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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Evaluating the Process to Develop the
Dietary Guidelines for
Americans, 2020-2025

A MIDCOURSE REPORT

Kathleen M. Rasmussen, Ann L. Yaktine,
and Katherine M. Delaney, Editors

Committee on Evaluating the Process to Develop
the Dietary Guidelines for Americans, 2020–2025

Food and Nutrition Board

Health and Medicine Division

A Consensus Study Report of

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THE NATIONAL ACADEMIES PRESS
Washington, DC
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by a contract between the National Academy of Sciences and the U.S. Department of Agriculture (Contract 12319821C0003). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-27408-1
International Standard Book Number-10: 0-309-27408-7
Digital Object Identifier: https://doi.org/10.17226/26406
Library of Congress Catalog Number: 2022930018

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Copyright 2022 by the National Academy of Sciences. All rights reserved.

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the process to develop the Dietary Guidelines for Americans, 2020–2025: A midcourse report. Washington, DC: The National Academies Press. https://doi.org/10.17226/26406.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

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Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process, and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
×

COMMITTEE ON EVALUATING THE PROCESS TO DEVELOP THE DIETARY GUIDELINES FOR AMERICANS, 2020–2025

KATHLEEN M. RASMUSSEN (Chair), Cornell University, Ithaca, New York

STEPHANIE A. ATKINSON, McMaster University, Hamilton, Ontario, Canada

KELLY D. BROWNELL, Duke University, Durham, North Carolina

MARTHA S. FIELD, Cornell University, Ithaca, New York

SHARON I. KIRKPATRICK, University of Waterloo, Waterloo, Ontario, Canada

BRUCE Y. LEE, City University of New York, New York

DOUGLAS A. LUKE, Washington University in St. Louis, Missouri

ESTHER MYERS, Myers Consulting, St. Louis, Missouri

EMILY OKEN, Harvard University, Boston, Massachusetts

JOSÉ M. ORDOVÁS, Tufts University, Boston, Massachusetts

A. CATHARINE ROSS, The Pennsylvania State University, University Park, Pennsylvania

JOHN B. WONG, Tufts University School of Medicine, Boston, Massachusetts

Health and Medicine Division Staff

KATHERINE M. DELANEY, Program Officer

ALI SCHKLAIR, Research Associate (until November 2021)

NICOLE CUNNINGHAM, Research Assistant (from December 2021)

MELANIE ARTHUR, Senior Program Assistant

ANN L. YAKTINE, Director, Food and Nutrition Board

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
×

Reviewers

This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this report:

DAVID B. ALLISON, Indiana University School of Public Health-Bloomington

CAROL BOUSHEY, University of Hawai‘i Cancer Center

WENDY DEMARK-WAHNFRIED, The University of Alabama at Birmingham

JOSEPH LAU, Brown University School of Public Health

ANGELA M. ODOMS-YOUNG, Cornell University

MARGARET SLAVIN, George Mason University

PATRICK J. STOVER, Texas A&M AgriLife Research

KATHERINE L. TUCKER, University of Massachusetts Lowell

PARKE WILDE, Tufts University

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the report nor did they see the final draft before its release. The review of this report was overseen by SUZANNE P. MURPHY, University of Hawai’i Cancer Center, and CUTBERTO GARZA, Cornell University. They were responsible for making certain that an independent examination of this report was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
×

Preface

The Dietary Guidelines for Americans (DGA) play a central role in the development of federal nutrition policy and programs in the United States. As a result, they are of great interest to a variety of individuals from policy makers to the general public. A prior edition of the guidelines created questions about the process used to update the DGA over a 5-year cycle. In response, Congress mandated that a comprehensive review of the entire process of developing the DGA be carried out by the National Academies of Sciences, Engineering, and Medicine (the National Academies). The final report, Redesigning the Process for Establishing the Dietary Guidelines for Americans, was released in 2017 and included seven recommendations directed at improving this process. Subsequently, in 2020, Congress mandated that the National Academies convene a new ad hoc committee to assess how well the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (HHS) implemented these recommendations. In particular, this committee was asked to answer three overarching questions:

  • How did the process used to develop the Dietary Guidelines for Americans, 2020–2025, compare to the seven recommendations included in the 2017 National Academies report? (task 1)
  • Did the criteria used to include scientific studies used to inform the Dietary Guidelines for Americans, 2020–2025, ensure that the evidence base was current, rigorous, and generalizable or applicable to public health nutrition guidance? (task 2)
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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  • How would the process with full implementation of the seven recommendations included in the 2017 National Academies report compared to the process used to develop the Dietary Guidelines for Americans, 2020–2025, have affected the time line, cost, and/or integrity of the more recently issued guidelines? (task 3)

This midcourse report is the first product of the Committee on Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020–2025. In this report, the committee provides its analysis of data relative to task 1 and a subset of task 2. The results of completing the remainder of task 2 as well as task 3, along with additional findings and conclusions will compose the committee’s final report in response to the study task.

This report is grounded in evidence from publications in the peer-reviewed literature that describe innovations in the 2020–2025 DGA as well as changes to the process of preparing these guidelines made in response to the 2017 National Academies report. In open meetings, the committee received additional information from key staff members from USDA and HHS. The committee also used the information contained in numerous federal websites that describe the DGA as well as the basis for the guidelines and descriptive material about how they were developed.

