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2020-2025 Dietary Guidelines for Americans Recommendations

The Dietary Guidelines for Americans—which provide nutrition recommendations and are the basis for federal food programs such as MyPlate—are updated every five years by the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS). The process begins with the Dietary Guidelines Advisory Committee (DGAC), a group of nominated individuals, which reviews current nutrition research and drafts a scientific report that the USDA and HHS use to develop the final guidelines.

Since 1995, the Physicians Committee has successfully worked to ensure that the DGAC reveals conflicts of interest from the meat, dairy, and egg industries and that the Dietary Guidelines for Americans recommend healthful plant-based diets and warn against consuming cholesterol and saturated fat found in animal products.

The 2020 DGAC released its report in July. The Physicians Committee applauded the DGAC  for recommending that Americans should avoid saturated fat, cholesterol, and red and processed meat and instead focus on carbohydrate-rich plant-based foods for optimal health.

But the DGAC failed to warn against dairy products, which are the leading source of saturated fat in the American diet and increase the risk of heart disease, breast and prostate cancers, and other health conditions. In August, the Physicians Committee submitted a letter to the USDA and HHS, signed by nearly 500 health care professionals, arguing that the DGAC’s scientific report “preserves antiquated, racially biased dairy-promoting guidelines, despite clear contributions to health problems that take a disproportionate toll in Black Americans and other demographic groups.” The American Medical Association also reiterated its call for the USDA to fight racial health disparities by indicating in the Dietary Guidelines for Americans that “meat and dairy products are optional.”

The 2020-2025 Dietary Guidelines for Americans are expected to be released in December 2020. The Physicians Committee continues to urge the USDA and HHS to strongly recommend plant-based diets and warn against meat and dairy products and low-carbohydrate diets in the final guidelines.

1. Do not include a low-carbohydrate eating pattern or recommend limiting consumption of carbohydrates.

Americans already consume too few carbohydrates in the forms of fruits, vegetables, grains, and legumes. Only one in 10 adults eats enough fruits and vegetables, according to the Centers for Disease Control and Prevention. In fact, a study in JAMA attributed 52,547 deaths from heart disease, stroke, or type 2 diabetes in 2012 to consuming too few fruits and 53,410 deaths to consuming too few vegetables. Consuming too few whole grains was associated with 11,639 deaths from type 2 diabetes.

Low-carb diets high in animal protein and fat have been linked to increased risk of type 2 diabetes and diabetes-like symptoms in healthy people, weight gain, atrial fibrillation (which is associated with a five-fold increased risk for stroke and may lead to heart failure), and heart disease.

Low-carb diets can also lead to early death. One study found that participants with the lowest intake of carbs had a 32 percent higher risk of all-cause death. The risks of death from coronary heart disease, cerebrovascular disease, and cancer were increased by 51 percent, 50 percent and 35 percent, respectively. Studies published in the Journal of the American Heart Association, The Lancet, and the Annals of Internal Medicine have also shown low-carb diets increase the risk of early death.

Fiber-rich carbohydrates should provide most of the calories in a healthy diet and are the main fuel for the brain and muscles. About three-quarters of daily calories should come from carbs. Studies show that a diet rich in healthy carbs from fruits, vegetables, grains and legumes can help prevent and reverse the risk of heart disease, type 2 diabetes, and obesity

2. Recommend water instead of milk.

Dairy products are a leading source of saturated fat in the American diet. In fact, the guidelines recommend people avoid saturated fat because of its link to heart disease.

Scientific evidence also shows that milk and other dairy products increase the risk of asthma, breast, ovarian, and prostate cancers, cognitive decline, and early death, and offer little if any protection for bone health.

Dairy products also cause bloating, diarrhea, and gas in the tens of millions of Americans who have lactose intolerance, the natural progression of not breaking down sugar in milk. The National Institutes of Health estimates that 30 million to 50 million American adults are lactose intolerant, including 95 percent of Asians Americans, 60-80 percent of African Americans and Ashkenazi Jews, 80-100 percent of Native Americans, and 50-80 percent of Hispanics.

In July 2018, the American Medical Association passed a resolution calling on the USDA and HHS to recognize that lactose intolerance is common among many Americans, especially African Americans, Asian Americans, and Native Americans, and to clearly indicate in the guidelines and other federal nutrition guidelines that dairy products are optional.

Canada’s latest food guide recommends that Canadians make water their “drink of choice.”

Calcium is plentiful in beans, leafy green vegetables, tofu, breads, and cereals. Oranges, bananas, potatoes, and other fruits, vegetables, and beans are rich sources of potassium. Legumes and green leafy vegetables are excellent sources of magnesium. The natural source of vitamin D is sunlight, and fortified cereals, grains, bread, orange juice, and plant milks are dietary options.

3. Warn against consuming red and processed meat.

The risks of consuming processed meat—such as hot dogs, bacon, and deli meat—were clear when the current guidelines were published, and the evidence against them has continued to mount.

In 2015, after 22 experts from 10 countries assessed more than 800 epidemiological studies, the World Health Organization’s International Agency for Research on Cancer classified consumption of processed meat as “‘carcinogenic to humans’ (Group 1) on the basis of sufficient evidence for colorectal cancer.” The experts highlighted a meta-analysis that concluded that each 50-gram portion of processed meat (about one hot dog) eaten daily increases the risk of colorectal cancer by 18 percent. Research shows that eating 50 grams of processed meat daily also increases the risk of breast cancer, prostate cancer, pancreatic cancer, and overall cancer mortality.

Studies show that processed meat also increases the risk of death from cardiovascular disease. A study published in JAMA found that processed meat consumption was tied to 57,766 deaths from heart disease, stroke, or type 2 diabetes in 2012. Other studies have linked it to chronic obstructive pulmonary disease.

A recent survey of nearly 44,000 U.S. adults found that “despite growing public health concerns about processed meat consumption, there have been no changes in the amount of processed meat consumed by US adults over the last 18 years.” The authors suggest that “findings of this study can inform public health policy priorities for improving diet and reducing chronic disease burden in United States.” 

Research shows that red meat also increases the risk of heart disease, diabetes, and certain cancers

4. Continue to promote plant-based eating patterns.

A plant-based diet, rich in fruits, vegetables, whole grains, and legumes, is a great way to achieve good health. These foods are full of fiber, rich in vitamins and minerals, free of cholesterol, and low in calories and saturated fat. Eating a variety of these foods provides all the protein, calcium, and other essential nutrients your body needs. It's important to include a reliable source of vitamin B12 in your diet. You can easily meet your vitamin B12 needs with a daily supplement or fortified foods, such as vitamin B12-fortified breakfast cereals, plant milks, and nutritional yeast.

Those who eat a plant-based diet lower their risk for heart disease, type 2 diabetes, obesity, and other health conditions.

Heart Disease: Plant-based diets have been proven to prevent and reverse heart disease, improve cholesterol, and lower blood pressure.

Diabetes: Plant-based diets prevent, manage, and reverse type 2 diabetes

Weight Loss: Plant-based diets are beneficial for maintaining a healthy weight

Cancer: Avoiding animal products and high-fat foods and eating plant-based foods can lower the risk of developing certain types of cancer.

Asthma: Diets that emphasize fruits, vegetables, grains, and legumes and minimize saturated fat and dairy products may reduce the risk for asthma and may improve asthma control.  

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