At the end of December, the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) quietly released a highly anticipated set of recommendations (at least in the nutrition world): the 2020-2025 U.S. Dietary Guidelines for Americans. Every five years, the groups update these guidelines, which can inform how doctors, dietitians, and other health professionals make nutritional recommendations to their patients. They can also shape how food companies approach what they put in their products.
Many dietitians applauded the updated guidelines for highlighting metabolic conditions like type 2 diabetes as a significant health concern for all Americans, as well as for focusing on eating patterns instead of singling out nutrients, says Maya Feller, RD, a Brooklyn-based registered dietitian-nutritionist who specializes in medical nutrition therapy for non-communicable diseases like diabetes.
But Feller and many other health experts also point out that the new guidelines—which overall are very similar to what has been in place since 2015—ignored important recommendations in a report published this past July by the USDA’s own advisory council of 20 independent doctors and nutritionists. The Center for Science in the Public Interest, an independent consumer advocacy organization that aims to improve the food system and support healthy eating, called the decision “disappointing.”
“As many of us want more transparency in government recommendations, omitting this feels as though the recommendations are political and not science-backed,” says Alex Caspero, RD, founder of Delish Knowledge.
Failure to address added sugars
One of the main critiques of the guidelines: They keep added sugars at 10 percent of daily calories, instead of lowering the recommendation to 6 percent as suggested by the advisory council. “Added sugars are a key contributor to chronic illnesses like heart disease, diabetes, obesity, and certain cancers,” says Brigitte Zeitlin, RD, owner of BZ Nutrition. “Less sugar, [fewer] health problems.”
In addition to complicating the management of chronic health conditions, “added sugars reduce the diversity of beneficial gut bacteria, which can contribute to poor health outcomes,” says Feller, noting that the GI tract plays a critical role in immune health.
Here’s the lowdown on added sugar and how it can affect your health:
However, other experts understand why the guidance on sugar stayed the same. Lisa Moskovitz, RD, CEO of New York Nutrition Group,argues that despite the well-known risks of excess added sugar, it’s better not to overwhelm Americans with goals they’re already struggling to follow. “Many consumers do not adhere to the federal guidelines as is,” she says.
Caspero says she’s mostly concerned about how this decision will impact packaged foods. “The guidelines have huge power in our food system, and making clear recommendations to reduce added sugar could encourage manufactures to reduce the sugar they use in their foods,” she says.
No changes to alcohol recommendations
Some nutrition experts were also surprised that the 2020-2025 guidelines ignored the independent committee’s recommendation to reduce daily alcohol intake for men from two drinks to one. (Recommendations for women remain at one drink per day maximum.) Zeitlin notes that the guidelines did suggest Americans should consume less alcohol but didn’t offer specifics. “There is so much credible research looking at the relationship between alcohol and an increased risk of developing chronic conditions,” adds Feller.
Other RDs we spoke to are fine with the guidelines as they stand. Moskovitz says that alcohol is safe in moderation, and the guidelines account for the fact that men are better able to process and metabolize alcohol than women. Caspero points out that the evidence against alcohol is mixed: some studies show that alcohol actually lowers heart disease risk, but that it also increases oral, breast and colorectal cancer risk.
Overall, the experts we spoke with generally agree that if you don’t already drink, there’s no good reason to start. But if you do, enjoy one drink per day, up to a few drinks per week max. And preferably choose red wine, especially over sugary cocktails.
New guidelines for pregnancy, breastfeeding, and kids under 2
In good news, dietitians applaud the guidelines’ inclusion of specific recommendations per life stage, including for toddlers and pregnant and lactating people. The policy will help shape government programs like the National School Lunch Program and WIC, says Caspero, and hopefully influence food manufacturers. “This is the first time guidelines have done it, and it’s an important step towards a holistic health approach,” she says.
How you eat during pregnancy affects not only your health but your baby’s health, “and each phase of life contributes to the health of the subsequent phase,” notes Zeitlin. She believes the guidelines will encourage parents to read the labels of baby food.
Want to learn more? Here’s some guidance from a top RD on what to eat during every phase of pregnancy:
As part of this, the guidelines suggest parents introduce allergenic foods (like peanuts) early in life to help prevent future food allergies—different from older guidance that urged parents to delay introducing those foods. The guidelines also specifically note that kids under 2 shouldn’t eat added sugars. Sweetened foods tend to be lower in nutrients, says Moskovitz; relying on them when kids are little may make balanced nutrition more challenging in the future. “Offering more bitter and bland-foods in the earlier years of life can help with children’s acceptance to a variety of foods as they get older,” she says.
More plant-based eating
The guidelines also continue to recommend that Americans eat more plants, which Moskoviz says is the wave of the future. “Not only does research prove the benefits of eating more plant-derived foods, but it may also be better for our environment,” she says.
Caspero, however, was disappointed that the guidelines only vaguely recommended cutting back on saturated fat to less than 10 percent of daily caloric intake. “They didn’t call out the specifics where [saturated fat] is usually found in the American diet: high-fat dairy foods, processed meats and red meat,” she says. She also points out that the guidelines did not mention the impact of diet on the environment, which was present in the 2015 guidelines. Animal farming accounts for 14.5 percent of all greenhouse gas emissions, according to the Food and Agriculture Organization of the United Nations.
Need to consider the individual
Ultimately, nutritionists across the board aren’t necessarily surprised that the latest round of nutrition guidelines didn’t change significantly. Some speculate that the USDA and HHS may have feared that more strict guidelines would backfire. “If they seem unattainable, people might use the new rules to create an unhealthy relationship with food,” says Moskovitz. Others are more skeptical. “The big food companies in America have lobbyists and sway in government, including the USDA,” says Zeitlin.
Regardless, it’s important to remember that any set of broad guidelines simply can’t account for every individual—everyone’s nutritional needs differ depending on their health, activity levels, and other factors. “There is no one-size-fits-all. Figure out what works best for you and do the best you can to eat a balanced, nutrient-dense diet,” says Moskovitz.
Nutritionists should also reframe how they work with the guidelines, which “need to be tailored to the socio-economic realities of the people we serve,” Feller says. That includes helping clients with low incomes find ways to afford fruits, vegetables, and whole grains. “Families who face and experience food insecurity have limited access to affordable, safe, and nutritious foods,” she says. “Inexpensive packaged goods tend to have an abundance of added sugars, and the recommendations do not take that reality into consideration.”
If you take a glass half full look, the recommendations will continue to evolve. “The guidelines are not perfect. Nothing is,” says Feller. Like many things in life, they’re a work in progress—due to be reviewed again in 2025.
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