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2020-2025 Dietary Guidelines for Americans

The U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) are seeking public comments on topics and supporting scientific questions to inform the development of the 2020-2025 Dietary Guidelines for Americans. This is a new step in the development process. View the Federal Register Notice here.

Topics and questions proposed by USDA and HHS are based on four criteria: relevance, importance, potential federal impact, and avoiding duplication. The topics for 2020-2025 Dietary Guidelines are within a life stages approach, focusing on priority scientific questions from birth through older adulthood. In addition, the topics reflect a continued focus on patterns of what we eat and drink as a whole, on average and over time.

Learn more on the development of the dietary guidelines hereSubmit your comments here.

Listed below are the five life stages with proposed topics and scientific questions. The guidelines will also describe current dietary patterns, including intakes of food groups and nutrients, for each stage of life.

Infants and toddlers from birth to 24 months (healthy, full-term infants)

Topic Question(s)
Recommended duration of exclusive human milk or infant formula feeding What is the relationship between the duration of exclusive human milk or infant formula consumption and 1) growth, size, and body composition; 2) food allergies and other atopic allergic diseases; and 3) long-term health outcomes?
Frequency and volume of human milk and/or infant formula feeding What is the relationship between the frequency and volume of human milk and/or infant formula consumption and 1) micronutrient status; and 2) growth, size, and body composition?
Dietary supplements (e.g., iron, vitamin D, vitamin B12) What is the relationship between specific micronutrient supplements for infants fed human milk and/or infant formula and 1) micronutrient status; and 2) growth, size, and body composition?
Complementary foods and beverages*: Timing of introduction, types, and amounts

*Beverages (cow’s milk, water, 100% fruit juice, sugar-sweetened beverages, milk alternatives)

What is the relationship between complementary feeding and 1) micronutrient status; 2) growth, size, and body composition; 3) developmental milestones; 4) food allergies and other atopic allergic disease; and 5) bone health?

What is the relationship between complementary feeding, including foods and beverages, and achieving nutrient and food group recommendations of infants and toddlers?

Note: Evidence related to dietary patterns (including beverage patterns) consumed during the complementary feeding period will be considered as part of these questions.

 

Children and adolescents, ages 2-18 years old (with data reviewed by age group)

Topic Question(s)
Dietary patterns to promote health and normal growth and meet nutrient needs What is the relationship between specific dietary patterns (Dietary Guidelines-related, Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH), vegetarian/vegan, and low-carbohydrate diets) consumed during childhood and adolescence and 1) growth, size, and body composition; and 2) bone health?

Are changes to the USDA Food Patterns needed based on the relationships identified? If so, how well do USDA Food Pattern variations meet nutrient recommendations for children and adolescents?

Beverages (cow’s milk, water, 100% fruit juice, sugar-sweetened beverages, milk alternatives, caffeinated beverages) What is the relationship between beverage consumption during childhood and adolescence and achieving nutrient and food group recommendations?
Added sugars What is the relationship between added sugars consumption during childhood and adolescence and achieving nutrient and food group recommendations?

How much added sugars can be accommodated in a healthy diet during childhood and adolescence while still meeting food group and nutrient needs?

 

Adults, ages 19-64 years old (with data reviewed by age group)

Topic Question(s)
Dietary patterns to promote health, prevent disease, and meet nutrient needs What is the relationship between specific dietary patterns (Dietary Guidelines-related, Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH), vegetarian/vegan, and low-carbohydrate diets) consumed during adulthood and 1) body weight or obesity; 2) risk of cardiovascular disease; 3) risk of type 2 diabetes; and 4) risk of certain types of cancer?

Are changes to the USDA Food Patterns needed based on the relationships identified? If so, how well do USDA Food Pattern variations meet nutrient recommendations for adults?

