How The 2016 Federal Budget impacts nutrition, dietary advice and calorie labeling

If you are confused about what foods to eat and which constitute a healthy routine diet, you are not alone. In fact, this year has been extraordinary for its confusion and contention surrounding nutrition science and dietary guidelines. In fact, the experts - nutrition and public health – do not agree. The controversy was simmering even before the release of the 2015 Dietary Guidelines Advisory Committee Report, an update to the Guidelines I meticulously explained and passionately promoted 5 years ago – before I joined the rank of researcher (i.e., became a more critical reviewer).

Did the uproar over the Committee’s recommendations make its way into your daily news briefs? If so, you’ll know that the contention was strongest around the recommendation to lower meat intake, not just for health, but for the planet – for sustainability.

After the report was released, a non-scientist, nutrition journalist published a scathing article on the recommendations, which led to a crusade by the Center for Science in the Public Interest and a point by point response letter signed by over 100 experts, researchers and scholars (myself included) that was posted just about a week ago.

There is not just dissent on the recommendations, which include less salt, less saturated fat, less sugar, but also on the scientific evidence used and the scientific process itself. So much so, that the recently passed Omnibus Appropriations Bill 2016, delays the release of the guidelines! Read for yourself (selected text from the Congressional directives):

Congress continues to be concerned about the quality of scientific evidence and extraneous factors that were included in the 2015 Dietary Guidelines Advisory Committee's Scientific Report.

To ensure the guidelines adhere to the nutritional and dietary scope of the law and are based upon sound science, bill language has been included clearly stating that the final guidelines cannot be released or implemented unless they are based upon significant scientific agreement and adhere to the statutory mandate.

Questions have been raised about the scientific integrity of the process in developing the dietary guidelines and whether balanced nutritional information is reaching the public. The entire process used to formulate and establish the guidelines needs to be reviewed before future guidelines are issued. It is imperative that the guidelines be based upon strong, balanced science and focus on providing consumers with dietary and nutritional information that will assist them in eating a healthy and balanced diet. At a minimum, the process should include: full transparency, a lack of bias, and the inclusion and consideration of all of the latest available research and scientific evidence, even that which challenges current dietary recommendations.

The agreement (the Budget) provides $1,000,000 to review the dietary guideline process.

And that’s not all! The Omnibus Appropriations Bill takes aim at school nutrition and calorie labeling as well. The federal government by enactment of this bill, further delays calorie postings for grocery stores and ‘similar retail establishments,’ which I am assuming are the bowling alleys, movie theatres and convenience stores. My colleagues tell me that the FDA had already made those postponements and the Budget Bill just makes it a mandate. I might have been too focused on vending – which was already set for 2016 – to have noticed. What I am thinking is 1) this calorie labeling is never gonna happen and 2) if the federal law is not in place, state and local laws can’t be pre-empted, thus they can remain more restrictive… good for Philadelphia.

With regard to the school lunch program, schools can have more time to figure out how to increase the whole grain content of meals – though 95% of schools haven’t suggested that they need more time, so this is dumb. Also, the rule to lower the sodium content to a new lower goal has been halted pending scientific evidence that it is necessary to do so for health.

Here are a couple of links re the budget that was just passed.

Summary

Pretty much the whole thing

USDA-FDA specific budget language

The 2015 Dietary Guidelines: The Advisory Committee Makes Recommendations

I am not going to spend many hours of our time creating numerous posts to break down the newest (and pending) edition of the Dietary Guidelines for Americans, as I did 5 years ago.  Holy cows! Five years ago?!

I am not going to do it because others, with better nutritional backgrounds, have already been hitting the highlights and controversies and because you can read the report yourself.

But as is my style, I will say a few things before I link you to the document and one of my favorite blog posts related to it.

• Calories are as important as ever and a majority of the population - all ages - consume more than they need to maintain a health weight.  A healthy weight, better measured as waist circumference or waist to hip ratio than on a scale or BMI, is one in which the body does not have excess fat.
• Sugar quickly increases calories without adding nutrients - except naturally occurring sugar in fruits and vegetables - and dietary fat, though not necessarily harmful, has a lot of calories and therefore should be limited in the diet - animal sources and full fat dairy are a continuing concern in these guidelines.
• Plant based diets are still the best.
• Exercise is key to better health - better health.  Let's just stop talking about it as a way to lose weight or eat more, whether it helps with that or not does not matter as much as this:  Exercise in and of itself is a necessary component of good health!
• Taxes and info: Environmental strategies, the likes of which I focus my research on, are promoted in the recommendations. The Dietary Guideline Advisory Committee talks about the need for information disclosure at the point of purchase and taxes on sugar sweetened beverages.

Two excerpts from the full report of the Scientific Report of the 2015 Dietary Guidelines Advisory Committee

What to eat: 

Following a dietary pattern associated with reduced risk of CVD, overweight, and obesity also will have positive health benefits beyond these categories of health outcomes. Thus, 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. These dietary patterns can be achieved in many ways and should be tailored to the individual’s biological and medical needs as well as socio-cultural preferences. 

The food environment:

Align nutritional and agricultural policies with Dietary Guidelines recommendations and  make broad policy changes to transform the food system so as to promote population  health, including the use of economic and taxing policies to encourage the production and  consumption of healthy foods and to reduce unhealthy foods. For example, earmark tax revenues from sugar-sweetened beverages, snack foods and desserts high in calories, added sugars, or sodium, and other less healthy foods for nutrition education initiatives and obesity prevention programs.  

