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Process to Develop the

Dietary Guidelines for Americans


Eve Stoody, PhD
Lead Nutritionist, USDA Center for Nutrition Policy
and Promotion
Designated Federal Officer, 2020 Dietary Guidelines
Advisory Committee
Today

1 What/Why: Dietary Guidelines Background

2 How: 2020-2025 Dietary Guidelines


Process and Current Status
Navigating the Nutrition Landscape

FOOD-BASED
NASEM DIETARY GUIDANCE: USDA/HHS
NUTRIENT
Dietary RECOMMENDATIONS:
I am a 42-year-old Dietary
Reference woman, what foods Guidelines for
I’m a 42-year-old
woman, how much should I eat for good
Intakes calcium do I need? health? Americans

CLINICAL GUIDANCE FOR


DISEASE TREATMENT /
MANAGEMENT:

I have diabetes, what should I Individual Federal agencies


eat as part of my (e.g., NIDDK) and
treatment plan?
professional medical
organizations (e.g.,
American Diabetes Assoc)
About the Dietary Guidelines

• The Dietary Guidelines for Americans serves as


the cornerstone of federal nutrition programs
and policies, providing food-based
recommendations to help prevent diet-related
chronic diseases and promote overall health.
• According to the National Nutrition
Monitoring and Related Research Act of
1990, the Dietary Guidelines is mandated
to reflect the preponderance of scientific
evidence, and is published jointly by
USDA and HHS every five years.
2020-2025 Dietary Guidelines
for Americans

USDA and HHS are committed to


ensuring that our process to develop
the 2020-2025 Dietary Guidelines for
Americans is transparent, inclusive,
and science-driven.
About the Dietary Guidelines
Q: Why every five years?
A: New research is published every month. Reviewing scientific
evidence every five years allows the Dietary Guidelines to
capture new relevant information.

Q: Isn’t dietary guidance always changing, causing


confusion?
A: Individual studies that are published and in the news
can make it seem confusing, but dietary guidance
has remained relatively constant from edition
to edition. There have been refinements along
the way to reflect the latest in the body of
scientific evidence.
About the Dietary Guidelines
Q: Do the Dietary Guidelines cover infants and pregnant women?
A: Historically, the Dietary Guidelines has focused on 2 years and older.
The 2014 Farm Bill mandated the addition of infants and toddlers and
women who are pregnant. The 2020-2025 edition will cover the entire
lifespan from birth through older adulthood.

Q: Why do the Dietary Guidelines only address healthy people when 60% of
adults are unhealthy?
A: The Dietary Guidelines are for the general public, including people who may be
labeled as “unhealthy.” It is based on studies with people who
are healthy, people at-risk for a diet-related chronic disease, and
people who have a diet-related chronic disease (e.g. obesity,
diabetes, cardiovascular disease). Research indicates that
moving towards the Dietary Guidelines – regardless of a
person’s health status – helps improve their health.
About the
Importance
Importance Dietary
of the of the Dietary
Dietary
Importance of the Dietary Guidelines
Guidelines
Guidelines
for Americans
for Americans

Americans do not follow the Dietary Guidelines.


About the
Importance
Importance Dietary
of the of the Dietary
Dietary
Importance of the Dietary Guidelines
Guidelines
Guidelines
for Americans
for Americans
Q: Isn’t the Dietary Guidelines the
reason Americans are unhealthy?
A: The vast majority of people in the
U.S. are not eating according to
the Dietary Guidelines.
Research indicates that higher HEI scores
are associated with lower risk for
cardiovascular disease, diabetes, and
certain cancers – and better health for
those with diet-related diseases.
About the
Importance
Importance Dietary
of the of the Dietary
Dietary
Importance of the Dietary Guidelines
Guidelines
Guidelines
for Americans
for Americans
Scientific peer-reviewed paper describing
estimated economic impact of the 2015-2020
Dietary Guidelines of Americans with respect
to health care costs.
If Then
HEI-2015 score of 71 Estimated $31.5 billion savings
(20% improvement) from reductions in
cardiovascular disease, cancer
and type 2 diabetes

HEI-2015 score of 80 Estimated $55.1 billion savings


from reductions in
cardiovascular disease, cancer
and type 2 diabetes
About the
About
Importance
Importance Dietary
of the
the Dietary
of the Dietary
Dietary
Importance of the Dietary Guidelines
Guidelines
Guidelines
for Americans
for Americans

• Current edition:
• 2015-2020 Dietary
Guidelines for Americans
• Released in January 2016
• Remains the current
edition as we prepare the
next edition
About the
About
Importance
Importance Dietary
of the
the Dietary
of the Dietary
Dietary
Importance of the Dietary Guidelines
Guidelines
Guidelines
for Americans
for Americans

• To support the process to update the Dietary


Guidelines, USDA/HHS convene a Federal Advisory
Committee.

• The Dietary Guidelines Advisory Committee is a group


of external scientific experts, jointly agreed upon by
the USDA and HHS Secretaries.

• The Advisory Committee conducts an independent


review of the current scientific evidence and submits
a report of its findings to the Secretaries.

