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Dietary Guidelines Process - General
Advisory Committee
Review of the Evidence
Background

Dietary Guidelines Process - General

  • A: USDA and HHS are adding some additional new steps in the process to develop the next edition of the Dietary Guidelines in response to the National Academies’ recommendations, stakeholder feedback, and our commitment to have a transparent, inclusive, and science-driven process. Many of the key steps to develop the Dietary Guidelines remain. We established an Advisory Committee to review the scientific evidence. The Committee provided the Scientific Report of the 2020 Dietary Guidelines Advisory Committee to the Secretaries of USDA and HHS. USDA and HHS will develop the Dietary Guidelines. Revisions to the Dietary Guidelines will be informed by the Scientific Report from the Committee and consideration of Federal agency input and public comments. Stay connected with us throughout this process at DietaryGuidelines.gov and sign up to receive updates.

  • A: The Departments announced the members of the 2020 Dietary Guidelines Advisory Committee (see Press Release) in February 2019. The Committee met six times to complete its work. All of the meetings were open to the public; two meetings included the opportunity for the public to provide oral comments to the Committee. The Committee concluded its work with the submission of the Scientific Report of the 2020 Dietary Guidelines Advisory Committee to the Secretaries of USDA and HHS at the end of June 2020. Our goal continues to be to release the Dietary Guidelines by the end of 2020.

    An ongoing open public comment period for written comments on the Scientific Report began on July 15, 2020 , and it will remain open until August 13, 2020, 11:59 pm, Eastern time. We encourage all who are interested in the development of the Dietary Guidelines to stay engaged.

  • The Scientific Report of the 2020 Dietary Guidelines Advisory Committee has been posted on DietaryGuidelines.gov and is now available for public comment until August 13, 2020. On Tuesday, August 11, 2020, USDA and HHS will hold a virtual oral public comment meeting to hear comments from the public on the Committee’s Scientific Report. USDA and HHS will consider the Scientific Report, along with public and agency comments, as the Departments develop the next edition of the Dietary Guidelines.

    We encourage the public to stay engaged and participate in the Dietary Guidelines development process. Announcements, including information about meeting registration will be made at DietaryGuidelines.gov, and through our list serv.

  • A: The National Academies committee identified five values to improve the integrity of the process to develop credible and trustworthy guidelines:

    1. Enhance transparency.
    2. Promote diversity of expertise and experience.
    3. Support a deliberative process.
    4. Manage biases and conflicts of interest.
    5. Adopt state-of-the-art processes and methods.

    USDA and HHS support these values and will continue to integrate steps to address these goals. For the first time, the Departments identified and asked for public comments on the topics and scientific questions to be examined in the review of the evidence supporting the development of the upcoming 2020-2025 edition of the Dietary Guidelines. The Departments added this step in order to promote a deliberate and transparent process, respond to feedback on the Dietary Guidelines development process, identify the expertise needed on the Committee, help manage resources, and ensure the science-based review provided by the Committee addresses Federal nutrition policy and program needs. For more information, see our page regarding the National Academies’ recommendations.

  • A:  Yes, from July 15, 2020 through August 13, 2020, the public can submit comments to USDA and HHS on the Scientific Report of the 2020 Dietary Guidelines Advisory Committee (see FRN). Additionally, on Tuesday, August 11, 2020, USDA and HHS will hold a virtual oral public comment meeting to hear comments from the public on the Committee’s Scientific Report. USDA and HHS will consider the Scientific Report, along with public and agency comments, as the Departments develop the next edition of the Dietary Guidelines.eport.  

    We strongly encourage the public to stay engaged and participate in the Dietary Guidelines development process. Announcements will be made at DietaryGuidelines.gov, via the Federal Register, and through our list serv. For more information on opportunities for public participation, see our page on this topic.

Advisory Committee

  • A: The public call for nominations to the Advisory Committee was open from September 6 to October 6 and the Departments announced the members in February 2019. See the list of members here.

