US Dietary Guidelines: 2010 version is very much focused on tackling the US’s near pandemic overweight and obesity problem and so salt, fat and sugar reduction feature prominently.
Suggestions include half-filling plates with fruits and vegetables at meal times; switching to low-fat milk; avoiding oversized portions and eating less.
Specific health conditions and sub-groups are seen as the most suitable for supplementation.
* Vitamin D fortification of yogurt, milk, orange juice and soy beverages are noted as being beneficial in helping to improve calcium absorption and preventing rickets, but levels over 100mcg per day are linked to increased chances of adverse events.
* Mandatory folic acid fortification is highlighted as helping to prevent neural tube defects in babies and women of childbearing age recommended to consume 400mcg of folic acid per day from dietary supplements, fortified foods and folate-rich foods.
* Crystallined vitamin B12 is recommended for the over 50s.
* Iron supplementation is recommended for all pregnant women.
Multivitamins are however not backed, as there is insufficient evidence to suggest they can assist, “the primary prevention of chronic disease for the healthy American population.”
However: “Supplements containing combinations of certain nutrients may be beneficial in reducing the risks of some chronic diseases when used by special populations. For example, calcium and vitamin D supplements may be useful in postmenopausal women who have low levels of these nutrients in their diets, to reduce their risk of osteoporosis. In contrast, high levels of certain nutrient supplements may be harmful, if a nutrient’s Tolerable Upper Intake Level is exceeded. Supplement use may be discussed with a health care provider to establish need and correct dosage.”
In making such allowances the Guidelines affirm: “A fundamental premise of the Dietary Guidelines is that nutrients should come primarily from foods. Foods in nutrient-dense, mostly intact forms contain not only the essential vitamins and minerals that are often contained in nutrient supplements, but also dietary fiber and other naturally occurring substances that may have positive health effects.”