Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025 A Midcourse Report (2022) / Chapter Skim
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Appendix D: Dietary Guidelines Advisory Committee/Dietary Guidelines for Americans Recommendation Comparison Table
Appendix D: Dietary Guidelines Advisory Committee/Dietary Guidelines for Americans Recommendation Comparison Table
Pages 191-238
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Appendix D Dietary Guidelines Advisory Committee/Dietary Guidelines for Americans Recommendation Comparison Table 191
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, Foods and beverages high in may contribute to unhealthy calories from added sugars weight gain and obesity- should be limited to help related health outcomes. achieve healthy dietary Reducing the amount of added patterns within calorie limits.
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DGA (2020–2025) c Individuals Above 2 Years of Age Added Sugars prevalence of overweight and Most adults exceed obesity is high, the addition recommended limits for added of sugar to the diet raises sugars as a result of eating concerns about the potential foods and drinking beverages risk of increasing unhealthy higher in added sugars and weight gain and, in turn, selecting foods and beverages increasing risk of obesity- across food groups that are related health outcomes.
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The committee more. concluded that no evidence exists to relax current DGA Evidence indicates that, recommendations, and there among those who drink, is evidence to tighten them for higher average alcohol men such that recommended consumption is associated limits for both men and with an increased risk women who drink would be of death from all causes one drink per day on days compared with lower average when alcohol is consumed.
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, changing Emerging evidence suggests recommended limits to one that even drinking within drink daily for men is justified the recommended limits may and should be strongly increase the overall risk of considered. It is important to death from various causes, acknowledge that many men such as from several types consume alcohol in excess of of cancer and some forms of this recommendation (and CVD.
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Currently, no evidence exists to relax current DGA recommendations, and there is evidence to tighten them, for men in particular, such that recommended limits for both men and women should be one drink per day on days when alcohol is consumed. The committee's suggestions regarding advice to the general public about drinking in moderation for the next DGA can be summarized as follows:b Do not begin to drink alcohol or purposefully continue to drink because you think it will make you healthier.b If you drink alcohol, at all levels of consumption, drinking less is generally better for health than drinking more.b For those who drink alcohol, recommended limits are up to one drink per day for both women and men.b
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contribute more including coffee and tea with than 40% of daily intake of added sugar, account for added sugars. More than approximately one-third of in earlier life stages, adults total beverage consumption consume coffees and teas and contribute approximately with additions, such as sugar 30%, 50%, and 60% of added and flavored syrup.
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The evidence was from sweetened beverages. insufficient to evaluate the Intake of SSBs should be effects of SSBs compared to limited to small amounts low- or no-calorie sweetened and most often replaced with beverage consumption in beverage options that contain children.a no added sugars, such as water.
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nutrient-to-energy content As a percent of total daily ratio and the high prevalence energy intake, average intake of overweight and obesity in of added sugars is 11% among the population, it is important young children and peaks to continue encouraging only at 15% during adolescence. limited intake of this class Coinciding with this increase of beverages.
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Again, the evidence base used to draw these conclusions was limited, but viewed as sufficient to acknowledge that such beverages may be a useful aid in weight management in adults.b
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Although average sources of saturated fat, total grains intakes meets the independent effects of recommendations, intake of dietary cholesterol on CVD whole grains is well below are difficult to assess. The recommendations, and recommended shift from intakes of refined grains saturated to unsaturated fats exceeds the upper end of the occurs best within the context recommended intake range of a healthy dietary pattern for adults in both age groups.
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Depending on the incidence of CVD.b body weight, some children should choose seafood lowest The committee recommends in methylmercury or eat less that dietary cholesterol seafood than the amounts in and saturated fat intake be the Healthy U.S.-Style Dietary as low as possible within Pattern. More information a healthy dietary pattern, is available on the FDA and and that saturated fat EPA websites at FDA.gov/ intake be limited to less fishadvice and EPA.gov/ than of 10% of total energy fishadvice.
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For those following dietary patterns that do not include seafood, regular intake of other foods high in omega-3 fatty acids, such as flaxseeds, walnuts, soy oil, algae, and eggs that contain omega-3 fatty acids, is appropriate. The 2020– 2025 DGA should contain information on amounts and types of seafood to consume as well as those to avoid based on the methylmercury content.b The committee recognizes that recommendations to increase seafood consumption by the American public can have environmental consequences and such impacts should be evaluated in the development of the DGA.b continued
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adapted to accommodate Common characteristics of budget, culture, and personal dietary patterns associated preferences to help adults with positive health outcomes follow a healthy dietary include higher intake of pattern and meet the DGA and vegetables, fruits, legumes, their Key Recommendations. whole grains, low- or non fat dairy, lean meat and In general, calorie needs are poultry, seafood, nuts, and lower for females compared to unsaturated vegetable oils males.
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unsaturated vegetable oils, and low consumption of Common characteristics of red and processed meats, dietary patterns associated sugar-sweetened foods and with positive health outcomes drinks, and refined grains. include relatively higher Dietary patterns associated intake of vegetables, fruits, with adverse or detrimental legumes, whole grains, low outcomes included higher or non-fat dairy, lean meats intake of red and processed and poultry, seafood, nuts, meats, sugar-sweetened and unsaturated vegetable foods and beverages, and oils, and relatively lower refined grains.
