The US Dietary Guidelines for Americans Committee is charged with identifying nutrients and food components that pose public health concerns.  These nutrients may be consumed at levels that are too high or too low.  Until now there has not been a formal or systematic process used to identify these nutrients or food components.  Bailey and colleagues have proposed such a framework and they describe this process and the results of its use in the most recent committee’s work in the May 2021 issue of The Journal of Nutrition.

The approach used by the Committee consisted of three prongs in a decision-tree framework.  The steps used included: 1) defining the terminology needed; 2) establishing the quantitative thresholds required to identify a nutrient or food component of relevance; and 3) examining national data.  Sources of data for the work included: 1) dietary intakes; 2) biological endpoints; and 3) the clinical health consequences associated, either directly or indirectly, with these outcomes using validated surrogate markers.

The Committee identified nutrients and food components of concern for various age groups.  For those over 2 years old, intakes of calcium, vitamin D and potassium were low and the intakes of sodium, added sugars, and saturated fats were high.  Infants (6-12 months) fed human milk consumed too little iron, and those over 1 year of age consumed too little fiber.  Iron (during all trimesters) and folate (during the first trimester) were consumed at low levels among reproductive aged or pregnant women, and biomarker data also suggested the intake of iodine among pregnant women was low.  Additional nutrients and food components were identified as being either under- or over-consumed throughout life. 

The authors concluded that the proposed decision tree framework would facilitate the work of Dietary Guidelines Advisory Committees and provide transparency in the processes used by the committee.  They suggest this approach will help to identify those nutrients or food components that should be encouraged or discouraged to reduce the risk of chronic diseases and promote health.


Bailey RL, Ard JA, Davis TA, Naimi TS, Schneeman BO, Stang JS, et al.  A proposed framework for identifying nutrients and food components of public health relevance in the Dietary Guidelines for Americans.  Journal of Nutrition, Volume 151, Issue 5, May 2021, Pages 1197–1204,

Images via