Search results: added sugar

Two articles I’ve written are in journals this week: a short one in Newsweek (!) and my monthly Food Matters column in the San Francisco Chronicle.

New York’s Calorie Counts: A Good National Model (Newsweek, April 30 online and May 10 in print)

The new health-care law contains an overlooked boost for nutritionists like me: by next year, all national chains with more than 20 locations must offer “clear and conspicuous” calorie information. It’s the most important obesity-related public policy since the USDA’s food pyramid. But reception to the new mandate has been muted so far, largely because the benefits of New York City’s similar 2008 law seem minor: one study found just 15 fewer calories were consumed per meal; another reported it was 30; and a third found that people ate more.

The problem with these studies is that they focus on Starbucks customers and fast-food goers in low-income neighborhoods—patrons who often care about convenience and value above all. They also fail to capture the long-term benefits of calorie counting, namely education and social pressure. Labels will offer case-by-case lessons in exactly what 1,000 calories looks like, and they may even spur restaurants to ease up on sugar and fat. (Denny’s, McDonald’s, and Cosi, among others, have debuted lighter fare in New York City.) Of course, much depends on the definition of “clear and conspicuous.” Still, the country’s nutritional literacy is about to improve—making my job a lot easier.

Sugary school meals hit lobbyists’ sweet spot (San Francisco Chronicle, Sunday, May 2)

Nutrition and public policy expert Marion Nestle answers readers’ questions in this monthly column written exclusively for The Chronicle. E-mail your questions to food@sfchronicle.com, with “Marion Nestle” in the subject line.

Q: I’m stunned by the amount of sugar my daughter is served routinely in school: candied cereals, flavored milk, Pop Tarts, breakfast cookies, fruit juice – 15 teaspoons of sugar, just in breakfast. Why no standards for regulating sugar in school meals, especially when obesity and diabetes are such concerns?

A: Politics, of course. The U.S. Department of Agriculture spends $12 billion a year on school meals. Kids buy foods from snack carts and vending machines. Food companies fight fiercely to protect their shares in that bounty.

If you watched “Jamie Oliver’s Food Revolution,” you witnessed the struggle to get sugary foods out of schools. Fifteen teaspoons – 60 grams and 240 calories – is a lot for breakfast, but kids get even more sugar from snacks, treats from teachers and birthday cupcakes.

Sugars were never a problem when we supported school lunch programs decently. That changed when schools ran out of money, sought vending contracts with soft drink companies and encouraged kids to buy sodas and snacks. Schools evaded restrictions on snack sales during lunch periods. Nobody paid much attention to what kids ate in schools – until kids began getting fatter.

Why no standards? Nobody wants to take on the sugar lobbyists.

In 1977, a Senate committee recommended an upper limit of 10 percent of calories from added sugars. This was so controversial that from 1980 to 2000, the Dietary Guidelines gave no percentages when they said “eat less sugar.” The 1992 food pyramid said “Use sugars only in moderation.” It defined moderation in teaspoons – for example, 12 a day in a diet of 2,200 calories, which comes to less than 10 percent of calories. By then, health officials in at least 30 countries had adopted the 10 percent sugar guideline.

A committee of the Institute of Medicine undermined that consensus. Because science provides only circumstantial evidence for the effects of sugars on obesity and other health problems, the committee suggested a safe maximum of 25 percent of calories. Sugar trade associations happily interpreted this percentage as a recommendation.

In 2003, the World Health Organization issued a research report restating the 10 percent guideline. Using the IOM report as evidence, sugar trade associations enlisted senators from sugar-growing states to lobby U.S. government officials to withdraw funding from WHO. They also lobbied governments of sugar-growing countries to oppose the 10 percent guideline. WHO dropped the 10 percent sugar guideline.

Dietary guidelines are the basis of federal nutrition policy. The 2005 guidelines advised limits on sugars without stating a percentage. In a footnote, the guidelines said that sugars could be part of a day’s “discretionary calories,” defined as 2 to 8 teaspoons a day. This is less than 10 percent of calories, but the guidelines do not say so explicitly.

Neither does the USDA’s 2005 pyramid, which personalizes diet plans based on age, activity level and gender. I, for example, am allowed 195 discretionary calories for added fats and sugars. If I use them all for sugars, I get to eat 12 teaspoons – about 10 percent of my daily calories. This is less than the amount your daughter ate for breakfast or the sugars in a 20-ounce soda. Hence: lobbying.

