The Dietary Guidelines for Americans have been updated to include, for the first time, recommendations across the lifespan. 

Dr. Donald Hensrud, director of the Mayo Clinic Healthy Living Program, says the dietary guidelines, which are updated every five years, are designed to give the best recommendations on what to eat and drink to promote health and prevent disease.

One of the changes for this edition of the guidelines is focused on a lifespan approach from infancy to older adulthood. "We've known for quite some time that for the first six months of an infant's life, they should be fed exclusively human breast milk," says Dr. Hensrud.

"Another addition that people may not be aware of is that when foods are introduced to an infant around the age of 4 to 6 months, peanut-containing foods can be added to the diet after checking with the infant’s health care provider. The evidence shows that by adding peanuts early in the diet, it may prevent allergies later on. Also, under the age of 2 years, no added sugars should be included in the diet of children. Added sugars do not provide any health benefit

Watch: Dr. Donald Hensrud discusses 2021 Dietary Guidelines for Americans.

Journalists: Broadcast-quality sound bites with Dr. Hensrud are available in the downloads at the bottom of the post. Please "Courtesy: Donald Hensrud, M.D./Healthy Living Program/Mayo Clinic."

Key recommendations from the guidelines include:

• For about the first 6 months of life, exclusively feed infants human milk. 
• At about 6 months, introduce infants to nutrient-dense complementary foods. Introduce infants to potentially allergenic foods along with other complementary foods. 
• From 12 months through older adulthood, follow a healthy dietary pattern across the lifespan to meet nutrient needs, help achieve a healthy body weight and reduce the risk of chronic disease.
• Limit foods and beverages higher in added sugars, saturated fat and sodium, and limit alcoholic beverages.

Dr. Hensrud says that before the guidelines are released, a scientific report on dietary guidelines is published. The dietary guidelines are then derived from this scientific report.

"What many people who work in nutrition would have liked to have seen is a lower limit for added sugars and alcohol. This was included in the scientific report, but did not end up in the Dietary Guidelines," says Dr. Hensrud.

"For example, the dietary guidelines recommend no more than 10% of calories as added sugars. But the scientific report recommended no more than 6%," he says. "Similarly, previous guidelines recommended up to no more than an average of two drinks per day for men. The scientific report recommended lowering this to one drink a day on average for both men and women. The Dietary Guidelines still recommend up to two drinks a day for men."

Dr. Hensrud says the less added sugars in your diet, the better it will be. "We know that there is very little health benefit and many health risks from including too much added sugars in the diet. Sugars that are naturally present, such as in fruit, are fine to have in the diet."

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In many people, whooping cough (pertussis) is marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like "whoop."

Before the vaccine was developed, whooping cough was considered a childhood disease. Now whooping cough primarily affects children too young to have completed the full course of vaccinations and teenagers and adults whose immunity has faded.

Deaths associated with whooping cough are rare but most commonly occur in infants. That's why it's so important for pregnant women — and other people who will have close contact with an infant — to be vaccinated against whooping cough.

Symptoms

Once you become infected with whooping cough, it takes about seven to 10 days for signs and symptoms to appear, though it can sometimes take longer. They're usually mild at first and resemble those of a common cold:

• Runny nose
• Nasal congestion
• Red, watery eyes
• Fever
• Cough

After a week or two, signs and symptoms worsen. Thick mucus accumulates inside your airways, causing uncontrollable coughing. Severe and prolonged coughing attacks may:

• Provoke vomiting
• Result in a red or blue face
• Cause extreme fatigue
• End with a high-pitched "whoop" sound during the next breath of air

However, many people don't develop the characteristic whoop. Sometimes, a persistent hacking cough is the only sign that an adolescent or adult has whooping cough.

Infants may not cough at all. Instead, they may struggle to breathe, or they may even temporarily stop breathing.

When to see a health care provider

Call your health care provider if prolonged coughing spells cause you or your child to:

• Vomit
• Turn red or blue
• Seem to be struggling to breathe or have noticeable pauses in breathing
• Inhale with a whooping sound

Causes

Whooping cough is caused by a type of bacteria called Bordetella pertussis. When an infected person coughs or sneezes, tiny germ-laden droplets are sprayed into the air and breathed into the lungs of anyone who happens to be nearby.

Risk factors

The whooping cough vaccine you receive as a child eventually wears off. This leaves most teenagers and adults susceptible to the infection during an outbreak — and there continue to be regular outbreaks.

Infants who are younger than age 12 months who are unvaccinated or haven't received the full set of recommended vaccines have the highest risk for severe complications and death.

Complications

Teens and adults often recover from whooping cough with no problems. When complications occur, they tend to be side effects of the strenuous coughing, such as:

• Bruised or cracked ribs
• Abdominal hernias
• Broken blood vessels in the skin or the whites of your eyes

Infants

In infants — especially those under 6 months of age — complications from whooping cough are more severe and may include:

• Pneumonia
• Slowed or stopped breathing
• Dehydration or weight loss due to feeding difficulties
• Seizures
• Brain damage

Because infants and toddlers are at greatest risk of complications from whooping cough, they're more likely to need treatment in a hospital. Complications can be life-threatening for infants younger than 6 months old.

Learn more about prevention, diagnosis and treatment.

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Make sure vaccinations are up-to-date, including your pertussis vaccination.

The Centers for Disease Control and Prevention recommends a single dose of tetanus, diphtheria, and pertussis - whooping cough (Tdap) for healthcare personnel who have never received Tdap, regardless of previous Td vaccination. All adults are also advised to get Td or Tdap every 10 years for ongoing protection against tetanus and diphtheria. With immunity able to wane over time, choosing Tdap for your routine booster dose will support ongoing immunity for pertussis. Speak with your provider if you have questions about Td or Tdap booster doses.

If it has been 10 years since your last Tdap vaccination, schedule an appointment with your health care provider to get a booster dose.

Related information:

• Mayo Clinic Q and A: Pertussis most contagious during early stages of illness
• Mayo Clinic Minute: The ABCs of the DTaP vaccine
• Infectious Diseases A–Z: Pertussis cases increasing

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JOIN THE TUESDAY TWITTER CHAT JULY 23,  1 - 2 pm ET

Getting to Know your #baby the first three months.

Bring your questions to @DrRichardBesser, experts from @MayoClinic and other medical institutions during the  #abcDrBchat.  Ask about feeding, sleeping, bonding and more!

If you’ve never participated in a Twitter chat, be sure to watch this how-to video before jumping in, and
here's how to participate in Dr. Besser's live twitter chat.  

*Here's the transcript if you missed the Tuesday chat: http://bit.ly/17D2GpX

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