Dietary Guidelines published without changes to added sugars or alcohol recommendations

Dive Brief:

The new Dietary Guidelines for Americans, published last week, recommend people follow a "healthy dietary pattern at every life stage," but do not advocate for adults to consume fewer added sugars or alcoholic beverages, despite recommendations made in the scientific report compiled by the 2020 Dietary Guidelines Advisory Committee.
This year's guidelines have the first specific recommendations for infants and toddlers, as well as pregnant and lactating women. There are few changes to the suggestions for adults; instead, they urge all people to choose nutrient-dense foods, but to limit food and beverages higher in added sugars, saturated fat and sodium, as well as alcoholic beverages.
The Dietary Guidelines for Americans is a series of recommendations updated every five years since 1980. This summer, a committee of doctors, scientists, dietitians and other medical professionals submitted recommendations for the report to the U.S. Department of Agriculture and U.S. Department of Health and Human Services, which jointly publish the document. While the guidelines don't set requirements for manufacturers or foodservice, they are used as a template for federal programs and policies about nutrition.

Dive Insight:

This year's Dietary Guidelines for Americans was published with a pretty significant footnote. While the scientific report the guidelines were based on recommended significant decreases in the amount of added sugars and alcoholic beverages that should be consumed as part of a healthy diet, those reductions were not included in the final guidelines. The scientific report recommended that no more than 6% of all calories consumed come from added sugars — down from 10% in the 2015 edition — and that adults drink no more than one alcoholic beverage a day — down from two per day for men and one for women five years ago. Recommendations for added sugar and alcohol consumption remained unchanged in the 2020 report.

USDA and HHS addressed this head on, saying in a response to the scientific report that "there was not a preponderance of evidence ... to substantiate changes" to how much of these substances people should consume on a daily basis. The report says it is important to limit added sugars and alcohol, and the departments' response urges more research on how added sugars and alcoholic beverages impact health.

However, there has been quite a lot of recent research on the health dangers of added sugars. One of the more prominent features on the revamped Nutrition Facts label is a row that tells consumers how much sugar was added to a product. Sugar has also been a major player in local policy. In recent years, states, counties and municipalities sought to dissuade consumers from drinking sugar-sweetened beverages — which are responsible for 24% of added sugar consumption, the new Dietary Guidelines say — by levying taxes on them. For those taxes to be passed, research was done to show why people should drink them less.

FDA explains that added sugars are included on Nutrition Facts labels because they have a lot of calories, but do not meet many nutritive needs. And while that's true, researchers have also found added sugars have a detrimental effect on overall health, leading to obesity, diabetes and high blood pressure. In 2019, researchers found a significant association between consuming sugary beverages and cancer. And a website from Harvard's T.H. Chan School of Public Health cites studies showing a correlation between consuming sugary beverages and risk of heart attack, gout, bone health and overall mortality.

Several studies have also found alcohol to be detrimental to health, in ways that go beyond the dangers of impairment from drinking too much. The U.S. Centers for Disease Control and Prevention has presented research on its website showing the link between alcohol consumption and cancer since 2014.

People in the medical and scientific community have already been pushing back against the guidelines, criticizing the government for ignoring some of the science-based evidence in the recommendations.

"USDA and HHS overrode the scientific decisions of the DGAC. So much for 'science-based' dietary guidelines," researcher, author and food policy expert Marion Nestle wrote on her blog.

However, the Dietary Guidelines for Americans are just that: guidelines. According to the 2020 report, if the average diet in the U.S. were scored between 1 to 100, with 100 meaning total adherence to the guidelines, it would get a score of 59. While it means there's a lot of room for improvement, it also indicates many people don't know much about the guidelines.

By and large, people in the United States are starting to eat better. Spurred by wider consumer knowledge of the relationship between food and wellness and the coronavirus pandemic, more people are eating for their health. They are already eating less sugar: A 2018 Ipsos study found seven in 10 were concerned with the amount of sugar in their diets. And people are drinking less alcohol. Nielsen noted in 2019 that 66% of millennials said they were making efforts to reduce alcohol consumption. It's likely these trends will continue, despite what the Dietary Guidelines for Americans say.