Diet and Disease Prevention

Definition

Research has shown that diet has a tremendous impact on short- and long-term health. Poor diet not only leads to nutritional deficiencies, but also contributes to the development of chronic diseases such as obesity, type 2 diabetes, and cardiovascular disease. A good diet combined with exercise promotes a healthy weight, reduces many health risks, and increases both physical and mental well-being.

Purpose

About half of all American adults have one or more chronic preventable diseases that has developed due to poor eating habits and physical inactivity. Rates of these chronic diet-related diseases continue to rise, along with associated health risks and high healthcare and societal costs, such as lost productivity. Nutrition researchers have therefore focused on investigating the relationships among diet, chronic disease, longevity, and quality of life.

Research has shown that following specific diets, such as the Dietary Approach to Stop Hypertension (DASH) diet and Mediterranean diet, can reduce cardiovascular risk factors such as high blood pressure and cholesterol, thereby preventing cardiovascular disease from developing. The DASH diet may also be beneficial for those with diabetes and obesity. The Mediterranean diet has also been shown to reduce cognitive decline and frailty in older adults. In 2018, U.S. News & World Report gave the DASH diet and Mediterranean diet its highest ranking in their annual Best Diets Overall evaluation due to their associated health benefits.

Description

The position of the Academy of Nutrition and Dietetics (formerly the American Dietetic Association) on the role of nutrition and diet in health promotion and disease prevention programs includes steps for primary, secondary, and tertiary prevention. These steps include the following guidelines:

Dietary guidelines

The 2015–2020 Dietary Guidelines for Americans, published in 2015 by the U.S. Department of Agriculture (USDA) and Department of Health and Human Services (HHS), provide an overall view of good nutrition along with specific recommendations for improved dietary habits. These dietary guidelines include:

Specific key recommendations related to a healthy eating pattern from the “2015–2020 Dietary Guidelines for Americans” include the following foods:

The guidelines have assigned limits for dietary components that are of particular concern in the United States due to the increasing number of obese and overweight individuals and the prevalence of chronic preventable diseases. These include consuming:

In conjunction with the above dietary recommendations, the USDA and HHS recommend that children, adolescents, adults, and older adults meet established physical activity guidelines to promote health, maintain a healthy body weight, and reduce risk of chronic disease.

MyPlate recommendations

More than one hundred years ago, in 1894, the USDA published its first set of national nutrition guidelines. MyPlate, replacing the former MyPyramid, is the most recent set of guidelines. The MyPlate design was simplified from the food pyramid to help consumers visualize the actual breakdown of each meal. Half of the plate is devoted to vegetables and fruits, slightly less than one-quarter is made up of protein (no longer meat and beans), and the remaining amount is dedicated to grains. A side of dairy is also featured, and the previous fats-and-oils category is obsolete. The MyPlate ethos emphasizes lifestyle factors such as exercise in addition to nutrition.

MyPlate is intended to help Americans become more aware of what they eat and what their nutrient requirements are. It is designed to help people learn how to eat a healthy diet, live an active lifestyle, and maintain or gradually move in the direction of a healthy weight, which will reduce the risk of weight-related diseases. MyPlate personalizes the specific amounts needed in each category based on the individual's age, gender, and activity level.

National objectives

Healthy People 2020 is a set of national health objectives in the United States. Many of these objectives are related to improving health by changing and improving the typical “American” diet. The goals of Healthy People 2020 are to:

Precautions

One precaution is to avoid filling up on empty calories. Empty calories are calories derived from solid fats or added sugars that provide little-to-no nutritional value. Foods such as desserts, soda pop, and fried foods may contain all or some empty calories. MyPlate acknowledges that occasional consumption of empty calories is okay, but these foods should be eaten in moderation and considered against daily caloric goals.

KEY TERMS
Cholesterol—
A waxy substance made by the liver and also acquired through diet. High levels in the blood may increase the risk of cardiovascular disease.
Fiber—
Also known as roughage or bulk; insoluble fiber moves through the digestive system, giving bulk to stool; soluble fiber is carbohydrate that dissolves in water and digestive juices and helps keep stool soft.
Obesity—
Excessive weight due to accumulation of fat, usually defined as a body mass index of 30 or above or body weight greater than 30% above normal on standard height-weight tables.
Overweight—
A body mass index between 25 and 30.
Registered dietitian (RD)—
A health professional who has a bachelor's degree specializing in foods and nutrition, and in addition undergoes a period of practical training in a hospital or community setting. Many dietitians further their knowledge by pursuing master's or doctoral degrees. The title “registered dietitian” is protected by law so that only qualified practitioners who have met education qualifications can use that title.

Interactions

Registered dietitians (RDs) have the training and knowledge to accurately assess the nutritional adequacy of an individual's diet, especially if chronic disease is present. Doctors are also able to conduct a dietary assessment or provide general nutrition advice and/or diet therapy. Nurses and allied health professionals can reinforce good dietary choices and provide nutrition guidance for individuals in hospitals or long-term care facilities or in community settings.