Will we get an explicit sugar policy when Congress gets around to reauthorizing the Child Nutrition Act? The draft bill says nothing about sugars but does require school foods to adhere to “science-based” nutrition standards based on the dietary guidelines. If so, this means a maximum of 10 percent of calories from added sugars.

The IOM has just released a “School Meals” report. This says that with careful planning, 10 percent should provide enough sugar discretionary calories to permit sweetened low-fat milk, yogurt and breakfast cereals. The IOM warns that without these sweetened foods, student participation rates and nutrient intakes might decline.

Sorry, but I don’t buy the “kids won’t eat it” argument. I’ve seen plenty of schools where kids eat unsweetened foods. Somehow, they survive. Kids will eat healthier foods when meals are prepared by adults who care what kids eat, as Oliver has demonstrated.

As for legislation, California led the way with the 2007 school food nutrition standards bill, which regulated soda sales and the amount of sugar in snacks. Companies responded by reducing the sugars in their products. Passing the Child Nutrition Act will help, but its big drawback is funding. The draft bill increases school reimbursements by only about 6 cents per meal, not enough to meet costs in many school districts and much less than the $1 increase that many believe necessary.

But with luck, 2010 will bring us national legislation and improved editions of the dietary guidelines and pyramid. Let’s hope these make it easier for schools to help kids cut down on sugars.

Note: Nestle and Malden Nesheim will speak about their new book, “Feed Your Pet Right,” at 3 p.m. May 22 at Omnivore Books in San Francisco and at 3 p.m. May 23 at Point Reyes Books in Point Reyes Station.  Addition: Holistic Hound, Berkeley, Tuesday, May 18, 6:30 p.m.

Marion Nestle is the author of “Food Politics,” “Safe Food” and “What to Eat,” and is a professor in the nutrition, food studies and public health department at New York University. E-mail her at food@sfchronicle.com and read her previous columns at sfgate.com/food.  This article appeared on page K – 8.

At last, the American Heart Association (AHA) has done something useful.  It advises eating less sugar.  Americans eat way too much, it says, a whopping 22 teaspoons a day on average.  Let’s work this out.  A teaspoon is 4 grams.  A gram is 4 calories.  So the 275 calories in that default 20-ounce soda you picked up from a vending machine come from nearly 17 teaspoons of sugar – close to the average right there.  If you have trouble maintaining weight, soft drinks are an obvious candidate for “eat less” advice.  Neither the Wall Street Journal (in which I am quoted) nor the New York Times say much about how soft drink manufacturers are reacting to this recommendation, but it isn’t hard to guess.

Here, for example, is what the industry-sponsored American Council on Science and Health (ACSH) has to say:

The study targets added sugars as the main culprit of dietary excess, but since “U.S. labels on packaged foods do not distinguish between naturally occurring or added sugars,” it is difficult to tell the difference. However, “our bodies can’t tell the difference either,” says ACSH’s Jeff Stier. “Natural and added sugars are nutritionally the same. Added sugar causes obesity as much as the orange juice promoted by the American Heart Association causes obesity [e-mail newsletter, August 25, 2009].

This is the first time the AHA has seriously weighed in on sugar.  I find this especially interesting because the AHA has a long history of endorsing sugary cereals (as I discuss in Food Politics and also in What to Eat).  In this example, the AHA’s endorsement is in the lower left corner.  This product has sugars of one kind or another listed 9 times in the ingredient list.

The AHA gets paid for such endorsements.  Let’s hope the new recommendation encourages the AHA to stop doing this.

Update August 27: I really don’t know what to say about the ACSH’s Jeff Stier.  he is acting more like the Center for Consumer Freedom’s Rick Berman every day.   Today’s e-mail newsletter from ACSH contains this statement:

In her blog in The Atlantic, NYU Professor of Nutrition Dr. Marion Nestle has fallen into the habit of suggesting that ACSH is incapable of objective analysis of public health concerns because we are, in her distorted view, “thoroughly industry-sponsored.”

ACSH’s Jeff Stier wrote to her editors: “Like many of the country’s top non-profits, Dr. Nestle’s NYU included, we accept corporate donations, with no strings attached. But we also receive significant support from individuals and foundations. Her misleading description of us suggests that we represent industry. We do not. We are advised by some of the nation’s leading scientists and represent consumers.

