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November 4, 2019 | 6 minute read

Evidence on Cancer Risks Should be Integrated into Dietary Guidelines, Says AICR

What are the Dietary Guidelines for Americans?

Every five years, the U.S. Department of Health and Human Services (HHS) and the Department of Agriculture (USDA) come together to release the Dietary Guidelines for Americans. These guidelines serve as a set of recommendations to help Americans make better choices when it comes to what they feed themselves and their families. By law, these guidelines also serve as the basis of all federal food and nutrition policy programs.

For example, the National School Lunch Program, which provides nutritionally-balanced meals to 30 million children each school day, and SNAP-Ed, which provides nutrition education programs to millions of people eligible to receive SNAP nutrition assistance, follow the Dietary Guidelines for Americans.

In order to produce these guidelines, USDA and HHS select a small group of distinguished researchers from a pool of candidates to form the Dietary Guidelines Advisory Committee (DGAC). The DGAC reviews the scientific evidence and provides recommendations to USDA and HHS on topics pertaining to nutrition and health. For the 2020 DGAC, USDA and HHS have identified a set of more than 80 questions to be examined. From this evidence base, the committee will produce a report that will inform the 2020-2025 Dietary Guidelines for Americans.

AICR and Dietary Guidelines

At AICR, we are committed to preventing cancer and increasing survivorship through lifestyle change. We have strong evidence that incorporating more fruits, vegetables and whole grains into the daily diet, while avoiding processed meat, alcohol and added sugars, is an essential part of preventing cancer and preventing recurrence in survivors. The current Dietary Guidelines for Americans offers many of the same recommendations, such as focusing on incorporating a variety of nutrient-dense foods into the diet and limiting calories from added sugars and saturated fats. In fact, the report that led to these guidelines cited AICR’s evidence a number of times. The guidelines also provide the basis for a number of state government and private health promotion policies, meaning that they have the capacity to broadly influence environmental factors that can help people make healthier choices, such as availability of fresh fruits and vegetables in schools and workplaces. Therefore, when our Cancer Prevention Recommendations are integrated into the guidelines, they can make a wider impact.

AICR recommendation for cancer prevention diagram

How has AICR been involved?

We have been involved in the creation of the 2020-2025 Dietary Guidelines for Americans since the beginning stages of the development to help ensure the guidelines are based on the most up-to-date research linking diet and weight management to cancer prevention.

Public Meetings

To complete its work, the DGAC scheduled five public meetings during 2019-2020 to review its approach to addressing the research questions, preliminary findings and recommendations. To stay abreast of the proceedings, a representative from AICR has attended the three meetings to date, including one that took place in the last two weeks. AICR also provided oral comments at the July 2019 public meeting.

Written Comments

AICR has submitted two comment letters to the DGAC, and we are in the process of drafting even more! Our first set of comments focused on six research questions addressing the relationship between dietary patterns, alcohol, or dietary fats and risk of cancer, as well as dietary patterns, added sugars, or beverage consumption and risk of obesity, the last being a key risk factor for cancer. In this letter, we recommended that, for cancer prevention, the DGAC advise consuming a diet rich in whole grains, vegetables, fruits and beans, while limiting the intake of highly processed foods, red meat, processed meats and sugar-sweetened drinks, along with avoiding alcohol. These recommendations are consistent with our Cancer Prevention Recommendations.

The second letter, which was co-signed by more than 30 national and state nutrition and health organizations, asked for reconsideration of a change to the DGAC process regarding not using literature reviews and reports from outside organizations to respond to its research questions. AICR also made similar recommendations in its July 2019 oral comments. In the development of the 2015-2020 Dietary Guidelines for Americans, the committee used research conducted by organizations outside of the government to answer nearly half of their research questions. This year, the committee will only use systematic reviews completed by the Nutrition Evidence Systematic Review (NESR), a division of the USDA that specializes in reviewing the current evidence on nutrition-related questions. AICR’s letter focused on the inefficiency of this change, noting that the DGAC has a finite capacity and excluding reviews done by outside entities could mean duplicating work that has already been done. Other organizations signing onto the letter include the Academy of Nutrition and Dietetics, American Society for Nutrition, American Academy of Pediatrics, Center for Science in the Public Interest, and American Diabetes Association.

AICR has since further communicated with the DGAC and federal staff. We have shared information about AICR’s research on the effects of lifestyle and weight management on cancer risk, as well as resources to facilitate the use of AICR’s evidence reviews in the development of the DGAC’s scientific report. As a nonprofit devoted to educating the public on these factors, AICR wants to make our status clear as a valuable resource. In response to the advocacy we led, it was announced that the DGAC report would acknowledge and address existing research and recommendations by organizations such as AICR that relate to each of the research questions.

What’s Next?

The entire DGAC evidence review process is expected to continue through Spring 2020, including two more public meetings. The next meeting, taking place in January in Houston, TX, will present another opportunity for organizations like AICR to offer public comments. The final meeting will take place in Washington, DC in March 2020. Following this meeting, the Committee will synthesize their evidence into a final report, which will be made available to the public for comment in late Spring. After reviewing the report, AICR will provide additional comments, as necessary. Informed by the DGAC’s recommendations and additional public comments, USDA and HHS will develop the 2020-2025 Dietary Guidelines for Americans.

AICR will continue to monitor the activity of the DGAC, including submitting comments on the research protocols, a summary of the evidence, conclusions and recommendations, as needed. We will also continue to advocate that studies by reputable non-governmental institutions like AICR be used to inform the development of the 2020-2025 Dietary Guidelines for Americans.

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