• This report is not the Dietary Guidelines,


nor is it a draft of Dietary Guidelines.
About the
About
Importance
Importance Dietary
of the
the Dietary
of the Dietary
Dietary
Importance of the Dietary Guidelines
Guidelines
Guidelines
for Americans
for Americans

• USDA and HHS write the


Dietary Guidelines for
Americans, taking into
consideration the
Committee’s report, and
public and Federal
agency comments.
About tothe
About
Importance
Importance
Process Dietary
of the
Update the Dietary
of the
Dietary
the Dietary Dietary
Guidelines:
Guidelines
Current Guidelines
Statusfor Americans
for Americans
2020
AboutDietary
the
ImportanceAbout Guidelines
Importance
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of the
the Dietary
of the Dietary
Dietary
Advisory
Guidelines Committee
Guidelines
for Americans
for Americans
Announced Thursday, February 21, 2019

Barbara Schneeman, PhD Ronald Kleinman, MD*


University of California- Harvard Medical School Jamy Ard, MD Regan Bailey, PhD, MPH, RD Lydia Bazzano, MD, PhD Carol Boushey, PhD, MPH, RD Teresa Davis, PhD
Davis Vice Chair Wake Forest School of Purdue University Tulane University University of Hawaii Baylor College of
Chair Medicine Medicine

Kathryn Dewey, PhD Sharon Donovan, PhD, RD Steven Heymsfield, MD Heather Leidy, PhD Richard Mattes, PhD, MPH, RD Elizabeth Mayer-Davis, PhD, RD Timothy Naimi, MD, MPH
University of California-Davis University of Illinois Louisiana State University University of Texas Purdue University University of North Carolina Boston University
(Summer 2019)

Rachel Novotny, PhD, RDN, LD Joan Sabaté, DrPH, MD Linda Snetselaar, PhD, RD Jamie Stang, PhD, MPH, RDN Elsie Taveras, MD, MPH* Linda Van Horn, PhD, RDN, LD
University of Hawaii Loma Linda University University of Iowa University of Minnesota Harvard University Northwestern University
*Massachusetts General Hospital
About tothe
About
Importance
Importance
Process Dietary
of the
Update the Dietary
of the
Dietary
the Dietary Dietary
Guidelines:
Guidelines
Current Guidelines
Statusfor Americans
for Americans
Advisory Committee Review of Scientific Evidence
• Charged with examining the evidence on specific topics and
scientific questions identified by USDA and HHS

• Working in 6 topic area subcommittees and a cross-cutting


working group:
1. Pregnancy and Lactation
2. Birth to 24 Months
3. Dietary Patterns
4. Beverages and Added Sugars
5. Dietary Fats and Seafood
6. Frequency of Eating
About tothe
About
Importance
Importance
Process Dietary
of the
Update the Dietary
of the
Dietary
the Dietary Dietary
Guidelines:
Guidelines
Current Guidelines
Statusfor Americans
for Americans
Advisory Committee Review of Scientific Evidence
• Examine evidence using rigorous, protocol-driven approaches
designed to minimize bias:
• Systematic reviews (USDA’s Nutrition Evidence Systematic Review team)
• Data analysis
• Food pattern modeling

• Approximately 5 Committee meetings, open to the public to


attend in person or online
• March 28-29, 2019
• July 10-11, 2019*
• October 24-25, 2019
• January 23-24, 2020*
• March 12-13, 2020
* Opportunity for oral comments to the Committee
About tothe
About
Importance
Importance
Process Dietary
of the
Update the Dietary
of the
Dietary
the Dietary Dietary
Guidelines:
Guidelines
Current Guidelines
Statusfor Americans
for Americans
Advisory Committee Review
of Scientific Evidence
• The public is encouraged to submit
public comments to the Committee
throughout the course of its
operation.
• The Committee will be terminated
upon delivery of its report to the
Secretaries of USDA/HHS or when
its 2-year charter expires
(whichever comes first).
About tothe
About
Importance
Importance
Process Dietary
of the
Update the Dietary
of the
Dietary
the Dietary Dietary
Guidelines:
Guidelines
Current Guidelines
Statusfor Americans
for Americans
Q: When will the Committee publish the draft Dietary
Guidelines and then the government publish the final
Dietary Guidelines?
A: To be clear, the Committee’s report is not the draft Dietary
Guidelines. The 2020 Committee is conducting an independent
scientific review of the evidence and then writes a scientific
report describing its findings. The Committee’s report does
not include guidance. We expect to receive the
Committee’s report in the spring of 2020.
USDA and HHS write and publish the
Dietary Guidelines for Americans. Our goal
is to publish the 2020-2025 edition by the end
of 2020.
About tothe
About
Importance
Importance
Process Dietary
of the
Update the Dietary
of the
Dietary
the Dietary Dietary
Guidelines:
Guidelines
Current Guidelines
Statusfor Americans
for Americans
Q: Is the process to develop the Dietary Guidelines running
late?
A: The 2020 Committee is starting later than the 2015
Committee, but it is starting at a different point in the
process. For the first time, the Committee is starting with
the defined topics and scientific questions. This puts them
farther along in the process than when previous
Advisory Committees started their work.
About theAbout
Importance
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National Dietary
of the
Academies of Dietary
the of the Dietary
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Sciences,
Guidelines
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Engineering, forMedicine
and Americans
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Americans
In 2016, Congress directed a comprehensive study of the
process to establish the Dietary Guidelines.
The study concluded in two reports with recommendations.
Five values to improve the integrity of the process to develop
credible and trustworthy guidelines:
1. Enhance transparency.
2. Promote diversity of expertise and experience.
3. Support a deliberative process.
4. Manage biases and conflicts of interest.
5. Adopt state-of-the-art processes and methods.

http://www.nationalacademies.org/hmd/Activities/Nutrition/DietaryGuidelinesforAmericans.aspx
DietaryGuidelines.gov
DietaryGuidelines.gov
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DietaryGuidelines.gov

FNSPress@USDA.gov