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Dietary Guidelines for Americans, 2015

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Robert Koch Comment ID #803

10/30/2014

See attachment

Affiliation: Industry/Industry Association Organization: Wine Institute
Topic:
  • Alcoholic Beverages

Anonymous Comment ID #802

10/30/2014

Why is concentrated fruit juice ( usually pear juice) not considered a sugar/carbohydrate.? Why can schools sell "fruit rollups" with concentrated fruit juice? Isn't the same nutritionally as "fruit rollup" with sugar?

Affiliation: Educational Institution: Secondary or School System Organization: none
Topic:
  • Carbohydrates (Added Sugars, Fiber, Glycemic Index, Whole Grains)

Anonymous Comment ID #801

10/30/2014

To: The 2015 Dietary Guidelines Advisory Committee
From: Constance Brown-Riggs, MSEd, RD, CDE, CDN Nutrition Advisor for Dannon

As a registered dietitian, certified diabetes educator and advocate for minority health and cultural relevancy, I would like to comment on data presented in meeting 5 of the DGAC. The data highlighted the nutritional disparities between African Americans and socioeconomically disadvantaged groups — supporting the need for specific strategies to improve the nutrient intake among these groups. Moreover, the data from meeting 5 mirrored the findings from a Harvard study “Trends in Dietary Quality among Adults in the United States: 1999 - 2010,” published in the September 2014 issue of JAMA.

The results of this study showed that people with higher socioeconomic status had healthier diets than people with lower socioeconomic status and that gap increased from 1999 to 2010.
Among racial and ethnic groups, non-Hispanic blacks had the poorest diet quality which was explained by lower income and education.

The study authors said the income related differences in diet quality are likely associated with price and access. Healthy foods generally cost more and low-income people may have limited access to stores that sell healthy foods.

One of the most profound findings of the study was an almost 80 percent reduction in trans fat consumption. This speaks directly to the impact of public policy efforts and nutrition education rather than depending solely on individual behavior change.

The nutrient shortfalls identified in meeting 5 and mirrored in the Harvard study can be addressed by calling out yogurt as one of the recommended servings of dairy in the 2015 Dietary Guidelines. Yogurt can help African Americans and socioeconomically disadvantaged groups consume more of 3 of the DGAs 4 nutrients of concern: calcium, potassium and vitamin D.

Research has shown that yogurt is not only nutrient dense, but it can address income related disparities in diet quality, as evidenced by the 2010 Woman, Infants and Children (WIC) pilot study published in the May-June issue of the Journal of Nutrition Education and Behavior.

The objective of the study was to examine the impact of providing yogurt to women enrolled in the Special Supplemental Nutrition Program for WIC. Study participants were given yogurt as part of their milk allowance accompanied with educational materials. Over 86% of women wanted to substitute some of their milk vouchers with yogurt and most reported preferring yogurt to milk. Also, the majority (89%) redeemed their yogurt coupons. Compared to controls, intervention women reported a trend toward an increase in yogurt intake of 1.0 fl oz/day while not decreasing other dairy consumption. Those in the intervention group with the lowest tertile of yogurt intake at baseline increased yogurt consumption by 2.8 fl oz/day relative to controls with lowest intake. The results of this study were significant and instrumental in the addition of yogurt to the WIC food package, effective April 2015.

Further, as evidenced by the results of the dairy group food pattern modeling presented in meeting 5, increasing the proportion of intake of fat free and low fat yogurt and milk would increase levels of magnesium, potassium, vitamin A, vitamin D, and choline in the USDA Food Patterns, and potentially decrease amounts of sodium, cholesterol, and saturated fat.

Many fat-free and low-fat yogurts provide approximately 25 percent more potassium than an equal 8-ounce serving of milk.1 Also a single 8-ounce serving of yogurt would provide approximately 6-14 percent of the recommended daily intake for potassium.2 Yogurt consumers are not only likely to have higher potassium intakes, but are less likely to have inadequate intakes of calcium and magnesium.3

The DGAC is charged with the task of providing science based recommendations to the Federal Government on how best to reduce the burden from major diseases and other health related problems at the individual and population levels. By virtue of the food modeling presented, the studies cited above, and yogurt added to the WIC food package, yogurt should be specifically identified as one of the servings of dairy in your recommendations.

