Dietary guidelines report carves out role for dietary supplementation, especially in maternal nutrition

By Hank Schultz

- Last updated on GMT

A federal dietary guidelines report makes specific mention of the importance of supplements for pregnant women, lactating mothers, and toddlers. ©Getty Images - yacobchuk
A federal dietary guidelines report makes specific mention of the importance of supplements for pregnant women, lactating mothers, and toddlers. ©Getty Images - yacobchuk

Related tags Vitamin d deficiency vitamin d fortification Calcium Choline Dietary guidelines advisory committee Dietary guidelines Dietary Guidelines for Americans

The USDA report that will underpin the development of the next set of Dietary Guidelines for Americans reflects a growing and welcome appreciation of the role of dietary supplements, industry observers say.

The 835-page report, titled Scientific Report of the 2020 Dietary Guidelines Advisory Committee​ ​is the work of a large group of contributors headed by Barbara Schneeman, PhD, of the University of California Davis and Dr Ronald MD, Massachusetts General Hospital and Harvard Medical School.  Like other such reports  that have gone before, it will form the basis from which the 2020-2025 Dietary Guidelines for Americans will be formulated by USDA and the Department of Health and Human Services (HHS).  It includes for the first time dietary recommendations for infants from birth through 24 months. The final guidelines are expected to be issued by the end of the year.

New focus on supplementation welcome, and overdue

Dietary supplement industry observers noted that the report contains a number of welcome mentions about the role dietary supplements can play in proper nutrition.  This is especially true in the sections of the report that deal with the life stages of pregnancy, lactation and birth to 24 months.

“We didn’t agree with all of the findings but I think Barbara Schneeman as chairperson did a fabulous job.  I think this was the first time in a report like this that you saw a real discussion of the value of supplementation in the executive summary,” ​said Daniel Fabricant, PhD, president and CEO of the Natural Products Association.

The Council for Responsible Nutrition was also enthusiastic about the findings and general tenor of the report.

“We thing the committee did an excellent job weighing the scientific evidence to support the development of the guidelines,”​ said Haiuyen Nguyen, senior director of scientific and regulatory affairs.

“CRN had been involved in the beginning, by submitting comments and even by supporting some of the nominations of who is on the committee,”​ Nguyen said. There were 20 members on the committee from a number of universities who were supported by 37 federal employees and contractors.

Nguyen said the welcome overall takeaway is that dietary supplementation seems to have finally arrived in the eyes of nutrition experts and federal officials.  

“The main message is that dietary supplement are an appropriate method to supplement the nutrient intake of Americans while maintaining energy balance,”​ she said.

NPA: New emphasis could support use of SNAP and WIC for supplements

Fabricant said the new emphasis on supplementation is important because the 2020-2025 guidelines will be used to make decisions about what is covered under the SNAP and WIC programs.  NPA has long advocated for that recipients of these federal support funds should be able to use them to buy supplements.

“This reinforces what we already know: that access to proper nutrition, especially for children and pregnant mothers, is critical to long-term health,” Fabricant said. “Congress needs to do more to ensure Americans have access to products that support their health, and expanding health savings accounts and programs like WIC to include nutritional supplements is the best way to make that happen.  This report provides a real world look at how supplements are an integral part of the American diet at all stages of development.”

Tone of reports has shifted over time regarding supplements

Nguyen said the tone of these scientific reports has been changing over time.  The 2010 report relied heavily on some scientific papers current at that time that found little evidence for the effectiveness of multivitamin and mineral supplements.  She said that tone softened somewhat in the 2015 report, which stated that achieving adequate vitamin D levels was difficult from food sources alone.

 This latest report goes even further, she said.

“The nutrients that need to be increased to prevent disease and promote health, including: iron and zinc for older breast-fed infants; iron, fiber, and potassium for young children; calcium, iron, vitamin D, fiber, and potassium for young children ages 24 to 59.9 months; and, calcium, iron, folate, vitamin D, fiber, potassium, and choline for women who are pregnant, lactating, or post-partum,” ​the report states.

“We have seen a slow shift in the tone and attention to dietary supplements in the dietary guidelines,”​ Nguyen said.

Choline makes the grade

One of the more recent arrivals to this party is choline. While the importance of various minerals and vitamins has been recognized for decades, choline has gained prominence more recently.  

“The Committee’s scientific report shines a light on the growing body of evidence that shows choline plays a critical role in health during specific life stages,” ​said noted choline expert Marie Caudill, PhD, of Cornell University. “Unfortunately, consumption data tell us choline is widely under-consumed, and it’s concerning that those populations who would benefit most from choline, such as pregnant and lactating women and infants and children, fall short of meeting intake targets. In fact, only 8 percent of pregnant women are meeting choline recommendations.” 

Choline is an essential nutrient that supports a variety of processes at all stages of life and throughout the body, including fetal and infant development; cognition and memory; energy and fitness; metabolism; and liver health. Choline is naturally found in some foods; yet, based on typical and recommended eating patterns, it is difficult to meet daily choline needs through foods alone. 

According to an analysis by choline supplier Balchem, the report presented three food pattern styles, which generally meet all nutrient needs across the lifespan, except for a few such as choline.  The report also notes that at the moment few supplements with choline on the label contain the nutrient in sufficient amounts.

 “Choline’s increased recognition in the DGAC report is an important scientific milestone for the public health community,” ​said Jonathan Bortz, MD, Balchem’s senior director of nutrition science. “We are quickly approaching an inflection point in time for choline awareness.”

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