What’s on YOUR plate?
Why your plate matters
Last week, the USDA and HHS released 2020-2025 edition of the Dietary Guidelines for Americans. Amid all the other news going on in the world, I don’t think this made headlines anywhere, but I have been waiting for this report for weeks (health nerd alert!). I have read (or at least skimmed through) all 835 pages of the Scientific Report of the 2020 Dietary Guidelines Advisory Committee, and I think the most profound and relevant message in the whole document was found on page 2.
As the 2020 Committee submits its report and the 2020-2025 Dietary Guidelines for Americans are prepared, we are in the midst of the COVID-19 epidemic. As more is learned about infection by SARS-CoV-2 and the development of COVID- 19, it is clear that it has significant nutritional implications. These parallel epidemics, one non infectious (obesity and diet-related chronic diseases) and one infectious (COVID-19), appear to be synergistic. Those at most risk for the most serious outcomes of COVID-19, including hospitalization and death, are people afflicted by diet-related chronic diseases (obesity, type 2 diabetes, and cardiovascular disease). Finally, throughout the world, the consequences of physical isolation and financial disruption by the threat of COVID-19 infection has led to significant increases in food insecurity and hunger, further increasing susceptibility to both infectious and diet-related chronic diseases. Thus, these interrelationships between chronic diseases, COVID-19, and social determinants of health, emphasize the critical importance of improving dietary patterns. These parallel epidemics demonstrate the central role of nutrition and healthy dietary patterns in susceptibility to both infections and diet-related chronic diseases and these relationships should be further examined in future dietary guidelines.
I feel that it is important to share this quote from the Scientific Report not only because of it’s timeliness, but because I believe it is incredibly empowering to you and your family now and in the future. What you put on your plate and into your body matters! This message is one I wish I heard more often and emphasized to Americans and people all across the globe when it comes to how we communicate about what we need to do to be/stay healthy in the current situation. Unfortunately, it is a missing puzzle piece in widespread messaging. I encourage you to re-read the paragraph above. Okay, I’ll get off my soapbox :)
Take it with a grain of salt
It is important for understanding the context of the Dietary Recommendations to have a little bit of background information and history. Since the first edition in 1980, every five years the United States Department of Agriculture (USDA) and Department of Health & Human Services (HHS) convene to review the current scientific evidence and provide dietary advice for Americans. These guidelines are a cornerstone for federal nutrition policy and education, so it’s a pretty big deal. In fact, every country has their own dietary guidelines. They can be as unique as each country’s culture, but the one thing they have in common is that they all continue to evolve and change to reflect current food trends and a greater understanding of nutrition.
For example, the dietary guidelines published in the 1980’s recommended less fat consumption, which encouraged processed food companies to replace fat with sugar. For years, there was a fear that adding fat into your diet would result in weight gain. People began limiting their fat intake and “low-fat” food products exploded on the market. Well—we now know that healthy fats are in fact an important part of a well balanced diet. They not only promote weight balance, but also support cardiovascular health and are needed in order to absorb vitamins A, D, E and K.
Here’s another example of how previous recommendations have changed as we have learned. I grew up on the Food Pyramid model in school, which was originally released in 1992, and it recommended up to 11 servings of carbohydrates every day including Wonder Bread, crackers and… Cheerios?! During this era, the foundation of a healthy diet seemed to be refined carbs. When we refine a grain, we are also removing most of the minerals along with most of the fiber, and it results in a big spike in blood glucose in the body. The recommendations at this time did not include information about the type or quality of fat or carbohydrate. A perfect storm of low-fat, high glycemic diets (along with other factors like reduction in physical activity) resulted in more diabetes and cardiovascular disease.
So I guess my point for including all of this background information is to say, “take it with a grain of salt” when it comes to the dietary recommendations. It’s also important to consider the influence of certain industries on a country’s guidelines. Take the dairy lobby, for example. Our most recent graphic, called MyPlate, was introduced by the USDA in 2011, and emphasizes a glass of milk with each meal as opposed to a glass of water. Water is almost universal for recommendations found outside of the United States. Just take a look at Canada’s plate, which I happen to favor above our own version.
What has changed… and what has not
Now, before I dive into the 2020 dietary recommendations and what has (and hasn’t) changed, it is important to know that there is no “one size fits all” diet when it comes to what people eat. As Joshua Rosenthal would frequently say at the Institute for Integrative Nutrition, one person’s food is another person’s poison. The bottom line is to stay mindful of what you’re eating, and while it can be helpful to keep up to date with ongoing research, no expert knows your body like you do. If you are including a wide variety of whole foods and filling up at least half your plate at every meal with plants, how much of each of the macronutrients (protein, carbohydrates and fat) you consume to optimize your health are are bio-individual. Experiment and have fun playing around with food to find what works best for you! You can always find another version of a plate that suits you better, like this one from Harvard.
