Table 7A. ATP III: Nutritional Components of the TLC Diet

Nutrient Recommended Intake Saturated fat* <7% of total calories Polyunsaturated fat  Up to 10% of total calories  Monounsaturated fat Up to 20% of total calories Total fat 25%–35% of total calories Carbohydrate (esp. complex carbs)  50%–60% of total calories Fiber 20–30 g/d Protein ~15% of total calories Cholesterol <200 mg/d

*Trans fatty acids also raise LDL-C and should be kept at a low intake. Note: Regarding total calories, balance energy intake, and expenditure to maintain desirable body weight.

Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda, Md: National Institutes of Health, National Heart, Lung, and Blood Institute; 2001. NIH Publication 01-3095.






Table 7B. Summary of Diet and Lifestyle Recommendations from the American Heart Association Nutrition Committee 2006

Population Goals Major Guidelines Consume an overall healthy diet Consume a variety of fruits, vegetables, and grain products, especially whole grains; choose fat-free and low-fat dairy products, legumes, poultry, and lean meats; and eat fish, preferably oily fish, at least twice a week. Aim for a healthy body weight   BMI 18.5–24.9 kg/m2 Achieve and maintain healthy weight throughout life with increased effort aimed at helping individuals avoid inappropriate weight gain during childhood years and subsequent weight gain during adult years.   Increased emphasis on prevention of weight gain in the first place.  Aim for a desirable lipid profile   LDL-C <100 mg/dL optimal        100–129 mg/dL near or above optimal        130–159 mg/dL borderline high   160–189 mg/dL high        >190 mg/dL very high   TG <150 mg/dL   HDL-C >40 mg/dL (men) >50 mg/dL (women) Reduce daily intake of saturated fat (<7%), trans-fat (<1%) and cholesterol (300 mg). Avoid excess body weight.   Drug therapy is often prescribed for those at moderate or high risk.   Dietary changes are recommended for all individuals. Aim for a normal BP   Systolic BP <120 mm Hg Diastolic BP <80 mm Hg Reduce salt intake, induce weight loss by caloric deficit, moderation of alcohol (among those who drink), increased potassium intake. Consumption of a healthy diet such as the DASH diet that emphasizes fruits vegetables, and low-fat dairy.   Include whole grains, poultry, fish, and nuts.   Reduce fat, red meat, sweets, and sugar-containing beverages.   Replace some carbohydrates with either protein from plant sources or with monounsaturated fat. Be physically active  All adults should accumulate >30 minutes of physical activity most days of the week. At least 60 minutes of physical activity most days of the week is recommended for children and those adults attempting to lose weight or maintaining weight loss. Avoid use and exposure to tobacco products Eliminate the use of tobacco products and minimize exposure to second-hand smoke.

Lichtenstein AH, Appel LJ, Brands M, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006;114:82-96.






Table 7C. USDA Dietary Guidelines for Americans

Risk Intervention    and Goals Key Recommendations Special Population Recommendations  Adequate nutrients within calorie needs   •   Consume a variety of nutrient-dense foods/beverages with the basic food groups.*  •   Limit intake of saturated and trans-fats, cholesterol, added sugars, salt, and alcohol. †  •   Balance intake of calories with energy needs.     •   Adults age >50 – consume vitamin B12.  •   Women planning pregnancy – consume foods rich in heme-iron and/or iron-rich plant and fortified foods; supplement with synthetic and fortified sources of food containing folic acid.  •   Women in first trimester – consume adequate synthetic folic acid in addition to food forms of folate.  •   Older adults, those with dark skin, and those not exposed to sufficient sunlight – consume extra vitamin D from vitamin D-fortified food and/or supplements.     Weight management  •   Maintain body weight in healthy range by balancing calories with energy expended.  •   Prevent gradual weight gain by making small decreases in food/beverage calories and increased physical activity.  •   Overweight adults – slow steady weight loss accomplished by decreasing calories and increasing physical activity; maintain adequate nutrient intake.  •   Overweight children – consultation with a healthcare provider is recommended to ensure that the reduction of body weight does not interfere with growth and development.  •   Pregnant women – ensure appropriate weight gain under supervision of healthcare provider.  •   Breastfeeding women – moderate weight loss is safe and does not compromise nursing infants.  Physical activity     •   Engage in at least 30 minutes of moderate-intensity physical activity on most days of the week.  •   Greater health benefits can be obtained by engaging in vigorous intensity or longer duration.  •   Manage body weight gain by engaging in 60 minutes of moderate-to-vigorous intensity activity on most days per week.  •   Sustain weight loss by engaging in 60–90 minutes of daily moderate-intensity physical activity while not exceeding caloric intake requirements.  •   Achieve over-all physical fitness by including a variety of exercise modalities (cardiovascular stretching, resistance, and calisthenics).  •   Children and adolescents – engage in 60 minutes of physical activity on most, preferably all, days of the week.  •   Pregnant women – if no medical or obstetric complications are present, engage in 30 minutes or more of moderate intensity physical activity most days of the week; avoid falls and abdominal trauma.  •   Breastfeeding women – no contraindications to exercise.  •   Older adults – regular physical activity will help reduce functional declines associated with aging.     Fats  •   <10% calories from saturated fat  •   <300 mg/d cholesterol  •   Limit saturated trans-fatty acids.  •   Total fat 20%–35% of total calories; emphasize polyunsaturated and monounsaturated fatty acids (ie fish, nuts, vegetable oils); consume only lean, low-fat or fat-free meat, poultry, milk, and dairy products.  •   Children and adolescents:    – ages 2 to 3 (30%–35% calories from fat)  – ages 4 to 18 (25%–35% calories from fat)  Carbohydrates   •   Fiber-rich fruits, vegetables, whole grains.  •   Limit intake of foods with added sugars or caloric sweeteners.       Sodium and potassium  •   Consume potassium-rich foods daily.  •   <2,300 mg sodium/d  •   Middle-aged and older adults, blacks, and those with hypertension:    – Sodium intake <1,500 mg/d  – Potassium intake 4,700 mg/d  Alcohol  •   Limit alcohol to 1 drink/d for women; 2 drinks/d for men.  •   Do not begin alcohol consumption if presently not used.     •   Restrict alcohol in women of child-bearing age who are planning pregnancy, pregnant women, children and adolescents, medication warnings/interactions, certain medical conditions.

* See Figure 7.
† See Table 7B.

Dietary Guidelines for Americans 2005. US Department of Health and Human Services. Available at: http://www.healthierus.gov/dietaryguidelines. Accessed on February 14, 2005.





Figure 7. Food Guide Pyramid


Food Guide Pyramid. U.S. Department of Agriculture and the U.S. Department of Health and Human Services.
Available at: http://www.mypyramid.gov/. Accessed on June 15, 2005.