October 18, 2018
Inside the New Dietary Guidelines

Inside the New Dietary Guidelines

by Berkeley Wellness  

Every five years the USDA and the Depart­ment of Health and Human Ser­vices update the Dietary Guidelines for Americans, which form the basis for fed­eral nutrition policy and serve as the blue­print for how Americans should be eating to promote health and reduce the risk of chronic disease and obesity. The guide­lines are based on recommendations made by an advisory committee that evaluates the latest peer-reviewed research.

In February 2015 this expert panel released its beefy 570-page report, which identified a healthy diet as one that is rich in vegeta­bles, fruits, whole grains, seafood, legumes, and nuts; moderate in low-fat or nonfat dairy products and alcohol (with caveats); lower in red and processed meats; and low in saturated fat, sodium, refined grains, and added sugars.

Here's a look at two of the more nota­ble proposals, which include new thinking about dietary cholesterol and limits on sugar, plus several other highlights we're applauding.

The recommendations are now under­going final review, following a public com­ment period. There may be some changes still, but because the government tends to closely follow the committee’s advice, these are likely to become the official 2015 guide­lines, which will be released later this year.

Cholesterol: no longer a 'nutrient of concern'

You might have read headlines such as "Dietary Cholesterol Doesn't Matter Any­more" and wondered what happened, since for decades the guidelines have said to limit cholesterol intake to no more than 300 milligrams a day (200 milligrams for those with cardiovascular risk factors). The panel decided to drop this upper limit because there is abundant evidence that the cholesterol in food has little, if any, impact on blood cholesterol in most peo­ple. Only a small percentage of the popula­tion has a clinically meaningful response to dietary cholesterol—fewer, in fact, than the 25 to 30 percent of "hyper-responders" often cited, according to Ron Krauss, M.D., director of Atherosclerosis Research at Children's Hospital Oakland Research Institute and a member of our editorial board. Of all dietary factors, saturated fats (found mostly in animal products) and trans fats (from partially hydrogenated oils in processed foods) raise LDL ("bad") cholesterol much more than dietary cho­lesterol does.

For several years now, Berkeley Wellness has questioned this 300-milligram limit, which has caused many people to needlessly shun high-cholesterol foods like eggs and shrimp. Meanwhile, many other countries, including Canada, the U.K., and Australia, have never set limits. Still, not all experts agree that cholesterol doesn't matter at all anymore—and this new advice does not give people a green light to overindulge in fatty meats, butter, whole milk, ice cream, and other cholesterol-rich foods, many of which are also high in saturated fat or are unhealthy in other ways. It’s unclear what the final dietary guidelines will advise regarding cholesterol intake for people with diabetes or others at high cardiovascular risk.

Added sugars: sweet news

For the first time, the panel set an actual limit for added sugars (as opposed to the current advice to just "reduce" them). Americans should get no more than 10 percent of their calories from added sugar, which amounts to about 12 teaspoons a day for a person on a 2,000-calorie-a-day diet (1 teaspoon equals 4 grams of sugar). It's easy to exceed this limit, and most Americans do. On average, we consume about 22 teaspoons of added sugar a day (more than one-third from soft drinks). One 16-ounce bottle of soda has about 11 teaspoons of added sugar. The committee even went so far as to recommend a tax on sugary soft drinks (like the one passed in Berkeley in 2014).

An excess of added sugar plays a major role in the obesity epidemic and contrib­utes to illnesses including diabetes and heart disease. Still, the proposed limit, which matches that of the World Health Organization, is more lenient than what the American Heart Association recom­mends: that most women consume no more than 6 teaspoons of added sugar a day (100 calories' worth) and most men no more than 9 teaspoons (150 calories).

Limiting added sugars will be easier to do in the future, since food companies will have to list them on the FDA's new nutrition labels, which were proposed in 2014 and are undergoing finalization. Of note, the advisory committee does not recommend using sugar substitutes in place of sugary products as a strategy for weight management, since their long-term effects "are still uncertain."

More advice to like

  • Much to the chagrin of the meat industry, the advisory committee singled out red and processed meats as foods to specif­ically limit (with only a footnote that lean meat can be part of a healthy diet).
  • Rather than endorsing a maximum for total fats (currently set at up to 35 percent of total calories for adults), the recommen­dations now call for limiting only saturated fats (to 10 percent of total calories), with no cap on healthy unsaturated fats, as found in vegetable oils and nuts.
  • The committee continues to recom­mend reducing sodium consumption—to less than 2,300 milligrams a day for the gen­eral population.
  • New on the menu: coffee. A moderate amount (3 to 5 cups a day, up to 400 milli­grams of caffeine) can be part of a healthy diet because it is not associated with any long-term health problems and may actuallyreducethe risk of cardiovascular disease, dia­betes, and other conditions (just watch the cream and sugar). Higher amounts of caf­feine could be problematic, however, and children and teens are advised to limit or avoid high-caffeine products.

An additional highlight (and one of our favorites): The new recommendations de-emphasize individual nutrients in favor of the totality of the diet, recognizing that there are many ways to eat healthfully. Some healthy patterns that Americans may choose to fol­low include a Mediterranean-style or vege­tarian diet. Another perk of such plant-based diets is that they have less environmental impact than those heavy in meat and other animal foods, the committee emphasized.