D.G.A.C.'s views on caffeine, cholesterol draw responses

by Jeff Gelski
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WASHINGTON — Recommendations on energy drinks and low-calorie sweeteners from the Dietary Guidelines Advisory Committee drew criticism as did the lack of a recommendation on cholesterol. The D.G.A.C. submitted its recommendations on Feb. 19 to the secretaries of the Health and Human Services and the U.S. Department of Agriculture. The finalized Dietary Guidelines for Americans 2015 should be released later this year.

The American Beverage Association, Washington, said the committee “went beyond its scope” in examining the safety of low-calorie and no-calorie sweeteners and caffeine.

The D.G.A.C. said moderate coffee consumption may be incorporated into a healthy diet, but high caffeine intake, or greater than 400 mg per day for adults, may occur with the “rapid consumption” of large-sized energy drinks. The D.G.A.C. recommended limited or no consumption of high caffeine drinks, or other products with high amounts of caffeine, for children and adolescents. The committee said energy drinks should not be consumed with alcohol.

“When it comes to caffeine, like coffee, the committee referred to ‘high’ caffeine intake, which lacks scientific definition, and arbitrarily focused on a single category of products — energy drinks,” the A.B.A. said. “However, other sources of caffeine, like coffee, contain the same and often times significantly higher amounts of caffeine than energy drinks, and contribute a much larger proportion of caffeine in the American diet. Thus, the committee’s approach to caffeine is inconsistent and far from scientific.”

The A.B.A. said energy drinks account for less than 10% of total caffeine intake and that the Food and Drug Administration should be the appropriate body to investigate caffeine’s safety.

The D.G.A.C. also recommended reducing intake of added sugars. The committee said instead of turning to products with low-calorie sweeteners, people should choose healthy options, such as water in place of sugar-sweetened beverages.

“Given the importance of the committee’s guidance on helping Americans control their weight, (the committee’s) lack of support for foods and beverages made with low- and no-calorie sweeteners is contradictory,” the A.B.A. said. “The body of evidence clearly shows that these ingredients can be an effective tool in weight loss, weight management and management of health conditions such as diabetes and hypertension.”

 

No cholesterol recommendation

Michael F. Jacobson, executive director of the Center for Science in the Public Interest, Washington, said he agreed with many of the D.G.A.C. recommendations, including reducing intake of added sugars and saturated fat. He took issue with the 2015 D.G.A.C.’s view on cholesterol.

Previous versions of the Dietary Guidelines for Americans recommended people limit cholesterol intake to no more than 300 mg per day. The 2015 D.G.A.C. said it will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol.

“The committee also erred by not including cholesterol as a ‘nutrient of concern,’” Mr. Jacobson said. “It still is. About 60% of men are eating too much cholesterol, much of it from eggs, Cholesterol in foods still raises blood cholesterol levels, and people should consume only modest amounts of it.”

Joanne C. Ivy, president and chief executive officer of the American Egg Board, Park Ridge, Ill., welcomed the cholesterol news. She also pointed out the D.G.A.C. listed eggs as a “nutrient-dense food” along with vegetables, fruit, whole grains, fish and nuts.

“While this is an excellent day for the industry, it should be remembered that in the coming months some health experts and others will submit comments to U.S.D.A. indicating their displeasure with the committee's recommendations,” Ms. Ivy said. “Some will say that removing cholesterol guidance will confuse consumers and create the impression that we can go back to eating fatty foods with impunity. Others will continue to dispute existing science. Rest assured that we will stay on top of this issue, make comments to the U.S.D.A. as necessary, and follow the process until the 2015 Guidelines are approved and released later this year.”

The American Heart Association, Dallas, did not express a problem with the D.G.A.C.’s new stance on cholesterol. The A.H.A. and the American College of Cardiology in 2013 jointly published a guideline on lifestyle management to reduce cardiovascular risk. They found insufficient evidence to determine whether lowering dietary cholesterol reduces L.D.L. “bad” cholesterol.

Elliott Antman, M.D., president of the A.H.A., on Feb. 19 said he commended the D.G.A.C.’s recommendation to maintain a limit on dietary saturated fat intake because of its relationship to L.D.L. and cardiovascular disease risk.

“It’s clear that Americans need to change their eating habits and make more nutritious choices,” Dr. Antman said. “Although the American Heart Association and the Dietary Guidelines Advisory Committee differ on the ultimate target levels for sodium, saturated fats and added sugars, the committee’s recommendations are a shift in the right direction and, if accepted by the H.H.S. and U.S.D.A., will help steer the public toward a more healthy path in their daily diets.”

The D.G.A.C. set goals for the general population of less than 2,300 mg of sodium per day (or age-appropriate Dietary Reference Intake amount), less than 10% of total calories from saturated fat per day, and a maximum of 10% of total calories from added sugars per day.

The D.G.A.C.’s recommendations are available on-line for public review and comment at www.DietaryGuidelines.gov for 45 days after publication in the Federal Register. A public meeting will take place March 24 in Bethesda, Md. People may register for the meeting at www.DietaryGuidelines.gov.
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