What’s missing in new U.S. diet guidelines

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(Courtesy: Harvard T.H. Chan School of Public Health.)
(Courtesy: Harvard T.H. Chan School of Public Health.)
(Courtesy: Harvard T.H. Chan School of Public Health.)

By Harvard Gazette

BOSTON— U.S. government officials released the new 2015-2020 Dietary Guidelines for Americans (DGAs) on January 7, 2016. Nutrition expert Frank Hu, who served on the 2015 Dietary Guidelines Advisory Committee—which made recommendations on what should be included in the guidelines—assesses the new advice on how the nation should eat.

What are the most significant changes between the new dietary guidelines and the previous ones?

One of the most positive changes is the recommendation that no more than 10% of daily calories come from added sugars. This is the first time that the DGAs set an upper limit for added sugar intake. This change has an important implication for the FDA’s decision to include the amount of “added sugars” and its percent daily value (%DV) in the upcoming revised Nutrition Facts label; currently the label lists only “sugars.”

Another important positive change is the removal of an upper limit for total dietary fat, and a greater emphasis on consuming certain types of fat. The guidelines recommend a limit of 10% of daily calories for saturated fat, and that saturated fat be replaced with unsaturated and especially polyunsaturated fat. It basically says that we should eat a low saturated fat diet rather than simply a low-fat diet.

The report also acknowledges that moderate coffee consumption (three to five 8-ounce cups per day) can be incorporated into a healthy diet—although not with too much sugar and cream.

Overall, this edition of the DGAs has put a greater emphasis on overall healthy diet patterns, which include the Mediterranean-style pattern and a healthy vegetarian pattern. These patterns can be adapted according to individuals’ cultural and food preferences.

The new guidelines say that eating processed meats and poultry—acknowledged as sources of sodium and saturated fats—“can be accommodated” in a healthy diet, and that lean meats are also okay. What do you think of this recommendation?

This recommendation is inconsistent with the DGAC report, which advised lower consumption of red and processed meats for the prevention of chronic diseases. Although the new DGAs recommend a “shift to healthier food and beverage choices,” it’s not specified which “less healthy choices” should be reduced in the main recommendations.

In general, the DGAC report was much more specific than the new DGAs. In the DGAC report, a healthy dietary pattern was defined not just in terms of “healthy choices” such as fruits, vegetables, whole grains, nuts/seeds, and seafood, but also in terms of reduced intake of red and processed meats, sugar-sweetened foods and beverages, and refined grains. In the new DGAs, these specific food-based recommendations are replaced by vague recommendations like eating “a variety of nutrient-dense foods.” Such vague language may lead to more confusion in the general public.

Are there any recommendations from the DGAC that did not make it into the new guidelines that you wish had been included?

Although there are some areas of improvement in this edition of the DGAs over previous ones, some simple but important recommendations are watered down, especially reducing consumption of red and processed meats and sugar-sweetened beverages. These recommendations would have been easier for the general public to understand and act upon than specific nutrient cutoff points—such as consuming no more than 10% of calories from saturated fat or added sugars—although it’s still important to keep these cutoff points in the DGAs.

Environmental sustainability, a major topic in the DGAC report, was unfortunately declared out of the scope of the DGAs by the USDA, due to political pressure from Congress and the meat industry. Current evidence indicates that a dietary pattern rich in plant-based foods such as fruits, vegetables, whole grains, legumes, nuts and seeds, and lower amounts of animal-based food—especially red meat—is more health promoting and is also associated with lesser environmental impact. Many countries, including Denmark, the Netherlands, Australia, Sweden, and Brazil have included food sustainability in their dietary guidelines. The fact that food sustainability is left out of the DGAs is a hugely missed opportunity to educate the public about the environmental impact of their food choices, and to create a food system that is more sustainable and conducive to the health of both humans and the planet. Hopefully the 2015 DGAC report has planted a seed for future DGAs to embrace food sustainability as part of the dietary guidelines.

(Published with permission from Harvard Gazette and Harvard T.H. Chan School of Public Health.)

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