It is noteworthy that this report is not an assessment of the merits of the 2020–2025 DGA, but rather, it is an assessment of the process by which they were created relative to the specific recommendations of the 2017 National Academies report. During its analysis, the committee considered the principles on which the recommendations in the 2017 National Academies report were based. The committee was cognizant of the timing of the release of the 2017 National Academies report relative to the time line required to produce the 2020–2025 DGA in conducting its analysis. This meant that it was, in some cases, not feasible to implement the 2017 National Academies recommendations during this DGA cycle. Importantly, the committee was guided by the preponderance of evidence relative to any single recommendation or scientific issue that it considered. Given the central role of systematic reviews in the development of the DGA, the committee developed a comprehensive systematic review matrix summary to facilitate its comparison of the content of these reviews and assessment of their application to the DGA process. The committee gave priority to addressing1 task 1, which it viewed as providing time-sensitive

___________________

1 This text, and similar text throughout the report, was modified after release of a prepublication version of the report to the sponsor to clarify that additional context and information relating to tasks 1 and 2 of the statement of task may be presented in the final report.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
×

information to USDA and HHS for the development of the 2025–2030 DGA, and presents its findings and conclusions herein.

I am especially grateful to the members of the committee, Stephanie Atkinson, Kelly Brownell, Martha Field, Sharon Kirkpatrick, Bruce Y. Lee, Douglas Luke, Esther Myers, Emily Oken, José Ordovás, Catharine Ross, and John B. Wong (see Appendix A) for their exceptional dedication to producing this midcourse report following the congressional mandate.

The committee offers its thanks to Julie Obbagy and Eve Stoody from USDA and Janet de Jesus from HHS, and their staff members, for providing essential information to the committee. The committee also thanks Rose Gladstein for preparing the Systematic Review Matrix Summary (see Appendix C). The committee thanks the National Academies’ study staff, Katherine Delaney, study director; Ali Schklair, research associate; Nicole Cunningham, research assistant; Melanie Arthur, senior program assistant; and Ann Yaktine, director of the Food and Nutrition Board, for their assistance to the committee in carrying out its task.

Kathleen M. Rasmussen, Chair
Committee on Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020–2025

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Acronyms and Abbreviations

AHA American Heart Association
AHRQ EPC Agency for Healthcare Research and Quality Evidence-based Practice Centers Program
AI Adequate Intake
AMDR Acceptable Macronutrient Distribution Range
AMSTAR A Measurement Tool to Assess Systematic Reviews
ARS Agricultural Research Service (U.S. Department of Agriculture)
ARS NND Agricultural Research Service National Nutrient Database for Standard Reference
B-24 children from birth to 24 months
BMI body mass index
CDC Centers for Disease Control and Prevention
CNPP Center for Nutrition Policy and Promotion
COI conflict of interest
CQA Continuous Quality Advancement
CSFII Continuing Survey of Food Intakes by Individuals
CVD cardiovascular disease
DASH Dietary Approaches to Stop Hypertension
DAT data analysis team
DGA Dietary Guidelines for Americans
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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DGAC Dietary Guidelines Advisory Committee
DGPCG Dietary Guidelines Planning and Continuity Group
DGSAC Dietary Guidelines Scientific Advisory Committee
DRI Dietary Reference Intake
EAR Estimated Average Requirement
EER Estimated Energy Requirement
FACA Federal Advisory Committee Act
FDA U.S. Food and Drug Administration
FNDDS Food and Nutrient Database for Dietary Studies
FTE full-time equivalent
GRADE Grading of Recommendations Assessment, Development and Evaluation
HDI Human Development Index
HHS U.S. Department of Health and Human Services
IOM Institute of Medicine
NEL Nutrition Evidence Library
NEL BAT Nutrition Evidence Library Bias Assessment Tool
NESR Nutrition Evidence Systematic Review
NFC nutrient or food component
NHANES National Health and Nutrition Examination Survey
NHIS National Health Interview Survey
NIH National Institutes of Health
P/B-24 Pregnancy and Birth to 24 Months
PICO population, intervention/exposure, comparator, and outcome of interest
RCT randomized controlled trial
RDA Recommended Dietary Allowance
ROB risk of bias
SEER Surveillance, Epidemiology, and End Results (National Cancer Institute)
SR systematic review
TEC Technical Expert Collaborative
TEP technical expert panel
Page xvii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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UL Tolerable Upper Intake Level
USDA U.S. Department of Agriculture
USPSTF U.S. Preventive Services Task Force
WHO World Health Organization
WIC Special Supplemental Nutrition Program for Women, Infants, and Children
WWEIA What We Eat in America
Page xviii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report. Washington, DC: The National Academies Press. doi: 10.17226/26406.
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This midcourse report provides an initial assessment of how the process used to develop the Dietary Guidelines for Americans, 2020-2025 (DGA) compares to the recommendations in the 2017 National Academies report on redesigning the process for establishing the DGA. It also assesses the criteria and processes for including the scientific studies used to develop the guidelines. The scope of this study was to address the process and not the content of the guidelines.

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