657-658 Controversies(all)

The US Department of Agriculture and the US Department of Health and Human Services first developed the Dietary Guidelines for Americans in 1980 (1). The dietary guidelines provide advice to healthy Americans on food choices to promote healthy eating and reduce risk of disease. The dietary guidelines were updated in 1985, 1990, and 1995 to ensure their accurate interpretation of the most recent science (2–4). The 1990 National Nutrition Monitoring and Related Research Act mandates the review of the dietary guidelines every 5 y. The Dietary Guidelines Advisory Committee was appointed to review the current guidelines and make recommendations for changes for the 2000 edition. This advisory committee will struggle with many issues while reviewing a myriad of new scientific data related to diet and health. For example, individual risk of chronic disease varies widely and is strongly influenced by genetics. This issue prompted the American Heart Association to remind health professionals in the Dietary Guidelines for Healthy Americans that “...population-wide guidelines do not address the specific needs of all individuals” (5). The current advisory committee must decide which recommendations need to be targeted to the population through the dietary guidelines and which should be promoted to individuals at risk through some other means. Another important issue that should be addressed is the value of segmenting the dietary guidelines by age (6). The 1995 Dietary Guidelines Advisory Committee “strongly” recommended the development of dietary guidelines for children (7). They suggested that a working group be charged with developing provisional guidelines for children and the supporting peer-reviewed documentation. The US Department of Agriculture targets dietary advice to children through its food guide pyramid for young children (8). In a similar context of age-segmented recommendations, a food guide pyramid was recommended for the elderly (9). The committee will need to rigorously review the available scientific data to develop valid and useful dietary guidelines for Americans. The American Society for Nutritional Sciences–American Society for Clinical Nutrition Public Information Committee organized a symposium at Experimental Biology ‘99 (held in Washington, DC, on April 19, 1999) to discuss timely scientific issues that the current committee will likely be addressing. Time constraints prevented this symposium from including presentations on all of the controversial nutrition issues the committee will face. Two dietary issues were chosen to be examined more closely with presentations both pro and con. This provided an opportunity to illustrate that there are usually 2 sides to most issues. Sometimes the sides differ greatly and at other times there is only little disagreement. The first of the issues examined was the need for a dietary guideline for calcium intake. The discussion is presented in the following 2 papers. The second issue, which focused on the current guideline for sodium intake, will be featured in an upcoming issue of the Journal. Ultimately, the information contained in the dietary guidelines will be transferred to consumers through educational efforts, food and supplement marketing, feeding programs, and policy decisions. Recommendations from the advisory committee will need to be based on sound science rather than on a consensus to ensure that following the dietary guidelines provides benefit without harm (10–13). How the dietary guidelines may eventually be applied by consumers must also be considered in the determination of what is recommended and how those recommendations are presented to both heath professionals and the general public. This issue was also addressed at the symposium.