New dietary guidelines prioritize protein, less processed foods

S1: Welcome in San Diego. It's Jade Hindman on today's show. What America's new dietary guidelines get right and wrong. This is KPBS Midday Edition. Connecting our communities through conversation. So new U.S. dietary guidelines were released earlier this month. And they prioritize proteins , animal proteins , especially , and take aim at highly processed foods. So what do we all need to know about these revised guidelines and how they may impact our health ? While I'm joined now by Professor Cheryl Anderson , she is a professor and dean of UC San Diego School of Public Health. Welcome , professor.

S2: Thank you.

S1: Also , Tracey Roberts is here. She's a dietitian supervisor with UC San Diego Health. Traci , welcome to you.

S2: Thank you for having me.

S1: Glad to have you both here.

S2: And in addition to that , the whole grains have kind of been put at the bottom at the tip of the pyramid. And I think that's causing a lot of confusion , especially when it's being compared to the food pyramid that we used in the 90s , where we had a wide base of whole grains at the bottom. Mm.

S1: Mm. Well , Cheryl , what was your initial reaction to the new guidelines ? What stood out to you ? Yeah.

S2: Thanks so much for asking that , Jade.

S3: So as someone who sat on the Dietary Guidelines Advisory Committee that provided the report over a year ago , on which the guidelines were supposed to be made , I was actually quite eager to see where the secretaries were We're going to go with that information. What stood out for me was similar to what Tracy said , this emphasis on proteins. Typically , when guidelines are being made , the nutrients of concern for being over consumed or under consumed are usually brought forward. And there's a case made for why the guidelines might push for Americans to consume more of something or less than something. And to be quite honest , there's nothing saying that proteins being under consumed in this country. And so I was very surprised to see that emphasized in the way that it was. Mhm.

S1: Mhm.

S2: And an additional thing about the infographic that's a little bit difficult for consumers is that it does seem to rank order a bit the foods that are quote good or bad. And I think we kind of like to stay away from a hierarchy and really kind of support an eating pattern , which is why we had used my plate for so many years , is because we are looking to integrate all foods in different proportions for health , not just rank order foods as good or as bad.

S3: Yeah , I think Tracy is spot on , right ? We think about what people eat in the patterns that they eat them in. We don't eat nutrients , we eat foods , and we don't eat foods in isolation. We generally eat them as a big pattern. And so these guidelines really push us toward one nutrient in a way that is very different from the way guidelines have in the past. I will , however , say that it's good to see the consistency around saturated fat that remains no more than 10% of all of the calories that people consume in these guidelines , and was so in the past guidelines. It's also good to see the limits on added sugars , although they don't give them a proportional limit as it does in the prior guidelines. They just say no added sugars at all. And it's also good to see that salt or sodium is still limited in these guidelines.

S1: Well , I want to get into the details and sort of pull all of that apart. But you know , one thing I found interesting when I first heard about these changes was the argument that the initial pyramid that we had was largely influenced by the food industry. So , Tracy , I mean , I know you say your reaction to these guidelines was twofold. One was around the science , the other political. So tell me what you meant by that.

S2: Yeah , I know that there was some discussion with the previous release of the guidelines. How in the past maybe there was a little bit too much emphasis on grain and what was the influence of industry on that recommendation ? But I think the same can be said for the emphasis now on proteins and on dairy , and what potential industry influences went into the guidelines as they were released last week. So food is not just nutrition , unfortunately. Food is cultural. Food is political , food is environmental. So I think there's more that went into the graphic than just the nutrition research. Mhm.

S1: Mhm. Um , and let me , let me tell me a bit more about that. What , what else do you think went into that.

S2: Um , well not being on the panel. Um , I think Doctor Anderson might have a little bit more insight to that , but I did look at the the team that was responsible for the final version of the guidelines , and they did disclose in the industry ties. I did just notice there were a number of people on that panel who had ties to the cattle industry or to the dairy industry , and we always hope that our science can be non-biased , but it always does make someone question what potential influence went into that final pyramid.

