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Dietary Guidelines for Americans, 2015

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Anonymous Comment ID #781

10/20/2014

Request 5-2

Our globalized food system is dependent on inexpensive energy to fuel the transportation of food around the world. The farms growing food are often thousands of miles away. In the United States, we have an unhealthy dependence on certain fertile regions to supply a plurality of the produce that we eat.
We must retake our food sovereignty by supporting the development of local and regional food systems. Efficient distribution infrastructure is essential for success; this is generally a weakness for many regional food systems, and deserves particular focus from external benefactors. Many institutions, including universities and hospitals, have sustainability goals. When food is involved, this typically involves a certain commitment to sourcing local products. UNC sources 16% of the food served on campus from within 250 miles; other organizations commit to sourcing up to 40% local. Currently, larger institutions are at a disadvantage because their demand often exceeds the local supply. Aggregating the supply from multiple producers solves this problem; processing partners increase the variety of products available. A collaboration between farmers, food aggregators, and value-added processors can meet the diverse needs of institutional customers, including high-volume demand.
In Michigan, Cherry Capital Foods has exemplified the success of this model. Founded in 2007, they developed partnerships with the Michigan public school system and Kroger, two influential customers that drive Cherry Capital’s $2.2 million in annual revenue. Iowa Choice Harvest demonstrates similar promise. Public policy must reflect our support of these innovations by providing the necessary funding to catalyze their spread.

Affiliation: Individual/Professional Organization: UNC Gillings School of Global Public Health
Topic:
  • Sustainability

Ndang Azang-Njaah Comment ID #780

10/19/2014

Given that greater than 50% of daily consumption of sodium, added sugars, and saturated fat consumed in the American diet is attributable to processed foods, there is greater impetus for food industry firms to modify and provide a healthier product for consumers. Efforts made by the food industry to reduce these nutrients have occurred slowly, albeit with differential levels of communication to health professionals and to the public about how such changes are occurring. While making the transition to a healthier product by food industry firms introduces valid concerns related to increased costs of input, loss of the quality and consistency of a food product, or loss consumer loyalty, many food industry firms have made a successful transition in their efforts to provide a healthier product for consumers.
There have been notable initiatives to reduce the sodium content of foods over the past decade, as the relationship between sodium and cardiovascular disease has been reinforced through scientific literature. One notable initiative, the National Salt Reduction Initiative (NSRI), which is a public-private partnership headed by the NYC Dept. of Public Health established in 2008, has set voluntary targets to reduce the sodium content in packaged and restaurant foods by 25% in over the next 5 years. As firms sign on to the initiative, they pledge for the overall sales for a given food to meet the relevant target for salt content. Currently, over 20 organizations have signed on to the initiative thus far, including food industry firms, Kraft Foods, Butterball, and Heinz. Replacing salt provides notable challenges. Some firms have addressed this concern by substituting salt with herbs and spices, or employing a variety of cooking techniques, like roasting or stewing to retain a concentrated flavor. Other firms have replaced sodium chloride, with potassium chloride, and a various combination of additional ingredients: yeast extracts, monosodium glutamate, umami, vinegar, in order to preserve the integrity of the properties originally attributable to salt.
As reduced sodium products introduced, the publicity of these foods has had a marked difference regarding the audience of choice. Though many firms display their commitment to sodium reduction on their websites, the message provided to consumers is varied. For instance, some messages may display the percentage reduction in sodium, provide a reference to the degree of saltiness, or note the substitutions for more herbs and spices within the product. Other firms have remained mum on reductions and have opted to introduce their lesser sodium food items, without any mention to the change. News reports have documented that firms such as Kraft, who has publicly agreed to the NSRI initiative and promoted a commitment to sodium reduction on their organizational site have remained silent in the most visible manner to consumers- the actual product label. This differential silence to consumers by firms may reflect a general fear of firms that increased publicity of lower sodium foods may lead to a drop in product loyalty and a loss of profit.
There appears to be greater ownership of food products created by firms that reduce added sugars and fats. Firms such as Nestlé have embraced new technologies in product innovation such as ‘slow churning’ ice cream as a method to provide their ice cream brands with half the fat, one third of the calories, while being able to maintain profit margins equivalent to their basic ice cream products. Several firms have also launched a line of “Better For You” products that provide a food that is lower in fats, added sugars, and sodium. Indeed this product line has received noted publicity not only for the formulation of a ‘healthier’ product, but also for the ability for larger firms to produce such a product at an affordable price to consumers en masse.
The call to reduce the content of fats, added sugars, and sodium content in foods is an important initiative that needs to continue in order to address the growing prevalence of chronic disease and in particular its treatment and management. This effort, however, needs to be bolstered by a stronger commitment by firms to communicate to consumers the benefits of choosing a healthier food option if it is truly ‘better for you’. The notable silence on the presence of reduced sodium products by firms to consumers highlights the tension addressing the concerns of consumers, whose goal is optimizing health, and firms, whose goal is to maximize profits. We have already seen evidence that the modified products can raise a profit. It will take time to discern how the consumer’s health behavior and outcomes will change. For the time being I will remain cautiously optimistic.