“By way of this email, I ask for a conspicuous and fair correction. We are happy to engage on the issues Dr. Nestle writes about, but her attacks on us are below someone of her stature. We’d prefer an informed and enlightening discussion of the issues, not underhanded and unfounded attacks on credibility.”

“Apparently, Dr. Nestle believes that your opinions are irrelevant, since they diverge from her ideological agenda,” says Stier. “We represent you, consumers, who want science rather than ideology informing public health decisionmaking. Does she really think that consumers are so monolithic that they either agree with her or are put up to it by some sinister entity?”

Readers: Does anyone know what is going on with this group?  It sounds so much like the Center for Consumer Freedom that I can’t help but wonder.

You may recall my previous posts about the new Smart Choices program.  This program was developed by food processors to identify products that are ostensibly “better for you”  because they supposedly contain more good nutrients and fewer bad ones.  This program is about marketing processed foods and I wouldn’t ordinarily take it seriously except that several nutrition professional associations are involved in this program and the American Society of Nutrition is managing it.  In effect, this means that nutritionists are endorsing products that bear the Smart Choices logo.

So what products are nutritionists endorsing?  I went grocery shopping last week and bought my first Smart Choice product: Froot Loops!

Look for the check mark in the upper right of the package.  Frosted Flakes also qualifies for this logo, and do take a look at what else is on the approved list.

A close look a the Nutrition Facts label of Froot Loops shows that it has 12 grams of added sugars in a 110-calorie serving.  That’s 44% of the calories (12 times 4 calories per gram divided by 110).  The usual program maximum for sugar is 25% of calories but it makes an exception for sugary breakfast cereals.  Note that the fiber content is less than one gram per serving, which makes this an especially low-fiber cereal.

OK.  I understand that companies want to market their processed foods, but I cannot understand why nutrition societies thought it would be a good idea to get involved with this marketing scheme.  It isn’t.  The American Society of Nutrition gets paid to manage this program.  It should not be doing this.

But, you may well ask, where is the FDA in regulating what goes on package labels?

Good news: I am happy to report that our new FDA is on the job!  FDA officials have written a letter to the manager of the program.  Although the letter is worded gently, I interpret its language as putting the program on high alert:

FDA and FSIS would be concerned if any FOP [Front of Package] labeling systems used criteria that were not stringent enough to protect consumers against misleading claims; were inconsistent with the Dietary Guidelines for Americans; or had the effect of encouraging consumers to choose highly processed foods and refined grains instead of fruits, vegetables, and whole grains [my emphasis].

Update August 25: I received an interesting e-mail message from a member of the Keystone group that developed the Smart Choices program.  The message confirms that this program is a scheme to make junk foods look healthy.  It says:

Glad to see your posting about Froot Loops! The negotiations over criteria were interesting. Lots of good debate on various points, but when the companies put their foot down, that was it; end of discussion. And sugar in cereals was one such point. Others included the non-necessity for breads, etc. to contain half or more whole grains and the acceptance of fortification to meet the nutrient requirement.

In other words, some people in the group argued that breads needed to contain at least half a serving of whole grains to quality and that added vitamins and minerals should not count toward qualification.  Too bad for them.  I guess the companies put down feet.  But why didn’t they speak up then?  And why aren’t they speaking up now?

The MAHA Commission released its report last week: The MAHA Report: Make Our Children Healthy Again.  Assessment.

This is one impressive report, forcefully written and tightly documented (it cites my work, among that of many others).

Overall, it paints a devastating portrait of how our society has failed our children.

It begins by stating that “The health of American children is in crisis” due to:

• Poor diet
• Aggregation of environmental chemicals
• Lack of physical activity and chronic stress
• Overmedicalization

The result: high rates of obesity, type 2 diabetes, neurodevelopmental disorders, cancer, allergies  and mental health problems among kids.

Here are some selected items I particularly appreciated in the report.  The bullet points are direct quotes.

On poor diet

• Most American children’s diets are dominated by ultra – processed foods (UPFs ) high in added sugars , chemical additives , and saturated fats, while lacking sufficient intakes of fruits and vegetables.
• Pesticides , microplastics , and dioxins are commonly found in the blood and urine of American children and pregnant women— some at alarming levels.
• Children are exposed to numerous chemicals , such as heavy metals , PFAS , pesticides , and phthalates, via their diet, textiles, indoor air pollutants, and consumer products.
• To get into schools , many food companies have reformulated their products with minor ingredient adjustments to qualify for the federal Smart Snack program by meeting the school nutrition standards, which children can purchase separate from school meals.