    About the Committee

  • A: The process used to establish the Advisory Committee included review of complete nomination packages by program staff from USDA Food, Nutrition, and Consumer Services (FNCS), the USDA Research, Education, and Economics (REE), and the HHS Office of the Assistant Secretary for Health (OASH); evaluation of nominees by leadership from USDA/FNCS, USDA/REE and HHS/OASH; vetting by the USDA Office of the Secretary; and review by the USDA Office of Ethics. All individuals considered to serve as members of the Advisory Committee completed a Confidential Financial Disclosure Report (the OGE Form 450) prior to being appointed, which was reviewed by UDSA’s Office of Ethics (see letter). Members of the Committee were jointly agreed upon by the Secretaries of USDA and HHS. The Advisory Committee receives ethics training on an annual basis.

    Factors considered in selecting individuals to serve on the Advisory Committee included educational background, professional experience, and demonstrated scientific expertise in the issues to be examined by the Committee, as well as statutory obligations under the Federal Advisory Committee Act and requirements regarding a balanced membership. This process is described further at Learn How USDA-HHS Established the Advisory Committee.

  • A:  The National Academies’ first report on the Advisory Committee selection process included four recommendations. USDA and HHS carefully considered each recommendation for establishing the 2020 Dietary Guidelines Advisory Committee, including consideration of Federal statutes, regulations, and guidance, and provide responses to the recommendations on our website.

    USDA and HHS have refined and will continue to refine the process to develop the Dietary Guidelines for Americans in response to the NASEM recommendations, stakeholder feedback, best practices in reviewing nutrition science and developing guidance, and the Departments’ desire to have a transparent, inclusive, and science-driven process. You can learn more about the process to develop the 2020-2025 Dietary Guidelines by visiting our timeline.

  • A: Factors USDA and HHS considered in selecting individuals to serve on the Advisory Committee include:

    • Educational background — advanced degree in nutrition- or health-related field, including registered dietitians, nutrition scientists, physicians, and those with public health degrees
    • Professional experience — at least 10 years of experience as an academic, researcher, practitioner, or other health professional in a field related to one or more of the topics to be examined; consideration of leadership experience and participation on previous committees or panels
    • Demonstrated scientific expertise — expertise related to one or more of the topics to be examined by the Committee as demonstrated by number and quality of peer-reviewed publications and presentations
    • Obligations under the Federal Advisory Committee Act — ensuring the Committee is balanced fairly in points of view and types of expertise
    • Requirements regarding a balanced membership — including, to the extent possible, individuals who are minorities, women, persons with disabilities, and representatives from different geographic areas and institutions
  • A: No. There is one 2020 Dietary Guidelines Advisory Committee to address nutrition from birth into older adulthood. This allows for an efficient review of the scientific evidence across the lifespan. We have allowed for a larger committee (up to 20 members) anticipating that more members are needed to address the additional topics related to pregnancy and birth to 24 months. Time and resource constraints also prevent the establishment of a separate Advisory Committee.

  • A: We accepted all nominations per the Federal Advisory Committee Act, which does not limit nationality. However, it was decided that the Advisory Committee members selected to examine topics and questions to help inform the Departments’ development of the Dietary Guidelines for Americans should be U.S. citizens, as the Guidelines’ purview and implementation is only in the United States. We do appreciate the nominations and, if appropriate, the Committee may invite guest speakers of any nationality if the individuals bring relevant scientific expertise in any of the topic and question areas provided to them.

  • A: The 2020 Dietary Guidelines Advisory Committee held six meetings to complete its work. During the first five meetings, the Advisory Committee discussed its review of the scientific evidence and made plans for future Committee work. Prior to submitting the Scientific Report of the 2020 Dietary Guidelines Advisory Committee to the Departments, the Committee held a meeting to discuss and finalize its draft report. All meetings were open to the public to attend either in-person or through webcast. More information about the Committee’s meetings, including archived materials from all of its meetings can be found by visiting the Advisory Committee Meeting page.

  • A: The public was able to provide comments to the Committee on all aspects of its work for more than a year – from March 12, 2019 through June 10, 2020 – and we value everyone’s participation.

Review of the Evidence

  • A:  USDA and HHS identified topics and scientific questions to be examined in the review of the evidence supporting the development of the upcoming 2020-2025 edition of the Dietary Guidelines. The topics and supporting questions focused on priority scientific questions from birth into older adulthood and reflected a continued focus on patterns of what we eat and drink as a whole, on average and over time. See the Topics and Questions Examined by the Committee for the list of questions the Committee answered in its review of the science.

