Private citizens and food industry representatives called on federal officials not to adhere too closely to new recommendations from the Dietary Guidelines Advisory Committee (DGAC), which will help shape the 2020-2025 dietary guidelines.
During a public comment session on Tuesday, the U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services (HHS) heard concerns and complaints over DGAC’s latest scientific report, which calls for various restrictions on added sugars, saturated fats, alcoholic beverages, and red and processed meats.
A lack of procedural transparency or clear explanation why certain DGAC recommendations have been ignored in previous dietary guidelines has fueled criticism of the process.
This year’s recommendations take a number of U.S. health issues into account, the committee stated. More than 70% of Americans are overweight or obese, driving the prevalence of chronic conditions like cardiovascular disease and type 2 diabetes, as well as certain cancer types. Recommendations also emphasize food insecurity, which disproportionately affects low-income, Black, and Hispanic communities.
The current recommendations outline new guidance for dietary patterns, saturated fat intake, and meal frequency; specify dietary guidance for pregnant and lactating women; and mark the first time DGAC has provided nutritional guidance for children under 2 years of age.
Less Added Sugars
DGAC recommended a decrease in added sugars, stating that it should account for less than 6% of daily calorie intake, down from less than 10% in previous guidelines.
Almost 70% of added sugar consumption comes from five food categories — sweetened beverages, desserts and sweet snacks, coffee and tea with added sugars, candy, and breakfast cereals, the report stated — and limiting sugar could reduce the high incidence of obesity, cardiovascular disease, and type 2 diabetes, the group argued.
Support for reductions in added sugar intake came from the American Heart Association, American Institute for Cancer Research, and others, which called for transparency if any recommendations are not included in the final guidelines.
But the sugar recommendation had its critics too.
Debra Miller, senior vice president for scientific and regulatory affairs at the National Confectioners Association, pointed out that new tools to implement the 2015-2020 guidelines — like new nutrition labels — are being put into effect only this year.
“Given that Americans are reducing their added sugar intake, and now will have more tools to effectively do so, it seems prudent for the agency to maintain the recommendation for less than 10% of calories from added sugar to be consistent and aligned with the existing labeling and educational efforts,” Miller said.
Tightened Alcohol Restrictions
The committee also called on limiting alcohol consumption to just one beverage a day for men and women. Previously the recommendation in men was two drinks per day.
This change was based on the association between alcohol intake and all-cause mortality. Some studies have found potential protective effects for certain cardiovascular conditions with low levels of alcohol consumption. But high levels of consumption and binge drinking are associated with an increased risk of coronary heart disease, stroke, congestive heart failure, atrial fibrillation, and hypertension. The committee also stated that alcohol is a carcinogen, and may be linked to seven types of cancer.
“Alcohol is responsible for lots of mortality,” said Sean Haley, PhD, MPH, of the American Public Health Association, in a statement of concurrence with the tightening of alcohol consumption guidelines.
But again not all parties agreed.
“The science has not changed in the last five years,” said Jim McGreevy, president of the Beer Institute. “I think the committee got it wrong.”
Critics of the tightened alcohol consumption guidelines say DGAC did not include any new evidence to support the recommendation. Kathleen Zelman, MPH, of No Nonsense Nutrition, stated that limiting moderate intake to just one drink a day contradicts a number of previous studies.
“Consumer confusion already exists,” Zelman commented. “When recommendations flip-flop, it’s unlikely the intent of the recommendation will actually have an impact.”
Reduced Red and Processed Meat Intake
A number of concerns were raised about the advisory committee’s recommendations to limit the intake of red and processed meats. While DGAC did not explicitly call for specific levels of consumption, it emphasized the benefit of eating more seafood.
Dietary patterns with lower intake of red and processed meats, as well as more fruits, vegetables, whole grains, and seafood have been associated with a lower risk of cardiovascular disease and colorectal cancer, according to the advisory committee. And decreased consumption of red and processed meats by pregnant women could reduce the risk for gestational diabetes, excessive gestational weight gain, hypertensive disorders, and preterm birth.
Doubts were raised about how these recommendations would be translated into guidelines. Susan Backus, vice president for regulatory and scientific programs at the North American Meat Institute, said that this might be harmful for specific populations, like older adults and adolescent girls who have low levels of protein and vitamin B12.
“The overall conclusions of the report regarding meat and poultry intake are inconsistent and could have adverse and unintended consequences if the findings are not translated effectively,” Backus said.
USDA and HHS will draft the final guidelines in the coming months, which will be released in December 2020.