The driving factors for poor diets

• Consolidation of the food system
• Distorted nutrition research and marketing
• Compromised dietary guidelines

On the dietary guidelines  

They maintain problematic reductionist recommendations, such as:

• Advising people to “reduce saturated fat” or “limit sodium” instead of focusing on minimizing ultra-processed foods.
• Treating all calories similarly, rather than distinguishing between nutrient-dense foods and ultra-processed products.
• Remain largely agnostic to how foods are produced or processed: There is little distinction between industrially processed foods and home-cooked or whole foods if their nutrient profiles look similar.
• Added sugars, saturated fats and sodium are treated as proxies for ultra-processed foods. For instance, a cup of whole-grain ready to eat fortified breakfast cereal and a cup of oatmeal with fruit might both count as “whole grain servings,” and the guidelines do not weigh in on differences in processing.

They also,

• Do not explicitly address UPFs.
• Have a history of being unduly influenced by corporate interests .

On food systems

• The greatest step the United States can take to reverse childhood chronic disease is to put whole foods produced by American farmers and ranchers at the center of healthcare.
• Traditional Field Crops vs. Specialty Crops : Historically, federal crop insurance programs have primarily covered traditional field crops like wheat , corn , and soybeans, while providing much less support for specialty crops such as fruits, vegetables, tree nuts, and nursery plants.

On Corporate Capture 

• Although the U.S. health system has produced remarkable breakthroughs, we must face the troubling reality that the threats to American childhood have been exacerbated by perverse incentives that have captured the regulatory bodies and federal agencies tasked with overseeing them .
• Limited comparisons between industry-funded research versus non- industry studies have raised concerns over potential biases in industry-funded research…Additionally, some industry leaders have engaged in promoting ghostwriting and sponsored reviews to influence the scientific literature.
• Notably, this ghostwriting strategy mirrors tactics used by the tobacco industry to distort scientific consensus is largely propelled by “corporate capture,” in which industry interests dominate and distort scientific literature, legislative actions, academic institutions, regulatory agencies, medical journals, physician organizations, clinical guidelines, and the news media.
• The pharmaceutical industry, with its vast resources and influence, is a primary driver of this capture, though similar dynamics pervade the food and chemical industries.

Research recommendations

• GRAS Oversight Reform: Fund independent studies evaluating the health impact of self-affirmed GRAS food ingredients, prioritizing risks to children and informing transparent FDA rulemaking.
• Nutrition Trials: NIH should fund long-term trials comparing whole-food, reduced-carb, and low-UPF diets in children to assess effects on obesity and insulin resistance.
• Large-scale Lifestyle Interventions: Launch a coordinated national lifestyle-medicine initiative that embeds real-world randomized trials-covering integrated interventions in movement, diet, light exposure, and sleep timing-within existing cohorts and EHR networks.

Comment

The report has been criticized for not getting some of the science right.  The agriculture industry is particularly concerned about the attack on the chemicals it uses.  It is said to be outraged by the report.  The report did throw Big Ag this bone: “Today, American farmers feed the world, American companies lead the world, and American energy powers the world.”

But the report raises one Big Question:  What policies will this administration come up with to deal with these problems?  These, presumably, will be in the next report, due in about 80 days.

This is an extraordinary report, a breath of fresh air in many ways, and I would love to know who wrote it.

But to fix the problems it raises will require taking on not only Big Ag, but also Big Food, Big Pharma, Big Chemical, and other industries affected by these and its other recommendations (the report also says a lot about drugs and mental health).  Big Ag has already weighed in.  Others are sure to follow.

Oh.  And it’s hard to know how policies can be implemented, given the destructive cuts to FDA, CDC, and NIH personnel and budget.

I will be watching this one.  Stay tuned.

Resources

• The press release: MAHA Commission Unveils Landmark Report Exposing Root Causes of Childhood Chronic Disease Crisis
• The Executive Order establishing the MAHA Commission
• The Commission report: Make Our Children Healthy Again Assessment

Additional resource

• Errol Schweizer sent me his analysis on Medium, well worth reading.

 

The FDA is an agency within the Department of Health and Human Services, now headed by Robert F. Kennedy, Jr.  It is getting busy on carrying out Secretary Kennedy’s stated agenda.  It took four actions of interest last week.  Check out #3; it requires action.

