The Nutrition Coalition applauds a recent move by the U.S. Department of Agriculture (USDA), following advice by the National Academies of Sciences, Engineering and Medicine (NASEM), to ensure a greater diversity of viewpoints on the expert panel that advises Americans on what to eat. This reform is long overdue.
Last week, the USDA announced the new charter for development of the next iteration of the Dietary Guidelines for Americans (DGA), in 2020.
A new and critical aspect of the charter directs USDA and U.S. Health & Human Services (HHS), the two agencies in charge of the guidelines, to select an advisory committee that is more balanced and diverse. This reform is essential, since in 2015, 11 of the panel’s 14 members (~80%) had consistently published work in favor of plant-based, low-animal-fat, vegetarian diets, and many had built their careers promoting these types of diets, according to an analysis by The Nutrition Coalition. This viewpoint does not represent the diversity of expert opinion across the country on healthy diets. The new charter takes steps to remedy this type of unbalanced approach seen in 2015.
Also, in an apparent effort to discourage a continuation of the status quo, which has done so little for health in America, the new charter largely prohibits previous committee participants from being reappointed, while simultaneously encouraging candidates with “fresh points of view.”
As stated in the charter, the committee “will be balanced fairly in its membership in terms of the points of view represented and the functions to be performed. Steps will be taken to encourage fresh points of view, such as establishing a Committee in which most members have not served on a previous Dietary Guidelines Advisory Committee (DGAC) and including members with varying points of view on the topics and questions to be examined by the Committee.”
This part of the charter echoes testimony by Nina Teicholz, executive director of the Nutrition Coalition, to the USDA in November 2017. Noting that the nation’s current obesity epidemic began in 1980, the very year the U.S. guidelines were launched, Teicholz said that “successive Dietary Guidelines Advisory Committees have been comprised of researchers largely devoted to maintaining status-quo advice….The inclusion of a true range of viewpoints on this committee is essential so that long-ignored science may come to light.”
This is important because the science on key issues in nutrition has evolved, with a new generation of researchers challenging longstanding views on such issues as saturated fats, carbohydrates, and more. New approaches are needed, to understand why our guidelines have for 40 years failed to combat nutrition-related diseases. As Fiona Godlee, Editor-in-Chief of one of the world's oldest medical journals, The BMJ, put it in 2016, “Given the ever increasing toll of obesity, diabetes, and heart disease, and the failure of existing strategies to make inroads in fighting these diseases, there is an urgent need to provide nutritional advice based on sound science.”
Or, as Albert Einstein said, “We cannot solve our problems with the same thinking we used when we created them.”
Following the National Academies Advice
These excellent additions by USDA to the 2020 charter are directly in response to recommendations made by the National Academies of Sciences, Engineering and Medicine (NASEM). Some of the report’s top suggestions are to:
Promote diversity of expertise and experience. A broad range of expertise and experience must be considered to create a balanced committee. Expertise has to align with the topic areas to be reviewed. Diversity with respect to nontechnical skills (e.g., ability to form consensus or develop compromise) also needs to be considered. Building on the first characteristic of transparency, involvement from a broad range of perspectives, including public involvement, is also critical to fostering diversity.
Support a deliberative process. A deliberative process that considers information from a wide variety of sources should be used. Decision makers ought to freely exchange information with one another toward the goal of coming to agreement or consensus. To the extent possible, the public should be engaged as well.
Earlier this year, The Nutrition Coalition applauded USDA-HHS for responding with such alacrity to the NASEM report by specifying the topics in advance to be analyzed by the advisory committee. Importantly, this step included a public comment period.
NASEM states that “topic prioritization” is a “critical task….Owing to time and resource constraints, and available evidence, not all topics would be able to be included in each cycle.”[1] The report also states, “The final prioritization would be made publicly available along with a statement of why some topics or a tier of topics were designated as being of lower priority.”
USDA-HHS took this advice to heart and defined a topic list early in the 2020 DGA process. In addition to greatly increasing transparency of the DGA process, this step allowed the committee selection process to target candidates with a background in the particular topic areas identified by USDA-HHS. Thus, the 2020 DGAC, when selected, will now be more likely to have the exact expertise it needs.
The Nutrition Coalition hopes USDA’s latest charter signals a turn toward greater scientific rigor, transparency and genuine diversity of opinion for the 2020 Guidelines.
[1] The National Academies of Sciences, Engineering and Medicine, “Redesigning the Process for Establishing the Dietary Guidelines for Americans,” September, 2017, http://nationalacademies.org/hmd/Reports/2017/redesigning-the-process-for-establishing-the-dietary-guidelines-for-americans.aspx pp. S-4 and 2-15.
[2] Ibid., 3-9