Click here for a great blog post by Dr. David Katz 

Get Your Fiber - from food

This quick post regarding dietary fiber is my reaction to a commercial for a supplement called Benefiber.  
It is true that most Americans need more fiber in their diets, and it is true that a diet high in fiber is associated with improved health.  
The Dietary Guidelines for Americans list fiber as a nutrient to increase and on page 88, the Guidelines  present a table of foods that are good sources of fiber. The best way to obtain fiber is from food, in fact, there is little, if any, evidence to suggest any benefit from a fiber supplement. Just like any other nutrient, the best place to get it is from your plate.  Choose foods that are naturally high in fiber instead of fiber pills - no matter what the commercial tells you.  The Guidelines do not recommend pills except under the rarest of circumstances, for example, if food is not available.

Notice the many fiber rich foods on the cover - these are the foods we should eat, within our own caloric limits.  The body needs food.

Information for Food Decisions

   The Dietary Guidelines for Americans recommend that calories be monitored on a daily basis.  The recommendation is based on the importance of consuming the appropriate amount of calories to prevent 'over fatness' - which appears to increase the risk for several diseases.
   To be fair, clear and honest, many of us do not know our calorie needs - the amount that balances with our energy expenditure.  This lack of knowledge needs to be addressed, but is not the focus of this post (calorie needs are assessed on an individual basis).  For now, lets pretend that everyone does know their personal needs- and agree that for most of us its between 1800 and 2500 calories a day (NOTE: if you need 1800 calories a day and consistently eat 2500 calories a day, you will have excess fat!)
   Presuming you need 1800 calories a day and you know this, and you obtain many of your meals away from home, to stay on target you need access to nutrition information at the point of purchase at those places . 
    I feel it is imperative that nutrition information be available everywhere  food decisions are made, but it is not.  The national menu labeling law (passed within the Affordable Care Act) amends an older law, the Nutrition Labeling and Education Act which excluded ready to eat foods, like those at restaurants- from nutrition labeling.  This oversight was a mistake and it took a new law to fix it.  The fact that the new law does not include all places that sell ready to eat foods, e.g., entertainment venues, is dumbfounding.  The FDA can fix this - they are responsible for the final rules.  It needs to be fixed now, not 20 years from now.  This is a real fight and certain industries and labeling advocates are battling it out - leading in some part to the delay of national labeling.
   The Center for Science in the Public Interest is lobbying for the expansion of nutrition labeling and today they shared the picture below from a New York City cinema.  NYC has a much broader labeling law, however, the federal law will override state and city laws.  That means even the NYC policy will not include movie theaters, (or theme parks, bowling alleys, etc.) if the federal law doesn't include them.  Take a look at the numbers below and see how important this information is to the person trying to stay in their limits.  BTW, we should all try to stay in our limits, at least most days.   
 

To take part in the campaign to expand labeling - click HERE

Just a note, the Nutrition Labeling and Education Act is the one that mandated nutrition information and nutrition facts panels on the foods you find on grocery store shelves.

More on labels and calorie disclosures

   Packaged food labeling is one of my research interests and my research interests are informed by my personal dietary goals. 
I believe that in order for the population (and me) to apply the nutrition recommendations offered by our government, we need to assess the foods available to us.  In order to assess them and choose the best, we need information.  We don't need a lot of information, but we need some.  We need enough to make an informed, but quick decision among many options.  
   I prefer the multiple traffic light system for any item, but at this time that isn't likely to occur.  The multiple traffic light (MTL) grades a food on imprortant attributes, e.g., saturated fat, salt and sugar.  A food gets either a red, yellow or green light in each category.  To eat well, you choose more foods that are green from all categories.
   The Institute of Medicine (IOM) has given the FDA a proposal that will make assessing the nutrient value of packaged food easier than our current Nutrition Facts Panel. I have discussed this at length in the past, so this is a bottom line refresher.  Instead of a MTL, the IOM suggests that each food item - if it first meets an overall eligibility criteria - be given one, two or three stars for each nutrient (saturated fat, sugar and sodium/salt). An example of something that wouldn't meet the eligibility criteria is candy.  Otherwise, a food item could have 1 to 3 stars.  ALL products, per the recommendation MUST list the calories per usual(practical) serving.  Whether or not something meets the eligibility criteria for stars, the calories per serving must be placed in eye catching text on the front of the package.
   It was that part of the recommendation I was thinking of as I shopped for groceries over the weekend.  You see, one of the main reasons for the IOM report is to address the confusion caused by food makers and grocers using their own front of package labels.  It is amazing how many do not include calories, and instead tell us things we can't intrepret or do not need to know.  For example, a grocery store shelf tag in Florida said, "20 carbs per serving".  SO WHAT??  That is not enough information to help me.   Another example, "contains 10 grams of fat".  SO WHAT?  Is it the kind of fat that is good for my heart?  If so, I want to buy it.  But no matter what it is, if it is energy dense (high in calories) I will probably avoid it (unless it is loaded with good fat, like salmon). We need our standardized, scientifically governed front of pack labels and we need them NOW.

  My other nutrition information interest is meals away from home  -  you need to see this new report from CSPI for some jaw dropping belly popping calorie counts.

 (If you are curious, my overall field of study is best explained this way - Public Health Law Research specific to Food Policy, specific to Policy that makes unhealthy (nutrient poor) foods less attractive > such as, information, price increases, zoning laws on fast food places, taxes, display bans/restriction, advertising limits.)