Dietary Guidelines for Americans

A woman and child pick fresh fruits and vegetables from a food cart.

Dietary guidelines form the basis for all federal nutrition policies.

What’s the Issue?

The 1990 National Nutrition Monitoring and Related Research Act requires the Department of Health and Human Services (HHS) and the Department of Agriculture (USDA) to jointly publish the Dietary Guidelines for Americans at least once every five years. The next guide­lines are set for release in December 2015 or early 2016. The new guidelines will be heavily informed by the Scientific Report of the 2015 Di­etary Guidelines Advisory Committee (DGAC), which was charged with analyzing the latest in nutrition science since the 2010 guidelines were published and coming up with food-based recommendations of public health importance. The secretaries of HHS and the USDA are not obligated to accept every DGAC recommendation and can reject any that they don’t want to include.

The guidelines are extremely influential and heavily lobbied; they form the basis for all federal nutrition policies, including the National School Lunch Program, which serves thirty-one million children daily; the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and the Supple­mental Nutrition Assistance Program (SNAP). And they serve as guideposts to the latest scientific thinking for health professionals throughout the country.

The DGAC’s 571-page report was released by its fourteen-member committee on Feb­ruary 19, 2015, nearly a year before the final guidelines are set. Its work, said the commit­tee in its executive summary, was guided by “two fundamental realities.” The first is that about half of all US adults have a preventable chronic disease and that two-thirds are obese or overweight because of lifestyle behaviors such as diet and physical activity. The second reality is that these lifestyle behaviors are “strongly influenced by personal, social, orga­nizational, and environmental contexts and systems,” which means that health outcomes could “substantially improve” with a better diet and more physical activity.

While most of the advice is consistent with the 2010 guidelines, there were a few issues on which the DGAC differed significantly from previous guidelines. These include limiting added sugar to no more than 10 percent of an individual’s total calories, removing the recom­mendation that cholesterol intake be limited to 300 mg per day, and eliminating a maximum percent of total fat consumption, recommend­ing instead that no more than 10 percent of to­tal calories come from saturated fat.

The committee also stressed that Americans should look at their total diet, or “dietary pat­terns,” and focus on certain food groups such as fruit, vegetables, and whole grains instead of concentrating on particular nutrients. And it addressed the controversial issue of the environmental impact of plant-based versus animal-based food by noting that “dietary patterns that promote health also promote sustainability.”

What’s Next?

The 2015 Dietary Guidelines for Americans are set to come out later this month, although the 2010 guidelines weren’t released until the following January, and the 2015 version could also be delayed until January 2016.

In addition, four US congressional subcom­mittees weighed in over the summer with language for fiscal year 2016, restricting the scope of the guidelines. Two House sub­committees added language to the HHS and USDA appropriations bills requiring that any change to the 2010 guidelines be backed by “strong,” not “moderate,” evidence from the Nutrition Evidence Library, a standard many scientists believe is unrealistic because it im­plies agreement by virtually every study on a particular subject.

And two Senate appropriations subcommit­tees added language that would limit the DGAC to subjects that are “solely” nutritional and di­etary. This requirement, if maintained, would keep any discussions of broader, systemic is­sues relating to nutrition—such as physical ac­tivity or economic barriers to eating well—out of the 2015 guidelines, even though such sub­jects have been routinely mentioned in previ­ous guidelines.

With Congress operating on a continuing resolution through December 11, 2015, it’s un­certain whether these four appropriations bills will ever become law and shape future dietary guidelines.

Meanwhile, in early October a new nonprofit, the Nutrition Coalition, was announced, whose goal is to have future committee reports subjected to additional expert review. The group is funded by John and Laura Arnold, whose foundation supported the Teicholz ar­ticle in the BMJ.