Complications

QUESTIONS TO ASK YOUR DOCTOR

Parental concerns

Many parents wonder if their children are getting proper nutrition. Following the MyPlate guidelines for each age group can alleviate those concerns. An additional concern is encouraging children to eat healthy meals rather than junk foods and empty calories. By presenting fruits and vegetables as snacks and offering well-balanced meals, parents can help children make better choices.

See also Academy of Nutrition and Dietetics ; Calcium ; Coronary heart disease ; Diabetes mellitus ; Dietary guidelines ; Dietary reference intakes (DRIs) ; Functional foods ; Healthy People 2020 ; MyPlate ; Obesity ; Soy ; Trans fats ; Whole grains .

Resources

BOOKS

Coulston, Ann M., Carol J. Boushey, and Mario Ferruzzi. Nutrition in the Prevention and Treatment of Disease. 4th ed. Amsterdam: Academic, 2017.

Dunn, Carolyn. Nutrition Decisions: Eat Smart, Move More. Burlington, MA: Jones & Bartlett Learning, 2013.

Ferraro, Katie. Diet and Disease: Nutrition for Heart Disease, Diabetes, and Metabolic Stress. New York: Momentum, 2015.

Fuhrman, Joel R. The End of Heart Disease: The Eat to Live Plan to Prevent and Reverse Heart Disease. San Francisco, CA: HarperOne, 2016.

PERIODICALS

Nowson, Caryl A., C. Service, J. Appleton, et al. “The Impact of Dietary Factors on Indices of Chronic Disease in Older People: A Systematic Review.” Journal of Nutrition, Health, and Aging 22, no. 2 (2018): 282–96.

Siervo, Mario, J. Lara, S. Chowdhury, et al. “Effects of the Dietary Approach to Stop Hypertension (DASH) Diet on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis.” British Journal of Nutrition 113, no. 1 (January 2015): 1–15. https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/effects-of-the-dietary-approach-to-stop-hypertension-dash-diet-on-cardiovascular-risk-factors-a-systematic-review-and-metaanalysis/C3B37FC59A6FE257F3750C429C1251E6 (accessed May 14, 2018)

WEBSITES

American Heart Association. “The American Heart Association's Diet and Lifestyle Recommendations.” Heart.org . http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/The-American-Heart-Associations-Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp#.WuYNCogvzIV (accessed May 14, 2018).

Food and Nutrition Board, Institute of Medicine. “Dietary Reference Intakes Tables and Application.” The National Academies of Sciences, Engineering, and Medicine. http://nationalacademies.org/HMD/Activities/Nutrition/SummaryDRIs/DRI-Tables.aspx (accessed May 14, 2018).

National Heart, Lung, and Blood Institute. “High Blood Cholesterol.” National Institutes of Health. https://www.nhlbi.nih.gov/health-topics/high-blood-cholesterol (accessed May 14, 2018).

Office of Disease Prevention and Health Promotion. “Developing Healthy People—2030.” U.S. Department of Health and Human Services. http://www.healthypeople.gov/2020/default.aspx (accessed on May 14, 2018).

U.S. Department of Agriculture. “MyPlate.” Choose MyPlate.gov . http://www.choosemyplate.gov (accessed on May 14, 2018).

U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2015–2020. 8th ed. December 2015. http://health.gov/dietaryguidelines/2015/guidelines (accessed May 14, 2018).

U.S. News & World Report. “Best Diets Overall.” Health. USNews.com . https://health.usnews.com/best-diet/best-diets-overall (accessed May 14, 2018).

ORGANIZATIONS

Academy of Nutrition and Dietetics, 120 S. Riverside Plaza, Ste. 2190, Chicago, IL, 60606-6995, (312) 899-0040, (800) 877-1600, amacmunn@eatright.org, http://www.eatright.org .

Center for Nutrition Policy and Promotion, U.S. Department of Agriculture, 3101 Park Center Dr., 10th Fl., Alexandria, VA 22302, (202) 720-2791, support@cnpp.usda.gov, http://www.cnpp.usda.gov .

Food and Nutrition Information Center, National Agricultural Library, 10301 Baltimore Ave., Beltsville, MD, 20705, (301) 504-5755, Fax: (301) 504-7042, fnic@ars.usda.gov, https://www.nal.usda.gov/fnic .

Food Standards Agency, Fl. 6 & 7, Clive House, 70 Petty France, London, United Kingdom, SW1H 9EΧ, +44 020 7276 8829, helpline@foodstandards.gsi.gov.uk, http://www.food.gov.uk .

Institute of Food Technologists (IFT), 525 W. Van Buren, Ste. 1000, Chicago, IL, 60607, (312) 782-8424, (800) 438-3663, Fax: (312) 782-8348, info@ift.org, https://www.ift.org .

International Food Information Council Foundation, 1100 Connecticut Ave. NW, Ste. 430, Washington, DC, 20036, (202) 296-6540, info@foodinsight.org, http://www.foodinsight.org .

U.S. Department of Agriculture, 1400 Independence Ave. SW, Washington, DC, 20250, (202) 720-2791, http://www.usda.gov .

Tish Davidson, AM
Revised by Jennifer E. Van Pelt, MA

  This information is not a tool for self-diagnosis or a substitute for professional care.