Affiliation: Individual/Professional Organization: UNC Gillings School of Global Public Health
Topic:
  • Food industry approaches to reducing sodium, added sugars, and fats

Anonymous Comment ID #779

10/18/2014

I am concerned with the phrase "Heart Healthy" and other similar terms used to indicate that the particular food item, cookbook, food label, etc. is healthy for people with heart disease. A great deal of food items, cookbooks, and literature make a claim that the product being promoted is "Heart Healthy". But is it really "Heart Healthy"?
A great number of "Heart Healthy" foods and cookbooks contain a significant amount more sodium per serving than many people with heart disease should be eating in their diet per day.
I think this term can be deceiving to the public. Sodium content needs to be considered while recommending foods that are "Heart Healthy".

Affiliation: Individual/Professional Organization: None
Topic:
  • Food Environment

Anonymous Comment ID #778

10/18/2014

Processed foods contribute "nutrients to encourage" and "constituents to limit" to the American diet. Processing foods yields items with longer shelf lives, but can also create items that are high in sodium, added sugars and fats and very energy dense. The creation of highly processed foods can also have unintended consequences- I'm thinking here of low-fat foods that have higher carbohydrate content in order to create a more palatable lower calorie food, which can leave consumers hungrier after consumption than if the fat was just left in the food. Granted, high saturated fat is a constituent to limit, but so is the addition of sugar. Additionally, just because a food has “no sugar added” doesn’t mean that the caloric content differs drastically from a normal food item, nor does it mean that the food is actually healthier or a better choice, especially if consumed in high quantities.

That being said, I think that the food industry does need to limit the addition of fats and sugars to items to increase their palatability into foods that could not be created at home or in a restaurant without the addition of some complicated food component manipulation. I feel that companies have begun to do this in regards to sodium intake, other commenters have discussed the gradual reduction in sodium intake that some soup companies have begun. I also think there also needs to be a focus on not demonizing different food groups and instead having a discussion about the benefits of having some naturally higher fat foods or foods naturally higher in sugars. I don't want to eat a low-fat avocado or almond, nor do I want to have a low-carb apple or banana, and although that’s a very over-simplified example, I feel that it applies to the greater scheme of processing our foods to reduce “bad” components and increase “good” components.

Affiliation: Other Organization: University of North Carolina
Topic:
  • Food industry approaches to reducing sodium, added sugars, and fats

Anonymous Comment ID #777

10/17/2014

Please see the attached comments submitted on behalf of the American Meat Institute and North American Meat Association.

Affiliation: Industry/Industry Association Organization: American Meat Institute/North American Meat Association
Topic:
  • Sustainability

Anonymous Comment ID #776

10/17/2014

As a consumer, I have never understood the rationale of considering white potatoes in the 'vegetable' group. And I have yet to meet anyone who thinks of potatoes as a vegetable in meal-planning. I usually think about whether to have potatoes or rice or pasta, not whether to have potatoes or broccoli. Many restaurants appear to do it that way, also - the baked potato is typically offered as a substitute for rice, and served with a vegetable.

Just as the concept of potato as a vegetable does not register with me at all, I wonder how many consumers ignore the dietary guidelines because they feel the advice is irrelevant to the way they plan and think about food groups. And is a meal of potatoes, rice, and meat loaf really consistent with dietary recommendations?

