After nearly two years of review and discussion, scientists charged with advising federal health and agriculture agencies on the next edition of dietary guidelines have released their report Tuesday clarification of the role of food in health promotion and disease prevention.
It’s not quite food writer Michael Pollan’s famous statement: “Eat food, not a lot of it, mostly plants.” recipebut it is closer than the current guidelines. The mantra the advisors want Americans to adopt: “Eat healthy your way.”
The overarching theme of the 20-member committee’s report emphasizes consuming vegetables, fruits, legumes (such as beans, peas, lentils), whole grains, nuts and fish and seafood across the lifespan. Low-fat and low-fat dairy products (cow or alternative) and unsaturated fats are encouraged, while red or processed meat, saturated fats and salty or sugary snacks are discouraged, along with sweetened drinks and foods. The 2020 guidelines placed an emphasis on reducing added sugars and alcohol intake, in line with the limits from the 2015-2020 edition.
The report contains dire statistics about America’s burden of chronic diseases, many of which are diet-related and are getting worse: the prevalence of overweight and obesity is 73% among American adults aged 20 and older and 36% among children and adolescents aged 2 to and with 19 years old. The prevalence of prediabetes among teenagers is 38%.
That’s why it says, “Nearly all American individuals can benefit from a transition to healthier diets.”
“The committee recommends that the proposed Eat Healthy Your Way Diet Pattern emphasizes the intake of beans, peas and lentils, while reducing the intake of red and processed meat, as supported by systematic reviews and modeling analyzes of food patterns indicating that nutrition targets are generally met with such a shift from the 2020 HUSS [healthy U.S.-style,] to include more plant-based protein foods,” the report said.
The academics’ work provides expert opinions derived from their systematic reviews of medical evidence available to develop the Dietary Guidelines for Americans 2025-2030. These are not the recommendations themselves. That is the responsibility of the U.S. Department of Health and Human Services and the Department of Agriculture, which together can reject or accept the scientific committee’s conclusions after a period of public comment. The next edition of the guidelines will be published at the end of 2025.
With the Make America Healthy Again movement influencing the policies of the next administration and the potential HHS leadership of Robert F. Kennedy Jr. inspires, the upcoming guidelines are likely to be more than academic. For example, MAHA supporters draw a direct line between ultra-processed foods and chronic diseases.
The dietary guidelines are updated every five years. In January 2023, the committee sought to use a health equity lens in its review of the evidence. Social determinants of health, including economic, environmental, social, educational, and structural factors, play a role in dietary intake across the lifespan, limiting how individuals and populations find healthy foods and achieve nutritional goals.
Compared to current guidelines, Tuesday’s report also adds new recognition of dietary patterns that take into account cultural differences in how healthy nutrients are included in meals, with a special focus on intake of iron, folate/folic acid, iodine and choline during pregnancy. and postpartum periods. These fall under food patterns, which are seen as less prescriptive and more flexible in achieving the same goal: high-quality, nutritious meals.
Previous diets were sorted into healthy American style, healthy vegetarian and healthy Mediterranean style. A pilot project this time around simulated foods found in selected American Indian and Native Alaskan diets to see if they met nutritional goals. They did, with one exception: sodium intake exceeded recommended limits even when foods with lower nutrient density were excluded from the simulations, prompting the committee to call for “significant efforts to reduce sodium levels in the U.S. food supply.” reduce’, and to suggest that more groups should intervene. next time considered.
HHS and USDA open one 60 day public comment period and also hold a public meeting on January 16 to hear public comments on the scientific report. (Pre-registration is required for the public meeting.)
Two separate entities will release their guidance advice on alcohol, also after analyzing the current evidence. The Interagency Coordinating Committee on Prevention of Underage Drinking and the National Academies of Science, Engineering, and Medicine will each weigh in on risk estimates and other research on alcohol use and health outcomes.
Conspicuously absent from the scientific report on nutrition is any position on this ultra-processed foodsa decision that was made public in October when the committee also addressed ICCOUD and NASEM on alcohol. High-quality research – including a definition that allows a systematic review – does not exist for processed foods, the committee found. The umbrella term has been criticized because it can include snacks high in fats, sugars and non-food additives as well as less processed bread found on supermarket shelves.
Marion Nestle does not agree with the lack of a position in the committee. The emeritus professor of nutrition and public health at New York University mentioned this observational research Led by Kevin Hall, it was shown that people who ate ultra-processed foods consumed an average of 500 extra calories per day compared to people who ate unprocessed foods in a laboratory setting. She said the advisory committee’s hands are tied by rules that exclude small observational studies from the body of evidence they review.
An article published in the Journal of the American Heart Association in November also claims that a definition of processed foods already exists in the Nova food classification system, which was first proposed in 2009 and completed in 2014.
JoAnn Manson, a professor of medicine at Harvard Medical School and Brigham and Women’s Hospital, thinks it will take several years before enough evidence for recommendations is gathered, possibly in time for the 2030-2035 dietary guidelines. She led a team that reported in Lancet Regional Health in September on a major analysis of long-term studies looking at links between ultra-processed foods and cardiovascular disease, but says more research is needed.
“It is important to focus on a whole-food diet, primarily plant-based,” Manson said in October, after the advisory committee discussed the draft advice in an online forum. “Certain types of ultra-processed foods can be included in a healthy diet. They do not need to be eliminated completely. They don’t have to become taboo. We know that doesn’t work with dietary guidelines.”
Processed foods were not the only ones without a strong conclusion from the committee. Portion size and its link to growth, body composition and the risk of obesity in children or adults also did not meet the bar for solid evidence. “There is also a lack of evidence on the role of portion size in achieving or maintaining a healthy weight and growth, body composition and the risk of obesity in general,” the report said.
Still, the report suggests what may seem like an obvious solution: smaller portions and more fruits and vegetables in those portions to increase nutrients for children. Adults can plan meals at home in portion sizes and choose smaller quantities outside the home. And, the committee said, portion size needs to be reexamined in federal food programs to move people toward healthier diets.
Some proposals seem to be more out of the weeds, such as how high on a list of food groups legumes appear, and whether they should fall under “vegetable” or “protein.” A clearer message calls for drinking water to be “the most important drink people can consume.” Milk and fortified soy drinks should be unsweetened and milk should be low fat or fat-free.
The committee also suggested surveying consumers about what to call food groups, saying the “protein group” excludes certain foods that contain protein. For ‘dairy and fortified soy alternatives’ it is recommended not to refer to lactose-free options and fortified soy milk and yoghurt as ‘alternatives’ as they are part of the dairy group.
The guidelines are more than ambitious, even though fewer than 1 in 5 Americans have consistently followed the advice to limit saturated fat since 1980, a message specified in 2005 to include less than 10% of the daily diet from the age of 2 years to make it out. What HHS and USDA ultimately adopt matters not only for clinical practice, but also more directly as they dictate decisions about foods available through federal nutrition assistance programs. About 1 in 4 Americans participate during a given year, from WIC for women and young children to school lunches and meals for veterans or seniors.
The committee also analyzed how Americans eat at different ages. Diet quality is higher in early childhood than later in childhood and adolescence. The scientists called poor nutrient intake among adolescents, especially women, worrying. The quality of the diet was slightly better for older adults than for younger adults, although some specific nutritional concerns still persist.
The dietary guidelines are meant to make “Science-based recommendations on what Americans should eat and drink to promote health and prevent chronic diseases – including obesity, type 2 diabetes and cardiovascular disease,” said HHS and USDA.
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