Q&A: 2015-2020 Dietary Guidelines for Americans

By: Katrina L. Piercy, Ph.D., R.D., ACSM-CEP

Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily reflect positions or policies of ACSM.

Katrina L. Piercy, Ph.D., R.D., ACSM-CEP is a physical activity and nutrition advisor in the U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion. She also is a lieutenant dietitian officer in the United States Public Health Service Commissioned Corps. She served as a policy writer for the 2015-2020 Dietary Guidelines for Americans and is the federal coordinator for the 2018 Physical Activity Guidelines for Americans. Dr. Piercy is an ACSM member and previously served on the Clinical Exercise Physiology Association (CEPA) Board.

The U.S. Departments of Health and Human Services (HHS) and Agriculture (USDA) recently released the 2015-2020 Dietary Guidelines for Americans, the nation’s trusted resource for evidence-based nutrition recommendations. The Dietary Guidelines encourage Americans to adopt a series of science-based recommendations to help reduce obesity and prevent chronic diseases like type 2 diabetes, hypertension and heart disease. This commentary is a Q&A interview with Dr. Piercy and also reflects information provided to her through consultation with her colleagues in the Division of Prevention Science in the Office of Disease Prevention and Health Promotion, HHS.

Q: How can health care providers and fitness professionals use the Dietary Guidelines? What recommendations should they give to their patients/clients?

A: We know that regular physical activity and a healthy diet are among the most powerful tools we have to prevent or slow development of disease, and reduce the money we spend on health care. Professionals can help communicate healthy lifestyle messages based on the needs of their patients and clients. The new Dietary Guidelines recommendations focus on making small, manageable changes while working toward a healthier eating pattern. This includes eating fruits and vegetables, grains, lean meats and other protein foods, low-fat and fat-free dairy, oils and limited amounts of saturated fats, trans fats, added sugars and sodium.

Q: Previous editions of the Dietary Guidelines included information on physical activity’s impact on health. In this latest edition, are there also new recommendations on how much physical activity we need?

A: Although the primary focus of the Dietary Guidelines is on nutrition recommendations, physical activity is mentioned throughout this edition because of its critical and complementary role in promoting good health and preventing disease. As in the previous edition, Americans are encouraged to meet the current Physical Activity Guidelines for Americans (PAG.) Also included are strategies for all sectors of society to support Americans in making healthy eating choices and providing opportunities for regular physical activity. HHS recently announced its intent to update the PAG in 2018, and nominations are being accepted for the PAG Advisory Committee through February 5, 2016.

Q: This edition of the Dietary Guidelines includes caffeine for the first time. Is there guidance on caffeine and exercise performance?

A: More science is emerging on caffeine and health, specifically related to coffee intake. Although the Dietary Guidelines do not include specific guidance on caffeine and exercise, there is guidance that moderate coffee consumption (three to five 8 oz. cups/day or up to 400 mg/day of caffeine) can be incorporated into healthy eating patterns. However, people who do not usually consume caffeine are not encouraged to add it to their diet. There is not enough evidence to support a recommendation on energy drinks.

Q: There has been a lot of controversy in the media about new recommendations on meat in these latest Dietary Guidelines. Should we be eating more or less protein foods?

A: It is important to clarify that there was no change to recommendations for meat (or overall protein) consumption in the 2015-2020 Dietary Guidelines. Three healthy eating patterns, which include a variety of protein foods (1 - Healthy U.S. Style; 2 - Healthy Mediterranean Style; and 3 - Healthy Vegetarian Style), are provided; the first two of these patterns include recommendations for meat intake. Data shows that some population groups, particularly teen boys and adult men, consume greater amounts of meat, poultry, and eggs than the Dietary Guidelines recommends. All Americans – and these two male groups, especially – would benefit from consuming a greater variety of protein foods, like seafood, legumes and nuts.

Q: What was the evolution of cholesterol recommendations included in the Dietary Guidelines and why were these changed in this latest edition?

A: The change in the cholesterol recommendations is a result of the increasing scientific rigor that is used to inform the Dietary Guidelines – this is a good example of why it is important for the guidelines to be updated every five years based on the total body of scientific evidence. The current data showed that there was not adequate evidence demonstrating a direct relationship between dietary cholesterol intake and LDL cholesterol levels. In contrast, the evidence does show that a clear relationship exists between foods that are high in saturated fats and LDL cholesterol levels. Many foods that are high in saturated fats also are high in cholesterol. Therefore, if you are following a healthy eating pattern that is low in saturated fats, the amount of dietary cholesterol you consume will also be low.

Health care providers and fitness professionals are critical partners in implementing the strategies in this edition of the Dietary Guidelines. We plan to release a toolkit on health.gov during National Nutrition Month in March that will help health and fitness professionals share the messages in the Dietary Guidelines with their clients and patients. Sign up for email updates to receive information about these resources at www.dietaryguidelines.gov.