Health as Energy Balance: Reducing Nutrition to Calories In-Calories Out

Just got the ACSM's latest Exercise and Sport Sciences Reviews. The first article discusses the Institute of Medicine (IOM) Macronutrient Report, which is also titled: Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids. This is a 1331 page document originally appeared via Web in 2002 and it has taken over 3 years for it to appear in paper form; it served as the basic research behind the development of the US Department of Health and Human Services and the USDA's new Dietary Guidelines for Americans, 2005. It is the basis of the new "food pyramid." (http://www.mypyramid.gov/)

From the ACSM's point of view, the document is important because is advocates physical activity and exercise as a part of national health policy on nutrition. Prior to this document, physical activity and exercise were not officially considered with nutrition; now the two are unified. In fact, the report initially caused a stink with the popular press as it recommended 60 min per day of activity; other agencies had been struggling to establish credibility for their 30 min per day recommendation.

I'm glad the two are now linked. But the following statements bothered me, however:

Explaining the necessity to balance dietary energy intake and expenditure was a goal of the Macronutrient Report. Using physical activity and exercise to achieve balance without restricting food intake, but rather taking advantage of the healthful and invigorating, but exergonic effects of exercise to balance energy intake in the absence of dietary restriction was another goal of the IOM Report.

Exercise is great; it is essential to human health. But are we, in our effort to simplify things for our overfed, under-nourished culture, reducing nutrition health to simply calories and calories out? I used to believe this--restriction, MODERATION and simple math--was the answer. But now I know it is not. It is not just about exercising enough to combat the calories we take in. It is about choosing GOOD CALORIES--the best calories that in their whole, natural form, provide us with fiber, micronutrients and macronutrients to give nutritional excellence and make health the default. Funny that since I've completely revamped my eating habits to focus completely on unprocessed, plant-based foods that I've lost over 15 lbs without actually counting a calorie? I (and many of my friends) are walking billboards that eating well combined with exercise allows the body to naturally take care of energy balance.

Have the panels of experts simply abandoned the idea of actually getting Americans to make substantial eating behavior changes--"oh the best we can do is to get people to eat a little less and move a little more?" Have we given up on the idea that people can actually change behaviors if given the right information?

I went to MyPyramid.com and put in my age and gender and activity level. The website suggested I consume 2200 calories a day, and says I need the same amount of milk and veggies (3 cups!) every day. Those who know me, know I am ROTFLMAO at this suggestion:

3 cups of ANY veggies a day (MyPyramid divids veggies into dark green, orange, starchy, other and beans/peas--AND THEY SAY I should shoot for a whole 3 cups of dark green veggies PER WEEK!--out of 21 cups of veggies total in a week!)
2 cups of fruit
3 cups of milk--a DAY!!!! (Of course, they say soy or other calcium fortified products "might not provide the other nutrients found in milk or milk products." Score a BIG one for the dairy industry!)
6 ounces of meat & beans
7 ounces of grains

This is SAD. The people who are supposed to educate us about nutrition and health have given up the ghost and watered the message down to calories, portions and BMI numbers. This does nothing but keep the status quo and satisfy special interests. Calorie counting / energy balance and portion restriction alone is pissing into the wind of the obesity hurricane that is upon us.

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