References
1. U.S. Department of Agriculture. National Nutrient Database for Standard Reference Release 26. Accessed 23 August 2013. http://ndb.nal.usda.gov/ndb/search/list.
2. U.S. Department of Agriculture, Agricultural Research Service. 2013. USDA National Nutrient Database for Standard Reference, Release 26. Nutrient Data Laboratory Home Page, http://www.ars.usda.gov/ba/bhnrc/ndl
3. Wang H, Livingston KA, Fox CS, Meigs JB, and Jacques PF. Yogurt consumption is associated with better diet quality and metabolic profile in American men and women. Nutrition Research, January 2013;33(1):18-26.

Affiliation: Industry/Industry Association Organization: Dannon
Topic:
  • Eating Patterns-Diets (USDA Food Patterns, DASH, Vegetarian, Low Carb, Hi-Protein, etc.)
  • Food Groups (Fruits, Vegetables, Grains, Dairy, Protein Foods)
  • Micronutrients (Sodium, Potassium, Vitamin D, Calcium, Iron)

Anonymous Comment ID #800

10/29/2014

Committee should address the valid concern about the wide distribution of (GMO) roundup ready soy and corn in the food supply. The pesticide residue has been detected in cord blood meaning that the potential harm from herbicide and insecticide exposure begins at birth. The 2015 US Dietary Guidelines need to provide valid and reliable information on this health concern. The funding of studies on this cannot come from Monsanto as it has in the past. Labeling of GMO ingredients in food products is the very least the public can make use of in selecting the foods they consume.

Affiliation: Individual/Professional Organization:
Topic:
  • Food Safety

Edward Groth PhD Comment ID #799

10/29/2014

October 29, 2014

TO: Dietary Guidelines Advisory Committee
FROM: Edward Groth III, PhD
RE: Thoughts About Seafood Consumption Advice

Dear DGAC:

Early this year, I and a dozen co-signers submitted a review and analysis of epidemiological evidence on issues of seafood consumption, methylmercury exposure, and the associated health benefits and risks. Included in our submission as attachments were 34 published studies. Last week, I submitted three additional studies. I hope the Committee has found that literature useful as it deliberates on how to update dietary guidance for Americans on this crucial food group.

Today, I am submitting my thoughts, as an individual with long experience analyzing and communicating about these issues, on what scientifically sound, helpful seafood consumption advice might look like. I will include a biosketch in my attached materials, but in brief, I specialize in environmental health, food safety and the interactions between science and values in policymaking. I worked at Consumers Union for 25 years (I retired a decade ago), where my role was analyzing risk/benefit issues, explaining those issues to the editors of CONSUMER REPORTS, and often, communicating directly with policymakers and consumers about such topics.

I have worked, usually with teams of colleagues, to craft scientifically sound, helpful advice on fish consumption—in particular, advice to manage the risks associated with methylmercury exposure—for about 35 years. Without question, this is one of the most difficult “risk communication” tasks I have ever been involved in. Not only are both benefits and risks associated with fish consumption, but the benefits and risks of different seafood choices vary enormously; i.e., one cannot advise about “fish” generically when, for example, salmon and tuna have very different benefit/risk profiles. In order to be useful, advice must delve into details, and draw meaningful distinctions. This complexity challenges both those offering advice and those trying to use it.

Nevertheless, the public health community collectively has an enormous amount of experience now both with iteratively trying to improve seafood consumption advice, and with communicating with the public about it. A lot is known today about what kinds of advice are needed to protect public health, and what works well and not so well in getting messages across.

The 2015 Dietary Guidelines for Americans present a wonderful opportunity to take seafood consumption advice to the next level: That is, to use the best available emerging science, and the experience of the past decade or so in communicating such advice, to make this next iteration the best it can possibly be. With your indulgence, I will now share my ideas on how to do that.

Also attached here, one more relevant recent study, which is discussed in the attached Word document.

Thank you,

Edward Groth III, PhD

Affiliation: Individual/Professional Organization: Retired
Topic:
  • Food Safety
  • Lifespan Needs (Infants, Children, Pregnant Women, Older Adults, etc.)

Anonymous Comment ID #798

10/29/2014

Food will always be personal thing. No amount of science can quantify a perfect diet for everyone. A diet cannot be pigeonholed into one idea. A wide variety of fresh and wholesome food available locally constitutes a healthy food matrix from the ground up. The food pyramid that the government designs should only be a reference based on sound reasoning taking into consideration the adverse health and environmental impacts of processed food. The more we can attune to balance with nature..the sooner we can return to a cleaner world and healthier diets.

Affiliation: Individual/Professional Organization: Ms.
Topic:
  • Eating Patterns-Diets (USDA Food Patterns, DASH, Vegetarian, Low Carb, Hi-Protein, etc.)

