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USDA/HHS Gear Up for Dietary Guideline Update

<ѻý class="mpt-content-deck">— New process follows recommendations from independent review
MedpageToday

WASHINGTON -- In the wake of severe criticism over the government's official dietary guidelines released in 2015, the U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services (HHS) will seek public comments ahead of developing their 2020-2025 updates.

This change follows an independent review from the National Academies of Sciences, Engineering, and Medicine that criticized and recommended a redesign of the current process for developing the guidelines.

USDA and HHS added this new step "early in the development process to ensure transparency in communicating the topics that are priorities to meet the needs for nutrition programs across the federal government -- the primary role of the DGA [Dietary Guidelines for Americans]," said Brandon Lipps, Acting Deputy Under Secretary for the Food, Nutrition, and Consumer Services at the USDA, during a press briefing.

The DGA provides food-based recommendations with the aim of promoting overall health and helping prevent diet-related chronic diseases. "The dietary guidelines have evolved and addresses a pattern of eating not a focus of individual foods or food groups," said Lipps.

The final 2015 guidelines were attacked by the American Cancer Society and others, in part for departing from Dietary Guidelines Advisory Committee (DGAC) recommendations on limiting red and processed meats. Processed meats such as bacon and sausage have been linked with pancreatic and other cancers, and numerous studies have linked red meat consumption and early mortality.

The newly proposed topics and questions for the 2020-2025 guidelines do not mention the word meat once. It is unclear if the DGAC will be allowed to include their own topics and questions that are not part of the USDA and HHS's list of topics.

The public comment period will be open for 30 days -- from February 28 to March 30, 2018.

USDA and HHS are inviting comments on a set of proposed that will guide the development of the upcoming edition of the DGA.

The departments' approach to the next edition of dietary guidelines will focus on "life stages." Birth to 24 months is a new focus following passage of the 2014 Farm Bill, which mandated that starting with the 2020-2025 edition, the DGA provide guidance for this life stage, as well as for women who are pregnant.

"This will be the first time that we've had this focus on life stages in the dietary guidelines," said Lipps. "We're doing this in the context of looking at eating patterns -- what we eat and drink as a whole on average and over time."

Examples of topics and questions open for public comment include:

Added sugars in children and adolescents (ages 2-18): "How much added sugars can be accommodated in a healthy diet during childhood and adolescence while still meeting food group and nutrient needs?"

Saturated fats (ages 19 to 64): "What is the relationship between saturated fats consumption (types and amounts) during adulthood and risk of cardiovascular disease?"

Other life stages included are pregnancy and lactation, and older adults (ages 65 and older).

The proposed topics by the USDA and HHS are based on four criteria: relevance to the guidelines (food-based recommendations); importance to public health; potential federal impact; and avoiding duplication or topics addressed by other federal guidelines.

"Guidelines are used by health professionals, policymakers, educators, and many more as guidance to promote the role of nutrition in promoting health and preventing chronic disease," said Don Wright, MD, MPH, Deputy Assistant Secretary for Health at HHS, during the press briefing. "We know that healthcare professionals use our tools and resources to help patients and clients understand how to make healthy choices and why nutrition is important for their health."

After the topics and supporting questions are finalized, the departments will post a public call for nominations to the DGAC. These final topics and supporting scientific questions, will determine the areas of expertise needed, resulting in a coordinated and efficient review.