Most Americans need to significantly cut back on their consumption of added sugars, the Dietary Guidelines Advisory Committee said in a scientific report released today, kicking off a public comment period that ends Aug. 13.
The current 2015-2020 Dietary Guidelines for Americans (DGA) recommended that Americans get less than 10% of their energy from added sugars; the latest recommendation reduces that to 6%, and notes that on average, Americans 1 year and older currently obtain 13% of their energy from added sugars.
The report also recommended that for Americans two years and older, dietary cholesterol and saturated fat intake “be as low as possible within a healthy dietary pattern, and that saturated fat intake be limited to less than of 10 percent of total energy intake, as recommended by the 2015-2020 Dietary Guidelines for Americans.” In its last meeting before producing its scientific recommendations, some members of the committee had expressed an interest in lowering that percentage.
“Evidence suggests that adverse effects of added sugars, particularly from sugar-sweetened beverages (SSBs), may contribute to unhealthy weight gain and obesity-related health outcomes,” the report says. “Reducing the amount of added sugars in the diet, either through changes in consumer behavior or in how food is produced and sold, is an achievable objective that could improve population health.”
The report is the first to look at the influence of diet from birth to 24 months. The committee said it’s important for infants two years and younger to avoid consuming sugar-sweetened beverages (SSBs).
The energy contributed by SSBs leaves less room for nutritious options, and “limited evidence suggests that SSB consumption by infants and young children” is related to the subsequent risk that children will be overweight. In addition, “intake of SSB in early life may set the stage for greater intake of SSB later in life, with potentially adverse health consequences.”
In the beverage category, only SSB intake was associated with being overweight or obese, the report says. “Because of their low nutrient-to-energy content ratio and the high prevalence of overweight and obesity in the population, it is important to continue encouraging only limited intake of SSB.” The committee added that there is “limited evidence” suggesting an association between consumption of low- or no-calorie sweetened beverages and reduced incidence of overweight and obesity in adults.
The report now goes to Health and Human Services Secretary Alex Azar and Agriculture Secretary Sonny Perdue, who will issue the DGA by the end of the year. The public and federal agencies will be able to comment until Aug. 13 and oral comments will be heard at a public meeting Aug. 11. In a statement, Brandon Lipps, USDA's deputy undersecretary for Food, Nutrition, and Consumer Services, said USDA “greatly appreciates the high-quality work done by this committee comprised of our nation’s leading scientists and dietary experts. We look forward to thoroughly reviewing the report and leveraging their scientific advice as we partner with HHS to develop the next edition of the Dietary Guidelines for Americans.”
In general, the report tracks the current DGA in its diet recommendations. “Common characteristics of dietary patterns associated with positive health outcomes include higher intake of vegetables, fruits, legumes, whole grains, low- or nonfat dairy, lean meat and poultry, seafood, nuts, and unsaturated vegetable oils, and low consumption of red and processed meats, sugar-sweetened foods and drinks, and refined grains.”
In contrast, the committee found that negative, or detrimental, health outcomes “were associated with dietary patterns characterized by higher intake of red and processed meats, sugar-sweetened foods and beverages, and refined grains.”
The health outcomes examined include death from all causes, cardiovascular disease (CVD), overweight and obesity, type 2 diabetes, bone health, breast, colorectal and lung cancer, and neurocognitive health.
The committee recommended replacing intake of saturated intake with unsaturated fats, particularly polyunsaturated fat, to lower the incidence of CVD in adults.
The best way to achieve that goal is to substitute “some animal-source foods, especially processed meats and certain dairy products, with sources of polyunsaturated fats, such as seafood, seeds, nuts, legumes, and appropriate vegetable oils,” the committee said. “In addition, if meat and dairy foods are included in the dietary pattern, choosing lean cuts and lower fat dairy options is preferred.”
The committee also tightened up the recommendations for alcohol, which it said “has little nutritional value” beyond providing energy.
“Binge drinking is consistently associated with increased risk compared to not binge drinking, and more frequent binge drinking is associated with increased risk compared to less binge drinking,” the report says. “Similarly, among those who drink, consuming higher average amounts of alcohol is associated with increased mortality risk compared to drinking lower average amounts.”
The current DGA says if alcohol is consumed, “it should be in moderation — up to one drink per day for women and up to two drinks per day for men.”
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But the committee lowered that recommendation to a drink per day for both men and women “on days when alcohol is consumed.”
For one-year-olds who do not get human milk or infant formula, the committee’s recommended dietary pattern “allows for a variety of nutrient-rich animal-source foods, including meat, poultry, seafood, eggs, and dairy products, as well as nuts and seeds, fruits, vegetables, and grain products, prepared in ways that are developmentally appropriate for this age.”
The committee did not address the issue of the sustainability of the food system in its recommendations, but said in the executive summary that both that topic and the issue of food insecurity bear further examination.
“The committee’s review and discussion, as well as the public comments submitted during the committee’s review period, reinforce the need to consider the DGA in the context of the food environment and the overall food system,” the committee said.
Sarah Reinhardt, lead analyst for food systems and health at the Union of Concerned Scientists, said the committee “has recognized what a growing number of studies have found: that what we eat every day has profound consequences for the environment and our future food supply. The USDA and HHS need to take this seriously. If they don’t, the diet they recommend today will put a healthy diet further out of reach tomorrow."
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