Limit on Added Sugar Is Biggest Change in New Dietary Guidelines for Americans

Photo © iStockphoto.com/Maksud_kr

Much of what’s in the 2015–2020 Dietary Guidelines for Americans, released today, isn’t new advice. Eat more fruits, vegetables, and whole grains. Choose nutrient-dense foods over empty calories. Limit salt and saturated/trans fats. These recommendations have not changed since the 2010–2015 Dietary Guidelines.

But one new recommendation is turning heads: a specific limit on added-sugar consumption.

Added Sugar

For the first time, the guidelines set forth an actual target for recommended sugar intake, instead of urging general reduction. The guidelines recommend consuming less than 10% of daily calories from added sugars.

On average, Americans consume almost 270 daily calories-more than 13% of total daily calories-from added sugar, with the guidelines noting that intake is especially high among children, adolescents, and young adults. Approximately 70% of Americans are at or above recommended intake levels for added sugar.

Nearly half of all added sugar comes from beverages (soft drinks, fruit drinks, sweetened coffee and tea, energy drinks, alcoholic beverages, and flavored waters), followed by snacks and sweets. As such, the guidelines recommend choosing beverages without added sugar, like water, and decreasing portions of sweet desserts and snacks.

It remains to be seen whether these new guidelines will add fuel to the fire of FDA’s proposal in 2013 to change the way added sugars are listed on nutrition facts labels.

In February 2014, the agency proposed adding a separate line to the nutrition facts label to declare added-sugar content (in addition to a line that would declare total sugar content, including naturally occurring sugar). This controversial proposal, some have argued, would confuse consumers who may not be able to distinguish between added and total sugar. This summer, the agency further proposed listing a percent daily value for added sugar on the nutrition facts label.

The guidelines also address the use of high-intensity sweeteners, such as saccharin, aspartame, acesulfame potassium (Ace-K), and sucralose.

“It should be noted that replacing added sugars with high-intensity sweeteners may reduce calorie intake in the short-term, yet questions remain about their effectiveness as a long-term weight-management strategy,” the guidelines state. “Based on the available scientific evidence, these high-intensity sweeteners have been determined to be safe for the general population. This means that there is reasonable certainty of no harm under the intended conditions of use because the estimated daily intake is not expected to exceed the acceptable daily intake for each sweetener.”

Other Recommendations: Are We There Yet?

In other areas of the diet, Americans are consuming adequate amounts of protein and total grains, with nearly 60% of the population at or above recommended levels for both. Still, most Americans are still not getting enough vegetables, fruits, dairy, and whole grains in the diet.

Americans are still consuming a majority of refined grains, and the guidelines recommend varying protein consumption to include more seafood. Of note, some criticize the new guidelines for not recommending Americans cut back on red and processed meat. The guidelines do point out that men and teenage boys specifically are consuming too much meat, poultry, and eggs.

Earlier recommendations that the guidelines include suggestions for adopting environmentally sustainable diets-e.g., eating more plant-based foods over animal meat-did not make it into the current guidelines. The proposal had come under heavy criticism from the meat industry.

In addition to sugar, Americans are still eating too much sodium and fat. About 70% of Americans are at or above recommended intake levels for saturated fat, and 90% are at or above recommended levels for sodium.

Fat

Saturated fat currently makes up 11% of American calories on average, with only 29% of Americans consuming amounts of saturated fat within the recommended 10% of daily calories. The guidelines recommend shifting to polyunsaturated and monounsaturated fats.

Notably, the 2015 recommendations removed a specific limit on cholesterol consumption, stating that cholesterol is no longer a “nutrient of concern.” Still, the guidelines remind, “This change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns.”

Sodium

Americans are still eating too much sodium, with average intakes of 3440 mg/day, above Tolerable Upper Intake Levels. The guidelines recommend that the population cut back to no more than 2300 mg/day. The Centers for Disease Control and Prevention just issued a new report stating that more than 90% of children and 89% of adults 19 and older eat sodium beyond the 2015–2020 Dietary Guidelines’ recommended levels.

Underconsumed Nutrients

Americans are still underconsuming the following nutrients: potassium, dietary fiber, choline, magnesium, calcium, and vitamins A, D, E, and C. Adolescent girls and women aged 19–50 are underconsuming iron.

The guidelines state, “Of the underconsumed nutrients, calcium, potassium, dietary fiber, and vitamin D are considered nutrients of public health concern because low intakes are associated with health concerns.”

Will the Guidelines Help?

Dietary Guidelines for Americans are published every five years by the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA). Their recommendations guide nutrition choices for government programs and policies, schools, the food industry, and the general public.

This year’s guidelines aimed to make recommendations more user-friendly and tailored to how today’s population actually eats, including eating out instead of cooking at home. As such, the recommendations in large part recommend “shifting” to healthier eating patterns, instead of focusing heavily on individual nutrients, and provide examples of how to choose a healthier food over a less healthy one.

“Now more than ever, we recognize the importance of focusing not on individual nutrients or foods in isolation, but on everything we eat and drink-healthy eating patterns as a whole-to bring about lasting improvements in individual and population health,” said Sylvia M. Burwell, HHS Secretary, and Thomas Vilsack, USDA Secretary, in a joint introduction.

The underlying message is clear. With more than one-third of the U.S. population now officially obese and with more than 30% of the population suffering from prediabetes, Americans need to assume healthier diets.

“Today, about half of all American adults-117 million people-have one or more preventable, chronic diseases, many of which are related to poor quality eating patterns and physical inactivity. Rates of these chronic, diet-related diseases continue to rise, and they come not only with increased health risks, but also at high cost. In 2008, the medical costs linked to obesity were estimated to be $147 billion. In 2012, the total estimated cost of diagnosed diabetes was $245 billion, including $176 billion in direct medical costs and $69 billion in decreased productivity,” said Burwell and Vilsack.

Considering that many recommendations are not much different from years past, whether these guidelines can help remains to be seen.

Read the full 2015–2020 Dietary Guidelines for Americans here.

Jennifer Grebow
Editor-in-Chief
Nutritional Outlook magazine
jennifer.grebow@ubm.com