Nutrition for Life - 2019


Dietary Guidelines of America

By Parul Kharod

This time we will move away from the topic of food and talk a little about food policy.

The U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) jointly publish the Dietary Guidelines for Americans (DGA) every five years. Public health agencies, health care providers, and educational institutions all rely on Dietary Guidelines recommendations.

The Dietary Guidelines have a significant impact on nutrition in the United States because they:

• Form the basis of federal nutrition policy and programs
• Help guide local, state, and national health promotion and disease prevention initiatives
• Inform various organizations and industries (e.g., products developed and marketed by the food and beverage industry)

In short, all the major decisions regarding food – manufacturing, regulations for food companies, agriculture, and price, how companies label the food, and what foods are approved for school lunches, food distribution, food stamps, etc are based on the Dietary Guidelines.

So, if you live in the United States, it is important for you to know how the Dietary Guidelines are updated and what the influencing factors that shape the food and health policies in this country are.

About the Dietary Guidelines

The Dietary Guidelines were first released in 1980. In 1990, Congress passed the National Nutrition Monitoring and Related Research Act, which states that HHS and USDA jointly review, update, and publish the Dietary Guidelines every five years. The current guideline term is 2015-2020, which means that next year we will get an update.

How are the Dietary Guidelines updated?

• The HHS and the USDA appoint an Expert Advisory Committee. The application and selection process began last year and the final committee members were selected in February 2019. The Advisory Committee is comprised of nationally recognized nutrition and medical researchers, physicians, dietitians, and science experts.
• The Advisory Committee hosts a series of open hearings where the general public and speak – sort of like an open town hall meeting. This will begin sometime in May.
• The Advisory Committee reviews the latest research, and makes a list of recommendations.
• After the Advisory Committee Report is submitted, the general public is allowed to submit comment. The public has opportunities to respond with written comments on health.gov/dietaryguidelines
• HHS and USDA use information in the Advisory Report, along with comments from the public and federal agencies, to form the new edition of the Dietary Guidelines.

Technically this is how the process is supposed to work. However, as you may have guessed, this is not what happens!

• Who gets selected to the Advisory Committee as always been controversial
• The public is not engaged enough to influence any decisions
• There are strong political lobbyists that have more influence

For example, research shows that excess salt and sugar is bad for health. So the Advisory Committee in 2015 made the recommendation that Americans should reduce the intake of salt and sugar in their diets. However, the final published guidelines ignored this advice. Also, even though the Advisory Committee said a healthy diet should be lower in red and processed meats, the new guidelines made no mention of red meats.

Do you remember the Food Pyramid? Introduced in 1992, the pyramid was supposed to represent a healthy balanced diet. However, the pyramid did not completely reflect the health of the consumers. It was shaped by agreements with big food companies and their lobbyists to produce something that was mutually beneficial for them all.

In 2011, the Food Pyramid was replaced by the MyPlate, which has sections for grains, protein (meat), fruits and vegetables. Next to the plate, is a glass of milk. There were questions from nutrition experts, including the Harvard School of Public Health, as to why milk was needed at every meal. Well, it was the influence of the lobbying from the dairy industry!

All food companies employ lobbyists or belong to trade associations that employ lobbyists. Some of the biggest employers of lobbyists are the National Restaurant Association, the Grocery Manufacturers Association, the American Beverage Association, Coca-Cola, and Monsanto. There is also McDonald's Corporation and PepsiCo. Then there is the National Corn Growers Association and the Beef Association and many such other groups that influence public food policy.

What can we do?

The best thing the public can do is be involved. Just like we can change the outcome of an election by voting for the right candidate, we have to voice our opinion in large numbers to actually make a difference. When the public comment section opens up in the next couple of months, write your comments! Go to health.gov/dietaryguidelines and fill out your responses.

Will it make a difference?

Can't say for sure, but we can get some hope from our neighbors up North. Canada recently revised its guidelines, and the new plate replaced the glass of milk with a glass of water!

Canada's 2019 Food Guide is a very pretty plate with fruits and vegetables. The protein section does not have just meat, but also includes beans, nuts, and tofu. The grains section shows a variety of whole intact grains, and then there's the glass of water. There are also very useful suggestions such as:

• Be mindful of your eating habits
• Cook more often
• Enjoy your food
• Eat meals with others
• Use food labels
• Limit foods high in sodium, sugars or saturated fat
• Be aware of food marketing

We can only take inspiration from Canada in revising our guidelines. So get involved, do your part, and hopefully we can change the course for better food and nutrition policy for the next generation.

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Parul Kharod, MS, RD, LDN is a registered dietitian and licensed nutritionist and works as a Clinical Dietitian with Outpatient Nutrition Services at WakeMed Hospital in Cary and Raleigh. She can be reached at parulkharod@gmail.com