Dietary Guidelines for Americans: Key Takeaways from the Draft Advisory Report Meeting
A quick snapshot:
270,000 citations screened for relevant research
150,000 scholarly articles reviewed
62,350 public comments submitted
500 pages of summarized research in the draft report
20 healthcare professionals committed to being members of the Dietary Guidelines Advisory Committee (DGAC)
Countless members of support staff from the U.S. Department of Health and Human Service (HHS) and the United States Department of Agriculture (USDA)
One common goal, to provide advice on healthy diets throughout the lifespan that can promote health, help prevent diet-related chronic disease, and meet nutrient needs!
As the work begins to wind down for the Dietary Guidelines Advisory Committee (DGAC) which was tasked with developing the 2020-2025 Dietary Guidelines for Americans (DGAs), it is easy to see that many have worked tirelessly over the last couple of years to get to this point. With each curve ball that was thrown their way, the team has continued to persevere forward so that they can bring the latest and most reliable nutrition research to the stage for the new DGAs. The long-awaited final Dietary Guidelines Advisory Committee Public Meeting was held via webcast on June 17. In this blog, I will walk you through what to expect next from the DGAC, the agencies responsible for creating the final guidelines, and key takeaways from the final meeting.
DIETARY GUIDELINES ADVISORY COMMITTEE REPORT
During the recent webcast, the DGAC presented an overview of the findings from their research that will be included in their Advisory Report. This final meeting included updates on the Committee’s draft conclusion statements and discussions on its draft advisory report. The Committee’s draft report, organized by life stages, summarizes its evidence review and provides overarching advice to the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) based on the consideration of all its conclusion statements. The Committee is now in the process of finalizing the report and adding in any final details from the discussions that were held during the meeting. The Committee’s work will end when it submits its final scientific report to the Secretaries of USDA and HHS, which is expected at the end of June or beginning of July. From there the USDA and HHS will jointly develop and if all goes as planned, publish the 2020-2025 DGAs Report by the end of 2020.
BIRTH TO 24 MONTHS AND PREGNANCY AND LACTATION SUBCOMMITTEE
The topic that stood out to me the most during this final meeting was the large amount of information pertaining to pregnancy, lactation, and recommendations for those under 2 years of age. They covered a wide variety of topics for this population, including toddler nutritional needs, what to eat when/while breastfeeding, and nutrients of public health concern for pregnant women. As discussed in previous blog posts, this is the first time the DGAs will include recommendations for these groups, but the time spent discussing these specific populations accounted for a large portion of the meeting. Chapters 1-7 of the Advisory Report covered nutrition information exclusively related to these populations. In addition, there is information pertaining to these populations scattered throughout the remaining chapters of the report. There clearly was a significant amount of time and research that went into providing guidelines for these populations.
FOOD BEFORE ONE IS JUST FOR FUN vs. EVERY BITE COUNTS
During the final meeting, the birth to 24 months Subcommittee addressed the importance of the nutritional content of complementary foods and beverages (CFB) in both infants and toddler diets. CFBs are foods and beverages other than breastmilk or infant formula introduced to provide nutrients. The reason CFBs need to be chosen carefully at this age is because infant formula and even breastmilk may not provide all the necessary amounts of nutrients required for healthy development once they reach six months of age. Although breastmilk and formula can contribute many vitamins, minerals, and nutrients, we need to understand the capabilities and limitations of these substances, such as inadequate amounts of iron and zinc once an infant reaches six months of age. In addition, CFBs are a wonderful way to start exposing infants to various flavors and textures. In fact, this is a highly malleable developmental stage for infants, because taste and flavor preferences and patterns are beginning to form.
Have you ever heard the rhyme “food before one is just for fun”? If so, I am sorry to break it to you, but this statement is incorrect. Food before one is NOT just for fun, it is actually extremely vital to the health and well being of childhood development. The DGAC thoroughly discussed this topic at their last meeting and have proposed a more appropriate statement- “every bite counts”, to replace the cutesy rhyme. Let’s be honest though, food at any age is fun, but food is not JUST for fun at this age.
DGAs LIMIT ADDED SUGAR TO LOWER THAN EVER BEFORE
Did you know that in 2013-2015, the U.S. population ages 1 and older had an average consumption of 13% of their daily caloric intake from added sugars? The current 2015-2020 DGAs recommends limiting calories from added sugars to no more than 10% each day. That's 200 calories, or about 12 teaspoons, for a 2,000 calorie diet. In the final meeting, the Beverages and Added Sugars Subcommittee recommended limiting added sugar to no more than 6% of total daily calories. That’s 120 calories, or about 7 teaspoons, for a 2,000 calorie diet. The DGAC has concluded that less than 6% of energy from added sugars is more consistent with a dietary pattern that is nutritionally adequate while avoiding excess energy intake than a pattern with less than 10% of energy from added sugars. They believe that reducing the amount of added sugar in the diet, through changes in consumer behavior, how food is produced and sold, and food policies, is an achievable objective that could improve population health.
NEW ALCOHOL CONSUMPTION GUIDELINES FOR MEN
First and foremost, the DGAC recommends that individuals do not begin drinking or drink more for any reason, but they do provide alcohol consumption advice for those who already drink alcohol. During the final meeting, the Beverages and Added Sugar Subcommittee discussed some interesting research and proposed a change in the alcohol consumption guidelines for men. Potentially this recommendation could change from 2 drinks for men and 1 drink for women to 1 drink for men and 1 drink for women. The DGAC explained that based on existing observational data, consuming 2 drinks/day among men is associated with a modest but meaningful increase in all-cause mortality risk compared to 1 drink/day. According to the American Institute for Cancer Research (AICR), limiting alcohol reduces the risk of several types of cancer, including breast, colorectal, esophageal, stomach, liver, mouth, pharyngeal, and laryngeal. It will be fascinating to see if this recommendation makes its way into the final 2020-2025 Dietary Guidelines, as the current 2/1 consumption limit has been in place since 1990.
CONCLUSION
Whether this is the first time you are hearing about the DGAs or if you have been actively engaged in food policy since the DGAs began, there is always more to learn when it comes to nutrition research because it is continually evolving. As with many areas in my life, as seasons come to a close, I like to take time to reflect on the work it has taken to get this far, and dream about the future to come. I encourage you to take a few moments to reflect on the many things that the DGAs have brought to pass over the last 40 years, and think about what you would like to see happen in the future for nutrition research and public health. Please comment with any questions you might have and review the previous DGAs blogs to get caught up on the latest DGAC recommendations.