It might be useful to spend some time thinking about how consumers think about, and use potatoes. Tomatoes are technically a fruit, but eaten as a vegetable -- and included as a vegetable in the Dietary Guidelines and meal patterns. Why not do the same with potatoes, and classify them in a manner consistent with reality?

As I understand it, from a recent presentation I attended, the resistant starch in potatoes basically function as dietary fiber. So it might make sense to move potatoes to another group, and expand the concept of 'grains' to something a little more general that would include potatoes (for ex., 'carbs'). This would automatically reduce the recommendations for vegetable consumption, and would allow the education to focus on the importance of consuming other vegetables, such as the dark-green and red/orange vegetables.

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

Anonymous Comment ID #775

10/13/2014

In many reduced fat and fat free food products the fat that has been removed is replaced by simple carbohydrates. If an individual consumes a high quantity of these products, they may be ingesting excess carbohydrates as a result, which the body will most likely end up storing as fat in the body, negating some of the positive health affects associated with diets that are lower in saturated and trans fats.

In many sugar-free or no-sugar added products, sugar alcohols are used in place of sugar. Consumed in high enough quantities, these sugar alcohols can have adverse effects on the people that consume these, which include bloating, diarrhea and laxative effects. Many sugar-alcohols can contain a lot of carbohydrates, and excess consumption of carbohydrates can contribute to weight gain, which can have negative implications on one’s health.

In a course I took regarding food policy while obtaining my MPH in Nutrition, I learned that some soup companies are decreasing the sodium content of the majority of their soups, but not advertising the fact that they are in hopes that they will receive less push-back from consumers. Many consumers associate foods that carry/advertise the “low-sodium” choice label with foods that are bland and/or unappetizing. In an effort to try and not lose any potential customers who would be put off by this label, these soup companies opted to decrease the overall sodium content of most of their soups, while also offering soups that carried this label to cater to the more “health conscious” consumers. I think that this is a great example of how a company can help to improve the health of the individuals that use their products.

Due to the fact that many of the lower fat and sugar products being produced have increased amounts of nutrients and ingredients that can have adverse effects on the health of the individuals who consume them, I agree with Mr. Ruff and his advise to the Committee to focus less on reducing the intake of specific nutrients and instead focus what to consume more of.

Affiliation: Individual/Professional Organization:
Topic:
  • Food industry approaches to reducing sodium, added sugars, and fats

Anonymous Comment ID #774

10/11/2014

The National Restaurant Association appreciates the opportunity to provide comments to the committee regarding research related to restaurants. We would like to highlight a few key points based on the discussion on “eating out” from subcommittee three during the fifth meeting of the committee. Research has indicated that the location where foods are obtained may not be as important as the nutritional quality of foods consumed. Restaurants continue to evolve their menu and offer many choices that are consistent with the 2010 Dietary Guidelines recommendations. Since the 2010 Dietary Guidelines were released, many restaurants of all types have added and are promoting healthier options to on their adult menus. Many restaurant chains are participating in broad programs, such as the National Restaurant Association’s, Kids LiveWell program which identifies children’s meals that meet established stringent nutritional criteria, as noted by one of your committee members. A recent scientific publication verifies this point.1 Bleich et al., 2014 analyzed national-level data from 2012 to 2013 from 66 leading U.S. chain restaurants about caloric content of menu items. The authors found an overall decline in calories in newly introduced menu items (-56 calories, 12% decline). These declines were concentrated mainly in new main course items (-67 calories, 10% decline), new beverage (-26 calories, 8% decline) and children’s items (-46 calories, 20% decline).
Attached are our comments. Thank you for the opportunity to provide comments regarding the 2015 Dietary Guidelines for Americans development process and discussion. We look forward to continuing our participation in this process.

Affiliation: Industry/Industry Association Organization: National Restaurant Association
Topic:
  • Food Environment
  • Other

Brian Weiner MD, MS Comment ID #773

10/11/2014

I wanted to bring to your attention a systematic error in your food labeling and calorie calculations for frozen foods [foods meant to be eating as frozen, such as Italian style ices].

