New U.S. dietary guideline recommendations take aim at sugar for children and adults

WASHINGTON - The future may not be so sweet.

The committee assembled to help formulate the 2020 Dietary Guidelines for Americans is taking aim at sugar-sweetened beverages and added sugars. In a surprising development during the Trump administration, which has rolled back nutritional standards for school lunch and food assistance programs, the group is strongly advising a reduction in the amount of added sugars consumed by children and adults.

The committee, a group of 20 doctors, registered dietitians and public health experts, recommends reducing added sugars to 6% of daily calories, from 10%. The previous Dietary Guidelines took a major step forward in 2015 by suggesting added sugars be limited to 10% of total daily calories, but leading health organizations, supported by science, have long argued that lower limits would better protect health.

And for the first time, the committee made recommendations for children up to 2 years old, suggesting a ban on sugar-sweetened beverages. The experts argued that calories from sugar-sweetened beverages may displace those from nutritious foods and increase the risk of the child becoming overweight.

The advisory committee's report guides the Department of Health and Human Services and the Agriculture Department in determining the 2020 Dietary Guidelines for Americans, which help shape federally funded food assistance programs and the contents of school lunches, how foods are labeled and what our doctors exhort us to avoid or embrace.

With half of American adults suffering from one or more preventable, chronic diseases and about two-thirds of U.S. adults overweight or obese, the committee's recommendations come at a critical time.

People with diet-related diseases are at higher risk during the coronavirus pandemic, according to the Centers for Disease Control and Prevention. And there has been greater national scrutiny of systemic racism and the ways in which it compromises the health and well-being of people of color.

Americans consume an average of 17 teaspoons of added sugar daily. Added sugars intake is higher among adults who are younger, less educated, less affluent and less physically active.

But there are signs Americans are moving in a more healthful direction. About 37% of the country met the guidelines to get less than 10% of their calories from added sugar in 2016, up from 30% in 2013.

"In our view, the committee got it mostly right with these recommendations," says Jessi Silverman, policy associate at the nonprofit Center for Science in the Public Interest. But she warned food industry lobbying groups may seek to weaken the official guidelines and that "there is often political interference after the committee's report."

Committee members themselves are prohibited from speaking to the media until their deliberations have concluded.

Mary Story, a nutrition professor at Duke who was on the 2015 advisory committee, says that the Agriculture Department has a history of watering down or disregarding committee recommendations in the final guidelines, often because of political pressures.

"Our 2015 report [had] recommendations on reducing meat intake and addressing diet and sustainability - what is good for human health and planetary health - and this caused a ruckus in the industry and Congress," she wrote in an email. These recommendations were removed from the finished guidelines.

Advocacy groups have been concerned about undue influence from food industry groups in shaping the questions that were asked and how they were answered. The nonprofit activist organization Corporate Accountability found that 68% of public comments this year were submitted by food and beverage industry groups.

"The public's health, the growing call for health equity now, and our democracy demands far better than national nutrition policy recommendations written by industry lobbyists, on the advice of industry-connected scientists, who were nominated by industry trade groups," says Ashka Naik, research director for Corporate Accountability.

In part because of the pandemic and government shutdowns, this year's committee failed to reach conclusions on 24 of the 80 topics they were charged with addressing. These were thus left out of its report to the USDA.

"USDA and our partners at the Department of Health and Human Services take all comments and concerns about the dietary guidelines process very seriously," said Food and Nutrition Service administrator Pam Miller when asked about the rush to push forward the committee's recommendations in the context of a pandemic and civil unrest.

"Throughout the entire 2020-2025 dietary guidelines process, we have relied on the nation's leading scientists and dietary experts to inform our development of science-based guidelines and have taken numerous steps to promote transparency, integrity and public involvement," she said.

The beverages and added sugar subcommittee was unable to get to three out of five assigned topics. For added sugars, only one of five questions were addressed, leaving out questions such as the relationship between added sugar consumption and risk of Type 2 diabetes, or the relationship between added sugar consumption during pregnancy and gestational weight gain.