Why the new US dietary guidelines have angered nutritionists

food pyraminds
New US dietary guidelines put limit on added sugars and remove limits on healthy fats. Pyramid image by bigbrand.

The 2015-2020 Dietary Guidelines just released by the US government have watered down some key recommendations by the nutrition scientists on whose work the guidelines are based. Fitness First magazine editor Tony Sarno reports.

Released every few years, the US dietary guidelines are probably the most important document in nutrition. They are essentially the rules for what’s considered healthy or unhealthy eating, and influence everything from school canteen menus to what nutritionists recommend we eat. In other words, they are probably the greatest influence on health (of the US and other western countries) there is. When they are wrong – as many believe they were in the late 70s, when they recommended that people switch to low fat diets, the guidelines have even been accused of “dietary mass murder.”

So it’s fascinating to see the angry reaction to the just released US 2015-2020 dietary guidelines. One of the US’s most influential nutritionists, David L. Katz, from Yale University, has branded the guidelines a betrayal and the day of their release a “day of shame.”

So what is it about the new dietary guidelines (DG) that has brought on this reaction?

Basically, it’s because the new dietary guidelines differ from the initial scientific report on which they are based — the 2015 Dietary Guidelines Advisory Committee (DGAC) Report — in the forcefulness in which they name and shame the villains of diet.

Put together by a selection of researchers in the fields of nutrition, health and medicine, the DGAC report didn’t mince words and identified foods such as red and processed meats as questionable and needing to be avoided. The DG, instead, take a much more softly-softly approach that gives you the impression they don’t want to offend anyone. If you read the fine print, the DG do actually say you should cut back your intake of red meat. But in its broad guidelines that everyone will read, tip-toeing around Big Food seems to be the order of the day.

No naming and shaming (except in the fine print)

In the key recommendations of the new Dietary Guidelines, specific language has been replaced by vague language. The original DGAC report was very pointed about what foods should be eaten (generally ones in a Mediterranean diet, such as seafood, fruits, vegetables, whole grains and nuts and seeds) and those you should cut back, such as red and processed meat, sugar-sweetened foods and beverages, and refined grains.

The official Dietary Guidelines have instead reframed everything in much vaguer terms, referring broadly to foods almost entirely in terms of nutrients (or macros, if you like) rather than their specific, easily understood names. For instance, the key guidelines recommend people cut down their intake of saturated fat but don’t name the main kinds of saturated fat-heavy foods to avoid. You will find these buried further inside the guidelines document.

In essence, this sentence from the DG sums up the entire approach: “To meet nutrient needs within calorie limits, choose a variety of nutrient-dense foods across and within all food groups in recommended amounts.”

In other words, according to the new guidelines, dietary health is essentially a battle to get enough nutrients into your body within certain calorie limits each day. That’s technically sound but for the average Joe, not as illuminating as it could be.

Recommendations on meat and sugar-sweetened beverages watered down

The original DGAC report highlighted red and processed meats and sugar-sweetened beverages as villains in health whose consumption needed to be reduced. But in the key recommendations in the new guidelines, this battle has been recast instead as people needing to stick to specific nutrient cutoff points. For instance, in the key guidelines, rather than making any mention of red or processed meat, the DG focus on nutrients, advising you should “consume less than 10 percent of calories per day from saturated fats,” and “consume less than 2,300 milligrams (mg) per day of sodium.”

To be fair, the report does say lower intake of meat is a good thing, but, again, it does it in the fine print: “Strong evidence from mostly prospective cohort studies but also randomized controlled trials has shown that eating patterns that include lower intake of meats as well as processed meats and processed poultry are associated with reduced risk of CVD in adults. Moderate evidence indicates that these eating patterns are associated with reduced risk of obesity, type 2 diabetes, and some types of cancer in adults.”

And this is what it says about beverages deep down in the report, where it actually identifies soft drinks as the main culprits of excess sugar intake after obstinately referring only to “added sugars” in the key guidelines: “The major source of added sugars in typical U.S. diets is beverages, which include soft drinks, fruit drinks, sweetened coffee and tea, energy drinks, alcoholic beverages, and flavored waters… Beverages account for almost half (47%) of all added sugars consumed by the U.S. population.”

The new dietary guidelines keep pushing all food groups

Again, seemingly unwilling to offend anyone, the new dietary guidelines bang on about the need to consume all food groups, even though the original DGAC report made it clear that some, i.e, meat, should be reduced.

Not everything is being criticised by the nutritionists

Nutritionists do point to a more overt stand by the DG on things such as sugar and fat intake as being positive. For the first time the dietary guidelines have put a cap on how much added sugar you should consume daily, saying “added sugars should be no more than 10 percent of your daily calories intake.”

Another lauded change is that the guidelines have now removed the upper limit for total daily dietary fat. Instead they now point the finger at saturated fat, saying it should make up no more than 10 percent of your daily calories. In other words, fat is no longer the evil previous dietary guidelines made it out to be, it’s just that the new guidelines want you to make it healthy fats rather than saturated fat.

And interestingly, the DG acknowledge that moderate coffee consumption can incorporated into healthy eating patterns, although they point to evidence that caffeine in moderate amount is not bad for you rather than it being good for you. “This guidance on coffee is informed by strong and consistent evidence showing that, in healthy adults, moderate coffee consumption is not associated with an increased risk of major chronic diseases (e.g., cancer) or premature death, especially from CVD.”

Read the key guidelines from from the new 2015-2020 Dietary Guidelines, and the key recommendations on the Dietary Guidelines website.