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'The huge disparity between what the guidelines advocate and what Americans actually eat is beyond alarming'

Dietitians respond to 2015 Dietary Guidelines: ‘The American public needs more forceful messages.’

2 comments

By Elaine Watson+

07-Jan-2016
Last updated on 26-Jan-2016 at 20:50 GMT2016-01-26T20:50:03Z

Picture credit: Istockphoto, dkapp12
Picture credit: Istockphoto, dkapp12

What do registered dietitians and nutritionists think of the 2015 Dietary Guidelines for Americans, and how much do they ultimately matter, since the gulf between what Americans are told to eat – and what they actually eat - remains huge?

While the guidelines are written for policymakers, industry stakeholders and other professionals, who in turn ‘translate’ them for consumers, they could still be more explicit about what to eat more of and what to eat less of in order to meet recommendations for key nutrients and adhere to healthy eating patterns, registered dietitian Andy Bellatti told FoodNavigator-USA.

“Given our current rates of hypertension, heart disease, and Type 2 diabetes, the American public needs more forceful messages. Instead of ‘shift to healthier food and beverage choices,’ I would love to see: ‘Eat less sugar, fried foods, red meat, and processed meats’ , ‘Drink less soda and fruit juice’ and ‘Eat fast food sparingly.’

I would be surprised if John Q. Public could name three guidelines, or even one

He added: “Although the dietary guidelines are a huge deal in the nutrition and public health world, I would be surprised if John Q. Public could name three guidelines, or even one. In reality, the average American is bombarded with confusing and misleading nutrition messages from industry and diet gurus peddling quick fixes - even more of a reason to provide clear and useful advice.

Andy Bellatti: "Instead of ‘shift to healthier food and beverage choices,’ I would love to see: ‘Eat less sugar, fried foods, red meat, and processed meats’ ."

“It's also quite disappointing that environmental and sustainability [factors] did not make the final cut, especially since we have a plethora of data demonstrating that meat production takes a serious toll on the environment.”

Others went much further, with Dr David Katz, MD, MPH, FACPM, FACP, founding director of Yale University’s Prevention Research Center at Griffin Hospital, claiming that the guidelines were a "national embarrassment" reflecting the "willful sacrifice of public health on the altar of profit for well-organized special interests".

He added: "The 2015 Dietary Guidelines for Americans is, alas, a virtuoso display of linguistic contortionism to remove from the nation’s official nutrition policy document the actionable clarity of the DGAC at every opportunity."

What people choose to eat is more determined by social media, friends and family than by any federal guidance  

Dr Rachel Cheatham, founder and CEO of consultancy Foodscape Group LLC, meanwhile, observed that “the huge disparity between what the guidelines advocate and what Americans actually eat is beyond alarming.”

Dr Rachel Cheatham: "The huge disparity between what the guidelines advocate and what Americans actually eat is beyond alarming.”

She added: “The reality is even if these new guidelines had boldly stated something closer to the scientific [advisory committee] report [which came out in Feb 2015] akin to ‘eat less red meat and eat more plants,’ it is still doubtful that Americans would listen and adhere.

“What people choose to eat is more determined by social media, friends and family than by any federal guidance at this point. The opportunity to translate them accurately, clearly and creatively falls on all food communicators from trained nutritionists and doctors to chefs and lifestyle bloggers.

“The problem is the new guidelines do, for better or worse, leave room for interpretation which means consumers will likely continue to hear wildly conflicting "guidance" from multiple sources. Who to trust and follow on dietary advice remains the pivotal question.”

What about the vegan diet?

That said, the guidelines are valuable in that they underpin multiple federal food, health and nutrition policies and programs, and as a policy tool, they are a necessary guidepost of consistency and direction, she argued.

The 2015 guidelines urge Americans to:

  • Consume <10% of calories from added sugars
  • Consume <10% of calories from saturated fat
  • Eat <2,300mg sodium/day 

As for the issue of explicit guidance (eat this not that), however, Dr Cheatham said getting consumers to ‘shift’ towards healthier eating patterns via small steps was “more positive and realistic than strict laundry lists of good foods and bad foods”.

As for omissions, she said: “The guidelines do serve up three different dietary patterns - healthy, Mediterranean and vegetarian. It's good to see the vegetarian option spelled out, but I wish there was more than one sentence on vegan. 

"Going vegan is an increasingly popular dietary pattern with high levels of consumer interest, and there needs to be more information on how to go about this as another potential 'shift' in the diet."

"There is a disgraceful backtracking on clear recommendations to eat less meat and more plants. The report advises particular age groups of men and boys to cut back somewhat on meat intake, but all this does is highlight the abandonment of the recommendation in the DGAC Report that 'less' meat was advisable to the general population for the sake of people and planet alike. 

"And while the report talks about foods being emphasized over nutrients, recommendations about what NOT to eat (or, even, what to limit) are entirely cast in terms of nutrients. We are advised to limit our intake of saturated fat, for instance -- but there is virtually no language, and none featured prominently, indicating what foods to avoid to achieve that." 

Dr David Katz, MD, MPH, FACPM, FACP, founding director of Yale University’s Prevention Research Center at Griffin Hospital

What’s for breakfast?