Beverages (cow’s milk, water, 100% fruit juice, sugar-sweetened beverages, milk alternatives, caffeinated beverages) What is the relationship between beverage consumption during adulthood and achieving nutrient and food group recommendations?
Added sugars What is the relationship between added sugars consumption during adulthood and achieving nutrient and food group recommendations?

How much added sugars can be accommodated in a healthy diet during adulthood while still meeting food group and nutrient needs?

Saturated fats What is the relationship between saturated fats consumption (types and amounts) during adulthood and risk of cardiovascular disease?

 

Pregnancy and lactation

Topic Question(s)
How additional calorie needs should be met during pregnancy and lactation What is the relationship between specific dietary patterns (Dietary Guidelines-related, Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH), vegetarian/vegan, and low-carbohydrate diets) consumed among women who are pregnant and 1) risk of gestational diabetes; 2) risk of hypertensive disorders during pregnancy; 3) gestational age at birth; and 4) birth weight standardized for gestational age and sex?

What is the relationship between specific dietary patterns (Dietary Guidelines-related, Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH), vegetarian/vegan, and low-carbohydrate diets) consumed among women who are lactating and human milk composition and quantity?

Are changes to the USDA Food Patterns needed based on the relationships identified? If so, how well do USDA Food Pattern variations meet nutrient recommendations for women who are pregnant or lactating?

Dietary supplements (e.g., iron, folate, vitamin D) What is the relationship between micronutrient supplements consumed during pregnancy and lactation and 1) micronutrient status; 2) birth outcomes; and 3) human milk composition and quantity?
Diet during pregnancy and lactation and risk of food allergy in the infant What is the relationship between maternal diet during pregnancy and lactation and risk of infant allergies and other atopic allergic disease?
Seafood What is the relationship between seafood consumption during pregnancy and lactation and neurocognitive development of the infant?
Beverages (cow’s milk, water, 100% fruit juice, sugar-sweetened beverages, milk alternatives, caffeinated beverages) What is the relationship between beverage consumption during pregnancy and lactation and 1) achieving nutrient and food group recommendations; 2) birth outcomes; and 3) human milk composition and quantity?
Alcoholic beverages What is the relationship between maternal alcohol consumption during lactation and human milk composition and quantity?

 

Older adults, ages 65 years and older (with data reviewed by age group)

Topic Question(s)
Dietary patterns to promote health, prevent disease, and meet nutrient needs What is the relationship between specific dietary patterns (Dietary Guidelines-related, Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH), vegetarian/vegan, and low-carbohydrate diets) consumed across the lifespan and 1) body weight or obesity; 2) risk of cardiovascular disease; 3) risk of type 2 diabetes; 4) risk of certain types of cancer; and 5) risk of osteoporosis?

What modifications to dietary patterns are effective in preventing or reversing declines in muscle mass or bone density in older adults?

Are changes to the USDA Food Patterns needed based on the relationships identified? If so, how well do USDA Food Pattern variations meet nutrient recommendations for older adults, age 65-80 years and those age 81+ years?

Specific nutritional needs related to older adults What modifications to food and beverage choices promote meeting nutrient needs in older adults with impaired dentition, dry mouth, or other aspects of aging that interfere with food and beverage consumption?

Comments are accepted through March 30, 2018. If you have a new topic or question to suggest, provide a brief summary including information pertaining to the four prioritization criteria. After the review of comments and finalization of topics and supporting questions, USDA and HHS will post a public call for the Dietary Guidelines Advisory Committee nominations.

Read more about the Dietary Guidelines here.

If you have any suggestions to inform ASN’s comments please reach out to Sarah Ohlhorst, Senior Director of Advocacy and Science Policy, at sohlhorst@nutrition.org or 240-428-3647.

 

 

The former First Lady Michelle Obama revealed her “Let’s Move!” campaign in February of 2010 with the intent of curbing the childhood obesity epidemic. The initiative included a modification to the nutrition standards of the U.S Department of Agriculture’s (USDA) National School Lunch and School Breakfast Programs which provide 32 million meals to children daily. The principle legislation effecting these standards is the Healthy Hunger-Free Kids Act (HHFKA) of 2010 which has been touted as the first major reform to school lunch and breakfast in nearly 30 years.

