Scientific Report of the 2015 Dietary Guidelines Advisory Committee

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Appendix E-6: History of Dietary Guidance Development in the United States and the Dietary Guidelines for Americans

In early 1977, after years of discussion, scientific review, and debate, the U.S. Senate Select Committee on Nutrition and Human Needs, led by Senator George McGovern, recommended Dietary Goals for the American people (U.S. Senate Select Committee, 1977). The Goals consisted of complementary nutrient-based and food-based recommendations. The first Goal focused on energy balance and recommended that, to avoid overweight, Americans should consume only as much energy as they expended. Overweight Americans should consume less energy and expend more energy. For the nutrient-based Goals, the Senate Committee recommended that Americans:

  • Increase consumption of complex carbohydrates and “naturally occurring sugars;” and
  • Reduce consumption of refined and processed sugars, total fat, saturated fat, cholesterol, and sodium.
  • For the food-based Goals, the Senate Committee recommended that Americans:
  • Increase consumption of fruits, vegetables, and whole grains;
  • Decrease consumption of:
    • refined and processed sugars and foods high in such sugars;
    • foods high in total fat and animal fat, and partially replace saturated fats with polyunsaturated fats;
    • eggs, butterfat, and other high-cholesterol foods;
    • salt and foods high in salt; and
  • Choose low-fat and non-fat dairy products instead of high-fat dairy products (except for young children).

The Dietary Goals was met with considerable debate and controversy, as industry groups and the scientific community expressed doubt that the science available at the time supported the specificity of the numbers provided in the Dietary Goals. To support the credibility of the science used by the Senate Committee, the U.S. Department of Agriculture and U.S. Department of Health and Human Services (then called the Department of Health, Education, and Welfare) selected scientists from the two Departments and obtained additional expertise from the scientific community throughout the country to address the public’s need for authoritative and consistent guidance on diet and health.

In February 1980, the two Departments collaboratively issued Nutrition and Your Health: Dietary Guidelines for Americans, a brochure that, in describing seven principles for a healthful diet, provided assistance for healthy people in making daily food choices (USDA/HHS, 1980). These Guidelines were based, in part, on the 1979 Surgeon General’s Report on Health Promotion and Disease Prevention (DHEW/PHS, 1979) and reflected findings from a study on the relationship between dietary practices and health outcomes (ASCN, 1979). Ideas for incorporating a variety of foods to provide essential nutrients while maintaining recommended body weight were a focus. The brochure also provided guidance on limiting dietary components such as fat, saturated fat, cholesterol, and sodium, which were beginning to be considered risk factors in certain chronic diseases. Both the Dietary Goals and the first Dietary Guidelines for Americans were different from previous dietary guidance in that they reflected emerging scientific evidence and changed the historical focus on nutrient adequacy to also identify the impacts of diet on chronic disease. These documents discussed the concepts of moderation as well as nutrient adequacy.

Even though the recommendations of the 1980 Dietary Guidelines for Americans were presented as innocuous and straightforward extrapolations from the science base, they, too, were met with controversy from a variety of industry and scientific groups.

The debate about the 1980 Dietary Guidelines for Americans led to Congressional report language that directed the two Departments to convene an advisory committee that would ensure that outside advice, both formal and informal, was captured in developing future editions of the Dietary Guidelines. A Dietary Guidelines Advisory Committee composed of scientific experts outside the Federal sector was established shortly after that directive and was very helpful in the development of the 1985 Nutrition and Your Health: Dietary Guidelines for Americans (USDA/HHS, 1985). The Departments made relatively few changes from the first edition, but this second edition was issued with much less debate from either industry or the scientific community. The 1985 Dietary Guidelines were widely accepted and were used as the framework for consumer nutrition education messages. They also were used as a guide for healthy diets by scientific, consumer, and industry groups.