Jaime Schwartz Cohen MS,RD, VP, Director, Nutrition, Ketchum, told us she was also “pleasantly surprised that the guidelines focused on eating patterns rather than nutrients. In the 2010 Dietary Guidelines, the word “snack” was not mentioned once. The new version provides guidance that better matches how Americans actually eat."

But she added: “I was surprised that research supporting breakfast was not referenced. The 2010 guidelines recognize breakfast is important in a healthy eating pattern but this not referenced in the 2015 guidelines.”

The 2015 guidelines urge Americans to eat more: Veggies (especially dark greens); whole fruits; whole grains; fat-free or low-fat dairy; a wider variety of protein foods including seafood, lean meats, poultry, nuts, andlegumes; and oils incl. canola, corn, olive, peanut, sunflower, soybean.

Affordability

Adam Drewnowski, PhD, director at the Center for Public Health Nutrition at the University of Washington said he also appreciated the focus on healthier eating patterns rather than rigid prescriptions (eat this, not that), but was frustrated that affordability did not factor more prominently in the guidelines.

My usual frustration is that the cost of eating healthy is not mentioned. The guidelines ought to pay more attention to food patterns that are both healthy and affordable.

“So for example, listing wild Atlantic salmon as a rich source of potassium is not helpful, given that most Americans get their potassium from coffee, potatoes and milk.”

What do Americans actually eat?

VEGETABLES: With few exceptions, the US population does not meet intake recommendations for any of the vegetable subgroups. Consumption is lowest among boys ages 9 to 13 and girls aged 14 to 18.

FRUITS: Average intakes of fruits are lowest among girls aged 14 to 18 and adults aged 19 to 50. Women over 50 and young children are more likely to meet recommendations.

DAIRY: Average intakes of dairy for most groups are far below recommendations.

ADDED SUGARS: Added sugars account for around 270 calories, or 13%+ of daily calories, with intakes particularly high among children, adolescents, and young adults.  The major sources are beverages, which account for almost half (47%) of intakes; and snacks and sweets.

SODIUM: Average sodium intakes are 3,440 mg per day. For adult men, the average intake is 4,240 mg, and for adult women, the average is 2,980 mg per day.  

SNACKS: 40 to 50% of Americans eat 2-3 snacks a day, while one-third consume four or more.

OVERALL DIET: About 75% have a diet too low in vegetables, fruits, dairy, and oils; while most Americans exceed recommendations for added sugars, saturated fats, and sodium.

GRAINS + PROTEINS: More than half of the population is meeting or exceeding total grain and total protein foods recommendations.

Portion sizes

 

Fergus Clydesdale, distinguished professor at the University of Massachusetts, meanwhile, said: “I am delighted they are food and diet (and exercise) based since it is the total diet that really counts and no one ingredient is a silver bullet to solve all our problems.

“However, I think they should have really emphasized portion sizes in both fresh and packaged foods and how packaged foods like frozen entrees can control meal portions.”

Asked about the ultimate value of the guidelines, he said: “All we can do is offer advice and hope that it will be followed."

"I believe that the USDA and HHS have produced, what is for the most part, a well done and user friendly guide to healthy eating, calling out shortcomings in our collective diet and offering helpful guidance for improving our diet and health.   

"As a population-based report, it would be inappropriate to be heavy in specific dietary recommendations - this is better left to an individual, a medical practitioner, and a registered dietitian who can consider the individuals' health profile and make specific instructions for dietary choices. 

"Where the report disappoints is Chapter 3...Instead of continuing the user-friendly plain speak of chapters one and two, the report launches into an intellectual discussion of a "social-ecological model" - which fairly identifies appropriate factors that must be addressed in order to bring about positive change in eating behaviors, but feels like it made its way into the wrong document."

Catherine Adams Hutt, PhD, RD, chief science & regulatory officer at Sloan Trends and principal at consultancy RdR Solutions

Read more about the 2015 Dietary Guidelines HERE .

"I like that the guidelines focus on healthy eating patterns and that they address nutrient density, variety and amounts.However, given that nearly 70% of Americans are overweight, I do not think that there is enough focus on calories and portion sizes, which is one of the most important issues to tackle when it comes to losing weight. 

"I also like the recommendation for limiting added sugars (for the first time.) 

"However, with this statement, 'Limit calories from added sugars and saturated fats and reduce sodium intake,' the emphasis is more on nutrients as opposed to specific foods we should limit (soda, red meat). It is always simpler for consumers if they are told which foods - as opposed to nutrients - to limit." 

Lisa Young, Ph.D., R.D., C.D.N, adjunct professor, New York University    

Read the guidelines in full HERE .

2 comments (Comments are now closed)

the problem is not that Americans don't know what they should eat

It costs close to $500. a month for 2 of us to eat a moderately healthy diet. We don't eat junk food or sugary desserts.We eat 1-2 fruits per day and 2 vegetables per day. Red meat is eaten no more than once a week.The most obese individuals are poor. When will the government and nutritionists wake up to the fact that poverty is the issue, not lack of knowledge.

Report abuse

Posted by Lorraine Williams
18 January 2016 | 21h492016-01-18T21:49:39Z

Government lead by the hand.

I believe the government should be out of the business of telling us what to eat.

Since 1965 the grocery store aisles have added space for vegetables such as potato chips, cake mixes, cereals, breads, etc. We should eat more of these as they are what is causing obesity.

Report abuse

Posted by AEB
13 January 2016 | 23h082016-01-13T23:08:28Z

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