by Marion Nestle

Search results: dietary guidelines

Nov 23 2021

The Dietary Guidelines as a marketing opportunity

You might think of the Dietary Guidelines for Americans as federal nutrition advice about how to eat healthfully but to some food companies it’s a marketing opportunity.

FoodNavigator-USA.com writes that the new guidelines for children under age 2 are a “treasure map” for Gerber, a leading baby food manufacturer.

the guidelines underscore the need for products that help babies consume sufficient iron, vitamin D and other nutrients of concern, safely introduce potential allergens, cut back on added-sugar, and cultivate diverse palate preferences to ensure healthy dietary preferences and reduce the risk of picky eaters later.\nInnovative, iron-enriched products need to boost consumption.

How does this work?

One of the main messages in the Dietary Guidelines is to provide infants and young children with sufficient iron.

Gerber to the rescue!

All you have to do is “feed children two servings of infant cereal a day.”

I still vote for feeding kids real food….

Nov 16 2021

The American Heart Association’s new and groundbreaking dietary guidelines

The American Heart Association (AHA) has just issued its latest set of dietary guidelines aimed at preventing the leading cause of death in the United States: 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association.

Because AHA guidelines apply not only to coronary heart disease but also to all other chronic disease conditions—and sustainability issues—influenced by dietary practices, they deserve special attention.

Most of these repeat and reinforce the 2020-2025 Dietary Guidelines for Americans.

The two big differences in the recommendations:

  • Clarifying protein recommendations: these include all sources but emphasize plant sources (#4)
  • Including a new one: minimize ultra-processed foods (#6)

These recommendations are way ahead of the US Dietary Guidelines in recognizing how much ultra-processed foods contribute to poor health, and how important it is to minimize their intake.

Also unlike the US guidelines, these are unambiguous and easily summarized.

 

The statement is worth reading for its emphasis on two other points.

  • This dietary pattern addresses problems caused by other chronic conditions and also has a low environmental impact.
  • Following this dietary pattern requires much more than personal responsibility for food choices.  It requires societal changes as well.

The press release summarizes the problems in society that make following healthy diets so difficult, if not impossible:

  • Widespread dietary misinformation from the Internet;
  • A lack of nutrition education in grade schools and medical schools;
  • Food and nutrition insecurity – According to references cited in the statement, an estimated 37 million Americans had limited or unstable access to safe and nutritious foods in 2020;
  • Structural racism and neighborhood segregation, whereby many communities with a higher proportion of racial and ethnic diversity have few grocery stores but many fast-food outlets; and
  • Targeted marketing of unhealthy foods and beverages to people from diverse racial and ethnic backgrounds through tailored advertising efforts and sponsorship of events and organizations in those communities.

As the statement concludes: “Creating an environment that facilitates, rather than impedes, adherence to heart-healthy dietary patterns among all individuals is a public health imperative.”

Amen to that.

Comment: From my perspective, this statement thoroughly supersedes the 2020-2025 Dietary Guidelines for Americans, which—because they say nothing about ultra-processed foods , differential protein sources, sustainability, or doing anything to counter societal determinants of poor diets—were out of date the instant they appeared.

Some of the details of the AHA statement will be debated but its overall approach should not be.

The committee that put these guidelines together deserves much praise for basing its advice on today’s research and most pressing societal needs.

Additional AHA Resources:

Jan 5 2021

More on the 2020 Dietary Guidelines

I only have a few more comments about the Dietary Guidelines beyond what I posted last week.

One is my surprise that the USDA did not do a new food guide.  The existing one, after all, dates from the Obama administration.  It has not changed.

Here’s how it is explained in the new guidelines:

My translation: Eat more plant foods, eat less meat, avoid ultraprocessed foods (including sugary beverages).

This requires a translation because the guidelines say nothing about ultraprocessed junk foods, and they try hard to avoid singling out foods to avoid.

These guidelines are similar to those in 2015 and are, therefore, woefully out of date.

They do mention the pandemic, once:

The importance of following the Dietary Guidelines across all life stages has been brought into focus even more with the emergence of COVID-19, as people living with diet-related chronic conditions and diseases are at an increased risk of severe illness from the novel coronavirus (p. 4).

They do mention food insecurity several times, for example:

In 2019, 10.5 percent of households were food insecure at least some time during the year. Food insecurity occurs when access to nutritionally adequate and safe food is limited or uncertain. Food insecurity can be temporary or persist over time, preventing individuals and families from following a healthy dietary pattern that aligns with the Dietary Guidelines. The prevalence of food insecurity typically rises during times of economic downturn as households experience greater hardship. Government and nongovernment nutrition assistance programs help alleviate food insecurity and play an essential role by providing food, meals, and educational resources so that participants can make healthy food choices within their budget (p. 50).