In 1989, USDA and HHS established a second scientific advisory committee to review the 1985 Dietary Guidelines and make recommendations for revision. The basic tenets of earlier Dietary Guidelines were reaffirmed, and the 1990 Nutrition and Your Health: Dietary Guidelines for Americans (USDA/HHS, 1990) promoted enjoyable and healthful eating through variety and moderation, rather than dietary restriction. For the first time, the Guidelines also suggested quantitative goals for total fat and saturated fat, though they stressed that the goals were to be met through dietary choices made over several days, not through choices about one meal or one food.

The 1980, 1985, and 1990 editions of the Dietary Guidelines were issued voluntarily by the two Departments. With the passage of the 1990 National Nutrition Monitoring and Related Research Act (Section 301 of Public Law 101-445, 7 USC 5341, Title III) (US Congress, 1990), the 1995 edition of Nutrition and Your Health: Dietary Guidelines for Americans became the first Dietary Guidelines policy document mandated by statute. This Act directed the Secretaries of USDA and HHS to jointly issue at least every 5 years a report entitled Dietary Guidelines for Americans.

A Dietary Guidelines Advisory Committee was established to prepare technical reports that advised the Federal government on the status of the evidence on nutrition and health. These technical reports were used  in developing the 1995, 2000, 2005, and 2010 versions of the Dietary Guidelines for Americans (HHS/USDA, 1995a; HHS/USDA, 1995b; USDA/HHS, 2000a; USDA/HHS, 2000b; HHS/USDA, 2004; HHS/USDA, 2005a; USDA/HHS, 2010; USDA/HHS, 2011). This report of the 2015 Dietary Guidelines Advisory Committee will serve a similar purpose for HHS and USDA as the Departments develop the 2015 edition of Dietary Guidelines for Americans.

Since 1980, the Dietary Guidelines have been notably consistent in their recommendations on the components of a healthful diet, but they also have changed in some significant ways to reflect emerging science as well as public health concerns, such as the increasing prevalence of major chronic diseases among the majority of the general population. In keeping with growing emphasis on data quality in developing recommendations, the 2005 Committee used a modified systematic approach for reviewing the scientific literature. This systematic review of the evidence was further realized for the 2010 Dietary Guidelines Advisory Committee with the establishment of the USDA’s Nutrition Evidence Library, a process that uses state-of-the-art methodology to search, evaluate, and synthesize food and nutrition-related research. This rigorous, protocol-driven methodology is designed to minimize bias, maximize transparency, and ensure relevant, timely, and high-quality systematic reviews to inform Federal nutrition-related policies, programs, and recommendations. (See Part C: Methodology for a brief description of the systematic evidence review process used by the 2015 Dietary Guidelines Advisory Committee and www.NEL.gov for additional information about the Nutrition Evidence Library.)

Over the past two decades, Nutrition and Your Health: Dietary Guidelines for Americans has evolved to become a broadly accepted, science-based document that serves as the Federal nutrition policy on which nutrition standards, nutrition programs, and nutrition education are based. The Dietary Guidelines have proven to be a mechanism for addressing public health concerns by providing focused guidance that can help to promote health and reduce chronic disease risk. As such, while earlier editions of the Dietary Guidelines focused specifically on healthy Americans ages 2 years and older, more recent editions also have included those who are at increased risk of chronic disease. The Dietary Guidelines, however, are not directly intended for disease treatment, but they can be used as a basis for developing clinical guidelines.

Future editions of the Dietary Guidelines will continue to evolve to address public health concerns and the nutrition needs of specific populations. For example, a Federal initiative has been established to develop comprehensive guidance for infants and toddlers from birth to 24 months and women who are pregnant so that by 2020, the Dietary Guidelines will also include these important populations comprehensively. For now, nutrition and health professionals actively promote the Dietary Guidelines as a means of encouraging Americans to focus on eating a healthful diet and being physically active throughout the entire lifespan.