In accordance with recommendations from the Institute of Medicine report “Nutrition Standards for Foods in Schools: Leading the Way toward Healthier Youth” and the 2010 Dietary Guidelines for Americans, the HHFKA informs the nutrition guidelines that schools must follow in order to be eligible for reimbursement under the National School Lunch Act and the Child Nutrition Act. Various standards resulting from the HHFKA went into effect in 2012, requiring schools to serve more fruits and vegetables, limit sodium, increase the whole grain composition of foods, and increase low-fat and non-fat options. To be more precise, all grains must be 50% whole grain by weight (or have whole grains as the first ingredient), food items can’t have more than 35% of total calories coming from fat, and only 10% of total calories can come from saturated fat. Many exceptions to these regulations exist and are enumerated in the final rule, which codifies the Act. For example, a high-fat food like peanut butter can be served if it is paired with a vegetable or fruit.

A 2014 study evaluated the initial implementation of the HHFKA in a cohort of students at four elementary schools in Washington State. The new guidelines were adhered to by 2013, and compared to the prior year, there was a decrease in average caloric intake by students across each individual macronutrient. Ingestion of key nutrients such as calcium and vitamin C decreased compared to the meals consumed under the old guidelines. Fiber was the only nutrient that was significantly increased. Despite the general dietary improvements that resulted, only about 1,000 meals in total were examined in this study. Following the implementation of these guidelines, childhood obesity rates have remained rather stable, but extrapolating the impact of this program on obesity rates over such a short time interval would not be sensible.

The new secretary of the USDA, Sonny Perdue, announced this past week that schools will be given “greater flexibility in their nutrition requirements for school meal programs in order to make food choices both healthful and appealing to students”. Schools have been facing increased financial burdens by adhering to the HHFKA regulations alongside a decline in school lunch participation, further exacerbating financial strain. Though students may be foregoing school lunches more often, the levels of food waste have not significantly changed compared to pre-implementation. Secretary Perdue acknowledged that 99% of the schools are partially compliant with the HHFKA standards, but noted that this metric is not indicative of program success. The temporary flexibility granted by Secretary Perdue includes a sodium target that is less rigorous, an exemption of the required 51% whole-grain composition, and the ability to serve 1% flavored milk rather than strictly non-fat flavored milks.

Dr. Margo Wootan of the Center for Science in the Public Interest, a consumer advocacy group, expressed disconcert with Secretary Perdue’s regulatory roll back, stating that “ninety percent of American kids eat too much sodium every day” and that “schools have been moving in the right direction, so it makes no sense to freeze that progress in its tracks.” Conversely, the School Nutrition Association, a nonprofit with 57,000 members, applauded this reform in a press release citing the HHFKA regulations as “overly prescriptive and having resulted in unintended consequences including reduced student participation, high costs, and food waste.” The new flexibility emphasizes the authority granted to localities to bolster the requirements of their own school nutrition and physical activity through the use of local “wellness policies.” The temporary deregulation of the HHFKA lowers the proverbial “floor” set by the federal government, giving the states an opportunity to have a direct impact in fighting the obesity epidemic.

References
https://www.fns.usda.gov/school-meals/healthy-hunger-free-kids-act
https://www.federalregister.gov/documents/2012/01/26/2012-1010/nutrition-standards-in-the-national-school-lunch-and-school-breakfast-programs
https://schoolnutrition.org/uploadedFiles/About_School_Meals/What_We_Do/Nutrition%20Standards%20for%20School%20Meals.pdf
https://www.cdc.gov/obesity/data/childhood.html
http://stateofobesity.org/childhood-obesity-trends
https://www.usda.gov/media/press-releases/2017/05/01/ag-secretary-perdue-moves-make-school-meals-great-again
https://schoolnutrition.org/news-publications/press-releases/sna-commends-usda-supporting-practical-flexibility-benefit-school-meal-programs/
https://www.cdc.gov/healthyschools/npao/wellness.htm
https://cspinet.org/news/trump-administration-undermining-school-meals-menu-labeling-20170501
https://www.ncbi.nlm.nih.gov/pubmed/24650841

