Gearing up for the Dietary Guidelines

by Jeff Gelski
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The official Dietary Guidelines for Americans 2015 may not arrive until almost a year from now, but clues to potential recommendations are emerging. Consumption of vitamin D and potassium might be encouraged. Americans probably will be told to reduce intake of saturated fats, sodium and added sugars.

Sources of saturated fat in the diets of the U.S. population


The Dietary Guidelines Advisory Committee (D.G.A.C.) held its seventh and final meeting on Dec. 15. The D.G.A.C. should issue its final report in January 2015 and then a public meeting may occur in the spring, said Lee Sanders, senior vice-president of government relations and public affairs for the American Bakers Association, Washington. The U.S. Department of Agriculture and the U.S. Department of Health and Human Service should publish the Dietary Guidelines for Americans 2015 by the end of 2015, she said.

What to eat

The Dietary Guidelines Advisory Committee on Dec. 15 said vitamin D, calcium, potassium and fiber are under-consumed across the entire U.S. population. The D.G.A.C. said iron is under-consumed by adolescents and pre-menopausal women.

While agreeing the lack of certain nutrients is a concern in the diets of many Americans, Alice Wilkinson, vice-president of quality and nutritional R.&D. for Watson Inc., West Haven, Conn., said food formulators wanting to add the needed nutrients may face processing and sensory issues.

“Your body needs a ton of (potassium),” she said. “Unfortunately, potassium and food don’t always go hand in hand.”

Potassium may be linked with other minerals, as is the case with potassium chloride or potassium sulfate, she said. Getting a significant amount of potassium in a product thus may require huge doses.

Calcium also is linked with other minerals and may require higher doses to achieve desired levels in food products, she said. Examples include dicalcium phosphate that is 23% calcium, calcium carbonate that is 40% calcium, and calcium gluconate that is 9% calcium.

Ms. Wilkinson said iron has been shown to cause oxidation and rancidity as well as color changes. Formulating with iron may require extra work, such as manipulating particle size.

“You can put iron in almost anything,” Ms. Wilkinson said. “You just have to make sure you balance it right.”

Vitamin D and potassium also were mentioned in the March 3 Federal Register. The Food and Drug Administration, in proposing changes to the Nutrition Facts Panel, proposed requiring the declaration of vitamin D and potassium.

Lallemand, Montreal, offers vitamin D baker’s yeast. “Good” and “excellent” claims for vitamin D are possible when using vitamin D baker’s yeast from Lallemand.

“Once the final regulations are released, we will all know better how to present the vitamin D information in an approved manner,” Lallemand said. “Some bakeries are already highlighting the vitamin D content in their products, but the new labeling should allow, or require, this information to be more prominently displayed.”

The F.D.A. in 2012 amended the food additive regulations to provide for the use of vitamin D baker’s yeast as a source of vitamin D at levels not to exceed 400 International Units (I.U.s) of vitamin D per 100 grams in the finished food if yeast is the source of the vitamin D. If other sources of vitamin D are used, the upper limit remains 90 I.U. per 100 grams of baked product. The 90 I.U. level makes “good source” or “excellent source” difficult, according to Lallemand.

According to an Angus Reid survey performed in the United States in July 2013, 85% of Americans believe vitamin D plays a great-to-moderate role in their health, which was an increase from 79% in 2010 and 76% in 2009. Consumers in the survey most commonly associated health benefits of vitamin D as osteoporosis and fracture (41%), cardiovascular disease (20%) and colds (19%).

At least one group will keep pushing for choline’s inclusion in the Dietary Guidelines for Americans 2015. The Healthy Nation Coalition sent a letter criticizing various aspects of past guidelines to the U.S.D.A. and the U.S. Department of Health and Human Services. About 600 people, including clinicians, academics, farmers and ranchers, signed the letter.

One part of the letter recognized that eggs and meat are sources of choline and claimed that dietary guidance limiting the consumption of eggs and meat thus restricts choline intake.

“Current choline intakes are far below adequate levels, and choline deficiency is thought to contribute to liver disease, atherosclerosis and neurological disorders,” the letter said.

Ms. Wilkinson said choline is found in the yolk of eggs. She said she agreed it was an under-consumed nutrient, but she doubted whether the Dietary Guidelines for Americans 2015 will push heavily for increased choline consumption.

“Choline would be great,” Ms. Wilkinson said. “There’s very good data on the need for choline in the diet. It’s basically brain food.”

Six grain servings

Nutrition labeling


Ms. Sanders said she expected the Dec. 15 D.G.A.C. meeting to reveal more details then it did. She said the D.G.A.C. presented three food models as options for Americans to use to reach their daily nutrient goals: a U.S. model, a Mediterranean model and a vegetarian model.

The D.G.A.C. said across all age and sex groups, the vast majority of the U.S. population does not meet recommended intakes for fruit, vegetables, whole grains and dairy food groups.

“The good news is that throughout the day (on Dec. 15) there was a discussion on how Americans need to eat more whole grains,” Ms. Sanders said.

Ms. Sanders said the D.G.A.C. on Dec. 15 recognized the importance of folic acid, which is found in enriched grains, and how it helps reduce neural tube birth defects. The folic acid recognition should help a “Grain Chain” coalition, which is made up of grain industry groups such as the A.B.A., as it seeks to keep the recommended servings of grain at six per day, including three whole grain servings.

