The healthy heart diet is the result of ongoing nutrition research by organizations including the United States Department of Agriculture (USDA) and the American Heart Association (AHA). The department first issued dietary recommendations for Americans in an 1894 Farmer’s Bulletin, according to the 1996 USDA report Dietary Recommendations and How They Have Changed Over Time.
The 1894 recommendations came from W.O. Atwater, first director of the USDA’s Office of Experiment Stations. He proposed a diet for American men based on protein, carbohydrate, fat, and mineral matter. In a 1902 Farmer’s Bulletin, he warned about the danger of a dieting consisting of too much protein or fuel ingredients (carbohydrates and fat). “The evils of overeating may not be felt at once, but sooner or later they are sure to appear—perhaps in an excessive amount of fatty tissue, perhaps in general debility, perhaps in actual disease,” Atwater cautioned.
More was known about nutrients in 1941 when the USDA first issued the Recommended Dietary Allowances (RDAs). The allowance allowances covered areas like calorie intake and nine essential nutrients: protein, iron, calcium, vitamins A and D, thiamin, riboflavin, niacin, and ascorbic acid (Vitamin C). The USDA also released national food guides during the 1940s. The guides provided a foundation diet with recommendations for foods that contained the majority of nutrients. The guide was modified in 1956 with recommended minimum portions from food groups that the USDA called the “Big Four”: milk, meats, fruits and vegetables, and grain products.
The guides remained in effect until the 1970s when an increasing amount of research showed a relationship between the over-consumption of fat, saturated fat, cholesterol, and sodium and the risk of chronic diseases such as heart disease and stroke. In 1979, the USDA guide included the Big Four and a fifth category that included fats, sweets, and alcoholic beverages.
The following year, the USDA and the Department of Health and Human Services (HHS) issued the first edition of Nutrition and Your Health: Dietary Guidelines for Americans. The recommendations for healthy Americans age 2 and older included consuming a variety of foods, avoiding too much fat, saturated fat, cholesterol, and sodium. Those guidelines were recommended for people older than age 2 because younger children need more calories and fat in their diet to aid in their growth and development.
The USDA and HHS update the federal guidelines every five years. The 1990 edition recommended a diet low in fat, saturated fat, and cholesterol. Salt and sugars were to be consumed in moderation. In Dietary Guidelines for Americans 2005, the federal departments featured more specific recommendations.
The recommendations for healthy Americans came from two departments that are part of the National Institutes of Health (NIH). Within NIH is the National Heart, Lung, and Blood Institute (NHLBI), which was formed by Congress in 1948. In the 21st Century, the institute’s focus on heart disease included the creation of a Heart Healthy Diet to keep cholesterol low and the Therapeutic Lifestyles Changes (TLC) Diet to help people lower their blood cholesterol.
Furthermore, the American Heart Association (AHA)has long been concerned with educating the public about the relationship between diet and heart health. The association started in 1924 as an outgrowth of local organizations including the Association for the Prevention and Relief of Heart Disease in New York City. That group was founded in 1915 and consisted of physicians and social workers.
The national organization’s public education activities include issuing nutritional guidelines that are periodically revised. The title of the association’s “2006 Diet and Lifestyle Recommendations” reflected the importance of diet and physical activity on health, a combination endorsed by the medical community and public health organizations.
