What Will the 2010 USDA Dietary Guidelines Advise?

The Washington Post's Jane Black gives us a heads-up about the forthcoming update to the Dietary Guidelines for Americans. Every five years, USDA's Center for Nutrition Policy and Promotion issues new dietary guidelines based on analysis by the Dietary Guidelines Advisory Committee, a group of scientific experts appointed by the Secretaries of HHS and USDA. Here's how the Dietary Guidelines for Americans 2005 publication explains the guidelines' role:

The intent of the Dietary Guidelines is to summarize and synthesize knowledge regarding individual nutrients and food components into recommendations for a pattern of eating that can be adopted by the public. In this publication, Key Recommendations are grouped under nine inter-related focus areas. The recommendations are based on the preponderance of scientific evidence for lowering risk of chronic disease and promoting health. It is important to remember that these are integrated messages that should be implemented as a whole. Taken together, they encourage most Americans to eat fewer calories, be more active, and make wiser food choices.

The 2005 guidelines advocate "adequate nutrients within caloric needs," weight management, and physical activity. They offer steps for avoiding foodborne illnesses and they urge sense and moderation in the consumption of alcoholic beverages (or no consumption, if you're a child, pregnant woman, person with certain medical conditions, etc.). They encourage consumption of some foods: eat a variety of fruits and vegetables, get half of your grains in the form of whole grains, consume 3 cups of fat-free or low-fat milk (or equivalent products) daily.

And then there are the recommendations about limiting consumption of certain substances. These tend to attract the most criticism from food lobby groups.

The 2005 guidelines include the following (for the general population - recommended limits are lower for some subgroups):

  • Consume less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep transfatty acid consumption as low as possible.
  • Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.
  • Choose and prepare foods and beverages with little added sugars or caloric sweeteners, such as amounts suggested by the USDA Food Guide and the DASH Eating Plan.
  • Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar- and starch-containing foods and beverages less frequently.
  • Consume less than 2,300 mg (approximately 1 tsp of salt) of sodium per day.
  • Choose and prepare foods with little salt. At the same time, consume potassium-rich foods, such as fruits and vegetables.

For the 2010 guideline update, the advisory committee released its report in June, and it includes the following suggestions that I'm guessing weren't popular with the relevant industries:

  • Avoid sugar-sweetened beverages
  • Shift to a more plant-based diet
  • Aim for a daily sodium intake of no more than 1,500 mg per day (compared to 2,300 in the 2005 guidelines)
  • Encourage restaurants and the food industry to offer health-promoting foods that are low in sodium; limited in SoFAS [solid fats and added sugars] and refined grains; and served in smaller portions

After the committee's report came out, USDA then had a month-long comment period in which it invited feedback on how to turn the scientific recommendations into formal guidelines, which it will release in December. Black reports that comments from multiple food lobbies and members of Congress express concern about what USDA's 2010 guidelines might say about sodium, added sugars, eggs, and meat:

In public comments, the meat lobby has opposed strict warnings on sodium that could cast a negative light on lunch meats. The milk lobby has expressed concerns about warnings to cut back on added sugars, lest chocolate- and strawberry-flavored milks fall from favor. Several members of the Massachusetts congressional delegation also weighed in against added-sugar restrictions in defense of the cranberry.

... The advisory committee's emphasis on a "plant-based" diet, for example, has caused much consternation among the powerful egg and meat lobbies who say the term might be misunderstood as advocating a vegetarian diet. (In fact, plant-based is defined as a diet that emphasizes fruits and vegetables but includes moderate amounts of meat, eggs and milk.) The Salt Institute has mounted an aggressive campaign to battle the recommended 35 percent reduction in the recommended allowance for sodium, saying the advice amounted to an "uncontrolled trial on more than 300 million Americans" that could result in greater obesity as individuals eat more to satisfy their sodium appetite.

And it seems it only took one case of political backlash to scare guideline authors away from suggesting consumers slash consumption of certain types of food:

In 1977, a Senate select committee led by Sen. George McGovern (D-S.D.) was forced to beat a hasty retreat after it initially recommended that Americans could cut their intake of saturated fat by reducing their consumption of red meat and dairy products. Its revised guidelines suggested choosing "meat, poultry and fish that will reduce saturated-fat intake."

McGovern, whose constituents included many cattle ranchers, lost his seat in 1980. Since then, in case after case, the guidelines have refrained from suggesting that Americans eat less of just about anything.

Public health advocates say that kind of vacuum is precisely the problem: By avoiding blunt messages about what not to eat, the government has spoken in a way that baffles consumers.

Here's how Black describes what the food industry wants from the guidelines overall:

The food industry has lobbied hard to ensure that the government emphasizes carrots, not sticks, in nutrition messages. Consumers want control over their diet, lobbyists say, and they resent messages that dictate what should and should not be eaten.

It's important to realize that USDA has multiple avenues for getting nutrition messages out. The 2005 guideline document "is intended to be a primary source of dietary health information for policymakers, nutrition educators, and health providers," while the food pyramid and the educational materials that accompany it are geared towards the general public. Regardless of how the pyramid its associated messaging evolve, the guidelines ought to contain the best nutritional recommendations USDA can give. Black points out that the guidelines also "dictate what is served in school breakfast and lunch, in education materials used by SNAP - formerly called food stamps - and in the development of information on the nutrition labels of food packages." In other words, there are a lot of reasons why it's important for USDA to get this right.

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eat less of ...
At the same time, consume potassium-rich foods...

One of my big gripes is that this sort of advice is useless to freshman college students (and I should know, because this was how I tried to learn nutrition) and others who don't know what you mean by "less"

This was a problem with saturated fats, when experts told people to eat "less of", of course there was a body of people who avoided it entirely. I'm sure this has happened so many times.

What we need is goals, which is something the mypyramid website helped me a lot with...

"eat fewer calories"

That sort of thing has also always puzzled me. No doubt these rules are being made by well educated middle class people, many of which could stand to lose some weight. But it makes no sense for a lot of people, especially the millions of undernourished children in America... And anorexics and young women (and men, but hey you have to admit it's not as common in men) bent so hard on keeping weight down based on the advice they hear that they drown out what their body is telling them. But not a peep about the unholy damage that not eating enough can do. Again, goals seem much more sensible.

The main thing is the dearth of hard, outcomes-based evidence supporting these recommendations. It's hard to find a clearer case of politics triumphing over science, time after time.

I have to agree with Pat. The Dietary Guidelines are not really evidence-based. They tend to be a mish-mosh of currently accepted beliefs and prejudices which are not neessarily wrong but also not necessarily right and not supported by good evidence. The prudent recommendations would be to eat a variety of foods, don't overconsume alcohol, don't salt your food too much, eat a lot of fruits and vegetables (despite the lack of real evidence that this makes any difference, it's still prudent because F&V have a lot of nutrients) and that's about it. This lack of scientific justification makes the DG very vulnerable to criticisms by food companies, I am sorry to say. So you can't really blame the food companies for pointing out the weaknesses as they relate to their own products. I heard someone on the last DG panel give a presentation on their decision-making and I found their process pretty appalling. They used long chains of reasoning to get from A to Z without any real links, so they would go from eating more F&V improves blood pressure (e.g. the DASH diet) to blood pressure is a risk factor for heart disease and they say , okay this proves that eating F&V will reduce heart disease risk so now we have solid evidence, when in fact it's more like a speculation. But since no one is against F&V, nobody would complain about this.