As the U.S. Departments of Health and Human Services (HHS) and Agriculture (USDA) develop the 2025 – 2030 Dietary Guidelines for Americans (DGAs), there are growing concerns that this process has lacked transparency. Further, many suspect that the federal government will, without sufficient evidence, significantly reduce alcohol intake guidelines as in Canada, or even assert there is “no safe level,” as the World Health Organization (WHO) has.
Currently, the 2020 – 2025 U.S. Dietary Guidelines for Americans recommends adult men consume two drinks or less per day and adult women consume one drink or less per day. For adults 65 and older, no more than one drink per day and for pregnant women, none. Sometime in 2025, the next iteration of the DGAs will be released.
It is important that there is transparency in developing these guidelines. The DGAs is used to influence lawmakers, Federal nutrition programs, regulatory efforts, education efforts, and local/state/national health promotions and disease prevention initiatives. Given their influence, it is also imperative that the HHS and USDA be science-driven when deciding which recommendations to include in the DGAs, so as not to stoke fear or baseless statutory/regulatory responses.
There has been a sheer lack of transparency in the development of alcohol consumption guidelines.
In April, U.S. Senators Bill Cassidy (R-La.), ranking member of the Senate HELP Committee, and John Boozman (R-Ark.), ranking member of the Senate Agriculture Committee, sent a letter seeking information from the Biden administration regarding the DGAs, citing a lack of clarity in how the agencies develop their recommendations.
The letter references a National Academies of Sciences, Engineering, and Medicine (NASEM) report which provided recommendations on how to improve the selection process for those appointed to the Dietary Guidelines Advisory Commission (DGAC). Specifically, ways in which the HHS and USDA could limit conflicts of interest and ensure balanced scientific perspectives. In a follow up NASEM report, the academies concluded that there was a lack of clarity in how the DGAC develops its recommendations.
Still, the Biden administration has failed to adopt these recommended reforms.
Further, in June, numerous members of the beverage alcohol sector penned a letter raising concerns about transparency in the next iteration of the DGAs. They note that, even though alcohol recommendations will be included in the DGAs, for the first time ever research will also be conducted through efforts separate from the DGAC. In fact, adult alcohol use will be subject to two concurrent reviews: one by NASEM and one by the Substance Abuse and Mental Health Services Administration (SAMHSA) – an agency notably created to provide resources and information on underage drinking.
While members applauded NASEM’s transparent work, they note that hardly anything was known about SAMHSA’s work until recently: and even still, it is insufficient.
All in all, even experts in these fields are not sure how the DGAs recommendations will be developed within this multi-layered process, nor how to provide stakeholder input or public comment.
Demonstrably, this lack of transparency could bring into question the legitimacy of the upcoming guidelines.
Given the influence the DGAs has, the HHS and USDA must be science-driven (and careful) in their recommendations. Guidelines can give way to further regulation and stoke unnecessary fear.
Not only is it required by law that the DGAs is developed solely based on the preponderance of scientific and medical knowledge, but it is also important for the health of industry and individual Americans.
This fact has been demonstrated numerous times. Despite lacking evidence, several DGAs in past decades have villainized dietary cholesterol, specifically in eggs, subjecting us all to sad, yolkless omelets and egg sandwiches. Now, we know that eating cholesterol generally does not affect your blood cholesterol levels unless you are genetically pre-disposed. In 2010, the DGAs recommended low-fat and fat-free foods, driving Americans towards hyper-processed foods that replaced fat with (more-dangerous) carbohydrates. Now, we know that people who eat diets heavy in full-fat dairy products actually experience lower rates of heart disease than those on low-fat diets.
When making decisive recommendations based on non-facts, agencies risk their credibility and the health of Americans.
If suspicions are true, the U.S. may follow in Canada or the WHO’s footsteps and significantly reduce (or eliminate) the recommended alcohol consumption levels.
In reference to the 2020 DGAs, the HHS and USDA concluded that “there was not a preponderance of evidence in the Committee’s review of studies… to substantiate changes related to the qualitative limits for either added sugars or alcohol.” Even so, the tone changed, as all mentions of the potential benefits of alcohol consumption were removed. Despite the science still having not changed much, there is a threat of the new temperance movement at HHS and USDA exacting their influence.
Reasonable members of the DGAC, NASEM, and SAMHSA should resist these efforts, as a condemnation of all alcohol consumption is arguably not supported by the preponderance of scientific and medical knowledge.
For decades, numerous studies have shown that light to moderate consumption of alcohol can be good for the heart. Some have tried to discount these studies by arguing that light drinkers may have healthier lifestyles overall and that those with health or prior substance-abuse issues abstain from alcohol.
While some of the benefit may be attributable to those things, a recent study (including more than 50,000 people) in the Journal of the American College of Cardiology, for the first time, found a direct link between light/moderate alcohol consumption and long-term reductions in stress. This impact “appeared to significantly account for the reductions in heart disease risk.” For those with anxiety, “light to moderate drinking was associated with nearly double the cardiac-protective effect.”
Other studies have linked light to moderate consumption to lower rates of kidney stones, reduced risk of Alzheimer’s disease, and a rise in good cholesterol levels. One of the most prominent benefits, of course, is that alcohol consumption is a catalyst for being social. Notably, social ties and, simply smiling, are integral to mental and physical health.
While there are costs and benefits to all that we indulge in, there is arguably enough evidence to discourage the outright condemnation of all consumption of alcohol. More, the ways in which the HHS and USDA come to these conclusions must be transparent and allow for stakeholder input and public comments.