Last week, just in time for New Years’ resolutions, the federal government released the 8th edition of the Dietary Guidelines for Americans. What do they say, and how do they affect you?

The headline grabbers in this year’s 500+ page Guidelines are the recommendations to eat less “added sugar” and go easier on cholesterol, but in order to figure out what, if anything this means to you, personally, or to how you should feed your family, it helps to know a little about the Guidelines process. And it also helps to know that the intended purpose of the Guidelines is to guide the policy makers who decide things like what nutrients should and shouldn’t be included in the government-subsidized school lunches, what eating advice you might see on the back of the city transit bus in front of you, and other high-level eating edicts.

The Dietary Guidelines have been updated periodically since they were first issued in 1980 (the first guidelines were really issued in 1977, as a report called the Dietary Goals for the United States, dubbed the McGovern Report, after Senator George McGovern, who headed the Senate Select Committee on Nutrition and Human Needs, spurred by an increasing concern about the rising rates of obesity and declining health of the US population. The Guidelines are now mandated by a 1990 government act to be updated every 5 years.

The Guidelines are supposed to be based on a stringent review of the scientific evidence on the effect of nutrition on health. But the contribution of scientific evidence compared with the contribution of the political clout of food industry stakeholders (the farmers, food manufacturers, and their lobbies) has been a big concern of nutritionists and skeptics in general, and this year is no exception. Yet the fault doesn’t lie entirely with the lobbyists: It’s easy to try to lay all the blame on lobbyists for misleading or biased guidance, but we also need to consider two other factors First, the evidence for the health, or disease, promoting qualities of various foods and nutrients has often been weak (or confusing and contradictory), at best. And second, some of the research that constitutes that evidence is actually conducted or paid for by the food manufacturers themselves!

Another problem with the Dietary Guidelines, at least one I have with them, is that regardless of the strength of the evidence, and its sources, the Guidelines have always framed their advice in terms of nutrients, as in, “eat less fat, sodium…” But as I often counsel, when we’re hungry and must decide what to eat, we don’t choose from a menu of nutrients, we choose foods, and foods are almost always combinations of nutrients. Hence, the Guidelines can’t help but be confusing to the average person and virtually impossible to use to guide dietary changes. I guess my concern is shared by many critics because the makers of this year’s Guidelines promised to make them food-based (in fact, food-based guidelines are a big area of effort in the public health nutrition world).

So did they succeed in issuing food-based guidelines? Well, yes and no, and guidance in some parts of the report contradicts guidance in other parts of the report. This contradiction might not be surprising, given that the full report is 571 pages, but the contradictions are in some major key messages. Here are the 5 main Guidelines followed by my attempts to translate (i.e. read between the lines) and comment:

1. Follow a healthy eating pattern across the lifespan;
2. Focus on variety, nutrient density, and amount;
3. Limit calories from added sugars and saturated fats and reduce sodium intake;
4. Shift to healthier food and beverage choices; and
5. Support healthy eating patterns for all.

So what do all these platitudes mean? The devil, as they say, is in the details.

1. Follow a healthy eating pattern across the lifespan.
The Guidelines spend a lot of effort trying to define what they call a “healthy eating pattern,” which is their way of saying, everything you eat or drink, or as most of us call it, a diet. They advocate including fruits (preferably whole, not juice), vegetables (fresh, frozen, or canned), lean meats, fish, eggs, and grain foods (breads, pasta, cereals, rice, and legumes/beans, half of which should be wholegrain). The “across the lifespan” phrase is probably shorthand for, “make sure you start feeding your children a healthy diet from birth, because the chance of getting diseases like heart disease, diabetes, and cancer might actually be affected by what you eat throughout your whole life… so in case you’re old, make sure you still eat a healthy diet!”

2. Focus on variety, nutrient density, and amount.
The advice to eat a variety of foods to get a full complement of nutrients is nothing new, and unfortunately, it doesn’t mean a variety of different donuts or cookies or jelly bean flavors! It means a variety of “nutrient dense foods.” What are those? And weren’t the Dietary Guidelines supposed to be focusing on foods, not nutrients? Nutrient dense foods are defined as foods that contain a lot of lean protein, “healthy” fats, complex carbohydrates, vitamins, and minerals for the amount of calories, but how do you recognize them at the store or on the menu? Think:
• whole fruit instead of fruit drinks, jam, pastries, or even juice;
• vegetables that are eaten raw, steamed, roasted, or baked, but not breaded, fried, or loaded with buttery sauces, oily or mayonnaise based dressings, gravy, or melted cheese;
• leaner (less fatty) cuts of beef and pork, skinless chicken and turkey breasts, eggs, fish and shellfish that are not deep fried, and
• 100% whole wheat bread, whole grain cereals, beans, and whole wheat pasta and brown rice, but NOT sugary, high-fat cakes, pastries, cookies, and pies, white bread, heavily sweetened breakfast cereals…
But the word, “amount” may be the most important word in the Guideline. All foods can be part of a healthy diet! The key is in the amounts!

3. Limit calories from added sugars and saturated fats and reduce sodium intake.
More nutrient talk…The Guidelines actually go on to set recommended limits on these nutrients.

