The guidelines, which are updated every five years and influence public health policies and programs related to food and beverage consumption, as anticipated recommended most Americans “shift” their diets to include more vegetables, fruit and whole grains. They also advocate Americans eat a variety of proteins, including more low-fat and fat-free dairy, and healthy oils.
Also not surprising is that the Department of Health and Human Services and the US Department of Agriculture adopted advisory committee recommendations that Americans cap at less than 10% of their daily calories those from added sugar and saturated fats. Likewise, they encourage Americans to reduce daily sodium consumption.
But what is surprising is how some of the more sensitive recommendations about how Americans should meet these goals are being interpreted as victories by both public health advocates and industry, even though these groups initially clashed violently over the advisory committee’s take on these suggestions.
Some of these hot button issues include recommendations about how much dietary cholesterol to consume, what type and how much protein Americans should eat, whether artificial sweeteners are appropriate to help reduce added sugar intake and the role of sugar sweetened beverages in the diet.
Dietary cholesterol cap dropped from guidelines
One of the most controversial recommendations by the dietary guideline advisory committee to make it into the final document is the one to drop the cap on dietary cholesterol at 300 mg daily because current scientific evidence does not support the relationship between dietary cholesterol and serum cholesterol.
This change is a major victory for manufacturers of eggs, consumption of which took a hit when the limit was introduced in the 2010 Dietary Guidelines.
The American Egg Board lauded the change and the inclusion of eggs in each of the recommended healthy eating patterns and noted that that many Americans no longer avoid the food for fear of consuming too much dietary cholesterol.
“The removal of a daily dietary cholesterol limit and inclusion of eggs within all recommended healthy eating patterns supports regular consumption of eggs along with other nutrient-rich whole foods such as fruits, vegetables and whole grains. As an affordable, nutrient-rich source of high-quality protein, eggs can help Americans build healthful diets,” AEB says in a statement.
But a closer look at the guidelines do not suggest a free for all on dietary cholesterol. Rather, the government cautions “this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns. As recommended by the [Institute of Medicine] individuals should eat as little dietary cholesterol as possible while consuming healthy eating pattern.”
It maintains that a healthy eating pattern includes 100 to 300 mg of cholesterol, which the Physicians Committee says strengthens recommendations to limit cholesterol consumption and is “a major rebuff for the purveyors of high-cholesterol food products,” including eggs.
"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." 2015 Dietary Guidelines
The guidelines acknowledge that egg yolks are high in cholesterol but note that because they are not also high in saturated fat they “can be consumed along with a variety of other choices … of protein.”
The ostensibly conflicting interpretations of this provision likely will lead to increased confusion by consumers and trigger additional education campaigns by both sides.
References to red meat dropped
The final guidelines also make no reference to sustainability, and exclude the advisory committee’s explicit suggestion to consume less red and processed meat, which triggered fast attacks by the meat industry and its Congressional supporters.
However, teen boys and adult men are advised to “reduce overall intake of protein foods by decreasing intakes of meats, poultry, and eggs and increasing amounts of vegetables or other underconsumed food groups”.
Meanwhile, the overall recommendation — unchanged from 2010 — to reduce saturated fat intake to less than 10% of calories, would in practice, likely require limiting intakes of red meat, as would the limits on sodium (2,300mg/day).
The report also encourages Americans to eat more fish and protein-rich plants, and emphasizes that “processed meats and processed poultry are sources of sodium and saturated fats.”
However, it softens this message by adding, “intake of these products can be accommodated as long as sodium, saturated fats, added sugars, and total calories are within limits in the resulting eating pattern.”
It also includes meat and poultry in two of the sample dietary patterns, which the North American Meat Institute (NAMI) interpreted as an “affirmation of meat and poultry nutrition,” according to a statement
“Meat and poultry products are among the most nutrient dense foods available. They are rich sources of complete protein, iron, zinc and B vitamins, and many peer reviewed studies show the contributions they make to healthy diets and the potential deficiencies that can occur when people exclude animal proteins,” NAMI president and CEO Barry Carpenter added in the statement.
“Given the huge health and environmental costs of diets high in factory farmed meat, the lack of clear guidance on lowering meat consumption does a disservice to the public and our future food security. The administration has clearly put the financial interests of the meat industry over the weight of the science and the health of the American people.” Kari Hamerschlag, senior program manager with Friends of the Earth
Sugar-sweetened drinks should be limited
The other notable omission from the guidelines are the advisory committee’s strong recommendations for how to restrict consumption of sugary drinks and its dislike of artificial sweeteners to reduce calories in such beverages.
While the final guidelines do not go as far as the committee, which recommended taxing such beverages and skipping artificial sweeteners out of concern for long-term health implications, it does note healthy diets typically are lower in such beverages.
“Sugar-sweetened beverages, such as soft drinks, sports drinks, and fruit drinks that are less than 100% juice, can contribute excess calories while providing few or no key nutrients. If they are consumed, amounts should be within overall calorie limits and limits for calories from added sugars,” according to the guidelines.
It also suggests Americans prioritize calorie-free drinks, such as water, and those that contribute beneficial nutrients, such as juice.
As for artificial sweeteners, it simply states that these are FDA approved as safe.
“Of course while the government publishes this earnest and well-intentioned advice, the soft-drink, restaurant, snack-food, meat, and cheese industries will continue to spend billions of dollars promoting foods and beverages that directly contradict that advice. Those sophisticated marketing campaigns make it harder for Americans to eat diets that will protect against obesity, diabetes, heart disease, cancer, and other serious diet-related problems.” Michael Jacobson, executive director, CSPI
Dr Marion Nestle: Euphemisms all around
Writing in her Food Politics blog this morning, Dr Marion Nestle, professor of nutrition, food studies, and public health, New York University, notes that the Dietary Guidelines, "like all previous versions, recommend foods when they suggest 'eat more', but switch to nutrients whenever they suggest “eat less".
She adds: “Saturated fat is a euphemism for meat; added sugars is a euphemism for sodas and other sugar-sweetened beverages; sodium is a euphemism for processed foods and junk foods.
”If the guidelines really focused on dietary patterns, they wouldn’t pussyfoot. They would come right out and say: Eat less meat… Cut down on sugary drinks… Eat less processed and junk food.”
Read the full dietary guidelines HERE.
Read the executive summary HERE.
Read Dr Marion Nestle's summary and analysis HERE.
Get the CSPI's (Center for Science in the Public Interest) reaction HERE.
Click HERE for an analysis of how the 2015 and 2010 guidelines compare from IFIC.