The dietary guidelines – released by USDA and HHS Tuesday Dec 29 – acknowledge that many adults in the US take one or more dietary supplements, which often include some nutrients that are “under-consumed among older adults, including calcium and vitamins D and B12”.
Supplements of vitamins D and B12 receive numerous mentions in the 164-page document, most notably for mothers and infants, and also for older Americans.
The guidelines call for vitamin D supplements for infants to start soon after birth. This is the first time the guidelines have included dietary recommendations for infants from birth through 24 months.
For B12: “Human milk has sufficient vitamin B12 to meet infant needs unless the mother’s vitamin B12 status is inadequate,” state the guidelines. “This can occur for different reasons, including when the mother eats a strictly vegan diet without any animal source foods. When the mother is at risk of vitamin B12 deficiency, human milk may not provide sufficient vitamin B12. In these cases, the mother and/or infant fed human milk may require a vitamin B12 supplement.”
Also for pregnant or lactating women who follow a vegetarian or vegan diet, the dietary guidelines recommend women to talk to their healthcare provider about supplementation to ensure they get adequate amounts of iron, choline, zinc, iodine, and EPA/DHA.
Folic acid supplements are also recommend for women prior to conception and during the first trimester to prevent neural tube defects.
“The United States Preventative Services Task Force (USPSTF) recommends that all women who are planning or capable of pregnancy take a daily supplement containing 400 to 800 mcg of folic acid,” note the guidelines.
“This reinforces what we already know: that access to proper nutrition, especially for children and pregnant mothers, is critical to long-term health,” commented Daniel Fabricant, PhD, President and CEO of the Natural Products Association (NPA).
In other age groups, the guidelines note that, “vitamin D recommendations are harder to achieve through natural sources from diet alone and would require consuming foods and beverages fortified with vitamin D. In many cases, taking a vitamin D supplement may be appropriate especially when sunlight exposure is limited due to climate or the use of sunscreen.”
The Council for Responsible Nutrition (CRN) applauded the dietary guidelines, with Haiuyen Nguyen, CRN’s senior director of Scientific and Regulatory Affairs, saying, “Underconsumption of key nutrients is a public health concern. We’re pleased to see USDA and HHS recognize certain U.S. population groups do not achieve recommended nutrient levels from dietary intake alone. The Guidelines reflect how dietary supplements can support the health of all Americans.”
EPA and DHA
While the guidelines recognize the benefits of seafood consumption, which is noted to provide “beneficial fatty acids (e.g., eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA])… Seafood choices higher in EPA and DHA and lower in methylmercury are encouraged.”
NPA: Access to supplements via HSA/FSA & WIC
“The next Congress and Administration can 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," said NPA's Dr Fabricant.
However, that is pretty much the extent of the conversation around omega-3, and their specific benefits are never mentioned (the term “omega-3” is only used once in the whole document).
Commenting on this, the Global Organization for EPA and DHA Omega-3s (GOED) said this was disappointing, particularly because the Dietary Guidelines Advisory Committee (DGAC) concluded: “Moderate evidence indicates that total intake of omega-3 polyunsaturated fatty acids, particularly eicosapentaenoic acid and docosahexaenoic acid from food sources, by adults is associated with lower risk of cardiovascular disease.”
In addition, Harry Rice, PhD, GOED’s VP of regulatory & scientific affairs, told NutraIngredients-USA: “Given that the Dietary Guidelines for Americans serves as the cornerstone of federal nutrition policy, the absence of an omega-3 recommendation for reducing the risk of preterm and early preterm birth was nothing short of a missed opportunity to have a profound impact on public health.
“Hopefully, the next Dietary Guidelines Advisory Committee won't ignore GOED's scientifically substantiated advice to encourage a recommendation in the next iteration of the Dietary Guidelines for Americans in five years.”
General response
The guidelines have not been universally welcomed by stakeholders in the food industry or food policy, particularly around advice around sugar and alcohol consumption.
The Dietary Guidelines Advisory Committee (DGAC)’s report called for a halving of consumption of added sugars, from 13% of daily energy intake to just 6% (30g for someone on a 2,000 calorie-a-day diet); and advised Americans to limit alcohol intakes to one drink per day.
However, the final guidelines advise Americans to cut down somewhat, from an average of 13% to 10% of calories from added sugar. The guidelines also retained the recommendation that men may consume up to two alcoholic drinks per day, which the American Institute for Cancer Research claims is “outdated advice”.
For comprehensive coverage of responses from the food industry, please visit our sister publication, FoodNavigator-USA.