Ask Anni | Expert Advice on the New Dietary Guidelines

5 Easy Takeaways from the most recent national nutrition guidelines.


Welcome to the Ask Anni series. Every Thursday on the blog, I’ll be answering your most asked questions and giving you evidence-based answers. This week on Ask Anni, many of you are wondering, “What do I need to know about the new Dietary Guidelines for Americans?


Read on for details about the new Dietary Guidelines and how you can incorporate them in a healthy diet plan.


What are the Dietary Guidelines for Americans?


Before we take a look at what the guidelines are, it is helpful to know what the Dietary Guidelines for Americans (DGA) are.


The DGA is a joint publication from two government agencies, the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (HHS). You may be more familiar with the Center of Disease Control and Prevention (CDC) -- it is on of the major operating components of the HHS.


The USDA and HHS work together to create a public resource that gives basic nutrition advice as well as instructions on how to live healthier lives. Both organizations have efforts directed at improving access to healthy foods and providing nutrition in accordance with recommendations.


You can access the recently released guidelines at Dietary Guidelines for Americans 2020-2025.


Are the guidelines evidence-based?


The organizations that develop these materials have a very fine line to walk. To make exact recommendations, there must be clear evidence. Otherwise, the committee can only place emphasis on limiting or encouraging certain dietary components.


The DGA is considered the nation’s trusted source for evidence-based nutrition guidance, supported by the science clearly pointing to the fact that good nutrition leads to better health outcomes. The guidelines are updated and released every five years to account for new evidence and to adjust or emphasize recommendations accordingly.


What do the experts have to say about the DGA 2020-2025?


When you consider that the prevalence of obesity has likely risen from 42.4% reported by the CDC National Center for Health Statistics in 2017-2018, the DGA offers recommendations in the right direction. Obesity rose from 30.5% in 1999-2000 to 42.4% in 2017-2018.

The rates of severe obesity also rose as well, and trends show that overweight & obesity are common, serious, and costly diseases. The data show that the medical cost for people with obesity was almost $1500 higher than people who maintained a normal weight.


One Dietitian’s Take on the New DGA


Functional dietitian Brigid Titgemeier, a nutrition expert focused on health through personalized nutrition, said the following of the new guidelines in an Instagram post on the day of publication:


“Today was a very important day in the nutrition world: the release of the 2020 dietary guidelines for Americans that happens once every five years. The new recommendations ignored the science around the risk of added sugar intake and will keep it at 10% of calories. ⁣
The science advisory committee recommended limiting added sugars to <6% of total calories (from 10%) and limiting alcohol for men to 2 glasses per day or less. The guidelines published today by HHS and USDA ignored these recommendations...These guidelines influence billions of dollars spent on food that feed Americans daily through SNAP, WIC, and The School Lunch programs in the United States.”⁣
-Functional Dietitian Brigid Titgemeier

My Advice

In the field of personalized nutrition, I completely agree with Titgemeier. In fact, many organizations focused on preventative health align with her professional opinion. With my expertise, I can definitely agree that the DGA has some areas where it falls short.


However, I do think they provide advice pertinent to a population where nearly half of the population is obese with an increasing prevalence of severe obesity. Added sugars and alcoholic beverages were two topics of contention among agencies, and the USDA-HHS well-documented their process in responding to complaints.


The bottom line when it comes to the DGA 2020-2025 is that it is intended for a population headed towards health prevention. It focuses on the evidence supporting the avoidance of excess intake rather than providing the science behind dietary patterns that are nutritionally adequate.


In other words, the new DGA guidelines focus on avoiding patterns of overweight and obesity rather than encouraging eating habits consistent with healthy nutrition. Experts could argue all day (and probably have) about what is more appropriate for our current population, especially since obesity worsens outcomes from COVID-19 and may triple the risk of hospitalization. The average person is likely to now be facing weight-related risks or chronic disease development.


I’d instead like to focus on what we can do and what the guidelines get right. More than half of adults have one or more diet-related chronic diseases, so diet education is quite frankly a matter of life or death. I say we give some easy solutions a try instead of pointing fingers at the obvious gaps.


