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USDA Dietary Guidelines released…a full year later

The Dietary Guidelines Advisory Committee’s scientific report, essentially the major draft of the USDA “Dietary Guidelines for Americans” guidelines, was finished last February. The Dietary Guidelines for Americans, 2015-2020 has finally been released in its official form to the public–but it’s only available online at health.gov as of this week, with promises of an eventual PDF.

To that end, because the Health.gov site doesn’t yet have a downloadable version, I’ve pulled the text and images of the final “Dietary Guidelines for Americans 2015-2020” into a quick-and-dirty two PDFs you can download below for free. It’s not perfect–the pages don’t all flow with gorgeous layout and some of the graphics were so oversized I had to kind of select-cut-and-paste them in sections to get the charts to fit. I think I’ve got it all in there, though, including most of the helpful nutrition and diet charts in the appendices (with notes where I didn’t catch on that there was more to a chart than first appeared).

What can I say–“Enjoy.” Ummm….well, anyhow, here they are:

Dietary Guidelines for Americans, 2015-2020–this includes the Table of Contents, Intro, Executive Summary, and body of the report (Chapters 1-3).

USDA DGA 2015-20 Final-IntroandChapters (PDF, 3.4 MB)

Appendices (14 of them) for the Dietary Guidelines –I couldn’t get Adobe to stick this on the end of the document nicely, so it’s separate but useful.

USDA DGA 2015-20 Final Appendices (PDF, 263 KB)

The original Dietary Guidelines Advisory Committee Scientific Report from last February is available here.

What was the holdup? What are the differences from the health-basis-only recommendations of the DG Advisory Committee’s version last year?

Given the shoddy job major media gave the advisory committee’s scientific report last winter and spring, perhaps the best thing to do this time around is skip the media coverage hyperbole and compare the two reports directly and see what gives.

Professor Marion Nestle digs in with dissatisfaction as to some of the likely buyoffs this time around–she deems that the big meat, egg, sugar, etc. producing industries have won some victories in what wasn’t said. She also complains, as I do, that the online version is full of stupid bells and whistles. It’s hard to navigate, there are a lot of windows and figures that are actually slide shows and you have to know to click on them to get the rest of the information. Hopefully the PDFs above will be more readable.

Nestle’s take is more political than mine (for a change? not really). She notices more of the inconsistencies with naming food categories only when they’re favorable, and using nutrient names (sugar, saturated fat, sodium) as substitutes for the big-business food categories that are poor nutritionally.

I’m less incensed about most of that– and ironically a little more optimistic about what was included. We know one big thing that was left out–the scientific report included a controversial call for a more environmentally sustainable food supply. That’s not a  nutritional position per se, however popular it might be, and the guidelines might not be the correct forum for it. Interestingly, what was left in were calls for increasing the availability and affordability of vegetables, fruits, lean proteins and dairy, legumes and whole-grain foods in poorer neighborhoods and food deserts, and for aligning farm subsidies and other agricultural incentive policies more closely with the aims of the dietary guidelines–as by growing and paying for more vegetables and maybe less corn and wheat…? Those recommendations were left very vague and noncommittal, though, and I get the feeling that the USDA will not actually move in that direction without a cattle prod being applied in a sensitive portion of its anatomy.

The final report does include specific calls to individuals to reduce saturated fats to 10 percent or less of daily calories, cut added sugars to 10 percent or less of daily calories, and limit sodium intake to 2300 milligrams per day.

So, not a great deal of difference from previous versions of the guidelines. Two notes of dissatisfaction:

First, “added sugars” is singled out rather than calling for a reduction in the grand total of carbohydrate grams per day. They do single out sodas and snacks as overconsumed and a large share of average daily calories–something like 20-30 percent of a typical person’s daily diet. But 10 percent of daily calories might be kind of a lot of added sugar for someone with a 2500 calorie diet–250 divided by 4? 62.5 grams, more than 15 teaspoons a day. And it’s not really good to scale up and eat even more than that if you eat 3200 calories a day. Most people who do (other than extreme athletes) are probably well overweight and insulin-resistant if not diabetic.

