2015 Dietary Guidelines Advisory Committee publishes report | TSLN.com

2015 Dietary Guidelines Advisory Committee publishes report

Agriculture Secretary Tom Vilsack and Health and Human Services Secretary Sylvia Burwell Thursday released the long-awaited report of the 2015 Dietary Guidelines Advisory Committee (DGAC).

The report, written by 14 nationally recognized experts in the fields of nutrition, medicine and public health, will be used by USDA and HHS in writing the 2015 Dietary Guidelines for Americans.

USDA and HHS officials have emphasized for weeks that the report is only advisory and that Vilsack and Burwell will make the final decisions on the dietary guidelines after receiving input from other federal agencies and comments from the public.

"For decades, the Dietary Guidelines for Americans have been at the core of our efforts to promote the health and well-being of American families," said Burwell and Vilsack in a joint statement.

"Now that the advisory committee has completed its recommendations, HHS and USDA will review this advisory report, along with comments from the public — including other experts — and input from other federal agencies as we begin the process of updating the guidelines."

Comments can be filed online after a notice is published in the Federal Register. The public will also have an opportunity to offer oral comments at a public meeting in Bethesda, Maryland, on March 24. Those interested in providing oral comments at the public meeting can register online through the HHS's Dietary Guidelines website.

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Capacity is limited, so participants will be accepted on a first-come, first-served basis, USDA and HHS said.

The dietary guidelines are likely to be complete near the end of 2015. USDA is expected to use those guidelines to revise the My Plate system to communicate the recommendations in 2016.

Controversial recommendations

The committee recommends the government encourage Americans to reduce consumption of sodium, saturated fats and added sugars and to take the sustainability of food production into consideration when making food choices.

The committee also recommended that the government drop its recommendations that cholesterol intake be limited, and it did not — as feared by the meat industry — leave moderate consumption of meat out of a healthy diet.

It also recommended that the government "align food assistance programs such as SNAP and WIC with the Dietary Guidelines for Americans."

WIC — the special nutrition assistance program for women, infants and children — is already supposed to follow the dietary guidelines but the recommendation raises the controversial question of whether food purchases under SNAP, the Supplemental Nutrition Assistance Program, should be limited to healthier foods.

The recommendations on sodium, added sugars and sustainability are bound to cause controversy.

The fiscal year 2015 omnibus appropriations bill has already halted regulations under the Healthy Hunger-Free Kids Act that call for continued reductions in sodium in school meals. The same law contained report language that Congress expects Vilsack to stop any inclusion of sustainability language in the dietary guidelines on the grounds that the subject of sustainability is not appropriate for the guidelines on what Americans should eat.

The advisory committee process allowed the committee to select the topics to be considered, however. The food industry has fought the Food and Drug Administration's plans to make added sugars a separate item on nutrition food labels.

The decision to drop the recommendation that cholesterol intake be limited to no more than 300 mg per day is likely to please the egg and meat industries, but has also raised questions about whether Americans can trust the government's dietary guidance since government and private medical experts have recommended reducing cholesterol for years.

But the committee said that the latest scientific research had changed their minds.

"Available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol," the committee said, concluding "cholesterol is not a nutrient of concern for overconsumption."

General conclusions

The report is important because it will guide government policy, but most of the basis for the report and the conclusions the scientists reached are already well known.

The committee, which disbanded upon the release of the report, said its work was "guided by two fundamental realities."

"First, about half of all American adults —117 million individuals — have one or more preventable, chronic diseases, and about two-thirds of U.S. adults—nearly 155 million individuals — are overweight or obese."

The committee added, "These conditions have been highly prevalent for more than two decades. Poor dietary patterns, overconsumption of calories, and physical inactivity directly contribute to these disorders."

"Second, individual nutrition and physical activity behaviors and other health-related lifestyle behaviors are strongly influenced by personal, social, organizational, and environmental contexts and systems. Positive changes in individual diet and physical activity behaviors, and in the environmental contexts and systems that affect them, could substantially improve health outcomes."

The DGAC found that Americans underconsume vitamin A, vitamin D, vitamin E, vitamin C, folate, calcium, magnesium, fiber, and potassium and subgroups have issues with other nutrients.

The DGAC also found that two nutrients — sodium and saturated fat — are overconsumed by the U.S. population relative to the tolerable upper intake level set by the Institute of Medicine and that intake of refined grains and added sugars is too high.