And they do mention food assistance programs (on page 81), although they do not discuss how the USDA has been relentless in trying to cut those programs.

Nothing about food systems.  Nothing about the effects of food production and consumption on climate change and sustainablity.

Nothing about eating less meat other than implying that eating less processed meat might be a good idea.

One other point: the complexity is increasing.  Here is the history of the page numbers:

As I’m fond of saying, Michael Pollan can do all this in seven words: “Eat food.  Not too much.  Mostly plants.”

If we can’t do better than this 164 pages of obfuscation, isn’t it about time to stop requiring these things every five years?

Here’s what other people are saying about them

 

Dec 29 2020

The 2020 Dietary Guidelines released today

So much for my plan to take the week off.

The new 2020-2025 Dietary Guidelines came out today.  See them at DietaryGuidelines.gov.  The new guidelines are much the same as the ones in 2015.

The big news: They paid no attention to the recommendations of the Dietary Guidelines Advisory Committee (I covered this in a previous post).

USDA and HHS overrode the scientific decisions of the DGAC.  So much for “science-based” dietary guidelines.

I would love to know what the members of the DGAC think of this.

More later.  These come from the USDA’s press release.

And here’s the USDA’s explanation, such as it is, of why it overrode the decisions of the DGAC on sugar and alcohol

 

Jul 16 2020

Dietary Guidelines Advisory Committee releases report

The report of the 2020 Dietary Guidelines Advisory Committee is now available in online preprint.

It sets a record at 835 pages.

Its conclusions are highly consistent with those of previous Dietary Guidelines.

It recommends eating more of these foods:

Common characteristics of dietary patterns associated with positive health outcomes include higher intake of vegetables, fruits, legumes, whole grains, low- or nonfat dairy, lean meat and poultry, seafood, nuts, and unsaturated vegetable oils.

It recommends eating less of these foods:

The Committee found that negative (detrimental) health outcomes were associated with dietary patterns characterized by higher intake of red and processed meats, sugar-sweetened foods and beverages, and refined grains.

It retained the recommendation: Eat less red and processed meats

It retained the recommendation to eat less saturated fat (replace with polyunsaturated or monounsaturated)

Thus, the Committee recommends that dietary cholesterol and saturated fat intake be as low as possible within a healthy dietary pattern, and that saturated fat intake be limited to less than of 10 percent of total energy intake, as recommended by the 2015-2020 Dietary Guidelines for Americans. This recommendation applies to adults and children ages 2 years and older.

It tightened up restrictions on alcoholic beverages from 2 drinks a day for men to 1 drink:

The Committee concluded that no evidence exists to relax current Dietary Guidelines for Americans recommendations, and there is evidence to tighten them for men such that recommended limits for both men and women who drink would be 1 drink per day on days when alcohol is consumed.

It tightened up restrictions on added sugars, from 10% of calories to 6%:

After considering the scientific evidence for the potential health impacts of added sugars intake, along with findings from model-based estimations of energy available in the dietary pattern after meeting nutrient requirements, the Committee suggests that less than 6 percent of energy from added sugars is more consistent with a dietary pattern that is nutritionally adequate while avoiding excess energy intake from added sugars than is a pattern with less than 10 percent energy from added sugars.

What’s missing?

  • Salt: The report says remarkably little about sodium beyond that it is overconsumed and people should “reduce sodium intake.”  It’s possible that I missed it, but I could not find suggestions for quantitative limits.
  • Ultraprocessed: The word does not appear in the report except in the references.  A large body of evidence supports an association of ultraprocessed foods to poor health.  If the committee considered this evidence, it did not spell it out explicitly.
  • Sustainability: This was off the table from the beginning but this committee recommends that it be considered next time in the context of a food systems approach to the Dietary Guidelines (p.771).

Comment

This is an impressive, solid, conservative review of the existing science highly consistent with previous Dietary Guidelines but with mostly stronger recommendations.

This committee was up against:

  • A tight time frame
  • A first-time mandate to review literature on infancy, pregnancy, and lactation in addition to that for adults
  • A first-time process in which the agencies set the research agenda, not the committee
  • The Coronavirus pandemic

At the outset, I was concerned that the committee members might be heavily biased in favor of food industry interests.  If they were, such biases do not show up in the final report.  I think this committee deserves much praise for producing a report of this quality under these circumstances.

Want to weigh in on it? 

The agencies are taking public comments until August 13.  On August 11, there will be an online public meeting for even more comments.

What’s next?

This report is advisory, only.  USDA and HHS must boil this down to the actual 2020 Dietary Guidelines.  Whereas the committee process was transparent, the boiling down process is highly secretive, or was in 2015.  It will be interesting to see what the agencies do, especially given the heavy lobbying by proponents of meat, saturated fat, and low-carbohydrate diets.