Second, the 2300 mg of sodium per day recommended tolerable upper limit is mentioned for anyone of healthy BMI above age 14, and the final report acknowledges (I think for the first time) that kids should be getting less than that, not more–that’s an actual improvement.

But the more relevant sodium intake recommendation for most Americans today is not 2300 mg per day. The standard clinical recommendation for sodium intake is actually 1500 mg per day for people with significant cardiovascular risk factors, and today that means most of us.

That’s because more than two-thirds of the adult population is now overweight and fairly sedentary, and about a third are obese, with a BMI of 30 or more. The 1500 mg standard also applies to anyone over 50 (I’d say 40, but that’s the new 25), anyone with a history of cardiovascular or kidney disease, anyone with Type II diabetes, anyone with high or borderline-high blood pressure. Today that includes an awful lot of younger people.

I know I harp on this every year at least once, but it’s still true, and it’s still a good question why 1500 mg isn’t even mentioned in the final USDA report when that’s the clinically recommended upper limit that actually applies to most people, including children.

The only other thing I’m hearing about the dietary guidelines on popular news outlets so far is that it’s “finally okay” to eat some eggs and that dietary cholesterol does not increase blood cholesterol significantly for most people the way saturated fat does.

Well–that’s not different from last year’s draft, and it’s not even particularly different from past editions of the dietary guidelines either. When I say “past” I’m talking at least twenty years of dietary guidelines and standard nutrition research. And they’re not talking about a dozen or more eggs with full yolks per week, per person–maybe four, up from two.

But boy, the news pundits jumped all over it last year too as though it were the main take-home message from the Advisory Committee report and a big reversal rather than a modest revision. And then they jumped to a very strange conclusion that it actually meant that saturated fat was fine to eat too, in unlimited quantity, and the older studies had “got it all wrong”–none of which was correct or even half-correct.

Major players like the New York Times, Wall Street JournalSlate.com and others gave contrarian/keto-diet enthusiast Nina Teicholz an awful lot of room to flog her saturated fat-promoting book with some pretty hairy claims, very few of which held up under closer inspection (I even went so far as to read her book and fact-check some of the references last spring. I ended up believing her even less than I had from her op-eds. Down to questioning the slippery wording of her bio blurb…I’ll spare you the details unless you really want them.)

So I hope the rest of us know better now that it’s been a year.

The actual guidelines–and the earlier scientific report–downplay the role of red meat as a great protein source (much to the displeasure of the cattlemen’s associations in the public comment period, which the USDA somehow extended from the standard 60 days to 75 at the meat producers’ request…).

I’m also exceedingly glad the final report doesn’t support the popular fantasy claims that coconut and palm oil are magically really good for you despite being more saturated than lard…see, something for me to be happy about!

The thing that stands out most when I read the final guidelines is not about meat or saturated fat or the prevalence of processed and fast food in the typical American diet at all–even though all those topics are present and accounted for.

It’s about how much emphasis is put on increasing vegetable intake. The report provides statistics charts and tables for typical diet, divided by gender and age, and says that most people are getting too little iron, vitamins and minerals, potassium and fiber and that the only vegetables most people ever seem to eat regularly at this point are potatoes and tomatoes. We can guess where a lot of those are coming in–french fries and either ketchup or tomato paste (from pizza), with all the vitamin C cooked out. That’s a lot more damning than anything about egg consumption. Of which they say very little at all, actually…

The guidelines provide specific recommendations for increasing vegetables and whole grains to increase the nutrients missing from most peoples’ diets today. DASH/MyPlate, Mediterranean and vegetarian diet plans are each featured with explicit charts in the appendices to show recommended numbers of standard servings for major food groups at many daily calorie levels, from 1000 to 3200 or more calories per day. [NOTE: when I was copying and pasting I only captured the charts up to 2000 calories a day in the appendices PDF file above; there’s an annoying scroll-right arrow in the online version at health.gov if you need to see serving recommendations for higher calorie counts, but it doesn’t cut and paste neatly, to say the least. I caught on eventually for the potassium, calcium and fiber charts, so those are complete].