"The data suggest cautious optimism about dietary intake of the youngest members of the U.S. population because many young children ages 2 to 5 years consume recommended amounts of fruit and dairy," the report added.

Immigrants are at high risk of losing the healthier dietary patterns characteristic of their cultural background as they acculturate into mainstream America, the report said.

It also called for stronger federal policies to prevent household food insecurity.

In changing dietary patterns, the committee recommended that consumers should not replace added sugars with low-calorie sweeteners but with water, that sodium be replaced by unsalted spices and herbs and that saturated fats be replaced with unsaturated fat, particularly polyunsaturated fatty acids.

"An important strategy for meeting recommended intake levels of calories, saturated fat, and sodium is to change the composition of mixed dishes — sandwiches, burgers, pizza, pasta or rice mixed dishes, stir-fries, soups, and meat or poultry mixed dishes — that are high in calories, saturated fat, and sodium to better meet these nutrition goals," the report said.

The report recommended adopting a "healthy" U.S, Mediterranean-style or vegetarian diet that is higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, and lower in calories and animal-based foods.

Alcohol and coffee

Regarding alcohol, the committee confirmed several conclusions of the 2010 DGAC, including that moderate alcohol intake by adults can be a component of a healthy dietary pattern.

But it did not recommend that anyone begin drinking or drink more frequently on the basis of potential health benefits "because moderate alcohol intake also is associated with increased risk of violence, drowning, and injuries from falls and motor vehicle crashes."

Women should not drink alcohol during pregnancy, the report said, but among women who are breastfeeding "occasionally consuming an alcoholic drink does not warrant stopping breastfeeding."

"Consumption of coffee within the moderate range (3 to 5 cups per day or up to 400 mg per day caffeine) is not associated with increased long-term health risks," the committee said, but it warned against added calories from cream, milk, and added sugars.

"Concern is heightened when caffeine is combined with alcoholic beverages," the report said.

Sustainable diet

The committee concluded that Americans should be concerned about a "sustainable diet" in order to assure a food supply in the future.

"Current evidence shows that the average U.S. diet has a larger environmental impact in terms of increased greenhouse gas emissions, land use, water use, and energy use, compared to the above dietary patterns," the report said.

"This is because the current U.S. population intake of animal-based foods is higher and plant-based foods are lower, than proposed in these three dietary patterns. Of note is that no food groups need to be eliminated completely to improve sustainability outcomes over the current status."

The committee also said a "moderate amount of seafood is an important component of two of three of these dietary patterns, and has demonstrated health benefits."

It added, "The seafood industry is in the midst of expansion to meet worldwide demand" and that "both farm-raised and wild-caught seafood will be needed."

"The environmental impact of food production is considerable and if natural resources such as land, water and energy are not conserved and managed optimally, they will be strained and potentially lost," the report said. "The global production of food is responsible for 80 percent of deforestation, more than 70 percent of fresh water use, and up to 30 percent of human-generated greenhouse gas emissions."

"It also is the largest cause of species biodiversity loss," the report said. "The capacity to produce adequate food in the future is constrained by land use, declining soil fertility, unsustainable water use, and over-fishing of the marine environment. Climate change, shifts in population dietary patterns and demand for food products, energy costs, and population growth will continue to put additional pressures on available natural resources.

"Meeting current and future food needs will depend on two concurrent approaches: altering individual and population dietary choices and patterns and developing agricultural and production practices that reduce environmental impacts and conserve resources, while still meeting food and nutrition needs."

The committee recommended that, "As the focus of the dietary guidelines is to shift consumer eating habits toward healthier alternatives, it is imperative that, in this context, the shift also involve movement toward less resource-intensive diets. Individual and population-level adoption of more sustainable diets can change consumer demand away from more resource-intensive foods to foods that have a lower environmental impact."

Health, exercise and sleep

The report said the U.S. government should encourage a "culture of health" in which healthy lifestyle choices are "easy, accessible, affordable, and normative — both at home and away from home. "

"In such a culture, health care and public health professionals also would embrace a new leadership role in prevention, convey the importance of lifestyle behavior change to their patients/clients, set standards for prevention in their own facilities, and help patients/clients in accessing evidence-based and effective nutrition and comprehensive lifestyle services and programs.

In addition to getting more exercise, the report said, "Get enough sleep!"

–The Hagstrom Report