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One diet fits all

BMJ 1999; 318 doi: (Published 19 June 1999) Cite this as: BMJ 1999;318:1646
  1. Janice Hopkins Tanne
  1. New York

    Led by the American Heart Association, four major health groups have agreed on a diet to reducethe risk of heart disease, stroke, cancer, and diabetes. The American Cancer Society, the AmericanDietetic Association, the American Academy of Pediatrics, and the National Institutes of Health have endorsed the diet, which is low in fat and high in fruits and vegetables.

    The “Unified Dietary Guidelines” should make it easier for the public to understand what a healthy diet is. The guidelines will be published in the 27 July issue of Circulation,the journal of the American Heart Association. Circulation is also available at

    The report was due to be released at a news conference in New York as the BMJ went to press. Richard Deckelbaum, director of the Institute of Human Nutrition at Columbia University in New York and one of the authors of the study, said, “I realised when I was giving talks about healthy lifestyle that you didn't need different diets [for the diseases listed above]. They should be the same.”

    The unified guidelines offer six simple rules: eat a variety of foods; choose most foods from plant sources; eat five or more servings of fruit and vegetables each day; eat six or more servingsof bread, cereals, pasta and/or rice each day; eat high fat foods sparingly, particularly those from animal sources; and keep the intake of simple sugars to a minimum.

    Fat should account for no more than 30% of calories, and saturated fat (found in dairy products and meat) should be less than 10% of total calories.

    Dr Deckelbaum suggests eating low fat dairy products, trimming meat carefully, and eating modest portions. Salt intake should be limited to 6 g a day–about a teaspoon–including the sodium in food. Cholesterol should be limited to 300 mg a day.

    Total calories should be only enough to maintain desirable weight, since a third of Americans are severely overweight. The diet meets nutritional needs of children over the age of 2 years, women, and elderly people, as well as the general public, the consensus said.

    In addition, the guidelines recommend that women consume low fat dairy products to increase calcium intake and lessen the risk of osteoporosis and eat foods rich in folates to reduce the risk of birth defects.

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