Italian style ices sold at the supermarket are commonly sold in 6 ounce cups. These cups characteristically list their calorie content as 100 calories. That number is calculated by knowing the number of grams of carbohydrate in the container, multiplied by the known calories per gram. The error that I have identified is that this calorie list does not calculate or include the energy required to melt the ice. After spending some time reviewing the Internet, the medical and clinical dietary literature, I found that no one has clearly identified this oversight. I could not locate references to considerations of the implications of the energy content of ice as food.

I wrote up this observation, and the editors of the Annals of Internal Medicine were kind enough to publish this in a letter to the editor, in their August 17, 2010 edition [Weiner BC, Weiner AC. Ann Intern Med. The Ice Diet. 2010;153[4]:279]. The Annals is published by the American College of Physicians.

I believe that this observation may have significant importance to persons trying to lose weight.

Up until August 17, 2010, if you wanted to lose weight, you needed to: 1. comply with a calorie deficient diet; 2. increase your level of exercise; or, 3. both. With regard to calorie deficient diets, there are many proposed strategies of modulating the diet, several active drugs and several surgical procedures. Some weight loss drugs act to increase the basal metabolic rate and increase the burning of calories. These drugs are controversial, because of concerns about side effects and addiction.

I have developed a concept, The Ice Diet, as a proposed new weight loss treatment choice with a unique mechanism. It exploits this error in the calculation of calorie content of frozen foods. The Ice Diet works by increasing the basal metabolic rate. When ingesting clinically significant amounts of ice, the body must burn energy to warm the ice to body temperature. The ingestion of ice would also be expected to provide some level of satiety. The ingestion of 1 liter of ice [equals 1.06 quart] would burn about 160 calories, the amount of energy used in running one mile. Ingesting ice at this level should not have any obvious adverse consequence in otherwise healthy persons.

By the way, in the case of the six ounce cup of ices, noted to have 100 calories on the label, you are actually only consuming 72 calories or icals [“Icals” are my term for the corrected caloric content of an ice containing food product, adjusted for the energy required to melt the ice].

In other words, it is my contention that Ice is the only negative calorie food! The more you eat, the more you lose!

I have released a free e-book about this concept, available at http://www.theicediet.com. Because of this release, the Ice Diet has recently received some media “buzz”. An article was published in the Atlantic magazine about the topic: http://www.theatlantic.com/health/archive/2014/05/the-ice-diet/371614/. Since then, I have had an on-air interview with National Public Radio. The article was picked up by MPR-Monthly Prescribing Reference. There have been articles in the Toronto Sun and other international media. I have been interviewed by news media in the UK and as far away as Santiago, Chile. Fox News has invited me to be their “Expert of the Day”, to discuss the concept on their radio network. I have received requests for my E book from all over the United States, North America, South America, Europe, Asia. It is my impression that this wide media interest is indicative of the importance of this finding to the general public. New, easy to apply, techniques for the management of obesity are needed and demanded by the populous. I invite you to go to my website and download a copy for yourself.

I have attached copies of typical nutritional levels associated with the above snack ice example, before and after proposed correction. The correction for the energy required to note the ice is significant in this case, approximately 30%!

I would appreciate your opinion on my observation. Also, how would you envision notifying consumers of this observation and the correction for the energy required to melt ice?

Affiliation: Individual/Professional Organization: Marlboro Gastroenterology PC
Topic:
  • Energy Balance (Weight Loss, Weight Maintenance, Calorie Intake, Physical Activity)

Leon Bruner DVM, PhD Comment ID #772

10/10/2014

The Grocery Manufacturers Association (GMA) respectfully submits comments to the U.S. Department of Health and Human Services and the U.S. Department of Agriculture for consideration by the 2015 Dietary Guidelines Advisory Committee. The attached comments provide recommendations for additional invited experts for consideration by the Added Sugars Working Group. Thank you for the opportunity to provide comments. GMA looks forward to regularly participating in the 2015 DGA development process through written comments.

Affiliation: Industry/Industry Association Organization: Grocery Manufacturers Association
Topic:
  • Carbohydrates (Added Sugars, Fiber, Glycemic Index, Whole Grains)
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