Jun 17 2020

The Dietary Guidelines Advisory Committee reports in today

The Dietary Guidelines Advisory Committee (DGAC) meets today to talk about its draft report.  Register for it here.  

The agenda is here.

Reporters tell me that the DGAC report will not be released at this meeting; it is not ready.

Here’s what today’s announcement says:

The Committee will finalize their advisory report based on Committee discussion at the meeting. They will then submit their final report to the Secretaries of USDA and HHS. USDA and HHS will post the final report online, send out a public notification, and open a new public comment period for the Departments to accept comments on the Committee’s report. This action is expected on or around July 15, 2020.

This meeting is being held despite calls for delay.  Politico’s Helena Bottemillier Evich describes these calls under “Influential groups press for delay of Dietary Guidelines” (behind a paywall at the moment).

The groups are turning up the pressure ahead of the committee’s final public meeting on Wednesday, where the panel will discuss its draft conclusion statements. The committee is then expected to release in mid-July a sweeping scientific report to advise the Agriculture Department and Department of Health and Human Services on what the 2020 iteration of the guidelines should say.

Some of the Dietary Guidelines’ staunchest allies and fiercest critics — including professional groups and low-carb advocates — are urging a delay. They note that last year’s government shutdown and the continuing pandemic have made it more difficult for the committee to complete the necessary work before advising the government on the 2020 guidelines, which will last five years.

Corporate Accountability notes the undue influence of industry on the guidelines.  One of its recent reports documents ties of DGAC members to ILSI, an industry front group.

The guidelines are subject to criticism from just about everyone (me too).  I’m interested to see what this committee does.  Stay tuned.

Mar 4 2020

Coca-Cola wants the 2020 dietary guidelines to say more about beverages

I am indebted to Margarita Raycheva, who writes for the highly informative newsletter, IEG Policy Agribusiness, for her recent article, which certainly got my attention: “Coca-Cola asks DGAC to develop detailed dietary recommendations for beverages” (this is probably behind a paywall).

Her article is about comments filed by Coca-Cola to the DGAC, the 2020 Dietary Guidelines Advisory Committee.  She did not provide a link to those comments, so I had to search for them.  This involved finding the DGAC comments page, searching for Coca-Cola, locating the company’s letter, and opening the pdf attachment.

The 12-page document reads like a highly sophisticated advertisement for Coca-Cola’s astounding number of beverage options, many of them low in sugar or sugar-free.

Over the last few years, Coca-Cola has been transforming to become a total beverage company that meets Americans’ fast-changing preferences across a wide array of beverage categories. We support the World Health Organization’s recommendation that people should limit added sugar to no more than 10% of their total daily calorie consumption1 and are rethinking existing recipes, package sizes and offerings to ensure we are helping consumers manage their daily intake of added sugar and other nutrients from our portfolio.  Today, we offer more than 800 drinks in the U.S. alone, ranging from soft drinks to juices, teas, coffee, dairy, sports drinks, water and more – more than 250 of which are low- or zero-sugar options. More than 40% of our sparkling beverage brands in the U.S. are now available in package sizes that are smaller than 8.5 ounces. We are increasing marketing support for low-sugar, no-sugar and unsweetened products…; we are introducing less sweet versions of classic soft drinks…; and we are accelerating our expansion into new beverage categories through the acquisition of brands….We are taking these actions because we recognize the critical role that we – and the entire industry – can play in advancing nutritional goals by using our scale for good.

Why do this?

• About 15% of energy comes from beverages
• Beverages, such as sweetened soft drinks, coffee and tea contribute more than 40% of daily added sugar intake
• Beverages, mainly milk and 100% juice, contribute over 40% of vitamin C and D intake and more than 20% intake of carbohydrates, calcium, potassium and magnesium
• Fruit intake (0.9 cup/day) is half of recommended levels (2 cups/day); 100% fruit juice contributes up to 24% of fruit intake in children, but decreases after adolescence
• Coffee and tea contribute up to 12% of potassium intake in adults
• Waters contribute up to 10% of calcium intake in adults

In other words, drink more (of our) beverages!

Coca-Cola’s proposals for how beverages can enhance diets:

  • Hydration
  • Nutrition and health
  • Enjoyment
  • Performance

What should the DGAC do?

By creating a framework that includes guidance for all types of beverages, the DGA can help drive Americans towards healthier versions of drinks they are typically consuming. Recommending limited
consumption or small shifts towards healthier beverages is more effective than simply discouraging the consumption of entire beverage categories.

