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Coming Together to Communicate the 2015-2020 Dietary Guidelines for Americans

Published:February 05, 2016DOI:https://doi.org/10.1016/j.jand.2015.12.010
      The recently released 2015-2020 Dietary Guidelines for Americans (DGA)

      US Department of Health and Human Services and US Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. 8th Edition. January 2016. Health.gov/DietaryGuidelines/2015/guidelines. Accessed January 3, 2016.

      serves as our nation’s nutrition policy backbone and an essential resource for health and nutrition professionals. Registered dietitian nutritionists (RDNs) rely on the evidence-based recommendations to help the public they serve make informed food and beverage choices. Now in its eighth edition, the DGA functions as a roadmap to guide Americans ages 2 years and older in preventing diet-related health conditions like obesity, type 2 diabetes, heart disease, and some cancers. The DGA is also used in developing federal food, nutrition, and health policies and programs and serve as the basis for federal nutrition education materials for the public. Produced by the US Department of Agriculture (USDA) and US Department of Health and Human Services (HHS), the DGA is updated every 5 years to reflect advancements in scientific knowledge and to translate the current science into food-based guidance to promote health in the United States.
      Developing the DGA is a multi-year, multi-stage process that involves many steps both within and outside of the federal government. From reviewing the scientific evidence to developing the DGA to implementing the DGA through various programs, RDNs play an important role in each of these stages. RDNs conduct research that continues to advance our knowledge and understanding of the relationship between diet and health. This research is reviewed by an external federal advisory committee, the Dietary Guidelines Advisory Committee (DGAC), whose review helped inform revisions to the DGA. Members of the DGAC included RDNs, and RDNs employed by the federal government supported the DGAC throughout its work, including assisting with systematic reviews of the scientific literature, food pattern modeling, and data analyses. In addition, RDNs within the federal government were involved in writing and reviewing the 2015-2020 DGA and will assist with implementing the DGA through various federal programs and education initiatives. We also want to acknowledge the important contributions of all RDNs who took the time to provide written or oral comments throughout the process. More than 29,000 public comments were received on the Scientific Report of the 2015 Dietary Guidelines Advisory Committee and were considered in the development of the 2015-2020 DGA.

      Recommendations throughout the Eight Editions

      In 1980, the first DGA was released to advise the public on diet and health. The next edition was released in 1985, and at that time it became widely used and accepted as a framework for nutrition education messages. Each edition of the DGA reflects the latest body of science and has provided relatively consistent advice about healthy eating. Key topics such as eating a variety of foods such as fruits and vegetables, grains, dairy products, and protein foods have been included, along with recommendations to choose foods and beverages to lower intake of saturated fats, sodium, and added sugars. Guidance about maintaining a healthy weight has also remained consistent, as well as advice about moderating alcohol consumption for adults of legal drinking age. Although science continues to evolve, many aspects of the previous DGA still ring true today.

      Helping People Meet Dietary Guidance Recommendations Remains a Challenge

      About half of all American adults, 117 million individuals, have one or more preventable chronic disease, many of which are related to poor quality eating patterns and physical inactivity. Concurrent with these high rates of diet-related chronic disease, trends in food intake over time show that, at the population level, Americans are not following the recommendations of the DGA (see Figure 1). For example, Healthy Eating Index (HEI) scores, a measure of how food choices align with the DGA, and physical activity levels have remained low, while the prevalence of overweight and obesity has risen and remained high for the past 25 years. Conversely, diets with higher HEI scores have been associated with a 15% to 22% reduction in the risk for both onset of and death from cardiovascular disease, cancer, and type 2 diabetes.
      • Schwingshackl L.
      • Hoffmann G.
      Diet quality as assessed by the Healthy Eating Index, the Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension Score, and Health Outcomes: A systematic review and meta-analysis of cohort studies.
      Figure thumbnail gr1
      Figure 1US dietary intake compared to Dietary Guidelines for Americans recommendations (percent of the US population ages 1 year and older who are below, at, or above each dietary goal or limit). Note: The center (0) line is the goal or limit. For most, those represented by the orange sections of the bars, shifting toward the center line, will improve their eating pattern. (Data Sources: What We Eat in America, National Health and Nutrition Examination Survey [NHANES] 2007-2010 for average intakes by age-sex group. Healthy U.S.-Style Food Patterns, which vary based on age, sex, and activity level, for recommended intakes and limits.)
      Helping Americans meet DGA recommendations at the population level will require broad coordination and collaboration at all levels of society. This collective action is needed to create a new paradigm in which healthy lifestyle choices at home, school, work, and in the community are easy, accessible, affordable, and normative.

