Every five years, the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) release the U.S. Dietary Guidelines for Americans, a set of "science-based" guidelines offering advice on "what to eat and drink to promote health, reduce risk of chronic disease, and meet nutrient needs."
The 2020-2025 guidelines are the first to offer guidance for healthy dietary patterns by what the departments call "life stages," since people at different ages should be consuming different diets. The new guidelines also offer advice for pregnant and lactating women.
What is new about the 2020-2025 guidelines?
Some experts are discouraged by what hasn't been amended in the guidelines. The 2020-2025 guidelines regarding alcohol and added sugar remain the same as previous years despite recommendations from a scientific committee of experts. In July, the committee said that both sugar and alcohol intake should be further limited. Specifically, experts advised that just one drink a day was best for both men and women, and that added sugars should account for less than 6% of calories.
Madelyn Fernstrom, Ph.D., NBC News contributor and diet and nutrition expert, said that those recommendations were likely not reduced because they are already low and if they are restricted too far, people may "give up" and stop trying to meet the restrictions at all.
"It is guidance, it's not nutritional requirements, and I think the problem here is not how low can you go in terms of sugar (and) alcohol, but what are people both willing and able to do?" she explained.
Keri Glassman, a registered dietitian, said she was disappointed that the restrictions on added sugar were not reduced.
"I think that it's ridiculous that they didn't change those," Glassman said, adding that she "never liked" the way that added sugar calories are used. "I think people misinterpret (that number) to begin with, so I think reducing it, knowing what we know about sugar and how bad sugar is, how unhealthy it is, I think it would have been useful and impactful for the dietary guidelines to reduce the amount of daily added sugar consumption."
Though the guidelines for children do emphasize that there should be no added sugar in their diets before the age of 2, and recommends that children consume only breast milk (or iron-fortified formula) for the first six months of their lives.
These are the current guidelines outlined for 2020-2025:
- Limiting added sugars to less than 10% of calories per day for ages 2 and older and to avoid added sugars for infants and toddlers;
- Limiting saturated fat to less than 10% of calories per day starting at age 2;
- Limiting sodium intake to less than 2,300 mg per day (or even less if younger than 14);
- Limiting alcoholic beverages (if consumed) to 2 drinks or less a day for men and 1 drink or less a day for women.
Fernstrom said that for most families, the takeaway from these guidelines should be forming healthy patterns.
"The big health messages are really the dietary pattern over time," she said. "... It's still the same basic messages (encouraging) whole grains, colorful fruits and vegetables, lean proteins and dairy products and a small amount of healthy fats. That message hasn't changed, but what is changing is that it's about balance and about dietary patterns over time, rather than a single day or single week."
The guidelines focus on the theme of "Make Every Bite Count," which encourages Americans and their families to make sure they're making healthy choices at every age and choosing foods and beverages rich in nutrients at every meal.
What has been added to the guidelines?
One major change in the guidelines is around the introduction of egg and peanut products for young children: The guidelines note that "infant and young children" should be introduced to "potentially allergenic foods" like egg, peanut, tree nut, shellfish and soy products with other complementary foods.
The guidelines specifically note that "introducing peanut-containing foods in the first year reduces the risk" of later developing an allergy to peanuts, and adds that there is "no evidence that delaying" the introduction of allergenic foods can help prevent food allergy.
In a press release, Lisa Gable, the chief executive officer of the Food Allergy Research & Education organization (FARE), shared enthusiasm for the changes.
"... FARE is thrilled to see the inclusion of more comprehensive dietary guidance around the early introduction of egg and peanut for infants and toddlers. The early introduction of proteins that can trigger an allergic reaction is a leading priority for FARE," Gable wrote in the release.
The 2020-2025 guidelines are also the first to include specific recommendations for pregnant and lactating women, including estimates on how daily calorie intake should vary based on pregnancy stage and details on what nutrients or vitamin intakes may need to increase.
How can people apply these guidelines to their diets?
The most effective way to apply the dietary guidelines is to make sure that the majority of food eaten is healthy and rich in nutrients. Just 15% of a person's daily calories should come from added sugars, saturated fat and alcohol.
The guidelines also emphasize a "pattern" of healthy eating, as opposed to single choices, since research shows that ongoing healthy eating habits have a greater impact on overall health. The guidelines include three "key dietary principles" that can help Americans develop a healthy diet:
- Meet nutritional needs primarily from foods and beverages.
- Choose a variety of options from each food group.
- Pay attention to portion size.
Fernstrom said that the portion size recommendations should be particularly noted.
"Portion size matters," she said. "(You don't have to) religiously read the package and measure out exactly 4 ounces, but look at the portions, because that's a big issue for Americans. It's not a judgment issue, but it's important to educate yourself and not be fooled by perceptions of what the portion size is."
Do most Americans follow these guidelines?
The Healthy Eating Index (HEI) measures how closely a diet aligns with the guidelines, but according to a press release, the average American diet scores a 59 out of 100 on that scale.
Yet, the guidelines are especially relevant for policy making and public perception, Glassman noted.
"They impact what the public hears and feels about what health guidelines are," she explained. "They also impact school lunch programs, (and) they impact food manufacturing programs to some extent."
The full guidelines are available here and another list gives examples of where people can find nutrient-dense foods and beverages. The USDA also operates MyPlate, a website where people can get personalized resources and make sure that they are "making every bite count."