Death and Life

Gains and Gaps in Guidelines for Eating Circa 2020

This happens only once every five years. The U.S. Department of Agriculture, along with Health and Human Services, issued new dietary guidelines yesterday. This is big news, but the reporting on it is pretty slim. In the 2020 guidelines for eating, we have some gains and some gaps in translating science into policy. In keeping with our polarized politics, most of the reporting is all about those gaps. The sizzle and spark comes from the gap between what scientists recommend regarding sugar and alcohol and the action government takes.

However, there’s a bigger story here. For the first time ever, our guidelines are tailored to different stages of life. The dietary needs of infants and toddlers are different from older adults. So these guidelines offer specific guidance for five different times of life – infancy, childhood, adulthood, pregnancy and lactation, and older adulthood. This is a big, positive change. But it’s not controversial, so it gets buried by health reporters.

Fussing About Alcohol and Sugar

The heat around this report is all about regulating the sins of too much alcohol and sugar. Scientists on the Dietary Guidelines Advisory Committee recommended lower limits on both of these. From added sugar, they recommended people get no more than five percent of their calories. That would have been half of what the guidelines say now, but USDA and HHS said no to this change.

For alcohol, the committee had recommended a limit of one drink per day for men – that’s half of the current recommendation. Again, USDA and HHS took a pass on making this change.

Thus the door opens for righteous advocates to complain about political aspects of this process. Marion Nestle told the New York Times:

“I’m stunned by the whole thing.

“Despite repeated claims that the guidelines are science-based, the Trump agencies ignored the recommendation of the scientific committee they had appointed, and instead reverted to the recommendation of the previous guidelines.”

Reasonable Disagreements

Of course, five years ago, Nestle and other advocates were praising the prior guidelines, produced under the Obama administration. The public has yet to catch up with that guidance for added sugars. So we’re not so sure that a tighter guidance would have been helpful.

Likewise, it’s not clear that guidance for men to stop after one drink would have a big impact. The committee knew this was a long shot, writing in its report:

“Although guidelines [for alcohol] may be aspirational they are important for communicating evidence around health, stimulating thought around behavior change, and prioritizing policies that may lead to changes in consumption.”

Lots of Heat, Not So Much Light

There’s nothing wrong with understanding where controversies lie. However, it becomes a problem when we overlook the real progress in these guidelines. That would be the adoption of guidance that meets distinct needs for different times of life.

It was no small task to do this for the first time. HHS, USDA, and the Advisory Committee should take pride in getting it done. No doubt, this guidance will benefit from future refinements, but it’s a pretty good start.

Click here for the full guidelines and related resources. For further reporting, click here, here, and here.

Death and Life, painting by Gustav Klimt / Wikipedia

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December 30, 2020