S1: Well , Cheryl , I know Tracy just mentioned that. What what are your thoughts on that ? She mentioned you know how food is not just about nutrition.

S3: And they've been going on for decades now. There's a process by which the committee that gets formed to in to do the research that matters and review the research that matters for the guidelines has to follow. We all come to our science with biases. It's not a matter of what biases we have , it's how we manage the biases. And we need to disclose them and the process needs to be transparent. And so in this case , after the committee that was formed released , its conflicts again got reviewed around conflicts , went through a process that all of America could see. The meetings are open to the public. There's opportunity for public comment. This is a well-documented process for guidelines making. In spite of that process having been followed for two years. Once the secretaries for Health and Human Services and the USDA got together to make the guidelines , we see now , that process was not at all transparent. So we have no idea who the individuals were , who were convened to write the guidelines , who was reviewing the guidelines , and now that they're being put forward. We have no idea what the potential influences might be , because , again , that was all done in a really non-transparent way.

S1: Well , I want to touch on some of the previous ways health officials framed food before these last changes.

S2: It really aimed to help people put together a meal that had variety , balance , moderation and kind of , again , taking the knowledge of nutrition and putting that more into practice. So we had tried to teach dietitians in practice , tried to use my plate as a way to teach healthy eating patterns to the public. Hmm.

S1: Well , you know , so Cheryl touched on this earlier. There is more importance on protein intake now.

S2: And I think it's really difficult to offer blanket guidance on things like protein when it comes to an individual level. Um , there are people who are more active who require higher amounts of protein if they're athletes , if they're weightlifting , people who are more sedentary may require a little bit less protein with the guidance that came out. Currently 1.2 to 1 point 5g/kg. Sometimes that's difficult to reconcile if we do have people who are maybe overweight or obese , to calculate protein based on actual body weight might not be physiologically accurate. So it really does take talking. It's helpful at least to talk to a nutrition professional to get some guidance on your own individual specific macronutrients. Hmm.

S1: Hmm. Cheryl , are all forms of protein created equal ? It seems these new guidelines emphasize animal based proteins , as we mentioned. But what do you what do you make of that advice ? Yeah.

S3: So the current science tells us that plant based proteins are actually quite helpful in not only helping us meet our protein intake. You heard me mention earlier that it's not about any one nutrient. It's really about the full complement of things that we do. It's really about the pattern in which we eat. And so there are going to be some proteins that will carry other beneficial things with them , for example , some of the micronutrients or fiber. And when we look at the full body of science , we see that plant based proteins really pack a real punch , and it doesn't bring with it sometimes the saturated fat that you might see with some of the fattier animal proteins. Mhm.

S1: Mhm. I mean , and what about saturated fats. Are there concerns there with this greater emphasis on things like red meat or whole milk ? Cheryl.

S3: Yeah , I have a few thoughts here. So as I mentioned at the top of our conversation , I was really excited to see the limits on saturated fat be maintained. However , it's hard to reconcile the graphic that you see where there are animal products so prominently displayed at the top of this graphic , which suggesting to Americans that that might be where they want to focus their intake. Because without the help of a dietitian or someone who's really well skilled in nutrition meal planning , it could be very hard to stay within those saturated fat guidelines when using a lot of animal products. I will say a bit. One benefit , though , of having this be within the confines of the guidelines is that these guidelines are the underpinning of many federally sponsored programs that have nutrition components. For example , the school meals program , where 30 million children are being impacted. Those food providers will likely be able to make it happen , right. There will be a lot of careful planning that goes on in those school meals such that they figure it out. However , an everyday citizen will have a harder time staying within the limits for saturated fat if they use that graphic as their guide. Mhm.

S1: Mhm.