The DGA's job is to promote health not treat disease. The problem is that sometimes the best prevention for disease is health promotion.
While the DGA can still provide helpful information, such as estimates of how many fruit and vegetables we should get in a day. But to really tell if your nutrient needs are being met, personalized nutrition therapy is your best option.
I recommend using the DGA as a general guide, but also regularly meeting with a registered dietitian to make sure your nutrient needs are really being met on a cellular level.

Here’s everything you need to know about the new dietary guidelines:


Top 5 Takeaways from the DGA


The DGA took an approach to nutrition that focused on patterns and a lifespan perspective. The mantra “make every bite count” can help you to choose more nutrient-dense foods and pay attention to portion size instead of counting calories.


1. Tips for Infants, Toddlers, and Breastfeeding Moms


Historically, the DGA has focused on providing recommendations for individuals ages 2 years and older. Evidence over the years has shown that proper nutrition in early stages of life was critical to healthy childhood development and prevention of chronic disease in adulthood.


For the first time since 1985, this edition of the DGA for 2020-2025 includes healthy diet patterns for infants and toddlers.


For the first 6 months of life (and continued through at least the first year):

Infants should be exclusively fed

  • human milk

  • iron-fortified infant formula when human milk is unavailable

At 6 months:

Infants should be introduced to

  • nutrient-rich complementary foods

  • potentially allergenic foods along with other complementary foods

Infants & Toddlers should be encouraged to

  • consume a variety of foods from all food groups

  • include foods rich in iron and zinc

From 12 months to adulthood:

  • follow a healthy dietary pattern at every age

  • meet nutrient needs

  • help them to achieve a healthy body weight

  • reduce the risk of chronic disease


2. Don’t Blame it on the Alcohol. Choose Healthy Habits.


Adults of Legal Drinking Age

You have choices:

  • choose not to drink

  • drink in moderation

  • Men- 2 drinks or less

  • Women- 1 drink or less

  • Pregnant women should not drink

"DRINKING LESS IS BETTER FOR HEALTH THAN DRINKING MORE”


3. Your Dietary Fats Might Need a Makeover


Healthy fats are in and they are here to stay.


Choose fats that are nutrient dense

  • Limit or avoid:

  • Saturated fat - aim for less than 10% of calories per day. Less than 7% (about 140-200 calories or 16 t0 22 grams per day) is shown to further reduce risk of heart disease Saturated fat comes from sources such as butter and fats that are generally solid at room temperature

  • Instead, get 25-30% of your daily calories from

  • Unsaturated fats- tend to be liquid at room temperature; come from eating a variety of foods, such as lean meats, fish, vegetable oils, fruits, vegetables, and whole grains


4. Again, Avoid Added Sugar


It was again emphasized in the new DGA that added sugars pose a significant risk. However, there was limited guidance offered on exactly how much sugar is appropriate in a nutritionally adequate diet.


For infants & toddlers under age 2: avoid foods and beverages with added sugars

From 2 years old through adulthood: Added sugars should be less than 10% of calories per day

Keep in mind, your body doesn't need to get any carbohydrates from added sugar.

  • The average American consumes 22 tsp of added sugar/day which is equal to 350 extra calories.

  • The American Heart Association recommends an added-sugar limit of no more than 100-150 calories/day, equal to about 6-9 tsp


5. Limitations & Considerations


Limitations


The DGA failed to account for significant evidence regarding added sugar and saturated fat intake. It also didn’t express any specific guidelines in light of global pandemic, although both the CDC and HHS both have free, online resources and information available regarding maintaining or developing healthy habits during the pandemic.

In addition, the DGA didn’t mention the importance of sustainable practices. This is an integral area of eating patterns, affecting everything from the food supply to food accessibility.


Considerations


What was accounted for were significant points relating to culture, budget, and access to food. It also acknowledged that the DGA is consistent over time but evolves as science expands and closes nutritional gaps.


The DGA 2020-2025 claims to do this in the following ways:

  1. Recognizing that diet-related chronic diseases are very prevalent in Americans and pose a major public health problem.

  2. Focusing on dietary patterns - nutrients and foods are not consumed in isolation but in various combinations over time.