The Committee reports that not much has changed in the American diet over the past couple decades. The typical American dietary pattern is not currently nor has it ever been aligned with recommendations issued by the Dietary Guidelines for Americans since their inception in 1980. In a nutshell, we are still not eating enough fruits and vegetables (9 out of 10 Americans do not meet daily recommendations) and we are eating too many burgers. It is “no surprise” to the Committee that more than 70% of Americans are overweight or obese, or that 6 out of 10 Americans have a chronic condition. In their effort to educate the public and shift dietary patterns to more closely align with the guidelines, they have provided many helpful tools and resources for health professionals, educators and families on the MyPlate.gov website, including information like how to eat healthy on a budget and a library of recipes.
I also want to share with you two major themes of the 2020 Dietary Guidelines that are great and a step in the right direction!
The Lifespan Approach: For the first time, the committee includes 5 different life stages in the Dietary Guidelines for Americans. These life stages include pregnancy, lactation, birth to 24 months, childhood, adolescence, and adulthood. Whereas traditional recommendations emphasized individuals ages 2 and older, the addition of tools and resources for babies and mothers is very exciting! We know that the first 1,000 days of life (conception to second birthday) are the most important in life. Overall, this time period—which included your nine months in the womb—have been identified as the most significant developmental period that will influence your health status as an adult.
Dietary Patterns: Instead of isolated nutrients and food groups, it is the combination of foods and beverages that make up someone’s dietary intake over time. This emphasis acknowledges the reality that people do not consume nutrients of foods in isolation but in various combinations, and also reflects the growing evidence that components of a dietary pattern may have interactive, synergistic, and cumulative relationships that can predict overall health status and disease risk more than individual foods or nutrients.
One more important update I thought was interesting is the Committee’s recommendation in the Scientific Report regarding added sugars. Added sugars include any sugars or sweeteners that are added during the processing of food or beverages, and can wreak havoc on our bodies. Sugar found naturally in foods like fruit are not included in added sugars. The 2020 Committee is advising the recommendation be decreased from 10 percent to 6 percent of energy from added sugars. Sugar has found it’s way into almost every type of packaged food, and sugar-sweetened beverages are consumed well beyond recommendations. As a result, we can very quickly and unknowingly (if you don’t read the nutrition label carefully) far exceed healthy amounts of sugar. It is helpful to know that one teaspoon of sugar equates to about 4 grams when reading labels, and be sure to look at the serving size as well. The average intake of added sugars in Americans is a whopping 17 teaspoons per day! While decreasing your sugar intake is not always easy (trust me, I know!) just having the awareness is a great first step! And you will probably add less sweetener than a manufacturer would, so sweeten foods yourself by cooking more at home.
If I could change one thing…
I do also want to share an area where I think the Dietary Recommendations for Americans can improve. As I mentioned earlier, even the experts can not create a plate that is perfect for every single individual and I encourage you to never blindly trust anyone—even the federal government—when it comes to your personal health.
Replace dairy with water as beverage of choice. I alluded to this above, and have to admit I was disappointed with how strongly the Committee still pushes dairy as part of a healthy diet for all Americans. The dairy lobby is powerful, and with the selection of Tom Vilsack as Agriculture secretary for the new administration (who has led the U.S. Dairy Export Council for the last four years), it will be a challenge. I have learned from organizations such as the Physicians Committee for Responsible Medicine and Switch4Good about the dairy industry and how lactose intolerance is common among Americans, especially minority groups. I was really hoping for the switch on the MyPlate graphic from dairy to water because of its links to various health issues. (Please don’t take this as saying all dairy is bad for all people. Some people tolerate dairy better than others, and although conventional dairy is inflammatory, high quality diary products can have a place in your diet. My family has benefitted from switching to dairy-free five years ago!)
Overall, the Committee does a good job with their goal to provide a comprehensive update on the American diet and health landscape, as well as provide tools and resources to help Americans meet nutrient and food group recommendations. On the other hand, the Committee specifically addresses that more effort is needed to encourage behavior change, which may be outside the scope of the Committee. There are also limitations to the Committee’s scope that it does not address the areas in our life OFF the plate that can nourish us just as much as the food ON our plate that can affect our health. And this is where a team of trusted providers and a health coach comes in ;) All of this information is great, but if we cannot implement it, what is the benefit to having it? If you are looking for support in this area—whether you need ideas of how to fill half your plate at every meal with fruits and vegetables or you want to experiment with personalizing your plate—please reach out to me here and I am happy to chat with you because food matters!