Today, people are more concerned than ever about their health and well-being. The global COVID-19 pandemic has created a sense of anxiety and brought to light the alarming disparities that exist in the U.S. healthcare system. While COVID-19 poses a greater threat to those with chronic conditions such as obesity, type 2 diabetes, and heart disease, the physical isolation and increasing unemployment rates are exacerbating rates of food insecurity. Nutrition and access to food play an important role in protecting the health of people across the lifespan, regardless of current health or nutritional status. For these reasons, the Dietary Guidelines for Americans, which provide guidance to help Americans eat a healthier diet, are especially relevant and timely. 

Published every five years by the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA), the Dietary Guidelines for Americans are the basis for federal nutrition programs and an important resource for health professionals. In the past year, the Dietary Guidelines Advisory Committee (DGAC) held a series of meetings and an open public comment period to help inform the recommendations for Americans ages 2 and older. On July 15, 2020, the committee released their official Scientific Report to the HHS and USDA, who will use the findings in the Scientific Report to create the 2020-2025 Dietary Guidelines. Highlights from the Final Report are noted below, including noteworthy recommendations and issues that are likely to stay the same. 

Food Patterns and Diet Quality

The Advisory Committee continues to recommend the three food patterns from the 2015-2020 Dietary Guidelines: Healthy U.S.-Style Eating Pattern, Healthy Vegetarian Eating Pattern and Healthy Mediterranean-Style Eating Pattern. These dietary patterns are meant to provide a template for people to follow, offering flexibility to customize food choices to individual preferences, cultures and budgets. Healthy dietary patterns are defined by the quality of foods that are included and the foods that should be limited. Evidence consistently shows that dietary patterns associated with beneficial health outcomes include a higher intake of whole and minimally processed foods, such as vegetables, fruit, legumes, whole grains, low- or non-fat dairy, lean meat, seafood, nuts and unsaturated vegetable oils, as well as lower consumption of red and processed meats, sugar-sweetened foods and drinks, and refined grains. The consumption of high-quality foods should be the foundation of any eating pattern. 

New Recommendations

In response to rising incidences of chronic health conditions and the prevalence of obesity among children, the Advisory Committee made a number of new recommendations in their Final report, including dietary guidance for pregnant and lactating women and the birth-to-24 month populations for the first time. Recommendations include: 

• Lower added sugars recommendations: The committee concluded that a 6% limit of daily calories from added sugars is necessary for children and adults to achieve nutrient needs within recommended calorie limits. This shift is well below the current 10% limit. For children under 2 years, the DGAC advised against any added sugars in the diet.
• New recommendations for pregnant women, infants and young children: Maternal health influences pregnancy and pregnancy outcomes for both mother and child, and dietary patterns that are associated with a lower risk of overweight and obesity, diet-related chronic health conditions, and all-cause mortality begins in utero. Early food preferences influence later food choices and diet quality, which tends to be higher in young children and decline throughout childhood and adolescence, impacts health throughout each subsequent stage of life. 
• Advice across the lifespan: Beyond the novel birth-to-24 month recommendations, the DGAC emphasized the importance of tailoring recommendations using a life stages approach. Nutritional needs from infancy to older adulthood may differ, but food and beverages consumed at each life stage can affect health and wellness within and across all life stages. 
• Sustainability, food access and behavior change: The committee acknowledged the importance of evaluating the sustainability of dietary patterns, access to food, and systemic changes that could encourage behavior change, though it did not specifically review questions related to these topics. The committee strongly encouraged the USDA and HHS to examine these topics to support improved dietary intake among Americans, especially in considering approaches to implementing the Dietary Guidelines. 
  

Ongoing Recommendations

Many of the conclusion statements and recommendations made by the Advisory Committee echo the 2015-2020 Dietary Guidelines. Noteworthy recommendations that remain the same include:

• Shifting from less healthy dietary choices to nutrient-dense options
• Indicating the same nutrients of public health concern—calcium, vitamin D, potassium and dietary fiber—with some variations per life stage. 
• Focusing on high-quality, nutritious foods to fill nutrient gaps. Most Americans over the age of two are underconsuming fruits, vegetables, whole grains, and dairy, which are the main contributors of the important nutrients listed above. 
• Limiting calories from added sugars and saturated fats and reducing sodium intake.
  

Dairy’s Role in a Healthy Eating Pattern

The final Scientific Report reinforces the important role dairy foods play in eating patterns across the life span, and the unique package of nutrients dairy foods like milk, cheese and yogurt contribute in the American diet, that would otherwise be under-consumed. In a review of dietary patterns and health outcomes in adults, the Advisory Committee concluded that consuming low-fat dairy foods as part of dietary pattern was associated with beneficial impacts on all-cause mortality, cardiovascular disease, growth, size and body composition, bone health, colorectal cancer and lung cancer. 

Despite growing scientific evidence that was submitted showing beneficial or neutral effects of dairy on chronic disease risk at all fat levels, the Advisory Committee did not recommend consumption of high-fat dairy foods. Instead, the Advisory Committee encourages more research focused on the food matrix and its relationship to saturated fat and health outcomes. This would provide additional evidence that high quality foods, like certain full-fat dairy, are distinguished as health-promoting. 

Looking Forward

The USDA and HHS will consider the Advisory Committee’s final Scientific Report, along with public and agency comments, as the Departments develop the 2020-2025 Dietary Guidelines for Americans. The public is invited to submit comments for consideration in the drafting of the final Dietary Guidelines. The new docket for public comments will remain open until August 13, 2020, 11:59 pm, ET. Dairy Council submitted its own public comments and encourages others to do the same. 

Nutrition greatly impacts the health and well-being of people across their life span and influences many aspects of the lives of children and their families. The Dietary Guidelines for Americans serve as a catalyst to spark collaborative action, nutrition policy and educational efforts, which can increase access to healthful foods and beverages and support adoption of healthy eating patterns for all ages and in all places people live, learn, work, play and gather. 

References

Dietary Guidelines Advisory Committee. 2020. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. U.S. Department of Agriculture, Agricultural Research Service, Washington, DC.