The company’s proposals for how the DGAC can help it sell more beverages include sample statements like these examples [with my translations]:

  • Water should be the primary beverage choice [recommend our bottled water]
  • Milk plays an important role in development and health, and contributes essential nutrients to healthy eating patterns, including protein, calcium, vitamin D and potassium [recommend our milk drinks]
  • When fortified, plant-based beverages may provide nutrients and support consumer choice, but generally should not be considered a replacement for dairy [please don’t recommend almond, soy, or oat milks–we don’t make any of those drinks]
  • Juice contributes to the public’s consumption of essential nutrients, phytonutrient and fruit/vegetable intake [recommend our juice drinks]
  • Coffee and tea are sources of health-promoting phytonutrients and are associated with reduced risk of rtain non-communicable diseases (NCDs) [recommend them; we sell those too]
  • Replace sugar-sweetened beverages >40 kcal that do not contribute significantly to nutrition needs with these beverages to reduce calorie and sugar consumption [if you must recommend avoing sugary beverages, at least recommend replacement with everything else we sell]
  • Sports drinks can be beneficial for individuals who engage in prolonged vigorous physical activity, or those sweating for prolonged hours due to warm to hot temperatures [OK, they have sugar, but recommend them anyway]

I can’t wait to see what the DGAC does with this impressively written document.

Not that it matters, really.  Recall: The DGAC submits the research report, but the agencies—USDA takes the lead this time—write the actual guidelines.

Feb 26 2019

At last: the 2020 Dietary Guidelines Advisory Committee

Very late in the process, the USDA and HHS have finally announced the membership of the Dietary Guidelines Advisory Committee for 2020:

Today the Secretaries of USDA and HHS announced 20 nationally recognized experts who have been selected to serve on the 2020 Dietary Guidelines Advisory Committee.

The independent Advisory Committee will review the scientific evidence on topics from the Departments and provide a report to the Secretaries that, along with public and agency comments, will help inform USDA and HHS’s development of the 2020-2025 Dietary Guidelines for Americans.

I know several of the members.  I served with Barbara Schneeman on the 1995 DGAC, for example.

Some members have financial ties to food companies with deep interests in the what the guidelines say.  This is despite the agencies’ statements that

The vetting process also included a background check by the USDA Office of the Secretary to determine if any of the candidates have a financial, ethical, legal, and/or criminal conflict of interest that would prohibit them from serving on the Committee…Each Committee member submitted a financial disclosure report prior to appointment and will continue to do so annually thereafter. Each report was reviewed by USDA ethics officials for financial conflicts of interest and compliance with Federal ethics rules.

Politico’s Helena Bottemiller Evich asked groups to say who they nominated to the committee.  What she found is here, but behind a paywall.  I’ve added the information from these lists in red.  She is still trying to find out who nominated the others.

  • Jamy Ard, MD – Wake Forest University
  • Regan Bailey, PhD, MPH, RD – Purdue University, Department of Nutrition Science Academy of Nutrition and Dietetics
  • Lydia Bazzano, MD, PhD – Tulane University  Atkins Nutritional
  • Carol Boushey, PhD, MPH, RD – University of Hawaii  National Cattlemen’s Beef Association
  • Teresa Davis, PhD – Baylor College of Medicine
  • Kathryn Dewey, PhD – University of California, Davis
  • Sharon Donovan, PhD, RD – University of Illinois
  • Steven Heymsfield, MD – Louisiana State University American Beverage Association
  • Ronald Kleinman, MD – Harvard University
  • Heather Leidy, PhD – University of Texas National Cattlemen’s Beef Association
  • Richard Mattes, PhD, MPH, RD – Purdue University Academy of Nutrition and Dietetics
  • Elizabeth Mayer-Davis, PhD, RD – University of North Carolina
  • Timothy Naimi, MD – Boston University
  • Rachel Novotny, PhD, RDN, LD – University of Hawaii
  • Joan Sabaté, DrPH, MD – Loma Linda University
  • Barbara Schneeman, PhD – University of California, Davis  American Beverage Association
  • Linda Snetselaar, PhD, RD – University of Iowa Academy of Nutrition and Dietetics
  • Jamie Stang, PhD – University of Minnesota, School of Public Health, Division of Epidemiology & Community Health Academy of Nutrition and Dietetics
  • Elsie Taveras, MD, MPH – Massachusetts General Hospital, Harvard Medical School, and Harvard Chan School of Public Health
  • Linda Van Horn, PhD, RDN, LD – Northwestern University

As for transparency:

Helena Bottemiller Evich (@hbottemiller) tweeted at 11:36 AM on Fri, Feb 22, 2019:
Everyone says they want a “more transparent” Dietary Guidelines process, but the minute I ask for who X group nominated to be on DGAC food/ag/health groups are like https://t.co/6J8GJnGpD7
(https://twitter.com/hbottemiller/status/1099030227009835008?s=03)

Overall, this looks to me like any other DGAC except that there are twice as many members as in the past.

Their job is to review the research and write a report.  The agencies write the guidelines.

I will be following all this with great interest, as always.