Context is critical to the coming dietary guidelines debate

by Keith Nunes
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KANSAS CITY — On Feb. 19 the Dietary Guidelines Advisory Committee submitted its recommendations to the departments of Health and Human Services and the U.S. Department of Agriculture. To anyone who has been paying attention as the D.G.A.C. has deliberated the past few years, the recommendations are not surprising — At the core they advocate for a diet rich in plant-based foods and recommend consumers reduce their intake of sugar, saturated fats and sodium. More detailed information may be found here.

Reactions to the panel’s draft are what one would expect: those groups and companies whose products are portrayed in what they perceive to be a positive light are satisfied while those that fear they may lose share of stomach are being critical of the recommendations. Yet lost in much of the early discussion is the proper context for which the recommendations were developed.

The committee was charged with examining the Dietary Guidelines for Americans, 2010 to determine topics for which new scientific evidence was likely to be available with the potential to inform the next edition of the guidelines and to place its primary emphasis on the development of food-based recommendations that are of public health importance for Americans ages 2 years and older published since the last D.G.A.C. deliberations.

According to the executive summary of the committee’s report, the 2015 D.G.A.C.’s work was guided by two fundamental realities: “First, about half of all American adults — 117 million individuals — have one or more preventable, chronic diseases, and about two-thirds of U.S. adults — nearly 155 million individuals — are overweight or obese,” the report said. “These conditions have been highly prevalent for more than two decades. Poor dietary patterns, overconsumption of calories, and physical inactivity directly contribute to these disorders.

“Second, individual nutrition and physical activity behaviors and other health-related lifestyle behaviors are strongly influenced by personal, social, organizational, and environmental contexts and systems. Positive changes in individual diet and physical activity behaviors, and in the environmental contexts and systems that affect them, could substantially improve health outcomes.”

It is important to remember as this debate moves forward to the final, updated Dietary Guidelines for Americans that these recommendations are focused on public health, specifically how to reduce the incidence of preventable chronic diseases in the U.S. population. The current D.G.A.C. draft recommends dietary patterns that its members believe will achieve this goal.

That diet and exercise play a role in the prevention of many chronic conditions is well documented. What the D.G.A.C. is trying to do is give consumers the tools necessary to aid with such prevention. It is that context that is critical to the coming dietary guidelines debate.

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