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Diet quality was higher when self-reported meal intake increased two meals per day to three, whereas late-night eating often contained food components recommended to be consumed in moderation. Despite the importance of this topic, the available evidence for many questions was insufficient to form conclusion statements, highlighting the critical need for additional research.a The NESR review did not yield specific answers to the questions concerning the relationship between frequency of eating and health outcomes of obesity, all-cause mortality, risk of CVD, or risk of type 2 diabetes.
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of energy consumed by Americans is provided by snacks.b The committee affirms that healthy dietary patterns and eating frequencies can be constructed in a variety of ways to suit differing life stages and cultural practices. The committee's findings also suggest that following a dietary pattern that reduces snacking and emphasizes meals, both primarily composed of foods and beverages that contribute to nutrient and food group recommendations, can help align eating patterns with dietary guideline recommendations.b continued
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components associated with Following a healthy dietary overall chronic disease risk pattern during these life reduction.a stages can help women meet the DGA and its Key Encourage women before and Recommendations. during pregnancy to choose dietary patterns that are In short, women should meet higher in vegetables, fruits, their increased calorie and whole grains, nuts, legumes, nutrient needs with nutrient seafood, and vegetable oils, dense foods instead of with and lower in added sugars, foods high in added sugars, refined grains, and red and saturated fat, and sodium.
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DGA (2020–2025) c Dietary Patterns clinical outcomes, these are 45 milligrams of iron.
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omega-3 fatty acids.a Based on FDA and EPA's advice, depending on body Encourage women to consume weight, some women should seafood in accordance with choose seafood lowest in recommendations by the methylmercury or eat less 2015–2020 DGA, FDA, and seafood than the amounts in EPA: at least 8 and up to 12 the Healthy U.S.-Style Dietary ounces of a variety of seafood Pattern. Additionally, certain per week, from choices that species of seafood (e.g., shark, are lower in methylmercury swordfish, king mackerel)
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DGA (2020–2025) c Weight and Weight Encourage women to achieve Weight management is Gain a healthy weight before complex, so women should pregnancy, and to strive seek advice from a health for gestational weight gain care provider on the best (GWG)
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Limited evidence suggests Women who are pregnant or that omega-3 fatty acid who are planning to become supplementation during pregnant are advised to take pregnancy can result a supplement containing iron in favorable cognitive when recommended by an development in children.a obstetrician or other health care provider. Encourage women to consume foods and beverages that are Meeting recommended intakes good sources of iron, folate, for the dairy and protein food calcium, choline, magnesium, groups -- with eggs, meats, and protein, fiber, and other some seafood being notable potential shortfall nutrients.b sources -- as well as the beans, peas, and lentils subgroup can help meet choline needs.
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increased risk of food However, women who are allergies, asthma, and related pregnant should pay attention atopic disease outcomes in the to some important food safety child, nor is the restriction of considerations. these foods associated with a decreased risk of these conditions.a Encourage women to not avoid potential allergenic foods during pregnancy unless it is medically warranted.b Alcohol Encourage women who Women who are or who are or may be pregnant to may be pregnant should follow guidance from the not drink alcohol.
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DGA (2020–2025) c Food Safety Encourage women who are Women who are pregnant pregnant to select foods in and their unborn children accordance with food safety are more susceptible than are recommendations outlined the general population to the in previous scientific reports effects of foodborne illnesses, of the DGAC and editions of such as listeriosis.
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to consume seafood at the same amounts recommended during pregnancy. Because of insufficient evidence, the committee was unable to draw conclusions about relationships between dietary patterns during lactation and infant developmental outcomes, between supplementation with omega-3 fatty acids and infant developmental outcomes, or between dietary patterns or consumption or avoidance of specific foods and food allergy, atopic dermatitis, allergic rhinitis, or asthma.a Encourage women who are lactating to consume a wide variety of foods that are consistent with the dietary patterns.b continued
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lactating, consuming folic acidpopulation apply to women supplements resulted in higher who are pregnant or serum and red blood cell lactating. For example, the folate concentrations, but no nutrients of public health difference in human milk folateconcern -- calcium, vitamin concentrations, compared to D, potassium, and dietary nonsupplement users.a fiber -- apply to these life stages as well.
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DGA (2020–2025) c Allergenic Foods Encourage women to not avoid Women do not need to potential allergenic foods restrict their choices during during lactation, unless it is pregnancy or lactation to medically indicated to protect prevent food allergy from the mother's health.b developing in their child.
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DGA (2020–2025) c Seafood However, the committee's Women who are pregnant or review suggested that lactating should consume at seafood choices are important least 8 and up to 12 ounces components of a healthy of a variety of seafood per dietary pattern for women.
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DGA (2020–2025) c Weight Encourage women to maintain Weight management is a healthy prepregnancy weight, complex, so women should achieve appropriate weight seek advice from a health gain during pregnancy, initiate care provider on the and maintain breastfeeding best way to achieve their throughout their child's goals.
