June 28 - 29, 2007 Advisory Committee Meeting Minutes

Process of the Dietary Guidelines Advisory Committee

Dr. Pate, a member of the 2005 Dietary Guidelines Advisory Committee, was asked to give an overview of the working process employed by the Dietary Guidelines Advisory Committee.

Dr. Pate outlined his overview as a summary of the overall process, comments on the physical activity component of the Dietary Guidelines, a review of some of the conclusive statements from the Guidelines and comments on the food guidance system that resulted from the process.

The Dietary Guidelines have been an important government function since 1980 with a revision cycle every 5 years. Physical Activity was not really included in the process until 2005, although was alluded to in earlier iterations. The 2005 Committee was charged with updating the earlier set of Guidelines and not to start from scratch. The Guidelines provide science-based advice for people ages 2 and up in areas related to health promotion and prevention of chronic disease. From a policy perspective they provide the government a vehicle in which to speak with a unified voice providing advice to "consumers" and impacting certain federal programs and policies.

The 2005 Dietary Guidelines process was focused initially on the formation of an Advisory Committee, organized into sub-committees, which submitted a report to the Department of Health and Human Services and the Department of Agriculture. The Committee was encouraged to be evidence based in the approaches that were taken and the process was very time-limited and open to the public. Once the report was submitted the Committee's work was over.

Early deliberations of the Committee produced a set of research questions thought to have significance for nutrition guidance and policy. There was then a preliminary review of peer-reviewed literature, a reconsideration of some of those questions, some of which dropped off the list based on lack of evidence in which to make a recommendation. High priority was given to randomized clinical trials but observational studies were given a great deal of consideration as well. The work of the Committee was preceded by several IOM panels that produced Dietary Reference Intake Reports providing important input and background material. The Committee went through several rounds of review and comment before recommendations were made. The Physical Activity Guidelines process will have a similar challenge to the Dietary Guidelines process in terms of communicating complicated scientific data to the public in ways that are readily interpretable.

The 2005 Dietary Guidelines produced 2 recommendations on Physical Activity. The first primary recommendation stated that to reduce risk of chronic disease in adulthood, people should engage in at least 30-minutes of moderate-intensity physical activity. The second recommendation focused on weight management which stated that to help manage body weight and prevent gradual unhealthy weight gain in adulthood, people should engage in approximately 60-minutes of moderate to vigorous-intensity physical activity. It was important to note the language from the second recommendation was not identical to the report submitted by the Committee as there was editing and modification between the Committee Report and the actual Guidelines.

An example of where the Committee's work was not incorporated in the actual Guidelines but subsequent implementation products is the "My Pyramid" guidance system. The Committee spent time discussing the concept of discretionary calories in which the more active a person is the more discretionary calories are needed to maintain energy balance. Language to this effect was not included in the Guidelines; however, the concept was incorporated in My Pyramid which energy intake is scaled based on a person's level of physical activity.

A question was asked whether the 2010 Dietary Guidelines Advisory Committee has been established in order for both groups to consult each other on areas of overlap. While the 2010 Dietary Guidelines Committee has not been established, Dr. Pate indicated it would be useful for this Committee to refer back to the Dietary Guidelines themselves as well as the actual report from the Committee.

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