      Main Themes from the 2015-2020 DGA

      A focus of the 2015-2020 DGA is healthy eating patterns. Eating patterns are the combinations of foods and beverages that make up an individual’s complete dietary intake over time. A growing body of research has examined the relationship between overall eating patterns, health, and risk of chronic disease, and findings were sufficiently well-established to support dietary guidance. The 2015-2020 DGA provides five Guidelines (see Figure 2). Additional information is provided in Key Recommendations, supporting text and appendices, which can all be found at Health.gov/DietaryGuidelines. The guidance is discussed within three chapters:
      • Chapter 1. Key Elements of Healthy Eating Patterns—discusses the relationship of diet and physical activity to health over the life span and explains the principles of a healthy eating pattern. Example eating patterns are provided to demonstrate how individuals can follow these principles and recommendations and adapt them to personal and cultural preferences.
      • Chapter 2. Shifts Needed to Align with Healthy Eating Patterns—compares current food and nutrient intake in the United States to recommendations and describes the shifts in dietary choices that are needed to help align current intakes with recommendations. For each food group and dietary component, current intakes are provided at the population level and by age and sex groups to describe areas where recommendations are being met but also highlight areas that need improvement.
      • Chapter 3. Everyone Has a Role in Supporting Healthy Eating Patterns—outlines how all individuals, groups, and segments of society have an important role to play in supporting healthy eating and physical activity choices. A variety of example strategies and actions that align with the DGA are included.
      Figure thumbnail gr2
      Figure 2The five guidelines of the 2015-2020 Dietary Guidelines for Americans.
      The DGA is an important part of complex and multifaceted solutions to promoting health and reducing the risk of chronic disease. RDNs are at the forefront of comprehensive and coordinated initiatives to reverse these and other diet-related health trends. RDNs, whether working with individuals or groups, or in schools, communities, worksites, hospitals, businesses or industries, governments, or other institutions can use resources such as the evidence-based DGA and the Physical Activity Guidelines for Americans as the foundation for nutrition and public health programs and education initiatives.

      Key Resources to Communicate the Guidelines

      RDNs serve an important role in implementing and helping the public understand the DGA. As experts in the field, RDNs are adept in comprehending and translating nutrition science; RDNs make population based guidance actionable for individuals, families, and communities. In addition to the DGA itself, DietaryGuidelines.gov and Health.gov/DietaryGuidelines provide digital and print-ready materials RDNs can adopt in their practice to aid individuals and groups in making healthy food and physical activity choices.
      Based on research with RDNs and other professionals, HHS developed and tailored materials to meet the needs of busy professionals and decision-makers. Throughout the year, Health. gov/DietaryGuidelines will feature a suite of resources to familiarize RDNs with the DGA and assist them in incorporating the recommendations into their practice.

      MyPlate and SuperTracker

      Originally developed by the USDA to support the 2010 DGA, MyPlate continues to serve as a primary consumer communication vehicle for the 2015-2020 DGA. A recent poll by Pollack Communications and Today’s Dietitian indicated that more than 73% of RDNs are currently using MyPlate in their nutrition education initiatives.

      PR Newswire. 15 Top diet trends for 2015. What's trending in nutrition? Survey of nutrition experts predicts popular trends. http://www.prnewswire.com/news-releases/15-top-diet-trends-for-2015-300011670.html. Published December 18, 2014. Accessed January 3, 2016.

      This illustrates the tremendous opportunity of RDNs to build on the momentum gained over the past 5 years and reach more people together with consistent, science-based nutrition messages.
      To reflect the new DGA, MyPlate messages have expanded to emphasize a healthy dietary pattern and how consumers can build a healthy dietary pattern over time (Figure 3). Messages were also added to encourage shifts in consumption, for example, from juice to whole fruit, and to consuming a wider variety of vegetables from the various vegetable subgroups, such as red-orange, dark green, and beans and peas.
      Figure thumbnail gr3
      Figure 3The MyPlate icon and 2015-2020 consumer messages.

