Briefing for Capitol Hill and Press on Dietary Guidelines Advisory Committee Report Release on June 15, 2010 Robert C. Post, PhD, MEd, MSc Deputy Director Center for Nutrition Policy and Promotion US Department of Agriculture Penelope Slade-Sawyer, PT, MSW, RADM, USPHS Deputy Assistant Secretary for Health (Office of Disease Prevention and Health Promotion) US Department of Health and Human Services I am Dr. Robert Post from USDA’s Center for Nutrition Policy and Promotion. Today, I will be providing you with information about the Advisory Committee Report for the 2010 Dietary Guidelines, which will be released tomorrow for public comment along with the announcement of a public meeting to be held July 8, 2010, at the Department of Agriculture. This Report is a crucial step in the development of the Dietary Guidelines for Americans. The dietary guidelines process is a collaborative effort between USDA and HHS. Today, I am accompanied by Rear Admiral Penelope Slade-Sawyer, with the HHS Office of Disease Prevention and Health Promotion. Let me say upfront that the Report is advisory in nature and not the actual 2010 Dietary Guidelines for Americans, as I will explain. This is a scientific report from an independent panel of recognized experts the recommendations of which will inform the Federal policy on dietary guidance. The Federal guidelines drawn from the Committee’s report form the basis for government nutrition initiatives and nutrition education and consumer outreach used by consumers, industry, and health professionals. As such, the dietary guidelines process is one that we take very seriously to which we apply four guiding principles: • We want to base the Dietary Guidelines on the best available scientific evidence. • We rigorously solicited public participation in the Dietary Guidelines Advisory Committee process and look forward to receiving comments on its report. • We ensure that the highest possible level of transparency is employed in the process. • We will continue to ensure that the Dietary Guidelines for Americans serve as the foundation for government nutrition programs and initiatives so that all agencies speak with “one nutrition voice.” The “Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010,” has been finalized and delivered to the Secretaries of Agriculture and Health and Human Services, and its delivery completes the work of the Dietary Guidelines Advisory Committee. I will begin the briefing by describing the Advisory Committee—specifically its selection and membership—then describe the process by which the Committee worked and highlights of its report. Finally, I will outline the process ahead—how the government will make use of this Report in developing the policy known as Dietary Guidelines for Americans. [Selection of the Committee] Robert Post The 2010 Dietary Guidelines Advisory Committee is a group of 13 recognized experts in nutrition and health who are external to the government. They are all from academic and/or medical institutions, or in one instance, retired from an academic institution. Nominations for the Committee were solicited publicly through a Federal Register Notice in April, 2008, in accordance with Federal Advisory Committee Act requirements, which mandate an open and transparent process. Over one hundred nominations of individuals were received from many sectors and organizations. The bulk of the nominations were submitted from research, university, professional, trade, and food organizations. Most nominees received multiple letters of nomination. Committee members were sought and selected based on their expertise. Expertise was sought in specific areas, such as, the prevention of chronic diseases, such as cancer, cardiovascular diseases, type 2 diabetes, obesity, and osteoporosis; energy balance, including physical activity; epidemiology; food safety and technology; general medicine; gerontology; nutrient bioavailability; nutritional biochemistry and physiology; nutrition education; pediatrics; public health; and evidence review methodology. As stated in the Federal Register notice, prospective members were expected to be knowledgeable in the application of the Dietary Guidelines and be respected and published experts in their fields, and familiar with the purpose and application of the Dietary Guidelines. Consideration of nominees was based on the degree to which credentials matched the fields of expertise listed. The criteria for selection also included assuring that the final mix of Committee members would include diversity in geographic, ethnic, and gender representation. The source of nominations played no part in selecting Committee members. Since the Committee was formed, biographical information about the Committee members’ credentials has been available for public viewing at www.dietaryguidelines.gov. There, for example, the public will see that the Chair of the Committee, Dr. Linda Van Horn, has expertise in nutrition research, medical nutrition education, and clinical nutrition epidemiology, and that Committee member, Dr. Xavier Pi-Sunyer, has expertise in obesity, type-2 diabetes, carbohydrate and lipid metabolism, and general medicine. Individuals were invited to serve on the Committee jointly by Former Secretary of Agriculture Edward T. Schafer and former Secretary of Health and Human Services Michael O. Leavitt in October 2008. The information provided to the Secretaries did not include the source of the nominations but rather focused on the nominees’ resumes, publications lists, and depth and breadth of their credentials. The roster of nominees had been cleared through the USDA Office of Ethics to check affiliations and financial disclosures for any conflicts of interest or other disqualifying issues before being submitted to the Secretaries. Each also received ethics training for advisory committee members. [Methods and Work of the Committee] Robert Post The charge given to the Committee was to review the scientific evidence and develop conclusions and recommendations based on the weight of the evidence. The full Committee met six times at public meetings over a 20 month period. Committee meetings were viewable by the general public. Before each public meeting, a Federal Register notice announced the meeting and reminded the public that comments on the process were invited. Written comments from the public were accepted throughout, and oral testimony was invited at the second public meeting. Between public meetings, Committee members met in subcommittees via conference calls to develop questions, based on their knowledge of the advances in nutrition research, and review, in detail, the weight of the scientific evidence that addressed these questions. Committee members evaluated evidence addressing some 180 questions in the following topic areas: Energy Balance & Weight Management; Nutrient Adequacy; Fatty Acids and Cholesterol; Carbohydrates and Protein; Sodium, Potassium & Water; Alcohol; and Food Safety & Technology. The topic areas form the major science-based chapters in the Report. While the 2005 Committee used a modified evidence-based review process, the 2010 Committee has benefited from the systematic review process employed in the medical community over the past two decades to review and analyze the latest science. This process