilutes the effects of the sugars. These fruits also stimulate the flow of saliva, which fights bacteria and helps protect against decay. Vegetables do not contain enough carbohydrates to be dangerous.
   • Worst choices — Candy, cookies, cakes, crackers, breads, muffins, potato chips, french fries, pretzels, bananas, raisins and other dried fruits. These foods provide a source of sugar that certain bacteria can use to produce acid. The problem can be worse if the foods stick to teeth or get caught between them.
2. Limit the amount of soft drinks or any other drinks that contain sugar. These include coffee or tea with added sugar, cocoa and lemonade. Fruit juices contain natural sugars that also can cause decay. Limit the amount of time you take to drink any of these drinks. Avoid sipping them throughout the day. A can of soda that you finish with a meal exposes your teeth to acids for a shorter time than a soda that takes you two hours to drink.
   • Better choices — Unsweetened tea and water, especially fluoridated water. Tea also has fluoride, which can strengthen tooth enamel. Water helps flush away bits of food. It also can dilute the sugar acids.
3. Avoid sucking on hard candies or mints, even the tiny ones. They have enough sugar to increase the acid produced by bacteria to decay levels. If you need a mint, use the sugarless varieties.
4. Very acidic foods (such as citrus fruits) can make the mouth more acidic. This may contribute to a loss of minerals in the teeth. The effects of acid exposure add up over time. Every little bit counts.
5. Brush your teeth after eating and after drinking sugary drinks, to remove the plaque bacteria that create the destructive acids. If you cannot brush after every meal, brush at least twice a day.
6. Chew sugarless gum that contains xylitol. This can help reduce the risk of cavities. The gum helps dislodge some of the food stuck to your teeth. It also increases saliva flow to help neutralize the acids.