A few more than the usual number of New Year’s pledges to eat better, exercise diligently, and shed flab just might be kept in 2011, pending the federal government’s about-to-be-unveiled revamping of the 2005 Dietary Guidelines for Americans. Updated by law every five years by the Department of Agriculture and Department of Health and Human Services, the guidelines direct federal nutritional policy from the contents of an 8-year-old’s cafeteria tray to the numbers displayed on the nutritional label of a can of tomato soup. Few Americans are left untouched by their recommendations.
The thrust and details of the 2010 guidelines won't be known until they are released, a change from before, when the government simply adopted the recommendations of an advisory panel. This time DOA and HHS are hammering out the final version behind the curtains, with a 13-member advisory panel providing input rather than dictating the content. But the report and recommendations released by the panel in June are bound to carry heavy weight. If the panel's input foreshadows the shape and scope of the guidelines the government will issue, the public will see a thorough overhaul, and one that reflects a sense of urgency.
The report marks the first time proposed guidelines have confronted obesity directly. It notes that nearly three-fourths of women and two-thirds of men are now considered overweight or obese, and it calls for quick and far-reaching changes—not only in personal diet and lifestyle but also in the marketplace, to reverse the trend. "The obesity epidemic has only gotten worse since 2005," says Linda Van Horn, chair of the advisory committee and professor of preventive medicine at Northwestern University.
The advisors also observed that Americans eat not only too much but not enough of what they should. The 2005 guidelines urged greater consumption of fruit and vegetables, for instance, but a recent report from the Centers for Disease Control and Prevention found that in 2009 only about one in three adults had more than a single serving of fruit a day and one in four had more than two helpings of vegetables—far short of the recommended two and three daily servings respectively.
The question is what will take some of the air out of the ballooning obesity rate—a trend that Walter Willett, professor of epidemiology and nutrition at the Harvard School of Public Health, partly blames on the existing guidelines. By vilifying fats and overpromoting carbohydrates, he says, "the current guidelines may have indirectly contributed to the obesity epidemic." Willett is among a chorus of critics eager for change. MyPyramid, the iconic visual summary of the 2005 guidelines, is widely viewed as hard to decipher (what do those colored stripes mean?) and the guidelines are seen as lagging behind current thinking both on desirable amounts of nutrients such as proteins, carbohydrates, and trans fats and in focusing too specifically on such nutrients. Advising the public to "avoid too much fat, saturated fat, and cholesterol," and to "eat foods with adequate starch and fiber," for example, is seen by the advisory panel as giving insufficient attention to other attributes of food quality.
At first glance, the advisors seem to follow the well-worn path of a general attack on fat, sugar, and salt (proposing a 35 percent decrease in the daily salt allowance, for example), exhortation to consume more vegetables and whole grains, and praise for seafood, lean meats, poultry, eggs, and fat-free and low-fat milk as opposed to fattier sources of protein.
But two new chapters in the report signal a clear change in direction. One blends the panel's findings into a practical approach to eating. The other discusses what it calls "powerful influences that currently promote unhealthy consumer choices, behaviors and lifestyles"—the billions of dollars spent on marketing junk food, for one—and lays out ways to sidestep barriers to a healthier lifestyle. Fruits and veggies could be more widely available by encouraging the growth of farmers' markets, for example. And all of the panel's proposals rely on solid findings—they are "evidence-based," in science-speak—that utilize the Nutrition Evidence Library established by the USDA in 2009.
"Tremendous effort was put forth to not stop at pointing to problems, but making specific recommendations on how to address them," says Van Horn. "It's one thing to review the evidence; it's another to take those findings and create implementable strategies that work." And infants, children, and pregnant women, vulnerable subgroups ignored in previous reports, each get individual attention.
Industry opposition and lobbying in response to the report have been intense. The meat lobby opposes the recommended shift toward a more "plant-based" diet. The Salt Institute has aggressively battled the proposed reduction in the daily ceiling on sodium. The dairy industry is wary of recommendations for reduced sugar, lest flavored milk falls out of favor.
But if they are to have real impact, the new guidelines must be aggressive, says Van Horn, who notes that prior guidelines mostly addressed nutrient deficiencies and other nutritional mainstays and generally avoided taking controversial stands. "We need to prioritize obesity," she says. "To do nothing more than we have means that five years from now we'll be in an even worse situation."