S2: Additionally something that I think we don't consider with whole grains do actually contain some protein. So if we're eating a diet that's rich in whole grains , not only are we getting some complex carbohydrates and fiber , but we are getting protein as well. So to my knowledge , there's never been a war on protein. And I think if we understand the full component of nutrients within our food , like whole grains , then we can see that we're getting multiple benefits , not just carbohydrates when it comes to whole grains.

S1: Cheryl , we hear about the dangers of processed and ultra processed foods more and more. Can you explain what those foods are exactly and how they're made ? Yeah.

S3: So ultra processed foods in this country come in a format that really doesn't take a lot of explanation , right ? People will often see them being full of added sugars. They'll be usually higher in salt. They'll sometimes have more saturated fats in them. And these are often snacky type products that we , you know , grab as a quick fix rather than starting from a whole food and usually processing them ourselves instead , the industry that , um , commercially processes them. So this is another , I think , really important , um , turn in our guidelines where we see this emphasis on reducing ultra processed foods within the American diet. One of the things that I was really disappointed about , and it relates to the grain content , because , you know , grains can sometimes be vilified because , again , they may come as in their ultra processed forms. Nonetheless , historically in this country , we have used the patterns within which people consume foods to think about things that we are deficient in and might require supplementation for. These guidelines are all about foods , not dietary supplements. And so when they're being made , they have to consider the places again where people are insufficient around micronutrient intake. For example , many of the B vitamins thiamin , niacin. A particularly important one for child health. Folic acid , which helps to prevent neural tube defect affected pregnancies. And these things are used in our food system through fortification to really boost and amplify us being able to get some of those micronutrients. And so this this placement of whole grains at the very bottom of this inverted pyramid and no conversation around fortification as a vehicle , fortification of cereals , grains , bread products is very concerning because we've seen the prevalence of neural tube defect affected pregnancies drop significantly. And I'd hate to see us in a situation where that gets reversed.

S1: Yeah , well , another important factor in this conversation over food is about cost , of course.

S2: I hear a lot in clinic that healthy eating is just too expensive. I think something that's important for us to discuss as health care providers is , you know , the availability of options for healthy , nutritious foods and limiting some of those more cheaper , refined , ultra processed foods. I think if we put more of an emphasis on providing access to healthier foods , not just in our school lunches like Doctor Anderson mentioned , but within our communities as well. Community partnerships , I think we would see downstream health care costs go down. So we need to put in the effort and the time now into our food system and our eating patterns to reduce those downstream health care costs.

S1:

S3: Um , thinking about limiting salt within the diet is something that they got. Right. Keeping sugars , added sugars down in the diet is something that I think came close to , right ? I mean , they say no added sugars at all , which I think is going to be really difficult for the American public to do given our food system. So what I'd like to see if we're aiming for those goals are a couple of things. Number one is we need a food system that makes it cost efficient , makes it accessible for people to really access these foods and these profiles of nutrition that it is that we're promoting in these guidelines. I'd also like for us to continue to support the public health surveillance systems that are going to help us know. Did they get it right ? We see right now funding for CDC , National Center for Health Statistics. Other public health agencies , um , being cut and being cut drastically. We're going to need to know five years from now , ten years from now , what the impact is on this shift in the graphic , as well as the messaging around foods for the American public. Mhm.

S1: Mhm.

S2: I think we do need to focus on food sources of nutrients and steer away from some of the more processed foods in our diet , but I think it is important. I also want to give a plug for research. We do need to fund a nutrition research because regardless of what the recommendations look like on paper and what our controlled research tells us. We do need to look at the American public and how they're eating and what impacts diet have on their health , so that we can refine those recommendations in the years to come.

S1: I've been speaking with Professor Cheryl Anderson. She is dean of the Herbert Wertheim School of Public Health and Human Longevity Science at UC San Diego , and also Tracey Roberts. She is outpatient dietitian supervisor at UC San Diego Health. Thank you very much to both of you.

S2: Thanks so much.

S3: Thanks so much , Jade.

S4: That's our show for today. I'm your host , Jade Hindman. Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.