Anonymous Comment ID #797

10/28/2014

See attached document.

Affiliation: Other Organization: National Consumers League
Topic:
  • Food Safety

Anonymous Comment ID #796

10/28/2014

Further emphasize that eating lower on the food chain can be a healthy diet-- we don't need to all be vegan, but getting Americans to feel more comfortable with flexitarian diets is key to the future of food.

Affiliation: Individual/Professional Organization: Stanford University
Topic:
  • Food Groups (Fruits, Vegetables, Grains, Dairy, Protein Foods)

Anonymous Comment ID #795

10/27/2014

Given the complexity in our food supply, defining superiority in food selection is an impossible task, and a risky one. Particularly in these stressful economic times, endorsing one food or dietary philosophy over another can be tantamount to telling parents they are giving their children inferior food. Instead of letting yourselves be bogged down by micro-managing food selection, think in broader and more inclusive terms. Support positive eating attitudes and behaviors as defined by the Satter Eating Competence Model (ecSatter).
According to research published in the Fall 2007 supplement to the Journal of Nutrition Education and Behavior, the ecSatter is being positive, comfortable and flexible with eating as well as matter-of-fact and reliable about getting enough to eat of enjoyable and nourishing food. ecSatter is predicated on the utility and effectiveness of biopsychosocial processes: hunger and the drive to survive, appetite and the need for pleasure, the social reward of sharing food, and the biological propensity to maintain preferred and stable body weight.
According to the original research and over 20 studies conducted since then, adults who score high on the Satter Eating Competence Inventory (ecSI) have nutritionally superior diets, weights that tend toward the average, and better health indicators: Activity, sleep, biological parameters.
To support eating competence, go back to supporting nutritional adequacy, and leave medical nutrition therapy to the clinical dietitians. Give basic information, then trust consumers, and the process, to bring themselves along.

Affiliation: Individual/Professional Organization: Ellyn Satter Associates
Topic:
  • Behavior

Eric Goplerud Ph.D. Comment ID #794

10/27/2014

In 2007, I led an interdisciplinary team of health services researchers, physicians, government leaders to successfully convince the American Medical Association that screening primary care patients for risky alcohol use and providing brief interventions is a medical procedure warranting separate medical procedure codes, the Common Procedure and Terminology (CPT) codes. We presented evidence that alcohol misuse is the third leading preventable cause of death in the United States. In 2001, this illness was associated with 75,000 deaths and 2.3 million years of potential life lost (30 years per premature death) (Stahre et al, 2004). Among adults in the United States, approximately 30 percent of current drinkers exceed recommended daily or weekly limits; and more than 90 percent of these excessive drinkers binge drink (Naimi et al, 2003). Among those who drink excessively, approximately 15 percent meet criteria for alcohol abuse. Approximately 10 percent of those who drink excessively are alcohol dependent (Dawson et al, 2005). Other types of alcohol misuse include any alcohol consumption among high-risk populations (e.g., pregnant women, youth) and drinking in association with certain activities (e.g., driving a motor vehicle, operating heavy equipment).
Alcohol misuse, measured as more than one drink per day for women and two drinks per day for men, and only by adults of legal drinking age, is linked to increased risk for unintentional injuries (e.g., motor vehicle crashes and falls), violence (e.g., homicide and suicide), liver disease, diseases of the central nervous system (e.g., stoke and dementia), hypertension and various cancers (e.g., breast, head and neck, stomach, colon and liver). Alcohol misuse is also associated with a variety of adverse reproductive health outcomes including unintended pregnancy, sexual assault, sexually transmitted infections (STIs), fetal alcohol spectrum disorders including fetal alcohol syndrome, low birth weight and sudden infant death syndrome. Finally, alcohol misuse often coexists with mental health problems and/or other substance abuse (NIAAA, 2000; Corrao et al, 2004; Thun et al, 1997; Naimi et al, 2003; Gladstone et al, 1996; Iyasu et al, 2002). We felt it critical that a standard drink be defined, equating distilled spirits, wine and beer.

In the years since that time, we have made great strides nationally introducing screening and brief intervention into routine medical care. The standard, internationally normed screening instruments such as the AUDIT and ASSIST specify the 2 drinks for men, 1 drink for women and equivalence between alcohol content of beer, wine and distilled spirits.

It is essential that these descriptions of moderate drinking and unhealthy drinking by maintained, and that the equivalence of a standard drinkg in the Dietary Guidelines be very clearly specified.

Affiliation: Individual/Professional Organization: George Washington University
Topic:
  • Alcoholic Beverages
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