October 6, 2012 by Sarah S.
As dietitians in training, we’ve discovered how difficult it is to formulate a nutrition prescription for just one person. Now, put 300 million people together from different ages, ethnicities, socioeconomic classes, and education levels and try to write AND communicate a nutrition plan for them. Now, try to do that in a room with a hundred different voices, all wielding varying amounts of power, money, and scientific credibility, whispering (not very softly) in your ear. I certainly don’t envy the USDA, who gets tasked with this job every 5 years as they create and communicate the Dietary Guidelines for Americans (DGAs).
Let’s explore some of the reasons that formulating dietary guidelines is so difficult. First, nutritional needs vary greatly over the lifespan, but attempts to stratify recommendations for specific age groups result in unwieldy, confusing messages. Second, the US population is made up of people from a variety of cultures with a myriad of food habits and beliefs. Part of the beauty of this “melting pot” is that we all bring our food traditions to the collective table. But, when a blanket prescription tells one group that they must drink milk to build strong bones when they’ve lost the ability to digest it because it hasn’t been part of their culture’s diet for thousands of years, confusion (and unhappy stomachs) ensue. Third, consider how difficult it is to reach a consensus on what a “healthy diet” looks like within our cohort of 20 students who are all aiming for the same goal of helping people be healthy. Then, consider all of the voices who have historically had a seat at the table when the DGAs are being reformulated – politicians, lobbyists from various food producing and selling groups, doctors, scientists, and citizens. For more on this issue, Marion Nestle’s blog Food Politics provides interesting insight. Of particular interest is this entry that highlights the food industry’s various reactions to the 2010 DGAs.
So, once we’ve decided on some recommendations that might help Americans be healthier, we must consider how to communicate them throughout the population. This is difficult for several reasons. First, many Americans have a very low level of literacy and numeracy. We could have the best dietary guidelines in the world, but if citizens can’t understand them, we won’t do much good. Second, we must consider how to communicate these messages to reach the broadest audience possible in a way that makes them seem “do-able” for the average person.
While the current DGAs may not be perfect, I believe that the USDA has made great strides in combating the communication barriers it faces. The recent switch to MyPlate provided a simple graphic to guide people in making food choices without asking them to figure out what 6-11 servings of this or 2-3 servings of that might look like. Although open to interpretation, it seems less overwhelming for people who don’t have a high literacy level or nutrition background. Furthermore, their on-line Supertracker website is a great tool for people who are motivated to apply the more specific aspects of the DGAs, provided that they have access to the internet. Finally, the government’s recent support of SNAP-Ed increases communication and application of the DGAs to populations that are less likely to be able to interpret and apply the DGAs on their own, due to financial and literacy restraints.
How do we combat these issues as we try to improve the health of Americans in a financially responsible way? First, I would argue (optimistically, I know) that the decision makers should focus more on supporting good science and less on pleasing industry. If billions of dollars are being spent on programs like SNAP, WIC, and school meals, don’t we want to ensure that their basis, the DGAs, are actually going to promote optimal health? (See this promising new initiative to produce higher quality nutrition and obesity research). Second, the communication of the DGAs should be kept simple, focusing on the broad messages of eating nutrient-dense foods and maintaining a calorie balance by being physically active. As the complexity of the messages increases, people get confused and frustrated while lobbyists pitch a fit, decreasing the effectiveness of the resources used to communicate them.
Any change that occurs will inevitably be slow and incremental, but it will be interesting to see what changes are made to the DGAs over time.
And for the globally-minded among us, check out the FAO’s database of various countries’ food guidelines. It’s fascinating!
2010 Dietary Guidelines for Americans Executive Summary
SNAPed Fact Sheet