I.  Approved Three Food Colors from Natural Sources

Since the HHS and FDA announcement last month during a press conference at HHS on petroleum-based food dyes, more U.S. food manufacturers have committed to removing them within the FDA’s set time frame of the end of next year.

“On April 22, I said the FDA would soon approve several new color additives and would accelerate our review of others. I’m pleased to report that promises made, have been promises kept,” said FDA Commissioner Martin A. Makary, M.D., M.P.H. “FDA staff have been moving quickly to expedite the publication of these decisions, underscoring our serious intent to transition away from petroleum-based dyes in the food supply and provide new colors from natural sources.”

FDA approved color additive petitions for:

• Galdieria extract blue, a blue color derived from the unicellular red algae Galdieria sulphuraria (by petition from Fermentalg).
• Butterfly pea flower extract, a blue color that can be used to achieve a range of shades including bright blues, intense purple, and natural greens (Sensient Colors LLC)
• Calcium phosphate, a white color approved for use in ready-to-eat chicken products, white candy melts, doughnut sugar, and sugar for coated candies (Innophos Inc).

II.  Announced top priorities for the Human Foods Program

FoodNavigator-USA report that Mark Hartman, who directs the new Office of Food Chemical Safety, Dietary Supplements, and Innovation, says the FDA soon will:

• Reveal how it will deal with the safety of chemicals in the food supply
• Create a new Office of Post Market Review to conduct risk reviews of chemical additives
• Increase transparency and stakeholder engagement in the review process
• Work through 70,000 comments on the FDA’s proposal for reviewing the safety of chemical additives
• Partner with the NIH to research how food additives affect children’s health
• Work with the food industry to phase out synthetic color additives
• Work through comments on sodium guidance
• Think about ways of addressing added sugars
• Identify ultra-processed foods as an “area of emerging study”

III.  Extended the comment period for front-of-package labeling until July 15

We are taking this action in response to requests to extend the comment period to allow interested parties additional time to submit comments. Comments should be submitted to Regulations.gov and identified with the docket number FDA-2024-N-2910.

Recall: This is what the Biden FDA proposed.  Here’s what I said about it (basically, we need something better).

Here’s a real opportunity.  If you want a front-of-package warning label like those in Latin America, here’s your chance to weigh in.

RFK Jr says he wants to Make America Healthy Again.  One way to do that is to discourage sales of food products high in saturated fat, sodium, and added sugars, but also discourage sales of ultra-processed foods.  Identifying foods as ultra-processed, on the basis of their chemical additives as well as their fat, sugar, and salt, would be an excellent step forward.

If you like the warning labels used in Latin American countries, send a note to the FDA Docket.  You have until July 15 to do that.

IV.  Announced a joint research initiative with NIH to address, among other unspecified questions,

• How and why can ultra-processed foods harm people’s health?
• How might certain food additives affect metabolic health and possibly contribute to chronic disease?
• What is the role of maternal and infant dietary exposures on health outcomes across the lifespan, including autoimmune diseases?

Comment

OK.  This represents action or proposed action.  My question: What will the FDA actually do?  I’m particularly interested in the joint NIH research initiative on ultra-processed foods.  Will NIH reverse its stance on Kevin Hall, whose research aimed to answer precisely that question?  I will be watching all this with much curiosity.

Several groups under the auspices of Healthy Eating Research got together to produce this guide for kids ages 5-18.

To summarize:

• • Drink: water or milk
  • Limit: 100% juice (too much sugar), plant-based milk alternatives (except for medical reasons), flavored milk (too much sugar)
  • Avoid: beverages with caffeine and other stimulants, sugar-sweetened beverages, beverages with non-sugar sweeteners

Resources

• Press Release
• Consensus Statement  [(Spanish) (Vietnamese) (Tagalog)]
• Technical Report
• Summary
• Tips for Families
• Provider Toolkit

Translated Materials

• Consensus Statement  [(Spanish) (Vietnamese) (Tagalog)]
• Recommendations Graphic  [(Spanish) (Vietnamese) (Tagalog)]
• Added Sugars  [(Spanish) (Vietnamese) (Tagalog)]
• Caffeine Facts  [(Spanish) (Vietnamese) (Tagalog)]

With much fanfare, the FDA released its proposed rule for a new front-of-package summary of the Nutrition Facts panel.  I’ve written about the history of this previously.

Of all the options tested (Food Fix had the best summary), the FDA picked this one—not my first choice.