History of Dietary Guidance Development in the United States and the Dietary Guidelines for Americans – A Chronology

1977

Dietary Goals for the United States (the “McGovern Report”) was issued by the U.S. Senate Select Committee on Nutrition and Human Needs (U.S. Senate Select Committee, 1977). The Dietary Goals reflected a shift in focus from obtaining adequate nutrients to avoiding excessive intake of food components linked to chronic disease. These goals were controversial among some nutritionists and others concerned with food, nutrition, and health.

1979

The American Society for Clinical Nutrition formed a panel to study the relationship between dietary practices and health outcomes (ASCN, 1979). The findings, presented in 1979, were reflected in Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention (DHEW/PHS, 1979).

1980

Seven principles for a healthful diet were jointly issued by the then U.S. Department of Health, Education, and Welfare (now HHS) and the U.S. Department of Agriculture (USDA) in response to the public's desire for authoritative, consistent guidelines on diet and health. These principles became the first edition of Nutrition and Your Health: Dietary Guidelines for Americans (USDA/HHS, 1980). The 1980 Guidelines were based on the most up-to-date information available at the time and were directed to healthy Americans ages 2 and older. The Guidelines generated some concern among consumer, commodity, and food industry groups, as well as some nutrition scientists, who questioned the causal relationship between certain guidelines and health.

1980

A U.S. Senate Committee on Appropriations report directed that an external advisory committee be established to review scientific evidence and recommend revisions to the 1980 Nutrition and Your Health: Dietary Guidelines for Americans (U.S. Senate, 1980).

1983

An external Federal advisory committee of nine nutrition scientists was convened to review and make recommendations in a report to the Secretaries of USDA and HHS about the first (1980) edition of the Dietary Guidelines (USDA/HHS, 1985a).

1985

USDA and HHS jointly issued the second edition of Nutrition and Your Health: Dietary Guidelines for Americans (USDA/HHS, 1985b). This edition was nearly identical to the first, retaining the seven guidelines from the 1980 edition. Some changes were made for clarity, while others reflected advances in scientific knowledge of the associations between diet and chronic diseases. The second edition received wide acceptance and was used as the basis for dietary guidance for the general public as well as a framework for developing consumer education messages.

1987

Language in the Conference Report of the House Committee on Appropriations indicated that USDA, in conjunction with HHS, “shall reestablish a Dietary Guidelines Advisory Group on a periodic basis. This Advisory Group will review the scientific data relevant to nutritional guidance and make recommendations on appropriate changes to the Secretaries of the Departments of Agriculture and Health and Human Services” (U.S. House of Representatives, 1987).

1989

USDA and HHS established a second Federal advisory committee of nine members, which considered whether revisions to the 1985 Dietary Guidelines were needed and made recommendations for revision in a report to the Secretaries (USDA/HHS, 1990a). The 1988 Surgeon General's Report on Nutrition and Health (HHS/PHS, 1988) and the 1989 National Research Council’s report Diet and Health: Implications for Reducing Chronic Disease Risk were key resources used by the Committee (NAS/NRC, 1989).

1990

USDA and HHS jointly released the third edition of Nutrition and Your Health: Dietary Guidelines for Americans (USDA/HHS, 1990b). The basic tenets of the 1985 Dietary Guidelines were reaffirmed, with additional refinements made to reflect increased understanding of the science of nutrition and how best to communicate the science to consumers. The language of the new Dietary Guidelines was positive, was oriented toward the total diet, and provided specific information regarding food selection. For the first time, quantitative recommendations were made for intakes of dietary total fat and saturated fat.

1990

The 1990 National Nutrition Monitoring and Related Research Act (Section 301 of Public Law 101-445, 7 USC 5341, Title III) directed the Secretaries of the USDA and HHS to jointly issue at least every 5 years a report entitled Dietary Guidelines for Americans (U.S. Congress, 1990). This legislation also required USDA and HHS to review all Federal publications containing dietary advice for the general public.

1993

HHS initiated a charter establishing the 1995 Dietary Guidelines Advisory Committee.