Ms. Sanders said the D.G.A.C. on Dec. 15 did not provide any specifics on the issue of six servings per day.

“We just heard more about whole grains, and one thing we learned through this process is the scientific term refined grains also encaptures enriched grains,” she said.

What not to eat

Saturated fat, sodium and sugars continue to receive criticism. Each one had its own working group within the D.G.A.C.

“They decoupled those and looked at each of those individually, but their recommendation will be to lower those things in the American diet,” Ms. Sanders said.

The D.G.A.C. on Dec. 15 said strong evidence shows replacing saturated fat with unsaturated fats, especially polyunsaturated fats, reduces L.D.L. “bad” cholesterol and cardiovascular disease risk. The D.G.A.C. also said strong evidence shows replacing saturated fat with overall carbohydrates does not lower cardiovascular risk.

The committee recommends retaining the 10% upper limit for saturated fat intake, a view that drew a positive response from Gerald McNeill, Ph.D., vice-president of research and development for Loders Croklaan, a palm oil company that has a U.S. office in Channahon, Ill.

“The transcript of the final D.G.A.C. meeting, just released, revealed that while the D.G.A.C. remains concerned with high intakes of saturates, the recent flood of positive news around saturated fat is having an impact,” he said. “Their final recommendation will likely be to restrict saturated fat intake to a maximum of energy 10% of the diet, preferably to be substituted with polyunsaturated fat.

“A maximum level of about energy 10% for saturated fat has consistently been recommended by D.G.A.C.s with a couple of recent exceptions. Major changes in traditional saturated fat consumption are likely to have negative unforeseen consequences, such as an increase in heart disease from trans fat and substitution of fat with sugar, now attributed to the obesity and type 2 diabetes epidemics in the U.S.A. A moderate approach to saturated fat will deliver the best outcomes.”

Since the 2010 guidelines came out, and even before then, the palm oil industry has sought to improve the health image of saturated fats. Some scientific studies have benefited that cause. Palm oil contains about 50% saturated fat.

Dr. McNeill and other saturated fat proponents argue saturated fats increase both H.D.L., or “good” cholesterol, and L.D.L., or “bad” cholesterol. They say people formulating dietary advice should give more emphasis to the ratio of total cholesterol to L.D.L. Dr. McNeill said the current Dietary Guidelines Advisory Committee has given little emphasis to H.D.L. benefits, which he found disappointing but to be expected.

“Looking through the transcripts, they mention H.D.L. as well, but what they are really focusing on is L.D.L.,” Dr. McNeill said.

Last March the Annals of Internal Medicine published a meta-analysis from the University of Cambridge that showed current evidence does not support guidelines that restrict the consumption of saturated fat to prevent heart disease. The researchers analyzed data from 27 studies with more than 600,000 people from 18 nations.

Several health experts, notably Walter Willett, Ph.D., chair of the Nutrition Department at the Harvard School of Public Health in Boston, criticized the study and said it had errors. The Dietary Guidelines Advisory Committee also apparently will keep associating saturated fat with cardiovascular disease.

The Healthy Nation Coalition in its letter also spoke up for saturated fats and pointed to not only the Annals of Internal Medicine study but also a study that appeared in the March 1, 2010, issue of The American Journal of Clinical Nutrition.

In regard to added sugars, the D.G.A.C. on Dec. 15 summarized strong evidence that added sugars, especially in sugar-sweetened beverages, increase the risk of obesity and type 2 diabetes. Moderate evidence linked added sugars to hypertension, stroke, cardiovascular disease, high blood pressure and dental caries.

The D.G.A.C. found moderate evidence for replacing sugar-containing sweeteners with low-calorie sweeteners for reducing calorie intake, body weight and adiposity in short duration studies. The D.G.A.C. concurred with the European Food Safety Authority Panel on Food Additives that aspartame in amounts commonly consumed is safe and poses minimal health risk for healthy individuals without phenylketonuria (PKU), a rare, inherited disorder.

The D.G.A.C. concluded strong evidence associates higher sodium intake and increased blood pressure while moderate evidence associates higher sodium intake and increased risk of cardiovascular disease. The D.G.A.C. said inconsistent and insufficient evidence exists for lowering recommended sodium intake below 2,300 mg per day.

Barbara O. Schneeman, Ph.D., professor emeritus at the University of California, Davis, recently wrote about how spices and herbs may fit into the upcoming Dietary Guidelines for Americans 2015 because of their potential to lower sodium intake. Her story appeared in the September/October issue of Nutrition Today.

“Well-designed studies are emerging to help determine whether a spicy, flavorful eating pattern incorporating a variety of spices and herbs will promote adherence to a healthy diet and improve American’s eating patterns,” she wrote.

Future studies may determine whether using spices and herbs in food may help people maintain a reduced sodium intake, she wrote.

Ms. Wilkinson said that once the final Dietary Guidelines for Americans 2015 are released, food companies probably will begin formulating products with the guidelines in mind.

“You’ll see food companies try to do the right thing, and they’ll launch products that are designed right around the regulations and right around the guidelines, just exactly what everybody should need, but if the consumer doesn’t love it, they are not going to buy it more than once or twice, and that’s a problem,” she said. “That’s a cultural thing for us.”

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