By Joyanna Hansen

Consumers navigating grocery store aisles have many choices, and food labels are one way in which food manufacturers compete for attention. The label “all natural” or “100% natural” can be found on diverse food products ranging from peanut butter and cereal to “all natural” sodas, and may bring to mind images of wholesome, minimally processed foods. However, the U.S. Food and Drug Administration (FDA), responsible for regulating and supervising food production, does not define or regulate use of the label “natural” on food products. Instead, the FDA official policy is that “the agency has not objected to the use of the term if the food does not contain added color, artificial flavors, or synthetic substances,” (1) an ambiguous policy that leaves interpretation of “natural” largely up to the food industry.

Without a formal definition of what “natural” means, let’s examine what this label does not mean. First of all, foods containing natural flavors, sweeteners, or other plant-derived substances can be labeled natural. In addition, foods containing highly processed high fructose corn syrup (HFCS) can also be labeled “natural”, since the synthetic materials used to generate HFCS are not incorporated into the final product (2). Finally, foods containing genetically engineered or modified ingredients can be labeled “natural,” something California’s recently defeated Proposition 37 tried to prevent (3). Although far from an exhaustive list of what can be labeled a “natural” food, these are a few examples of how “natural” may mean something different than consumers think.

In contrast to the FDA, the United States Department of Agriculture (USDA) does regulate use of the word “natural” when applied to meat, poultry, and eggs, stating that a “natural” food is “a product containing no artificial ingredient or added color and is only minimally processed” (4). Although consumers purchasing “natural” meat, poultry, and eggs can be confident that there are no artificial ingredients or colors added, it’s important to note that “natural” does not necessarily mean hormone-free or antibiotic-free; these are separate labels, also regulated by the USDA.

Unlike “natural,” which has no clear definition, use of the “organic” food label and seal is strictly regulated by the National Organic Program, which is administered through the USDA. Foods with an organic seal are certified organic and contain at least 95% organic content (5). Organic food is produced using approved organic farming methods “that foster cycling of resources, promote ecological balance, and conserve biodiversity. Specifically, “synthetic fertilizers, sewage sludge, irradiation, and genetic engineering may not be used” to produce organic food, meaning that organic food products are not genetically modified and have not been treated with synthetic pesticides or fertilizers (5).

Unless the FDA adopts a stricter definition of “natural,” consumers trying to make informed decisions should be wary of the “natural” food label and pay close attention to ingredient lists, or choose organic foods that have been produced through a closely regulated process.

References
1.    What is the meaning of ‘natural’ on the label of food? FDA.gov. Retrieved Feb. 7, 2013 from http://www.fda.gov/AboutFDA/Transparency/Basics/ucm214868.htm.
2.    Crowley, L. (2008, July 8). HFCS is natural, says FDA in a letter. Foodnavigator-usa.com. Retrieved Feb. 7, 2013 from http://www.foodnavigator-usa.com/Business/HFCS-is-natural-says-FDA-in-a-letter
3.    Sifferlin, A. (2012, Nov. 7). California Fails to Pass GM Foods Labeling Initiative. TIME.com. Retrieved Feb. 8, 2013
4.    Meat and Poultry Labeling Terms (last modified April 12, 2011). USDA.gov. Retrieved Feb. 8, 2013 from http://www.fsis.usda.gov/FACTSheets/Meat_&_Poultry_Labeling_Terms/index.asp#14.
5.    National Organic Program (last modified Oct. 17, 2012). USA.gov. Retrieved Feb. 8, 2013.