The United States Department of Agriculture (USDA) and the United States Department of Health and Human Services (HHS) recently released the 2020 Dietary Guidelines Advisory Committee’s (DGAC) scientific report, the culmination of months of hard work reviewing scientific literature and providing nutrition recommendations that are the basis for a healthy dietary pattern for Americans. This report provides the foundation for the 2020-2025 Dietary Guidelines for Americans, expected to be released later this year. 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.
As mentioned in previous blogs, the American Institute for Cancer Research (AICR) has been heavily engaged in the development of the 2020-2025 Dietary Guidelines for Americans by submitting comment letters, attending the DGAC’s public meetings and providing oral comments at those meetings. The conclusions presented in the report are well-aligned with AICR’s 10 Cancer Prevention Recommendations, providing the USDA and HHS with evidence-backed conclusions that we are asking be translated into guidelines that will help Americans adopt healthy eating patterns that can help reduce cancer risk, as well as a multitude of other chronic diseases.
Limit Alcohol Consumption
AICR has strong evidence that alcohol consumption is directly linked to six different types of cancer. Moreover, our evidence shows that even less than one standard drink per day increases risk of breast, esophageal and mouth, pharynx and larynx cancers. Hence, our recommendation is that, for cancer prevention, it is best to avoid alcohol.
While some companies try to market certain types of alcohol as healthy (such as spiked seltzers or red wine), the truth is that all types of alcohol increase the risk for developing chronic diseases such as cancer and cardiovascular disease. The DGAC recommends that both men and women limit alcohol consumption to no more than one drink per day, a change from the current recommendation of limiting alcohol to no more than two drinks per day for men. AICR supports and urges the agencies to adopt this recommendation.
Incorporate More Whole Grains, Fruits and Vegetables into Your Diet and Avoid Red and Processed Meats
There is a strong correlation between processed meat and risk of colorectal cancer, as evidence shows that even small amounts of processed meat increases the risk of this cancer. Processed meats include those that have been smoked, cured, salted, fermented or had preservatives added to them, such as deli meat, sausage and bacon. AICR recommends avoiding processed meats entirely.
Studies have shown that consuming moderate amounts of red meat (up to 12-18 ounces, cooked per week) can be safe, but more than that could increase the risk of developing colorectal cancer. In contrast, the current 2015-2020 Dietary Guidelines for Americans recommends eating up to 26 ounces of meat per week. While the guidelines note that the majority of meat intake should be lean, there is no limit on red meat intake and total intake can include processed meat, as long as it does not exceed sodium and calorie limits. In alignment with AICR’s evidence, the 2020 DGAC’s report showed moderate evidence that red and processed meat intakes are linked with colorectal cancer. We ask the agencies to include the recommendation that red meat intake should be limited to no more than 18 ounces, cooked per week and to consume little, if any, processed meat in the 2020-2025 Dietary Guidelines for Americans.
Alternatively, whole grains, fruits and vegetables play an important role in helping to reduce colorectal cancer risk, as well as cancers of the esophagus, stomach, mouth, pharynx and larynx. AICR is working to not only ensure that whole grains are included as part of a disease-protective diet in the 2020-2025 Dietary Guidelines for Americans, but also that these essential nutrients are easily identifiable by consumers. As part of our work with the Food and Drug Administration’s (FDA) Nutrition Innovation Strategy, we are advocating for increased and clear labeling of whole grains to help Americans make informed choices about what they’re eating.
After not smoking, being a healthy weight is the most important thing one can do to prevent cancer, as having overweight and obesity are linked to 12 different types of cancer. Added sugars, particularly in the form of sugar-sweetened beverages, are a large contributor to weight gain, overweight and obesity. The DGAC’s recommendation to reduce the intake of added sugars from no more than ten percent of daily caloric intake to no more than six percent is aligned with AICR’s Cancer Prevention Recommendations to be a healthy weight and reduce intake of sugar-sweetened beverages.
This recommendation, coupled with actionable steps to help reduce added sugar consumption, is a step in the right direction to curb overweight and obesity, and by extension, diseases like cancer that are related to these conditions.
While AICR is pleased with the conclusions presented in the 2020 DGAC’s scientific report, we recognize that there is still work to be done in ensuring that these recommendations make it into the final 2020-2025 Dietary Guidelines for Americans. To that end, we are asking the federal agencies to be more transparent in their development of the 2020-2025 Dietary Guidelines for Americans and incorporate the DGAC’s evidence-based recommendations.
AICR recently submitted our comments on the final scientific report, concentrating on the areas listed above and including our recommendations to increase transparency and adherence in the process. We also provided oral comments at a virtual meeting of the DGAC on August 11, urging the USDA and HHS to take the above conclusions and recommendations into account when drafting the final 2020-2025 Dietary Guidelines for Americans.
More work is also needed to help Americans follow the 2020-2025 Dietary Guidelines for Americans. In 2015, the USDA conducted a nationally representative study to help examine diet quality in the United States. The survey data, known as “What We Eat in America,” is compared against the recommendations in the Dietary Guidelines for Americans to create the Healthy Eating Index (HEI), which provides a score to evaluate adherence. A score of 100 would suggest that the average American eats a diet in line with the Dietary Guidelines for Americans recommendations. However, the average HEI score is 59 out of 100, indicating that there is a lot of work to be done to help Americans adhere to the Dietary Guidelines for Americans. For this reason, AICR recommends that the USDA and HHS provide guidance for helping Americans understand the guidelines, support and implement policies that make it easier to follow the Dietary Guidelines for Americans and translate the evidence into actionable steps to help Americans eat a diet that aligns with the 2020-2025 Dietary Guidelines for Americans.
Once the final guidelines are published, AICR will provide resources to help the public understand the importance of the nutrition recommendations and how to incorporate them.