was supported by USDA’s new Nutrition Evidence Library or NEL, which was inaugurated at the time of the first Committee meeting. NEL nutritionists and experts in systematic evidence review assisted the Committee in synthesizing the scientific evidence to answer the research questions it raised, and these research syntheses formed the foundation of the Committee’s Report. Committee members developed research questions on specific topics and the procedure for a literature search to address each question. For example, one research question was “What are the effects of potassium intake on blood pressure in adults?” Based on the weight of the evidence, the Committee developed evidence summaries and conclusion statements, graded each conclusion, and translated these findings in the Committee report to form recommendations. To add to the transparency of the process, the NEL staff is making publicly accessible all of the questions, literature, evidence summaries, and graded conclusion statements that form the Committee’s recommendations, at the same time the Committee report is posted. This NEL information will be available at www.dietaryguidelines.gov. While the majority of the questions considered were answered through systematic evidence-based review methodology, some were answered through data analyses, food pattern modeling analyses, or consideration of other existing evidence-based reports. For example, dietary intake data from NHANES, the National Health and Nutrition Examination Survey, was used to answer questions about nutrients and food groups that are under-consumed or over-consumed by Americans. The Committee’s report has been completed and submitted to the Secretaries of Agriculture and HHS. The Report, and NEL evidence summaries, and all related materials will be available on the CNPP website. The direct URL to access all of these materials is www.dietarygudieleines.gov. [Content of the report]- Penny Slade-Sawyer It’s helpful to note that the report is the work of the Advisory Committee. The Departments are reviewing the Report in that it will be used to inform the ultimate dietary guidance policy. Thus, we aren’t in a position to discuss the specifics of the Report or take positions on it. I’d like to take this opportunity to highlight some general recommendations of the Committee, and note some topics that are new to the 2010 Report. First, the Committee noted that this report is unprecedented in addressing the obesity epidemic, and stated that the obesity epidemic is the single greatest threat to public health in this century. Every section of the report was developed in a way that addresses the challenges of obesity. They noted that this was especially true for children, in whom the prevalence of obesity has tripled in the past thirty years. In several topic areas, questions with a specific focus on children were also included for the first time. These included questions on the relationship between dietary intake and the degree to which children gain fat tissue, and the effects of sodium intake on blood pressure in children. For the first time, the Committee also explicitly addressed the importance of eating behaviors, such as breakfast eating, snacking, portion sizes, and eating fast foods, particularly in relation to weight control. A new report chapter, focused on the total diet and on health-promoting dietary patterns. In keeping with the focus on obesity, the total diet chapter also identifies how all of the individual recommendations from the Report can be integrated into a healthful dietary pattern that meets nutrient needs without exceeding one’s energy needs. The Committee summarized this approach by describing a total diet that is: • Energy balanced, limited in total calories, and portion controlled • Nutrient-dense and includes: -- Vegetables, fruits, high-fiber whole grains -- Fat-free or low-fat fluid milk and milk products -- Seafood, lean meat and poultry, eggs, soy products, nuts, seeds, and oils • Very low in solid fats and added sugars • Reduced in sodium The Committee also noted that physical activity will assist in the helping to achieve a balance between calorie intake and expenditure, leading to body weight maintenance. [Committee’s Summary] Penny Slade-Sawyer The Committee summarized their recommendations by highlighting four major priority action steps for Americans. They are: 1. Reduce overweight and obesity of the US population by reducing overall calorie intake and increasing physical activity. 2. Shift food intake patterns to a more plant-based diet that emphasizes vegetables, cooked dry beans and peas, fruits, whole grains, nuts, and seeds. In addition, increase the intake of seafood and fat-free and low-fat milk and milk products and consume only moderate amounts of lean meats, poultry, and eggs. 3. Significantly reduce intake of foods containing added sugars and solid fats because these dietary components contribute excess calories and few, if any, nutrients. Reduce sodium. Eat fewer refined grains, especially those in foods with added sugar, solid fat, and sodium. 4. Meet the 2008 Physical Activity Guidelines for Americans. [Moving the Process Forward] Robert Post As mandated by Congress in Public Law 101-445, Section 301, the National Nutrition Monitoring and Related Research Act of 1990, the Dietary Guidelines for Americans are developed and released jointly by USDA and HHS every five years, to assure the public that they receive the most current and scientifically sound nutrition advice available. USDA and HHS will consider the recommendations of the Committee’s report in preparing the Federal policy document, which is called the Dietary Guidelines for Americans, which is dietary advice for Americans ages 2 and older. The departments will also actively solicit public participation and consider the comments it receives. All Federal dietary guidance for the public is required to be consistent with the Dietary Guidelines for Americans. The Guidelines allow the government to speak with multiple voices, but in a consistent and uniform manner. In addition, the Guidelines serve as the basis for nutrition educators and health professionals to communicate to the public about healthy eating and physical activity, and they inform the development of messages, tools, and programs targeted to consumers. They are the cornerstone upon which all Federal nutrition policy, education, and food assistance programs are based. The Guidelines policy document is due for release to the public by December 2010. A consumer-focused outreach campaign to broadly publicize Guidelines -related educational materials is being planned for Spring 2011. At USDA and HHS, there are many nutrition-related initiatives that relate to the priority of reducing childhood obesity and improving the effectiveness of nutrition education. The departments are working closely together and with other Federal agencies to ensure that these efforts are collaborative and complementary. Within USDA, the Center for Nutrition Policy and Promotion (CNPP) is the administrative lead for the 2010 DGA activities, with the support of HHS’s Office of Disease Prevention and Health Promotion (ODPHP). Included in its leadership role, CNPP develops and disseminates the DGA through promotion, education, and outreach programs. ###