Last year, the federal government proposed modifying the Food Facts labels on processed foods to include the amount of “added sugars.” At the time, I asked my Facebook friends what the term “added sugar” meant to them; although I have a pretty nutrition-informed group of friends, many weren’t really sure what the term meant, how it was calculated, or how they would use the info to make better food choices. Added sugars are best defined by example: the sugar in non-diet soda, sugar-sweetened breakfast cereal, the sugar syrup in canned fruits with syrup; the parts of preserves, jams, and jellies that are not actual fruit; and the sugar added to condiments like ketchup and most peanut butter, sweetened dairy products like chocolate milk, flavored yogurt, ice cream, frozen yogurt, and of course pastries, cookies, cakes, and candies. So, you would need to see the amount of “added sugar” on the label of a processed food to have any idea how much it contained. Non-added sugars are the sugars naturally found in fresh fruits and dairy products (yes, dairy products contain a sugar called lactose: see my intro to carbohydrates under “Terms of Interest” on my site. To the Guidelines folks, foods with added sugars are like the antithesis of nutrient-dense foods, but added sugars can serve an important place in our diets (eating patterns). I would rather see a child drink chocolate milk than no milk at all and eat fruit-flavored Greek yogurt than to avoid that great source of protein and calcium. The Guidelines don’t exactly say to ban added sugars from your diet but to limit them to 10% or less of your total calorie intake. By far the biggest contributor of added sugar to many people’s diets is soda. Say you consume 2000 calories a day: 10% of 2000 calories is equivalent to 1 1/3 cans of soda! At that rate, you can see that it doesn’t take much to make up 10%! And how did they arrive at 10%? By estimating the calories you would need to consume to supply all the protein, fiber, vitamins, minerals, and good fats you need in an average day, which brings me to the fat part of the Guidelines.

Some recent evidence suggests that foods that are high in “saturated fat” (the fat in meat and milk) may not be as unhealthy as previously thought, but this evidence is controversial. Unfortunately, most consumers will interpret this guideline as more of the same “low-fat eating,” they’ve heard in the past, especially because no actual foods are mentioned. Foods that contain what we think are healthy UN-saturated fats that should have been encouraged include dark fish, olives, nuts, legumes, and olive and nut oils. Foods higher in saturated (animal) fats, like less-lean meats (bacon!) and full-fat dairy products are ok in smaller amounts: The Guidelines set a limit on saturated fats to 10%, using the same logic as the limit on added sugar.

What about that old enemy, cholesterol? Although the summary of the Guidelines doesn’t mention cholesterol, the fine print mentions cholesterol plenty, but not in a way that provides much clarity; in fact, it even contradicts itself! Cholesterols are waxy substances manufactured in the bodies of all animals (but not in any plants) that serve as transporters for fats: fats in foods and fats made by our own bodies. High levels of total cholesterol and a particular cholesterol, LDL-cholesterol, in our blood have been linked to a greater chance of having heart disease. For that reason, in the 1980s, dietary guidelines strongly recommended against eating eggs, as egg yolks happen to be especially rich in cholesterol. The problem is that our bodies make all the cholesterol we need, and “dietary” cholesterol, by itself, may not contribute much to higher levels of “blood” cholesterol. Recently eggs have been let off the hook somewhat, and regained their reputation as a good, cheap source of protein and several other nutrients. But the new Dietary Guidelines waffle about whether eggs, and even shellfish, which also contains a fair amount of cholesterol, are ok to eat. My suggestion: a few eggs a week are fine (watch the bacon); the eggs in processed foods (like pancakes) are probably not as big a concern as the calories in those foods; and eat as much shrimp and lobster as your budget allows!

The Guidelines’ position on limiting sodium (salt!) has changed slightly in an interesting way. Recognizing the huge challenge of trying to achieve the prior suggested limits of 1500 milligrams of sodium per day (3/4 teaspoon of actual salt), the Guidelines makers now suggest 2300 milligrams (1 teaspoon) as the target. The research on the health consequences of salt is very controversial, to say the least, but we would all benefit from limiting our salt intake a bit. The point to remember, though, is that the salt we add to our food is not the problem: It’s the salt that is added during processing and manufacturing! The best example I can think of to illustrate this point is that the biggest source of salt in Americans’ diets is…bread!!!

4. Shift to healthier food and beverage choices.
My interpretation of this guideline is that no one needs to completely abandon the dishes he or she loves and has grown up eating, but that we should strive to use more “fresh” ingredients and minimize oils we use to cook the dishes, to make them healthier and lower in calories. Like the way our grandparents cooked them in the old country.

5. Support healthy eating patterns for all.
The meaning of this vague platitude appears to be that everyone–the government, school teachers, school nutritionists and cooks, parents, food establishment owners, and even we ourselves—is responsible for what we and our children eat. I don’t think this shared responsibility is news to anyone. But I do see a much needed call for increasing parents’ knowledge base on good eating habits. After all, they play THE most critical role in shaping their children’s eating habits from birth, if not before. In addition, children tend to repeat what they see. Only by intervening at the earliest possible moments can we as a society begin to ensure that all parents know how to feed their children a healthy diet.

So there you have it! Check the Guidelines out, if you dare, and tell me what you think!