New Dietary Guidelines for Americans Include Birth to 24 Months for the First Time

Written by: Marina Wang | Issue # 102 | 2021

The U.S. government recently released its 2020-2025 Dietary Guidelines for Americans (DGA), designed to help policymakers and health professionals advise everyday Americans on how to consume a balanced and nutritious diet. New to this edition are recommendations for the tiniest Americans, from Birth to 24 months. This latest edition is also organized by age group for the first time, as well as includes recommendations for pregnant and lactating women. As ever, dairy remains a key food group to consume for all age groups, as it is a unique source of quality proteins, vitamins, and minerals.

Diet is undoubtedly a key component of health and wellness, and with 74% of American adults overweight or obese and 60% having diet-related chronic diseases [1], the guidelines are imperative in helping people maintain a healthy lifestyle. Eating right can also reduce the risk of diet-related conditions such as cardiovascular disease, cancer, and diabetes, and while diet has an undisputed role in prevention of these conditions, the suggested dietary patterns are not meant as a treatment.

A Failing Grade

The DGA are evidence-based recommendations jointly published every five years by the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) and have been in publication since 1980. Despite this, the average American is still getting a failing grade on their dietary report card. According to the Healthy Eating Index (HEI), a measure out of 100 that indicates how close a diet adheres to these guidelines, the average American adult has a score of only 59 [1]. This score also hasn’t budged much in the past few years.

Surprisingly, nearly 90% of the US population are not meeting their recommended intake for dairy or fortified soy. To counter this, the guidelines suggest drinking low-fat milk or fortified soy beverages with their meals, or incorporating yogurt into breakfasts and snacks. Other food groups that have low scores overall were whole grains at 98% and vegetables at around 90%.

The New Guidelines

Many of the recommendations in the latest version echo guidelines past, with suggestions to eat more vegetables and whole grains and to cut back on added sodium, sugars, saturated fats, and alcohol. But the authors of the latest 149-page dietary guidelines have organized their recommendations through four overarching principles:

1. Follow a healthy dietary pattern at every life stage.
2. Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations.
3. Focus on meeting food group needs with nutrient-dense foods and beverages, and stay within calorie limits.
4. Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages [1].

The new guidelines are also structured to be inclusive and cater to a diversity of diet choices, whether they be influenced by personal preferences, cultural traditions, or budgetary considerations. Rather than give a single specific dietary pattern, the guidelines are meant to be a customizable, adaptable framework.

In sum, adults on a 2,000 calorie diet should be consuming 2.5 cups of vegetables, 2 cups of fruit, 6 ounces of grains, 3 cups of dairy, 5.5 ounces of protein, and 27 grams of oils per day [1]. These portions should ideally be met through whole, nutrient-dense foods and beverages, with little added sugars and salt.

Make Every Bite Count

In addition to conducting systematic reviews and analyzing the latest in health and nutritional studies, the recommendations in the DGA are made through a process called dietary pattern modelling. This analysis involves changing the amounts or types of foods in a dietary pattern to see how those changes would affect meeting nutritional needs. This type of modelling highlighted the importance of choosing nutrient-rich foods. These foods are rich in vitamins, minerals, fibers, and proteins and consuming them can help people reach their daily nutritional requirements without going overboard on the caloric budget. Adults are advised to limit added sugars to less than 10% of calories per day to reach their nutritional requirements without consuming too many calories [1].

The dietary pattern modeling also found that children under the age of two should not be eating foods with added sugars because their high nutritional but low caloric needs leave no space in the diet for added sugars. Now, this doesn’t mean that toddlers can never enjoy a cookie, but the overall dietary pattern should be free of added sugars.

The dietary pattern modelling also places dairy and fortified soy as a highly recommended food group to consume. Dairy is a rich source of healthy proteins seldom found in other foods and contains a suite of nutrients such as calcium, vitamin B12, vitamin D (if fortified), potassium, phosphorus, and zinc.

To help Americans improve their dietary patterns, helpful tips on how to replace low-nutrient foods with healthier alternatives are littered throughout the DGA. For example, rather than eating applesauce, consumers can opt for a whole apple, as the peel contains fiber and important micronutrients, whereas processed foods often contain a bevy of added sugars and less fiber. Another alternative is consuming low-fat yogurt with fresh fruit rather than a fruity, full-fat yogurt with added sugar.

Consumers serious about eating right can also try MyPlate, a suite of customizable digital tools and online resources to help implement their dietary goals. Users can input their weight, height, activity level, and nutritional goals, and the service provides meal plans, progress tracking, and resources such as recipes and budgetary cheat sheets.

New Age Groups

Perhaps the biggest shift from previous guidelines is an organization based around age groups. Previous guidelines only had recommendations from two years onward, but the Agricultural Act of 2014 (aka the “Farm Bill”) mandated that the 2020-2025 edition and all editions thereafter include recommendations for infants, young toddlers, and pregnant and lactating women.

The guidelines recommend that infants from birth to 6 months be fed exclusively human milk or infant formula, and at around 12 months cow’s milk and other dairy can be introduced to the baby’s diet. For young infants, it’s not recommended to replace human milk with cow’s milk because the two have very different nutritional properties; human milk is much higher in lactose and oligosaccharides, the latter of which are beneficial for gut bacteria, whereas cow’s milk contains an excess of protein that may be difficult for the infant to digest. After 1 year, toddlers can be fed dairy as a rich source of calcium, vitamin D, potassium, and protein–critical nutrients for children’s growth.

Dietary recommendations for pregnant and lactating women resemble those for non-pregnant women of the same age group but with an added caloric budget dependent on the stage of the pregnancy or lactation. Pregnant and lactating women also tend to score higher on the Healthy Eating Index at 63 and 62, respectively, but pregnancy also ushers a more urgent need for nutrients such as folate/folic acid, iron, iodine, and vitamin D [1]. Because meeting these nutritional requirements may be difficult for some women, many health experts recommend taking a prenatal vitamin. In sum, the guidelines encourage Americans to enjoy a nutrient-dense dietary pattern, low in added sugars, salts, and saturated fats, and catered to personal preferences and age group. With 90% of American adults not reaching their recommended dairy intake, incorporating low-fat milk and yogurt into the diet becomes an essential part of a healthy lifestyle.

References

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