Friday, January 22, 2016

Review: 2015 Dietary Guidelines for Americans

The 2015 Dietary Guidelines for Americans have finally been released. Although these guidelines contain some advances over the previous years, they still don't do enough to adequately encourage the health of Americans.

For actionable recommendations that can actually make a difference, I encourage you to read the Dietary Guidelines Committee's submitted recommendations in their report.

Summary of the 2015 Guidelines


The current guidelines advocate for "shifts" in eating habits, along the lines of eat this, not that. They moved away from language focused on individual food components and nutrients to encourage healthier eating patterns. They also say you should eat more fruits and vegetables.

Changes this round

Cholesterol. Previous version put limits on how much cholesterol you should consume. Current research has shown that the relationship between saturated fat, cholesterol, and heart disease is complex. The committee removed specific limitations on cholesterol, but still suggests limiting saturated fat.

Sugar. For the first time, sugar made it into the final guidelines. The new language says "Consume less than 10 percent of calories per day from added sugars." Although I'm happy sugar restrictions made it into the guidelines at all, this statement is essentially meaningless.

For one, you'll have to carry around a calculator to figure up this percentage. Even if you choose to do the math, you rarely know the amount of added sugars. Added sugar means grams of sugar not naturally occurring. Let's say you've got a container of low-fat strawberry yogurt made with real strawberries. The container says 14g of sugar, but how much is added sugar? Milk and strawberries have naturally occurring sugars. Those don't count toward your 10 percent. With our current labeling structure, you don't know what's added sugar. With luck, that may be changing.

Eating patterns.
To help give examples of healthy eating patterns, the guidelines contain three examples, two of which are new. These provide recommended servings and sizes within each food group for different calorie ranges. The 2015 guidelines keep the Healthy U.S.-Style Eating Pattern (That name is not a joke), the Healthy Mediterranean-Style Eating Pattern, and the Healthy Vegetarian Eating Plan. I am excited about the inclusion of the Mediterranean plan. That style of eating has consistently shown to improve multiple health factors.

What didn't make the cut?


A few key points were included in the committee's report that were cut from the final version.

Red meat. Yet again, the committee's report said in bold and underlined that Americans should limit consumption of red and processed meats. Processed meats made the cut, most likely because of the WHO's decision to label it as a carcinogen. Although committee reports since the 1970s have explicitly said to limit red meat consumption, lobbying has effectively kept that language out of the final guidelines. Nearly 40 years later, that's still the case.

Sustainability. For the first time, the committee felt that the environmental impact of our eating habits was enough to warrant being included in the guidelines.

From the report:
"The availability and acceptability of healthy and sustainable food choices will be necessary to attain food security for the U.S. population over time. Integral to this issue is how dietary guidance and individual food choices influence the nation’s capacity to meet the nutritional needs of the U.S. population. Food sustainability and food safety are also interrelated in generating a secure food supply."
...
"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 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 (GHG) emissions.3 It also is the largest cause of species biodiversity loss.3 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."
The Secretaries disagreed.

However, the Mediterranean and vegetarian diets both mostly follow sustainable practices, so you could argue that the sentiment has remained, just in a much diluted form.

 

Why do these guidelines matter?


You may not pay much attention to the guidelines or even care enough to read the committee's report and make comments to the Secretaries. I argue that you should.

  • "About half of all American adults have one or more preventable, diet-related chronic diseases, including cardiovascular disease, type 2 diabetes, and overweight and obesity."
  • These guidelines are used to develop federal food policies and programs, including WIC-approved foods, food stamps, and school lunch program guidelines, as well as other health policy and education programs.

You may not care about WIC or food stamps, but when people on these programs are being fed crap, then you see more prevalence of the diseases in the first bullet. That means more medical care, which we all pay for. Food policy that comes from these guidelines affects us all.

Why the guidelines consistently come up short


These guidelines have been around since the first committee headed by Sen. George McGovern in 1977. That led to the release of the 1980 Dietary Guidelines for Americans.

A committee meets to review the latest scientific research related to food, nutrition, and lifestyle habits. It also reviews the current habits of Americans. The committee then makes recommendations in a range of categories, which go to the Secretaries of the USDA and Department of Health and Human Services.

The committee's report is heavily debated, and lobbyists for the food industry get involved. That's why red meat and, previously, sugar have been kept out of the guidelines.

The debate over specific language in the 1970s led to Sen. McGovern losing in the next election. It also set the precedent for language like "limit saturated fat" and "reduce calories," rather than specific, actionable items.

That trend towards diluted, unspecific language has continued into the current recommendations.