      MyPlate, MyWins

      With the 2015-2020 DGA, the Center for Nutrition Policy and Promotion (CNPP) is encouraging consumers to build a healthy eating style that fits with their daily life. They can do this by making small changes to their food and beverage choices. Each small change is a victory on the road to a healthier diet and is a “win” for the individual. CNPP’s “MyPlate, MyWins” theme reflects the 2015-2020 DGA and conveys a positive and empowering message to the public. Specifically, the campaign will highlight multiple ways to meet DGA recommendations and encourage individuals and families to make healthier choices they can enjoy.
      Over the next several years, CNPP will implement a comprehensive campaign with timed releases in conjunction with topical events that encourage individuals to implement the “MyPlate, MyWins” strategies and make healthy eating easier and more attainable. In January 2016, the campaign focused on finding healthy eating solutions, instead of resolutions, that can be maintained throughout the year. This sets the stage for releases in March for National Nutrition Month and June for MyPlate’s 5th birthday. Stay tuned to this column or visit ChooseMyPlate.gov to find out about subsequent releases.

      SuperTracker Provides Personalized Advice Based on the DGA

      For individuals and RDNs that seek tailored guidance, SuperTracker offers personalized nutrition plans to help guide food and beverage choices. Updated to reflect the 2015-2020 DGA, SuperTracker users who enter their age, sex, height, weight, and activity level can receive an individualized plan that includes daily calorie and food group targets. SuperTracker also allows users to track sodium, saturated fat, and added sugar consumption across their food and beverage choices. RDNs can leverage SuperTracker’s newest enhancement to create a healthy eating and physical activity challenge for clients, colleagues, or students. Group challenges encourage healthy behaviors through friendly competition and gamification. Group leaders can choose from a ready-made “MyPlate Challenge” or create a custom challenge at SuperTracker.usda.gov/AboutGroups.

      Resources for Material Development

      In addition to the wealth of resources available at Health.gov/DietaryGuidelines, ChooseMyPlate.gov, and SuperTracker.usda.gov, RDNs can develop their own resources based on the DGA and adopt MyPlate consumer messages. Through audience-specific materials and messaging, RDNs can help individuals in a variety of settings develop healthy eating patterns that accommodate physical health, cultural, ethnic, traditional, and personal preference, as well as food budgets and accessibility. This type of tailored nutrition guidance is more likely to be seen as motivating, accepted, and maintained over time, which may lead to meaningful shifts in dietary intake, and consequently, improved health.
      The Communicator’s Guide available at ChooseMyPlate.gov can assist RDNs and others with creating materials based on the 2015-2020 DGA. This online resource offers a synopsis of the DGA and key areas of focus as well as best practices in communicating health and nutrition information to various audiences. This resource also includes specific consumer messages and key considerations for translating the DGA into consumer messages and materials.
      Over the next 5 years, there will be numerous opportunities for RDNs to empower consumers with implementing healthy eating behaviors. Join the “MyPlate, MyWins” conversation as a National Strategic Partner, Community Partner, or Campus Ambassador. Utilize campaign resources and engage with other partners in the CNPP Nutrition Communicators Network to share programs, projects, ideas, and best practices. See the USDA Center for Nutrition Policy and Promotion Corner in the March 2016 issue for more details and ideas to engage and challenge consumers to adopt healthier dietary patterns!

      Acknowledgements

      The authors thank Jackie Haven, MS, RD, Colette Rihane, MS, RD, and Shelley Maniscalco, MPH, RD, at the US Department of Agriculture, Center for Nutrition Policy and Promotion, as well as Don Wright, MD, MPH, and Richard Olson, MD, MPH, at the US Department of Health and Human Services, Office of Disease Prevention and Health Promotion, for their contributions to this article.

      References

      1. US Department of Health and Human Services and US Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. 8th Edition. January 2016. Health.gov/DietaryGuidelines/2015/guidelines. Accessed January 3, 2016.

        • Schwingshackl L.
        • Hoffmann G.
        Diet quality as assessed by the Healthy Eating Index, the Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension Score, and Health Outcomes: A systematic review and meta-analysis of cohort studies.
        J Acad Nutr Diet. 2015; 115: 780-800.e5
      2. PR Newswire. 15 Top diet trends for 2015. What's trending in nutrition? Survey of nutrition experts predicts popular trends. http://www.prnewswire.com/news-releases/15-top-diet-trends-for-2015-300011670.html. Published December 18, 2014. Accessed January 3, 2016.