Dietary Guidelines for Americans
Dietary Guidelines for Americans (DGA) - Introduction
For the past 35 years, the federal government has published the Dietary Guidelines for Americans (DGAs) —the principal policy guiding diet in the United States—with the goals of promoting good health, helping Americans reach a healthy weight, and preventing chronic disease.
Why are the Guidelines important?
The Guidelines have extraordinary influence on American eating habits.
The advice that you get from your doctors, nutritionists, dieticians or other health professional is very likely to come directly from the Guidelines, since their education is based on the Guidelines. Advice from professional associations (AMA, ADA, etc) also comes from the Guidelines. So even though you may know nothing about the Guidelines, they reach you through your health professionals.
The Guidelines inform government nutrition assistance programs, which touch one in four Americans every month (they are the single-biggest expense at the US Department of Agriculture), including the:
- National School Lunch Program (NSLP);
- Supplemental Nutrition Assistance Program (SNAP) (formerly “Food Stamps”);
- Special Nutritional Program for Women, Infants and Children (WIC);
- Feeding programs for the elderly
The Guidelines also help determine the content of military rations.
The Guidelines guide FDA regulations on food, including the information on packaging. For example, the Guidelines inform health claims (whether a food can be advertised as “healthy”) and the information listed on the back of the package (the “Nutrition Facts” panel).
In sum, more Guidelines probably are more influential than any other single factor in determining what Americans eat.
Since the introduction of the DGAs, however, there has been a sharp increase in nutrition-related diseases, particularly obesity and diabetes, which the DGAs have been unable to stem. A number of experts have expressed concern about both the science underlying the DGAs as well as the process used to draft them. Some of these issues are outlined here. The science behind the guidelines is not settled and Congress is concerned.
It’s hard to overstate what a radical departure from the government’s stand on nutrition the Dietary Guidelines for Americans represented when it first came out in 1980. Since 1956, the USDA had been advising people to seek out nutritious foods by eating a “well-balanced” diet of the basic food groups - first five of them, then seven, then four. The four food groups were milk, meat, fruits & vegetables, and cereals & grains. American had been encouraged to eat some foods from each group every day. The USDA has always suffered from a conflict of interest, since it entire mission is to promote American food commodities, and the agency has long been heavily influenced by those very industries.
- Nina Teicholz, The Big Fat Surprise
The process for developing the Dietary Guidelines for Americans is the subject of a major new report by the National Academies of Sciences, Engineering and Medicine:
These are large reports that use many terms that general public may be unfamiliar with. Here are a few key definitions of terms related to the DGA:
The term "DGA" has been broadly used in the nutrition community over time to refer to the DGA report itself, as well as the specific dietary guidelines that the DGA report describes. The DGA report integrates the science-based recommendation, which are based on a scientific report developed by the current Dietary Guidelines Advisory Committee (DGAC) into a form that can be used for policy development. Since 2005, the target audience for the DGA have been policy officials, nutritionists, and nutrition educators (USDA/HHS, 2016).
“DGA recommendations” refers to the main messages from USDA and HHS – the most recent guidelines call for Americans to “follow a healthy eating pattern across the life span; focus on variety, nutrient density, and amount; limit calories from added sugars and saturated fats and reduce sodium intake; shift to healthier food and beverage choices; and support healthy eating patterns for all” and were accompanied by 13 supporting key recommendations (HHS/USDA, 2015).
“DGA Policy Report” refers to the report released every 5 years by the secretaries of USDA and HHS in response to the National Nutrition Monitoring and Related Research Act. The 2015 version was titled the Dietary Guidelines for Americans 2015–2020: Eighth Edition. DGA recommendations and supporting evidence are first presented to the public in this document.
“Dietary Guidelines Advisory Committee Scientific Report” denotes the document produced by the DGAC. The 2015 DGAC report was titled the Scientific Report of the 2015 Dietary Guidelines Advisory Committee. The conclusions from the scientific report serve as the scientific basis for the DGA Policy Report.
“DGA” refers to all of the collective efforts and products to produce and disseminate the dietary guidelines. In some editions of the DGA, key recommendations were released in lieu of guidelines; others produced guidelines and/or key recommendations.
Food Guides. For over a century, the U.S. Government has been providing general guides for Americans on what to eat. Recent iterations include the "Food Pyramid" and the current "My Plate." In theory, these guides are supposed to provide a loose guide for following the DGA. Unfortunately, these visual - abstract - guides are confusing and rarely mean much to the general public. The one-size-fits-all approach to nutrition has been widely rebuked.
Scientific Report of the 2015 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture
The scientific report guiding the U.S. dietary guidelines: is it scientific? The expert report underpinning the DGA fails to reflect much relevant scientific literature in its reviews of crucial topics and therefore risks giving a misleading picture, an investigation by The BMJ has found. BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4962 (Published 23 September 2015)
U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/.
National Academies of Sciences, Engineering, and Medicine. 2017. Redesigning the Process for Establishing the Dietary Guidelines for Americans. Washington, DC: The National Academies Press. https://doi.org/10.17226/24883.
Nutrition Evidence Library. The United States Department of Agriculture’s (USDA) Nutrition Evidence Library (NEL) is an entity that specializes in conducting systematic reviews (SRs) to inform Federal nutrition policy and programs. The systematic reviews compiled for the 2015 DGA are available here: https://www.cnpp.usda.gov/nutrition-evidence-library-2015-dietary-guidelines-advisory-committee-systematic-reviews