What role should dietary supplements play in the 2020 Dietary Guidelines for Americans?

The United States Department of Agriculture (USDA) and US Health & Human Services (HHS) released a list of proposed topics and scientific questions​​ to help draft the new guidelines.

Based on the US Farm Bill from 2014, the Dietary Guidelines must now provide guidance for women who are pregnant, as well as infants and toddlers from birth to 24 months. The guidelines are now divided into five groups: Infants and toddlers form birth to 24 months; children and adolescents, ages 2-18 years old; adults, ages 19-64 years old; Pregnancy and lactation; and older adults, ages 65 and older.

In its original list, the USDA and HHS included the topic ‘Dietary supplements (e.g., iron, vitamin D, vitamin B12)’ only for two populations: Ages 0 to 24 months, and pregnant and lactating women.

The departments then solicited written comments on the topics and questions to be examined in the review of scientific evidence, which will support the development of the 2020-2025 Dietary Guidelines for Americans.

Here is a small selection of comments in the docket​​ (6,061 total received, 5,872 posted) relating to what role dietary supplements should play in the guideline.

‘GOED is surprised by the absence of any mention of DHA’​​ - Global Organization for EPA and DHA Omega-3 (GOED)​

“Given the documented importance of docosahexaenoic acid (DHA) during this life stage, GOED is surprised by the absence of any mention of DHA. ​

“GOED recommends expanding the topic of duration of breast milk and infant formula feeding to include composition (including DHA). The questions listed, including “1) growth, size, and body composition; 2) food allergies and other atopic allergic diseases; and 3) long-term health outcomes” are relevant/applicable to composition, including DHA. For the topic of “Dietary supplements (e.g., iron, vitamin D, vitamin B12)”, GOED recommends including DHA.”​

“[Include] specific guidance throughout ages: Children and adolescents ages 2-18 years old; adults ages 19-64 years old; pregnancy and lactation; older adults, ages 65 years and older.”​

Read the full comment HERE​​

‘Dietary supplements should be a topic included for all life stages’​​ - Council for Responsible Nutrition (CRN)​

“CRN notes that, although dietary supplements are a topic for the life stages to be included in the Dietary Guidelines for the first time in the 2020-2025 edition (infants and toddlers from birth to 24 months and pregnancy and lactation) they were not included as a topic for the traditionally included stages of life (children and adolescents, adults, and older adults). CRN suggests that dietary supplements should be a topic included for all life stages. ​

“Dietary supplements, a category of food, fall within the scope of the Dietary Guidelines. Dietary supplements are already a proposed topic for two specific life stages.”​

“Dietary supplement use is widespread in the U.S., and dietary supplements are a good option to help individuals that consistently do not achieve nutrient adequacy, such as iron for adolescent females3; iron, folic acid, and iodine for women who are pregnant or capable of pregnancy; and vitamin D for the general population.”​

Read the full comment HERE​​

‘We need to better understand the role nutritional supplements play in helping Americans meet their nutritional needs’ -​​ Nestlé​

“While we understand the Dietary Guidelines for Americans have traditionally been focused on whole foods vs. specific nutrients, certain nutrients such as potassium continue to be consumed at level slower than recommended therefore we recommend considering whether there should be an increased focus on other nutritional strategies to help individuals close these gaps? ​

This is important in light of the Office of Dietary Supplements reporting that the majority of adults take supplements either daily or occasionally. We need to better understand the role nutritional supplements play in helping Americans meet their nutritional needs.”​

Read the full comment HERE​​

‘Dietary guidance is most effective when it is practical and actionable for most Americans’ -​​ American Society for Nutrition (ASN)​

“We also appreciate the continued focus on dietary patterns and support a total diet approach, which includes intake of food groups, nutrients, and bioactive dietary components, given the complex interactions of foods and beverages consumed and their impact on health. ASN also notes that dietary guidance must support the various cultural, social, and economic factors that affect individual dietary patterns and eating behaviors and habits, such as snacking and dietary supplement intake. ​

"Dietary guidance is most effective when it is practical and actionable for most Americans. The need to balance nutrients, foods, and behaviors to achieve a healthful eating pattern should be highlighted, and a continued focus on calorie reduction and chronic disease and obesity prevention should be emphasized.”​

In its amendments of topics proposed by the USDA and HHS, ASN added the topic of dietary supplements to the 65+ group.

Read the full comment HERE​​

‘Prioritize recommendations for whole foods before dietary supplements’​ -​ The National WIC Association​

“While it is important to ensure the micronutrient needs of the population are met, reliance on supplements to do this may be detrimental, particularly given that review studies have shown multivitamin and mineral supplements to be ineffective in preventing disease.”​

Read the full comment HERE​​

Developing plant-based sources of omega-3 fatty acids –​ Institute of Food Technologists (IFT)​

“Evidence shows that omega-3 fatty acids are associated with health benefits for the general population.  Docosahexaenoic acid (DHA) is associated with fetal growth and development and improved infant health outcomes, such as visual and cognitive development.  ​

“Developing plant-based sources of eicosapentaenoic acid and DHA through innovative technologies, such as biotechnology, could help increase availability and consumption of omega-3 fatty acids, particularly for consumers who are allergic to fish, who do not eat fish or products derived from fish, and women who are pregnant or breastfeeding.”​

“Further, plant sources of omega-3 fatty acids provide alternate options to include these fatty acids in the diets of pregnant women, women who are breastfeeding, and young children, which can help address potential concerns related to methyl mercury in fish.”  ​

Read the full comment HERE​​

‘USDA and HHS should not include an assessment of caffeine in the next iteration of the Dietary Guidelines’​​ - American Beverage Association (ABA)​

“USDA and HHS should not include an assessment of caffeine in the next iteration of the Dietary Guidelines, and the Agencies should acknowledge that the inclusion of caffeine in prior versions was inappropriate. ​

“Caffeine is an ingredient in numerous beverages and other foods that has been subject to active regulation by FDA over the last several years. Every global body that has examined the safety of caffeine (including FDA, the 2015 Dietary Guidelines Advisory Committee, the European Food Safety Authority (EFSA),and the World Health Organization (WHO)) has concluded that the inclusion of caffeine in the diet is consistent with safety, and that adults can incorporate caffeine as part of a healthy eating pattern at a moderate level of400 mg/day.”​

“Even in the context of energy drinks, consumption of caffeine is not an issue, as the prevalence of energy drink consumers remains low and overall caffeine intake among energy drink consumers falls below the 400mg/day moderate amount.”​

Read the full comment HERE​​