  3. Focusing on a lifespan approach, from infancy to adulthood.


How to Start Healthy Habits



Education

Education is one of the main pillars of my practice (learn more about my E-3 Approach). According to the CDC, obesity decreased by level of education. Simply learning about healthy habits can decrease the risk of health problems.


Acknowledge Age

Young adults are estimated to be half as likely to have obesity when compared to middle-age adults. The highest prevalence of obesity is with the category of adults aged 45-54 years.


What your doctor or dietitian says may sound like a broken record, but consider that they might be repeating something because of its importance.


Location, Location, Location

Where you live may plan a factor in your health habits. Colorado and the District of Columbia were reported to have 20-25% of adults with obesity while states in the Midwest and South had rates in the 30% range. Luckily, the internet, support groups, and global awareness communities create access to resources from almost anywhere. Ask your healthcare providers about groups you can join to help you address your health risks.


Positive Self-Talk

Change starts from the inside out -- making it important to pay attention to the way we talk to ourselves. A key perspective to maintain is positive emphasis on aspects such as:

  • Character

  • Intelligence

  • Abilities

  • Lifestyle habits

This can help to avoid placing unnecessary and distorted assumptions, views, or emphasis on body weight. It can also help to avoid weight-based stereotypes such as “fat and lazy”. Using appropriate and respectful language and terminology to describe yourself can be an important step in your process to move towards healthier habits.


Social Media

Remember that you and everyone else are at different stages in their health journey. It can be harmful to portray yourself or others, especially those affected by obesity, merely for the purpose of humor or ridicule.


Your weight is not equivalent to your worth. Your worth is independent of any other measure, and you are capable of change at your own pace. No matter your weight, you can learn to adjust, make healthy changes, and recognize accomplishments and areas to improve. Your professional life, skills, and other areas and activities you enjoy can thrive as a result of your shifts towards a healthy diet.


Focus on Holistic Healing

As the DGA says, “nutrients and foods are not consumed in isolation. Rather, people consume them in various combinations over time—a dietary pattern—and these foods and beverages act synergistically to affect health.”


By focusing on wholeness, balancing a varied plate with different nutrient-rich options, you can heal and direct your energy towards healthy habits. Don’t get too caught up in the tiny details -- where your attention goes, your intention goes, and your energy flows.

Just focus on the next good decision when it comes to your health instead of being overwhelmed with all the available options. How does your body feel? What does it need? Are my thoughts about food healthy and productive? Are my ideas about food wrapped in shame or guilt? What do I need to take the next step in my health journey?


Need help getting started?

Join the waitlist for my Meal Planning Made Simple program, launching on March 1. I can help you carry out a customizable meal plan that lasts past new years resolutions. Contact me if you have any questions or concerns -- your inquiry might end up on the next installment of #askanni!


References

Centers for Disease Control and Prevention. Overweight & Obesity (Adult Obesity Facts). U.S. Department of Health and Human Services. 2021. www.cdc.gov/obesity/data/adult.html

Centers for Disease Control and Prevention. About CDC 24-7 (CDC Organization). U.S. Department of Health and Human Services. 2021. www.cdc.gov/about/organization/cio.htm


Medical Encyclopedia. Facts about saturated fats. MedlinePlus. 2021. https://medlineplus.gov/ency/patientinstructions/000838.htm#:~:text=You%20should%20limit%20saturated%20fat,of%20saturated%20fats%20a%20day


Obesity Action Coalition. Guidelines for Media Portrayals of Individuals Affected by Obesity. Obesity Society, et al. 2021. https://4617c1smqldcqsat27z78x17-wpengine.netdna-ssl.com/wp-content/uploads/Guidelines-for-Media-Portrayals-of-Individuals-Affected-by-Obesity-2016.pdf#page=4


The Nutrition Source. Added Sugars in the Diet. Harvard School of Public Health. 2021. https://www.hsph.harvard.edu/nutritionsource/carbohydrates/added-sugar-in-the-diet/


USDA Food and Nutrition Service. Make Every Bite Count: USDA, HHS Release Dietary Guidelines for Americans, 2020-2025. U.S. Department of Agriculture. 2020. Press Release No. 0470.20. www.usda.gov/media/press-releases/2020/12/29/make-every-bite-count-usda-hhs-release-dietary-guidelines-americans