DGA News

Highlights of the 2015-2020 Dietary Guidelines for Americans

By Sarah Levy, MPH, RD

The federal government has issued dietary recommendations in one form or another for more than 120 years. However, 1980 marked the inception of the modern Dietary Guidelines for Americans (DGA) when the USDA and the Department of Health, Education, and Welfare, now the Department of Health and Human Services (HHS), jointly issued seven principles for a healthful diet. These were based on the 1979 Surgeon General report “Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention.” They called for a variety of foods to provide essential nutrients while maintaining recommended body weight and moderating dietary constituents such as fat, saturated fat, cholesterol, and sodium that might be risk factors in certain chronic diseases. This, rightfully, will prompt many RDs to think, “The more things change, the more they stay the same.”

The DGAs are the cornerstone of federal nutrition policy and nutrition education activities in the United States and influences dietary guidance around the world. By law, the federal government updates the DGA every five years.

The most recent round of updates has proven to be particularly controversial. In February 2015, the 2015 Dietary Guidelines Advisory Committee (DGAC) submitted its scientific report to the secretaries of the USDA and HHS. The ensuing public comment period generated a record number of comments—over 2,000% more than were received in response to the 2010 scientific report, according to an analysis by FoodMinds, LLC. An unprecedented federal hearing was called, primarily to deliberate on whether the DGA should address the environmental sustainability of the food supply. The scientific review and evaluation process, the relative virtues of plant and animal protein sources, and strategies to reduce the intake of added sugars also were subjects of debate, both inside and outside the beltway.

While the broader debate on these topics may not be fully resolved, many experts believe that the final DGA policy largely represents a balanced interpretation of the current body of science. The government determined that while environmental sustainability is important to society, the DGA aren’t the appropriate venue to evaluate sustainable food choices. In contrast to the scientific report, the DGA contain few specific recommendations for policy and environmental changes. Specifically, the DGAC’s recommendations to require labeling of added sugars and establish a percent DV, restrict purchasing standards for Supplemental Nutrition Assistance Program benefits, and tax certain foods and beverages weren’t carried over to the DGA policy document.

That said, the DGA call for all sectors of society to help “create a new paradigm” in which healthful choices are “easy, accessible, affordable, and normative.” This includes product reformulation, menu labeling, and environmental changes to promote increased access to healthful foods and physical activity opportunities. Individuals, the food industry, communities, health professionals including RDs, and the government are all encouraged to contribute to improving the health of current and future generations.

To shed light on the evolution of the DGA over time, FoodMinds conducted a word content analysis across all eight editions. The most significant change in the content of the guidelines has been a shift in focus from individual foods and single nutrients to a recognition that overall eating patterns matter most. In addition, the recommendations have increasingly acknowledged the importance of individual needs and preferences, with the new DGA embracing the concept that a healthful eating pattern is an “adaptable framework” in which individuals can choose foods that meet “personal, cultural, and traditional preferences and fit within their budget.”

In concert with the release of the 2015-2020 DGA, the ChooseMyPlate.gov website and consumer education initiative was refreshed with the theme, “MyPlate, MyWins.” RDs can use the ChooseMyPlate.gov hub for professionals to incorporate the new DGA into counseling and educational sessions with clients.

While MyPlate can be a self-help tool for individuals, RDs are perfectly positioned to help members of the general public adopt the new DGA by providing individualized, tailored recommendations for healthful meals and menu plans that fit their lifestyles and food preferences. The bottom line: RDs have a unique opportunity in 2016 and beyond to capitalize on the new guidance to build relationships with existing and new clients, and to play a leadership role in fostering communities that encourage healthful eating patterns.

— Sarah Levy, MPH, RD, is a vice president with FoodMinds, LLC, a food and nutrition consulting and communications company that specializes in harnessing science, public affairs, and communications to meet business and public health objectives.

FoodMinds, LLC, conducted the word analysis via word cloud generator program wordle.net. Text from each edition of the Dietary Guidelines for Americans was used to generate word clouds and calculate word frequencies. Common English words (eg, a, the, of) were excluded from the analysis and frequencies of different forms of the same word (eg, fat, fats, FAT) were combined. Less insightful words such as “eating” and “food” also were excluded from the analysis. FoodMinds is reporting on the word prominence and observed trends, not the quality of evidence referenced in the documents or perspectives the words imply.

Differences Between the 2010 and 2015-2020 Dietary Guidelines for Americans
As experts in nutrition, RDs are charged with disseminating evidence-based nutrition recommendations to the general public. This means RDs must be proactive in understanding how the new Dietary Guidelines for Americans (DGA) will impact their counsel with clients. Key distinctions between the 7th and the 8th editions of the DGA include the following:

• With the focus on healthy eating patterns, the 2015 DGA model three separate eating patterns: the Healthy US-Style Eating Pattern, Healthy Mediterranean-Style Eating Pattern, and Healthy Vegetarian Eating Pattern. Given the variety and approachability of these diets, RDs have more flexibility than ever to educate and counsel clients. 

• The 2015-2020 DGAs don’t provide a quantitative limit on cholesterol, noting the lack of evidence to support a relationship between dietary cholesterol intake and higher blood levels of LDL-cholesterol. This is an historic recommendation as previous DGAs have included a cholesterol intake limit of no more than 300 mg/day. Certain foods, including eggs and shellfish, are now recognized as important components of a healthful diet, provided they’re consumed within and across protein subgroup recommendations. The consumption of dietary cholesterol sources that also are significant sources of saturated fat are discouraged.

• Daily added sugar intake is now limited to 10% of calories for a 2,000 calorie diet. RDs who counsel clients to reduce sugar intake now have a more direct, clear recommendation to provide them. How this recommendation will be incorporated into the forthcoming FDA final rule on revisions to the Nutrition Facts label remains to be seen. The final rule is expected to be published in March 2016; the FDA has proposed to require labeling of added sugars and establish a percent DV.

• The DGAs list potassium, dietary fiber, choline, magnesium, calcium, and vitamins A, D, E, and C as underconsumed nutrients; teenaged girls and women aged 19 to 50 underconsume iron. Calcium, potassium, dietary fiber, vitamin D, and iron (for young children and women of childbearing age) are considered “nutrients of public health concern.”

— SL