Speaking to NutraIngredients-USA.com, the Natural Products Association and the Council for Responsible Nutrition praised the Guidelines for specifically recommending vitamin D, folic acid, vitamin B12 and iron supplementation, but called for further inclusion of scientifically backed nutrients in the next Guidance due in five years time.
The specific reference to selected supplementation can be found on page 49 of the United States Department of Agriculture and Department of Health and Human Services Guidelines .
“The Guidance reflects a growing acceptance of dietary supplementation especially in regard to specific population groups,” said Dr Cara Welch, the NPA’s scientific and regulatory affairs manager. “The references to supplements are also a little more positive than in last year’s draft, but there remain supplements where the scientific evidence is strong that have not been mentioned and we hope they will be recognized in the next Guidance.”
CRN’s vice president of scientific and regulatory affairs, Duffy MacKay, ND, said the Guidelines were a strong step in the right direction, but said there was room for even greater dietary supplement prominence given the financial and pragmatic difficulty many Americans would have in meeting some of the committee’s suggestions, such as fish consumption.
“You have to remember these Guidelines have always been food-focused,” MacKay said. “The committee has always been hesitant to recommend dietary supplements in general because they have been fearful that healthy eating will be replaced by dietary supplementation if they recommend them. But the evidence suggest this is not the case and this Guidance suggests a fading bias against supplements.”
In the case of seafood, the 7th edition of the Guidance recommends consumption levels of 8-12 ounces per week with specific references to its omega-3 (DHA and EPA) content, a recommendation Duffy said offered an indirect opportunity for supplementation.
“The fact is many Americans will struggle to meet these recommendations but that opens the door to omega-3 supplements in a major way,” he said.
But the EPA/DHA seafood reference did not go far enough, according to Adam Ismail, the executive director of the Global Organization for EPA and DHA Omega-3s (GOED).
“We view it as a step in the right direction overall because it recognizes roles for EPA and DHA from seafood in maternal health and cardiovascular disease risk reduction,” Ismail said.
“But while the report noted functional foods and supplements can play a role for many nutrients, EPA and DHA was not included. We believe functional foods and supplements containing EPA and DHA can help close some of the nutritional gap that results from poor seafood consumption, especially from these fatty acids which are not found in other food sources.”
Ismail said EPA and DHA should have made it onto the list of public health nutrient deficiency concerns, pointing to evidence that EPA/DHA deficiencies cause more deaths than low fruit and vegetable intakes.
The Guidance did however outline DHA and EPA levels in a range of seafood products.
The 2010 version is very much focused on tackling the US’s near pandemic overweight and obesity problem and so salt, fat and sugar reduction feature prominently.
“The 2010 Dietary Guidelines are being released at a time when the majority of adults and one in three children is overweight or obese and this is a crisis that we can no longer ignore,” said Agriculture Secretary Tom Vilsack.
Suggestions include half-filling plates with fruits and vegetables at meal times; switching to low-fat milk; avoiding oversized portions and eating less.
Specific health conditions and sub-groups are seen as the most suitable for supplementation.
- Vitamin D fortification of yogurt, milk, orange juice and soy beverages are noted as being beneficial in helping to improve calcium absorption and preventing rickets, but levels over 100mcg per day are linked to increased chances of adverse events.
- Mandatory folic acid fortification is highlighted as helping to prevent neural tube defects in babies and women of childbearing age recommended to consume 400mcg of folic acid per day from dietary supplements, fortified foods and folate-rich foods.
- Crystallined vitamin B12 is recommended for the over 50s.
- Iron supplementation is recommended for all pregnant women.
Multivitamins are however not backed, as there is insufficient evidence to suggest they can assist, “the primary prevention of chronic disease for the healthy American population.”
However: “Supplements containing combinations of certain nutrients may be beneficial in reducing the risks of some chronic diseases when used by special populations. For example, calcium and vitamin D supplements may be useful in postmenopausal women who have low levels of these nutrients in their diets, to reduce their risk of osteoporosis. In contrast, high levels of certain nutrient supplements may be harmful, if a nutrient’s Tolerable Upper Intake Level is exceeded. Supplement use may be discussed with a health care provider to establish need and correct dosage.”
In making such allowances the Guidelines affirm: “A fundamental premise of the Dietary Guidelines is that nutrients should come primarily from foods. Foods in nutrient-dense, mostly intact forms contain not only the essential vitamins and minerals that are often contained in nutrient supplements, but also dietary fiber and other naturally occurring substances that may have positive health effects.”