Back to vegetabalia:

The standard servings for vegetables and fruits are demonstrated in cup and half-cup “equivalents” which somehow serve to confuse things a bit–frankly, they’re pretty awkward. I’m not sure why nutritionists always have such a hard time discussing and teaching how to measure food consistently. Volume-based cup-and-spoon measurement, the traditional cookbook kind of thing, is an inconsistent mess to begin with. Given my experience as the mother of a diabetic kid, my personal take is that weights in grams would be more consistent and definitive if you’re trying to figure out what constitutes a standard serving and determine the nutritional content in it.

But okay, it’s a start. And the nutrition charts in the appendices for iron-, potassium- and calcium-rich foods list each nutrient both in terms of standard portions and per 100 grams of food. If you really want to work through the report to improve your own diet, you can get some real information. Especially if you decide to work with a decent online nutrition calculator that can interconvert the grams and cups, keep it simple, and do most of the wading through the USDA’s comprehensive nutrient analysis database for you. I favor myfitnesspal.com’s nutrition calculator but there are plenty of others, paid and free, and some meal planners from the National Heart, Lung, and Blood Institute’s DASH Diet and Obesity Education Initiative pages and the newer “supertracker” online food calculator from the USDA-administered ChooseMyPlate.gov.

If you want a purer and more complete analysis of American dietary patterns without commercial lobbying interruptions, do go back to the DGAC’s Scientific Advisory Report. It will almost certainly be more detailed, more specific, less simplistic and somewhat more difficult to read through quickly. It will also include some key information that was mostly left out of the DGA final report–namely, the comparative diet and health trends of the American public over time.

Even though there are some obvious omissions in the final DGA report–Dr. Nestle considers them political sins of omission, and she’s probably right–I see at least some hope for helping ordinary people figure out how to put together a daily diet that can get them back down off the high-calorie, high saturated-fat-and-sodium-and-sugars fast-food ledge. As long as they can find some vegetables of worth in their neighborhood shops, that is.

 

2 Responses

  1. I agree, it’s a start. I am even less thrilled than you are, and think it’s sad that the best I can muster is…it could have been worse. But then part of the delay and some of the surprises might have well been orchestrated from getting threatened by PCRM… the threat they would be sued if certain criteria weren’t met, as I’m sure you know! Love these guys! http://www.pcrm.org/USDA

    It still boggles me though how pale the advice is compared to what we actually know is true. $$$ is sure powerful! [excerpted for length] Our whole system is twisted and has to change, which is why these stupid guidelines are so important…for whatever it’s worth.

    • Thank you again for your comments, Charzie. For those who don’t know, PCRM is Physicians’ Committee for Responsible Medicine, a Washington, DC-based nonprofit with about 12,000 members. The main themes are research and nutrition education to promote preventive medicine through measures like low-fat vegan diet, and lobbying efforts to stop animal testing. I stopped by to look through the PCRM web site and was intrigued to find that they actually were happy that the Institute of Medicine’s recommendation to eat as little cholesterol as possible was left in the Dietary Guidelines for Americans final version. When I read that, I consider that “as little as possible” is pretty vague and unspecific as to amounts or upper tolerable daily limits. So I tend to see that as an evasion rather than a win, but evidently Neal Barnard, MD (president of PCRM) and his colleagues are looking at it as preserving the warning that the Advisory Committee seemed to be softening on back in February. PCRM did indeed threaten a lawsuit if it was dropped, but I can’t tell just from their own announcement whether the USDA’s inclusion of the IOM recommendation resulted primarily from their actions or not.

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