What's for dinner? 2015 Dietary Guidelines Advisory Committee report

Studies continue to report that patients look to their physicians for advice about nutrition. M. Molly McMahon, M.D., an endocrinology consultant at Mayo Clinic's campus in Rochester, Minnesota, says: "You may be familiar with the initial Dietary Guidelines Advisory Committee (DGAC) report released in February 2015. Dietary guidelines for Americans were first published in 1980. Beginning in 1990, Congress mandated that the Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) release a new edition every five years.

"The report is written for nutrition and health professionals, policymakers, and educators, and is the framework for federal nutrition initiatives, including education initiatives and food assistance programs. Reports are sent to the HHS and USDA for review, and input from federal agencies and the public is requested in the process. The change will not be official until it is approved by the HHS and USDA, but these groups usually closely follow the committee's recommendations."

The DGAC was charged with developing food-based recommendations that are of public health importance for Americans ages 2 years and older and that were published since the 2010 guidelines.

Dr. McMahon explains: "The DGAC stressed two key points: First, half of all American adults have one or more preventable, chronic diseases, and approximately two-thirds of U.S. adults are overweight or obese. Poor dietary patterns, excess calories and physical inactivity contribute to these results. Second, individual lifestyle behaviors are strongly influenced by organizational and environmental systems. The DGAC stated that the nation must accelerate progress toward reducing the incidence and prevalence of overweight and obesity and chronic disease risk and reduce disparities for certain ethnic and racial groups and for those with lower incomes."

Current status and trends

The report assessed current status and trends in food and nutrient intakes, dietary patterns and health outcomes, individual diet and activity behavior change, food environment and settings, food sustainability and safety, topics of public health importance, and physical activity.

Underconsumed nutrients of public health concern include calcium, vitamin D, fiber and potassium. Underconsumption has been linked in the scientific literature to adverse health outcomes. Iron is included for adolescent females and postmenopausal females. Two nutrients, sodium and saturated fat, are overconsumed by the U.S. population.

The DGAC found that although food quality varies by setting, the diet quality of the U.S. population does not meet its recommendations for vegetables, fruits, dairy or whole grains, and exceeds recommendations, leading to overconsumption of the nutrients sodium and saturated fat and the food components of refined grains, solid fats and sugars.

Dr. McMahon notes: "The DGAC had enough information from research and data to model three dietary patterns and examine their nutrition adequacy. These patterns of eating include the Healthy U.S.-style Pattern, Healthy Mediterranean-style Pattern and the Healthy Vegetarian Pattern. In general, the healthier diet patterns are higher in vegetables, fruits, whole grains, low-or nonfat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and drinks and refined grains.

"The DGAC encourages the consumption of healthy dietary patterns that are low in saturated fat, sodium and added sugars — with a challenge to differentiate added sugars from natural sugars, as the current Nutrition Facts Label on packaged food does not differentiate the two.

"The goals for the general population are: less than 2,300 milligrams (mg) dietary sodium a day (or age-appropriate dietary reference intake amount), less than 10 percent of total calories from saturated fat a day and a maximum of 10 percent of total calories from added sugars a day. Newer recommendations include focusing on healthy patterns of eating, limiting sugar and red and processed meat, and not placing emphasis on the 1,500 mg daily intake of sodium. The committee also recommended a repeal of the guideline that Americans limit their cholesterol intake to 300 mg a day."

Dr. McMahon concludes: "The report suggests a paradigm shift in health care toward a greater focus on prevention and integration with food systems. The recommendations suggest offering incentives to businesses that establish employee health benefit plans and support health care facilities, such as clinics and hospitals, to achieve 'cultures of health' by offering healthy food choices for patients, visitors and staff, and referring staff and patients to federal and local food assistance programs as needed.

"Mayo Clinic has introduced worksite wellness champions to help different medical areas become healthier while having fun. Nutrition physicians led the creation of evidence-based nutrition criteria to guide food that is served on campus to patients and employees, while focusing on great taste. Many nutrition-culinary, activity and stress management programs are offered in the Dan Abraham Healthy Living Center, the patient and employee wellness facility, in an effort to improve the health of Mayo Clinic staff and patients."

For more information

The final report, Dietary Guidelines for Americans, 2015, is due out at the end of 2015. For more-specific information and scientific rationale regarding recommendations about nutrition; activity; worksite, school and community efforts; or sustainable practices, refer to the Scientific Report of the 2015 Dietary Guidelines Advisory Committee at http://www.health.gov/dietaryguidelines/2015-scientific-report.