Why not?  I don’t think it’s much of an improvement over this one, produced by industry to head off something that might be more useful.  This one is easy to ignore and pretty much everyone does.  The FDA’s is a bit better, but not nearly enough.

I was hoping the FDA would at least use traffic light colors.  Even more, I wish the FDA had used “High in” warning labels used in Latin America.

 

These have been shown to be highly effective in discouraging purchases of food products high in sugar, saturated fat, sodium, and calories—the point of this exercise, after all (and why the food industry so opposes it).

Will this label do as well?  We will have to wait and find out.

In the meantime, this is your chance to comment.  Please do.

To Submit Comments

Comments on the proposed rule can be submitted electronically on http://www.regulations.gov by May 16, 2025.

Written comments can be submitted to:
Dockets Management Staff (HFA-305)
Food and Drug Administration
5630 Fishers Lane, Rm. 1061
Rockville, MD 20852
All written comments should be identified with the docket number FDA-2024-N-2910 and with the title “Food Labeling: Front-of-Package Nutrition Information.”

The 2025-2030 Dietary Guidelines Advisory Committee did not make a recommendation about alcohol.  The agencies, HHS and USDA, will do that later based on two expert reviews.

I wrote about the first, from the National Academies, last week: Review of Evidence on Alcohol and Health.

I also wrote about the Surgeon General’s Advisory on Alcohol and Cancer Risk

Still to come is the report from the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD).

At issue is the amount of alcohol that is safe to drink, if any.

Just for fun, I did a summary of what the Dietary Guidelines say about alcohol from 1980 to 2020.  Note that the Moderation advice has not changed since 1990 (but then see the note on 2020).

                                      Alcohol recommendations: Dietary Guidelines for Americans

YEAR	ALCOHOL ADVICE	BENEFITS	MODERATION
1980	“If you drink alcohol, do so in moderation.”		“One or two drinks daily appear to cause no harm in adults.”
1985	“If you drink alcoholic beverages, do so in moderation.”		“One or two standard-size drinks daily appear to cause no harm in normal, healthy, nonpregnant adults.”
1990	Ditto	“Some studies have suggested that moderate drinking is linked to lower risk for heart attacks.”	No more than 1 drink/day for women, and 2 for men.
1995	Ditto	“Alcoholic beverages have been used to enhance the enjoyment of meals by many societies throughout human history…Current evidence suggests that moderate drinking is associated with a lower risk for coronary heart disease in some individuals.”	Ditto
2000	Ditto	“Even one drink per day can slightly raise the risk of breast cancer…Drinking in moderation may lower risk for coronary heart disease, mainly among men over age 45 and women over age 55.”	Ditto
2005	“Those who choose to drink alcoholic beverages should do so sensibly and in moderation.”	“Alcohol may have beneficial effects when consumed in moderation.  The lowest all-cause mortality  [and heart disease mortality] occurs at an intake of one or two drinks per day…compared with women who do not drink, women who consume one drink per day appear to have a slightly higher risk of breast cancer.”	Ditto
2010	“If alcohol is consumed, it should be consumed in moderation…and only by adults of legal drinking age.”	“Strong evidence from observational studies has shown that moderate alcohol consumption is associated with a lower risk of cardiovascular disease….[and] reduced risk of all-cause mortality among middle-aged and older adults and may help to keep cognitive function intact with age…[but also] increased risk of bfreast cancer, violence, drowning, and injuries from falls and motor vehicle crashes.”	Ditto
2015	Ditto	[heart disease and breast cancer not mentioned	Ditto
2020*	“Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages”	“Emerging evidence suggests that even drinking within the recommended limits may increase the overall risk of death from various causes, such as from several types of cancer and some forms of cardiovascular disease. Alcohol has been found to increase risk for cancer, and for some types of cancer, the risk increases even at low levels of alcohol consumption (less than 1 drink in a day). Caution, therefore, is recommended.”	Ditto

*From the 2020 Dietary Guidelines Advisory Committee report: “evidence points to a general rule that drinking less is better for health than drinking more. Therefore, the focus should remain on reducing consumption among those who drink, particularly among those who drink in ways that increase the risk of harms. 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.

Despite the language in the 2020 guideline, the agencies did not change the overall recommendation about moderate drinking.

Will the Surgeon General’s Advisory and the upcoming third report cause the agencies to suggest no more than one drink a day for men?  Or suggest that no level of alcohol intake is safe?

I’m looking forward to finding out.

Resource: the process for alcohol in the Dietary Guidelines