1994

An 11-member Dietary Guidelines Advisory Committee was appointed by the Secretaries of HHS and USDA to review the third edition of the Dietary Guidelines and determine whether changes were needed. If so, the Committee was to recommend suggestions and the rationale for any revisions.

1995

The report of the Dietary Guidelines Advisory Committee to the Secretaries of HHS and USDA was published (HHS/USDA, 1995a).

1995

Using the 1995 report of the Dietary Guidelines Advisory Committee as the foundation, HHS and USDA jointly developed and released the fourth edition of Nutrition and Your Health: Dietary Guidelines for Americans (HHS/USDA, 1995b). This edition continued to support the concepts from earlier editions. New information included the Food Guide Pyramid, Nutrition Facts label, boxes highlighting good food sources of key nutrients, and a chart illustrating three weight ranges in relation to height.

1997

USDA initiated the charter establishing the 2000 Dietary Guidelines Advisory Committee.

1998

An 11-member Dietary Guidelines Advisory Committee was appointed by the Secretaries of USDA and HHS to review the fourth edition of the Dietary Guidelines to determine whether changes were needed and, if so, to recommend suggestions for revision.

2000

The Committee submitted its report to the Secretaries of USDA and HHS (USDA/HHS, 2000a). This report contained the proposed text for the fifth edition of Nutrition and Your Health: Dietary Guidelines for Americans.

2000

The President of the United States spoke of the Dietary Guidelines in his radio address after USDA and HHS jointly issued the fifth edition of Nutrition and Your Health: Dietary Guidelines for Americans earlier in the day (USDA/HHS, 2000b). Earlier versions of the Guidelines included seven statements. This version included 10—created by breaking out physical activity from the weight guideline, splitting the grains and fruits/vegetables recommendations for greater emphasis, and adding a new guideline on safe food handling.

2003

HHS initiated the charter establishing the 2005 Dietary Guidelines Advisory Committee.

2003

A 13-member Dietary Guidelines Advisory Committee was appointed by the Secretaries of HHS and USDA to review the fifth edition of the Dietary Guidelines to determine whether changes were needed and, if so, to recommend suggestions for revision.

2003-2004

In keeping with renewed emphasis on data quality, the Committee used a modified “systematic approach” to review the scientific literature and develop its recommendations. Committee members initially posed approximately 40 specific research questions that were answered using an extensive search and review of the scientific literature. Issues relating diet and physical activity to health promotion and chronic disease prevention were included in the Committee’s evidence review. Other major sources of evidence used were the Dietary Reference Intake (DRI) reports prepared by expert committees convened by the Institute of Medicine (IOM) as well as various Agency for Healthcare Research and Quality (AHRQ) and World Health Organization (WHO) reports. In addition, USDA completed numerous food intake pattern modeling analyses and the Committee analyzed various national data sets and sought advice from invited experts.

2004

The Committee submitted its technical report to the Secretaries of HHS and USDA (HHS/USDA, 2004). This 364-page report contained a detailed analysis of the science and was accompanied by many pages of evidence-based tables that were made available electronically. After dropping some questions because of incomplete or inconclusive data, the Committee wrote conclusions and comprehensive rationales for 34 of the 40 original questions.

2005

Using the Committee’s technical report as a basis, HHS and USDA jointly prepared and issued the sixth edition of Dietary Guidelines for Americans in January 2005 (HHS/USDA, 2005a). This 80-page policy document was the first time the Departments prepared a policy document that was intended primarily for use by policy makers, healthcare professionals, nutritionists, and nutrition educators. The content of this document included nine major Dietary Guidelines messages that resulted in 41 Key Recommendations, of which 23 were for the U.S. population overall and 18 for specific population groups. The policy document highlighted the USDA Food Guide and the DASH Eating Plan as two examples of eating patterns that exemplify the Dietary Guidelines recommendations. A companion, 10-page brochure called Finding Your Way to a Healthier You (HHS/USDA, 2005b) was released concurrently with the Dietary Guidelines to provide advice to consumers about food choices that promote health and decrease the risk of chronic disease. Shortly thereafter, USDA released the MyPyramid Food Guidance System, an update of the Food Guide Pyramid, which included more detailed advice for consumers to help them follow the Dietary Guidelines.

