The committee submitted its recommendations Feb. 19 to Health and Human Services Secretary Sylvia Burwell and Agriculture Secretary Tom Vilsack. Their guidance will underpin the 2015 edition of the Dietary Guidelines for Americans. The recommendations are subject to public comment as well as input from other federal agencies before the guidelines will be released later this year.
Even as it leaves its formal grains recommendation unchanged, the committee report is replete with calls for cutbacks in intake of “refined grains” in favor of whole grains.
“The U.S. population should be encouraged and guided to consume dietary patterns that are rich in vegetables, fruit, whole grains, seafood, legumes, and nuts; moderate in low- and non-fat dairy products and alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and beverages and refined grains,” the group said. Later, the committee said that “to improve diet quality, the U.S. population should replace most refined grains with whole grains.”
At the same time, data cited by the committee suggested that even after gains in whole grain intake over the past decade, progress toward intake targets has been negligible.
“In general, the best scores for the HEI (Healthy Eating Index) components were for protein and seafood and plant proteins, while the poorest score was for whole grains,” the committee said. Because consumption of whole grains relative to 2010 recommendations have missed so badly, the committee examined the impact on nutrient intake if refined/enriched grains intake were cut to no more than 25% or 15% of grains intake and if overall grains intake were reduced. At the heart of its decision to “bring forward” the 2010 grains recommendation unchanged was unease about the potential for micronutrient deficiencies to result from a change.
The committee expressed concern about a number of under consumed micronutrients: vitamin A, vitamin D, vitamin E, vitamin C, folate, calcium, magnesium, fiber, and potassium. For adolescent and premenopausal females, iron also was described as a shortfall nutrient. Grain-based foods are a principal source for several of the micronutrients.
First-blush reviews from grain-based foods groups were less than glowing.
“The Dietary Guidelines Advisory Committee’s inclusion of enriched grains in the refined grains category is a big setback for women and infants’ health, particularly in the Hispanic community,” said Robb MacKie, president and chief executive officer of the American Bakers Association. “This recommendation puts at risk the significant health gains made due to folic acid fortification of enriched grains, most notably a 36% reduction in neural tube defects — a success the C.D.C. has touted as one of the top public health achievements of the past decade.
“Whereas A.B.A. supports the committee’s recognition of the nutritional contribution of whole grains to the diet and the need to increase consumption among all Americans, A.B.A. also feels it is important to acknowledge the crucial contribution made by enriched grains in the diet to ensure adequate nutrients, like folic acid, fiber, and iron, especially for women of child bearing age and infants.
“This is a lengthy report that requires further study and review. We look forward to working with the departments of Health & Human Services and Agriculture in translating the D.G.A.C. report into science-based dietary guidelines that communicate the vital role of both enriched and whole grains in a healthy, balanced diet.”
A similar tenor was evident in remarks from the Independent Bakers Association.
“Overall, we’re disappointed that the D.G.A.C. recommendations fail to consider the full breadth of science and research on healthful nutrients, especially those found in baked goods,” said Ron Cardey, chairman of the I.B.A.
Of particular concern are the recommendations on sodium as well as the characterization of “added sugars.”
“These recommendations continue an approach of ‘good food versus bad food’ rather than a balanced diet with all things in moderation,” he said.
Public health issues related to eating habits drove the D.G.A.C. recommendations for 2015, the group said.
“The 2015 D.G.A.C.’s work was guided by two fundamental realities,” the group said. “First, about half of all American adults — 117 million individuals — have one or more preventable, chronic diseases, and about two-third of U.S. adults — nearly 155 million individuals — are overweight or obese. These conditions have been highly prevalent for more than two decades. Poor dietary patterns, overconsumption of calories, and physical inactivity directly contribute to these disorders.”
Judi Adams, M.S., R.D.N., president of the Wheat Foods Council, said the W.F.C. “is closely reviewing the report.” Ms. Adams said the W.F.C.’s response will be part of written and oral comments that will be filed by the Grain Chain.
The North American Millers’ Association said it is still reviewing the report and plans to continue working with its allied organizations as part of the Grain Chain to submit comments, but offered up the following initial reaction: “The 2015 Dietary Guidelines has been a top policy priority for NAMA and our members. Briefly, NAMA is generally pleased that the Committee seems to have recognized the important role grains have in the diet by maintaining the 2010 Guidelines that call for six total servings of grain, half enriched grain and half whole grain, and that this has been an important public policy priority for NAMA and the milling industry. The report also noted that enriched grains that have been fortified remain an important source of folic acid (and B vitamin) for women of childbearing potential and that the effect of the folic acid fortification on health was extensively reviewed by the 2010 D.G.A.C. and the 2010 D.G.A.C. concluded there has been a large reduction in the incidence of neural tube defects in the United States and Canada following mandatory folic acid fortification.”