The process for the 2020-25 U.S Dietary Guidelines for Americans (DGA) got off to a strong start this week, when the U.S. Department of Agriculture (USDA) solicited public comments about a list of key issues for the guidelines to review. This was the first time that the USDA or the U.S Department of Health and Human Services (HHS), the two agencies tasked with developing the Guidelines, took this unusual step.
The announcement is good news, because it signals that the USDA and HHS are committed to increasing transparency in the Guidelines’ process, which in 2015 became a political battle field, riddled by activist agendas and corporate interests. It’s also good news because on the USDA’s list of topics for review are saturated fats and “low-carbohydrate diets,” both of which The Nutrition Coalition has identified as areas where DGA recommendations are not in line with current scientific thinking.
In taking this step, the Administration is clearly heeding the call of the National Academies of Sciences, Engineering and Medicine (NASEM), whose September 2017 report found that the DGA process lacks scientific rigor, falls short of meeting best practices for scientific reviews, needs greater transparency, and altogether “needs to be redesigned….to be trustworthy.”
Ensuring that the Guidelines are based on rigorous, up-to-date science is essential so that the nation has a fighting chance to stem the epidemics of nutrition-related diseases that now plague us, including obesity, type 2 diabetes, heart disease, hypertension, and fatty liver disease.
Since the DGA were first issued in 1980, the food pyramid–and now the MyPlate icon–have been used to direct the federal government’s nutrition programs, such as the School Lunch Program, feeding programs for the elderly, and military rations, as well as nutrition information provided to patients, school children, and consumers. However, the guidelines have often issued nutrition advice based on weak or flawed evidence, resulting in significant mistakes, such as a 35-year cap on cholesterol, which was dropped in 2015, and several decades of advice to eat a “low-fat” diet, language that has slowly disappeared from the DGA over the last decade.
With this announcement, USDA and HHS implied there are other topics where recommendations could be out of sync with current nutrition science. Saturated fats have clearly been the subject of much rethinking in recent years, and the DGA’s three “Dietary Patterns,” have been criticized for being nutritionally insufficient, in addition to remaining a one-size-fits-all diet.
USDA and HHS are also seeking public feedback on nutrition for infants, proper nutrition for those over 65, and the role of beverages and sugars in the diet for adults.
In a departure from tradition, Brandon Lipps, who serves as both administrator of USDA’s Food and Nutrition Service and acting deputy undersecretary of food, nutrition and consumer services, said the guidelines – for the first time ever – “would not review the entire body of evidence,” and that “we do think that there are a number of issues that haven’t changed significantly over time.”
We agree: it certainly makes sense to set priorities and focus on areas where the science has been updated.
A month-long public comment period is set to start February 28. You can comment here.
Learn how to submit a comment by reading our guide here.
Here are the two topics that rise to the top for The Nutrition Coalition:
- Saturated fats: the science has clearly evolved. See our primer on the latest science here.
- The DGA should offer a true range of diets, including one for people with metabolic conditions, such as obesity, type 2 diabetes, and heart disease. We suggest an additional, low-carbohydrate “Dietary Pattern” for these populations. Carbohydrate restriction is supported by a sizeable body of rigorous clinical trial evidence, showing it to be both safe and effective for combatting these diseases. The diet is clearly “evidence-based,” as demonstrated in a recent letter signed by nearly 34,000 people. The text of this letter provides a summary of the evidence.
Also important are:
- There is scant scientific evidence on diets for infants 0-2, post weaning, or children generally. Past recommendations have extrapolated from data on adults, based on the assumption that the same diet would be appropriate for children, but the advice given to middle-aged men and women, for the avoidance of heart disease, obesity, etc., may very well not appropriate for growing children, who have different nutritional needs. Based on the principle of “first, do no harm,” The Nutrition Coalition recommends that the DGA not issue recommendations for these populations, other than for nutritional sufficiency.
- There is a lack of rigorous clinical trial data showing health benefits of a vegan/vegetarian diet. A review prepared by the USDA Nutrition Evidence Library (NEL) for the 2015 Dietary Guidelines report concluded that the evidence for this diet’s disease fighting powers is only “limited,” which is the lowest rank for available data. Moreover, although the NEL conducted eight reviews on fruits and vegetables, none found strong (grade 1) evidence to support the assertion that these foods can provide health benefits.
The Nutrition Coalition will submit public comments, and we encourage you to make your voices heard in this important process. Again, comments can be submitted here.