Fresh From DGAC Service, Harvard's Hu Discusses Why Less Beef Is Better

Evidence-Based Diabetes Management, Patient Centered Diabetes Care 2015, Volume 21, Issue SP9

The Dietary Guidelines Advisory Committee broke new ground in 2015 by looking at overall dietary patterns in announcing its findings, according to member Frank Hu, MD, MPH, PhD, of the Harvard School of Public Health.

Less beef is better for the health of people and the planet, and the updated diet recommenda-tions the federal government is finalizing ought to say so, according to findings from the 2015 Dietary Guide-lines Advisory Committee (DGAC).1

Frank Hu, MD, MPH, PhD, professor of epidemiology and nutrition at Harvard School of Public Health and a member of the advisory committee, outlined the 2015 Scientific Report of the DGAC on April 17, 2015, during Patient-Centered Diabetes Care 2015, held in Boston. Among DGAC’s conclusions:

  • coffee can be part of a healthy diet •everyone, especially children, should drink mostly water and re-duce sugar consumption
  • the limit on calories from fat to 30% total calories can be lifted
  • the limit on saturated fat to 10% of total calories should remain
  • one egg per day is not a health risk for a healthy adult
  • cholesterol should be removed from the list of “nutrients of concern.”

“In terms of environmental sustainability, our evidence-based review indicates that a dietary pattern relatively high in plant-based foods and relatively low in animal-based foods is more health-promoting and also associated with less environmental impact than the current average US diet,” Hu said.

One-third of adults in the United States suffer from chronic diseases including high blood pressure, cardiovascular disease, diabetes, and obesity all of which Hu said can be largely prevented through diet and lifestyle modifications. “The overall quality of the diet is suboptimal, low in fruits, vegetables, and whole grain products, but high in sodium, saturated fat, refined grains, added sugar, and empty calories,” is how Hu described the typical American diet.

The committee focused on “overall dietary patterns instead of individual nutrients” and found a number of distinct diets that achieved the recommended goals, he said. “One size doesn’t fit all.”

The longstanding recommendation that a healthy diet cap total fat at 30% of total calories was dropped by the committee. “Type of fat is more important than the total amount of fat,” he said. “We still retain the 10% upper limit on saturated fat. Saturated fat comes mostly from animal products such as red meat and high-fat dairy products.”

The recommendation to reduce red meat consumption to improve both human health and planetary health “is really a groundbreaking recommendation,” Hu added.

Among the more controversial recommendations is eliminating the upper limit of 300 mg of dietary cholesterol per day.

“We didn’t find a strong relationship between dietary cholesterol and serum cholesterol,” Hu said. The committee supports reducing high blood cholesterol but “the best way (is) through medications such as statin. Second is through a change in dietary fats, reducing saturated fats, increasing unsaturated fats, increasing dietary fiber, and increasing physical activity.’’

Coffee, along with an egg, is encouraged. The committee found that “relatively high” coffee consumption—up to 400 mg of caffeine daily—is not associated with increased risk of heart disease or cancer, but “There is consistent evidence that regular consumption of coffee is associated with a decreased risk of developing type 2 diabetes and the cardiovascular outcomes.”

Aside from coffee being permitted, “Water should be considered the preferred beverage choice, especially for children,” Hu said.

To discourage the consumption of foods with added sugar, the committee recommends label changes to display sugar content in grams and teaspoons, restrictions on marketing high-sugar foods to children, and “pricing strategies to promote the purchase of healthy foods and beverages,” Hu said.

As outlined by law, the report is be- ing reviewed by a committee appointed by the secretaries of the Department of Agriculture and the Department of Health and Human Services. Public comments were accepted through May 8, 2015. Once adopted by the 2 secretar-ies later in 2015, the Dietary Guidelines for Americans will serve as the nation’s official nutrition policy, affecting the foods purchased for the National School Lunch Program, foods permitted for purchase with public assistance, and military meals. The Guidelines will also affect the administration of the Affordable Care Act, National Prevention Strategy, nutrition facts labeling, and many other policies, Hu said.

A month after Patient-Centered Diabetes Care, Hu was the lead author on a commentary in JAMA that called for global policy initiatives similar to the DGAC recommendations, which the authors said are needed to combat rising rates of diabetes, especially in low- and middle-income countries.2 A list of suggestions for healthier eating and more physical activity—to combat obesity and reduce diabetes incidence—based on their article is included in the FIGURE.

REFERENCES

1. Dietary Guidelines Advisory Committee. Scientific Report of the 2015 Dietary Guide-lines Committee. http://www.health.gov/ dietaryguidelines/2015-scientific-report/. Published February 19, 2015. Accessed May 16, 2015.

2. Hu FB, Satija A, Manson JE. Curbing the diabe-tes pandemic: the need for global policy solutions [published online May 21, 2015]. JAMA. 2015 doi:10.1001/jama.2015.5287.