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It is important supports recommendations for to take precautions to ensure women who are lactating to that expressed human milk consume food sources of long- and prepared infant formula chain polyunsaturated fatty are handled and stored safely. acids, such as fish.
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DGA (2020–2025) c Despite the importance of the If families do not have topics examined for the long- sufficient human milk for term health of the child, the their infant but want to feed available evidence for many their infant human milk, they questions was insufficient to may look for alternative ways form conclusion statements, to obtain it.
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DGA (2020–2025) c Therefore, the committee supports the following recommendations: • Encourage exclusive breastfeeding, ideally for the first 6 months of life, with continued breastfeeding through the first year of life or longer as desired by the mother and infant.b • Encourage the broader implementation of policies and programs that promote, protect, and support breastfeeding to benefit both the health of the mother and the infant.b
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the need to provide CFBs that contain adequate amounts of At about age 6 months, polyunsaturated fatty acids. infants should be introduced The committee's review to nutrient-dense, indicated that introducing developmentally appropriate peanut and egg, in an age foods to complement human appropriate form, in the milk or infant formula first year of life (after age feedings.
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Drinks labeled to 6 months, does not offer as fruit drinks or fruit long-term advantages or flavored drinks are not the disadvantages with regard same as 100% fruit juice and to growth, size, body contain added sugars. These composition, overweight or beverages displace nutrient obesity; iron status; or risk dense beverages and foods of developing food allergy, in the diet of young children.
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The evidence also supports the need to provide CFBs that contain adequate amounts of polyunsaturated fatty acids, given their critical role in brain development and the link between dietary intake and the child's fatty acid status. Intakes of omega-3 and omega-6 fatty acids from CFBs among human milk-fed infants at ages 6 to 12 months are below the estimated needs.
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226 EVALUATING THE PROCESS TO DEVELOP THE DGA, 2020–2025 TABLE D-1 Continued DGAC Recommendation (2020–2025 Scientific Report)
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Thus, at any animal source foods. this time, the existing body When the mother is at risk of evidence does not provide of vitamin B12 deficiency, a basis for recommending human milk may not provide vitamin D supplementation sufficient vitamin B12.
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pediatric care provider about However, screening for iron whether there may be a need deficiency using appropriate for infants supplementation biomarkers, such as serum with iron before age 6 months. ferritin, could be challenging because it is not as simple as measuring hemoglobin.
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The limited evidence available since 2000 suggests that doses higher than 400 IU per day (the current American Academy of Pediatrics [AAP] recommendation for infants do not result in differences in biomarkers of bone metabolism in infancy or early childhood.
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DGA (2020–2025) c Food Patterns Using the USDA Food An important part of Patterns for individuals establishing an overall ages 2 years and older as a healthy dietary pattern is starting point, the committee careful consideration of modeled several scenarios beverages.
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The This gives families substantial vegetable subgroup of beans, flexibility to accommodate peas, and lentils also provides cultural preferences and cost a good source of protein and considerations, and provides dietary fiber. opportunities to introduce children to a wide variety For dairy, families can of healthy foods that are introduce yogurt and cheese, important in shaping healthy including soy-based yogurt, dietary patterns.a before 12 months.
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Calories them.b and nutrients should • For toddlers ages 12 to 24 predominantly be met from months whose diets do a healthy dietary pattern not include meat, poultry, of age-appropriate foods or seafood, provide eggs and beverages. The Healthy and dairy products on a U.S.-Style Dietary Pattern regular basis, along with presented here is intended soy products and nuts or for toddlers ages 12 through seeds, fruits, vegetables, 23 months who no longer grains, and oils.b consume human milk or • Avoid foods and infant formula.
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Because food foods and beverages. preferences and patterns are beginning to form during this developmental stage, and taste and flavor preferences appear to be more malleable in this life stage than in older children, it is important that caregivers limit consumption of foods that contain added sugars, while encouraging consumption of nutrient dense foods.b continued
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days of life can support The USDA Dietary Patterns lifelong chronic disease risk provide a framework of reduction and improved nutrient-dense foods and quality of life.a beverages that can be adapted to accommodate The recommended USDA budget, culture, and personal Food Patterns for Americans, preferences to help adults which achieve healthy dietary follow a healthy dietary intake and meet nutritional pattern and meet the DGA and goals and energy balance, their Key Recommendations. include the Healthy U.S.-Style, the Healthy Vegetarian, and the Healthy Mediterranean Style Patterns.
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DGA (2020–2025) c guidance on Patterns issued from this and previous committees.b Food pattern modeling helps to affirm the recommended dietary patterns by demonstrating their effect on nutrient adequacy.
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If healthy eating patterns can be established early in life and sustained thereafter, the impact on the prevalence of chronic disease could be significant.b To facilitate shifting American dietary intakes toward healthier directions, access to healthy food options is critical. The committee recognizes that several barriers and facilitators affect access and influence consumers' dietary behaviors beyond nutritional considerations, including food costs and food security status.
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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.
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