2008

USDA initiated the charter establishing the 2010 Dietary Guidelines Advisory Committee.

2008

A 13-member Dietary Guidelines Advisory Committee was appointed by the Secretaries of USDA and HHS to review the sixth edition of Dietary Guidelines for Americans to determine whether changes were needed and, if so, to recommend suggestions for revision.

2008-2009

USDA’s Center for Nutrition Policy and Promotion established the Nutrition Evidence Library (NEL) to conduct systematic reviews to help inform Federal nutrition policy and programs. The NEL supported the Dietary Guidelines Advisory Committee in answering approximately 130 of the total 180 diet and health-related questions posed. This was the most rigorous and comprehensive approach used to date for reviewing the science in order to develop nutrition-related recommendations for the public. Other sources of evidence for answering scientific questions included modeling analyses of USDA’s Food Patterns, review of reports from various data analyses, as well as other available authoritative reports (e.g., 2005 DGAC Report and IOM reports). An elaborate web-based public comments database was developed and provided a successful mechanism for the public to provide comments and thereby participate in the Committee’s evidence review process. The database also allowed the public to read other comments that were submitted. This database eventually included more than 800 public comments related to the DGAC process.

2010

The Committee submitted its technical report to the Secretaries of USDA and HHS (USDA/HHS 2010). This 445-page report contained a detailed analysis of the science and was accompanied by additional 230 pages of food pattern modeling appendices made available electronically at www.DietaryGuidelines.gov.

2011

Using the Committee’s technical report as the basis, HHS and USDA jointly prepared and published the seventh edition of Dietary Guidelines for Americans released publically in January 2011 (USDA/HHS, 2011). The 95-page policy document encompassed the overarching concepts of maintaining calorie balance over time to achieve and sustain a healthy weight, and consuming nutrient-dense foods and beverages. The policy document included 23 key recommendations for the general population and six additional key recommendations for specific populations. To assist individuals to build a healthy diet based on the Dietary Guidelines, the USDA Food Patterns were updated and new vegetarian adaptations were included. The DASH Eating Plan also was included as an example of a healthy dietary pattern. This publication will serve as the basis for Federal nutrition policy until the next policy document is released in 2015. In June, USDA released MyPlate, a new visual icon, and the ChooseMyPlate.gov website that provides tools to help consumers of all ages, educators, and health professionals learn about and follow the Dietary Guidelines.

2013

HHS initiated the charter establishing the 2015 Dietary Guidelines Advisory Committee.

2013

A 15-member Dietary Guidelines Advisory Committee was appointed by the Secretaries of USDA and HHS to review the seventh edition of Dietary Guidelines for Americans and recommend suggestions for revision. One member resigned due to professional obligations within the first three months after appointment; 14 members served the remainder of the two-year charter. The Committee also added three consultant subcommittee members during its work to address specific issues; these members participated in discussions and decision at the subcommittee level but were not members of the full Committee.

2015

The Committee submitted this technical report to the Secretaries of USDA and HHS in January 2015. This 580-page report contained a detailed analysis of the science and was accompanied by substantial documentation of the process made available electronically at www.DietaryGuidelines.gov and www.NEL.gov.


References

American Society for Clinical Nutrition (ASCN). Symposium. Report of the Task Force on the evidence relating six dietary factors to the nation’s health. Am J Clin Nutr. 1979;32(Supplement):2621-748.

Murphy S. Development of the MyPyramid Food Guidance System. J Nutr Educ Behav. 2006;38(6S):S77-S162.

National Academy of Science, National Research Council (NAS, NRC). Diet and Health: Implications for Reducing Chronic Disease Risk. Washington (DC): National Academy Press, 1989.

U.S. Congress. National Nutrition Monitoring and Related Research Act of 1990, Public Law 445, 101st Cong., 2nd Session, Section 301, 7 USC 5341, October 22, 1990.

