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Taking politics out of diet rules

Confused about what constitutes a proper diet?

No wonder. Results of scientific studies get more complex and conflicting weekly, and more important, many of the "official guidelines" actually are diets drafted by committee.

Since those committees often include members of industry as well as dietitians and health activists, the resulting advice is often a compromise between what is ideal nutritionally and what is practical and politically acceptable.

So some recommendations _ like those to cut fat consumption to 30 percent of calories and to eat no more than six ounces of meat a day _ are not the pure advice; many health professionals on the panels that draw up such diets think Americans should cut out much more of the fat and meat.

To find out what the experts really think when they don't have to worry about compromise with industry and politicians, Consumers Union turned to a super-committee of its own making. It asked 94 scientists, clinicians, registered dietitians and educators who had been members of various nutrition committees, both public and private, for frank dietary advice on the makeup of the "ideal" diet. Sixty-eight completed an 18-page questionnaire, the results of which are published in the October issue of Consumer Reports.

Their recommendations differ markedly not only from what most Americans eat and from the standard recommendations of the Federal Dietary Guidelines, the Surgeon General's Report, the American Heart Association, and the National Cancer Institute.

Their advice is strong dietary medicine: Eat even more fruits vegetables and grains and cut out more meats and fats. Here are some results:

Carbohydrates

Recent recommendations to eat at least five servings of fruit and vegetables a day are not the ideal, these experts say: At least seven servings is better, plus at least six servings of grains. More than half of daily calories should come from carbohydrates.

Slightly more than half of the experts agree with the National Cancer Institute's advice to eat 20 to 35 grams of fiber a day.

Protein

One nutrient no one seems concerned about is protein. Everyone who eats enough food gets enough protein.

Fat

Most of the experts in the survey believe that fat consumption should be cut to 25 percent of daily calories or less, not the 30 percent maximum that is usually recommended. Two-fifths of the experts think that cutting down to 20 percent or less is better.

About half of the experts believe that the current maximum recommendation of 300 milligrams of dietary cholesterol a day is too high, suggesting instead a figure of 200 milligrams.

Generally, however, they believe it is more important to cut back on total fat and saturated fat than on cholesterol. They recommend a reduction of saturated fat to less than 7 percent of daily calories; current recommendations say 10 percent or less.

The experts believe that the evidence that polyunsaturates cause cancer is weak, but there is widespread agreement that mono-unsaturates _ olive and canola oils _ help to lower cholesterol levels when they replace saturated fats.

A solid majority recommend eating fish two or more times a week, but few believe that fish-oil supplements containing omega-3 fatty acids are necessary, even though those acids do reduce triglycerides, fats contributing to heart disease.

Vitamins and minerals

There are only two minerals that might require supplementation, the experts say: calcium and iron. Otherwise they believe that if the diet they recommend is followed there will be sufficient amounts of vitamins and minerals.

The experts believe that all women who are at risk of osteoporosis _ those who smoke, who drink large amounts of alcohol, who get little weight-bearing exercise or those who have a family history of the disorder _ should consume slightly more than 1,000 milligrams of calcium a day.

Black American women have a lower risk or osteoporosis than white or Asian women.

People who require extra iron may need to take iron supplements in addition to the iron they get in food. They are generally women with excessive menstrual bleeding, pregnant or lactating women and people with certain medical conditions.

Almost half of the experts also believe that there is enough evidence to increase consumption of fruits and vegetables high in the anti-oxidants _ vitamins C, E and beta-carotene _ which may have a protective role in cancer and heart disease.

Sugar, salt, coffee and alcohol

Half of the experts recommend reducing consumption of sugars added to food (as opposed to sugars occurring naturally in food) to 5 percent of calories.

Most of the experts agree with the National Research Council's advice to keep salt intake at 6 grams a day (or 2,400 milligrams of sodium).

A small majority believe that no more than two cups of caffeinated coffee a day would be ideal.

Alcohol appears to produce the greatest quandary. Half of the experts believe there is strong evidence that moderate alcohol consumption _ no more than two drinks a day _ provides health benefits, but they are reluctant to recommend that people start drinking, even in moderation. All agree that pregnant women and people who have a family history of alcohol abuse should abstain.

Most of these experts believe that one-third of all cancer deaths and a large proportion of heart attacks are probably the result of high-fat, high-calorie foods, but how individuals are affected is determined, in part, by their cholesterol count, blood pressure and their family trees.

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