U.S. Department of Agriculture and U.S. Department of Health and Human Services (USDA/HHS). Nutrition and Your Health: Dietary Guidelines for Americans. 1st edition. Washington (DC): USDA/HHS, 1980. Home and Garden Bulletin No. 232.

U.S. Department of Agriculture and U.S. Department of Health and Human Services (USDA/HHS). Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 1985. Washington (DC): USDA, Human Nutrition Information Service, 1985a.

U.S. Department of Agriculture and U.S. Department of Health and Human Services (USDA/HHS). Nutrition and Your Health: Dietary Guidelines for Americans. 2nd edition. Washington (DC): USDA/HHS, 1985b. Home and Garden Bulletin No. 232.

U.S. Department of Agriculture and U.S. Department of Health and Human Services (USDA/HHS). Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 1990. Washington (DC): USDA, Human Nutrition Information Service, 1990a.

U.S. Department of Agriculture and U.S. Department of Health and Human Services (USDA/HHS). Nutrition and Your Health: Dietary Guidelines for Americans. 3rd edition. Washington (DC): USDA/HHS, 1990b. Home and Garden Bulletin No. 232.

U.S. Department of Agriculture and U.S. Department of Health and Human Services (USDA/HHS). Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2000. Washington (DC): USDA, Agricultural Research Service, 2000a.

U.S. Department of Agriculture and U.S. Department of Health and Human Services (USDA/HHS). Nutrition and Your Health: Dietary Guidelines for Americans. 5th edition. Washington (DC): USDA/HHS, 2000b. Home and Garden Bulletin No. 232.

U.S. Department of Agriculture and U.S. Department of Health and Human Services (USDA/HHS). Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010. Washington (DC): USDA, Agricultural Research Service, 2010.

U.S. Department of Agriculture and U.S. Department of Health and Human Services (USDA/HHS). Dietary Guidelines for Americans. 7th edition. Washington (DC): U.S. Government Printing Office, 2011.

U.S. Department of Health and Human Services and U.S. Department of Agriculture (HHS/USDA). Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 1995. Washington (DC): USDA, Agricultural Research Service, 1995a.

U.S. Department of Health and Human Services and U.S. Department of Agriculture (HHS/USDA). Nutrition and Your Health: Dietary Guidelines for Americans. 4th edition. Home and Garden Bulletin No. 232. Washington (DC): HHS/USDA, 1995b.

U.S. Department of Health and Human Services and U.S. Department of Agriculture (HHS/USDA). Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2005. Washington (DC): USDA, Agricultural Research Service, 2004.

U.S. Department of Health and Human Services and U.S. Department of Agriculture (HHS/USDA). Dietary Guidelines for Americans. 6th edition. Washington (DC): U.S. Government Printing Office, 2005a.

U.S. Department of Health and Human Services and U.S. Department of Agriculture (HHS/USDA). Finding Your Way to a Healthier You. Washington (DC): U.S. Government Printing Office, 2005b. HHS-ODPHP-205-01-DGA-A; USDA Home and Garden Bulletin No. 232.

U.S. Department of Health and Human Services, Public Health Service (HHS, PHS). The Surgeon General's Report on Nutrition and Health. Washington (DC): DHHS, PHS, 1988. Publication No. 88-50215.

U.S. Department of Health, Education, and Welfare, Public Health Service (DHEW, PHS). Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention. Washington (DC): DHEW, PHS, 1979. DHEW Publication No. 79-55071.

U.S. House of Representatives Conference Committee (U.S. House of Representatives). 100th Cong., 1st sess., H. Rep. 498, 1987.

U.S. Senate Agricultural Appropriations Committee (U.S. Senate). 96th Cong., 1st sess., S. Rep. 1030, 1980.

U.S. Senate Select Committee on Nutrition and Human Needs. Dietary Goals for the United States. 2nd edition. Washington (DC): U.S. Government Printing Office, 1977.