  • A: The Federal government is required to define the Committee's mission and specific duties. USDA and HHS added the step of determining the topics and questions for the 2020 Committee to:

    • Promote a deliberate and transparent process;
    • Ensure the Committee addresses diet and health across the lifespan, including pregnant women, infants, and toddlers;
    • Identify expertise needed on the Committee;
    • Help manage resources; and
    • Ensure the scientific review addresses Federal nutrition policy and program needs.

    USDA and HHS did not determine the topics and questions unilaterally. We created a transparent and inclusive process that involved input from scientists across multiple Federal agencies and thousands of public comments.

  • A:  During the public comment period of February 28 - March 30, 2018, more than 12,000 comments were received via more than 6,000 submissions to Regulations.gov. All submissions are accessible to the public on our page on Regulations.gov. USDA and HHS reviewed and considered every comment in relation to our four criteria: relevance, importance, potential Federal impact, and avoiding duplication. For more on this subject, see our page on this process. In brief, the criteria were:

    • Relevance: Topic is within the scope of the Dietary Guidelines. The focus of the Dietary Guidelines is food-based recommendations; changes to the Dietary Reference Intakes are not within the scope of the Dietary Guidelines. Clinical guidelines for the medical treatment and care of individuals with specific diseases and conditions are not included in the Dietary Guidelines.
    • Importance: Topics for which there are new, relevant data and that represent an area of substantial public health concern, uncertainty, and/or a knowledge gap.
    • Potential Federal Impact: Probability that guidance on the topic in the Dietary Guidelines would inform Federal food and nutrition policies and programs.  
    • Avoiding Duplication: Topic is not currently addressed through existing evidence-based Federal guidance (other than the Dietary Guidelines).
  • A: USDA and HHS asked the 2020 Committee to review all aspects of the diet under the questions on “dietary patterns” (i.e., patterns of foods, drinks, and nutrients, including meats, fruits, vegetables, grains, and dairy in all forms people consume). USDA and HHS expanded the charge for the topic of dietary patterns, asking the 2020 Committee to look at a larger number of health outcomes compared to what the 2015 Committee was asked to consider.

    Aspects of the diet also were addressed in other questions the Committee examined, including questions on beverages, added sugars, and types of dietary fat. Some diet-related topics, such as sodium and food safety, are addressed in existing evidence-based Federal guidance. As such, the 2020 Committee was not tasked with new reviews of these and other topics to prevent duplication of efforts. This was noted in the list of topics and questions posted with the call for nominations in September 2018. As an example, the Committee relied on Dietary Reference Intakes (DRIs) for sodium, potassium, and other nutrients set by the National Academies of Sciences, Engineering, and Medicine (NASEM) as it evaluated current nutrient intakes and identified nutrients of public health concern. This is the same approach as previous Committees used and is outlined in the Scientific Report of the 2020 Dietary Guidelines Advisory Committee.

  • A: The 2020 Committee is made up of nationally recognized scientists selected from the public’s nominations based entirely on factors outlined in the call for nominations: education; scientific expertise related to the topics and questions to be examined; professional experience; requirement to balance the full Committee; and Federal Advisory Committee Act (FACA) obligations, including, representing to the extent possible, individuals who are minorities, women, persons with disabilities, and individuals from different geographic areas and institutions.

    For the first time, as part of the selection process, the financial conflict of interest reviews were completed by the USDA Office of Ethics officials before appointing each member to the 2020 Committee. Historically, these reviews were completed after the Committee was appointed. Ethics officials reviewed the financial disclosure reports for potential conflicts of interest and impartiality concerns as defined by the Ethics in Government Act of 1978 and its implementing regulations, as well as compliance with all other pertinent federal ethics laws and regulations. They concluded that none of the 20 Committee members reported any entries on their financial disclosure report that would prevent them from being appointed and providing the complete range of duties required of a Dietary Guidelines Advisory Committee member.

  • A:  The 2020 Dietary Guidelines Advisory Committee used three rigorous approaches to examine the evidence: data analysis, systematic reviews, and food pattern modeling. Each of these approaches has a unique, complementary role in examining the science. Visit this page to learn more about the three approaches.

  • A:  The decision to use systematic reviews solely using NESR maintains the scientific integrity of the 2020 Committee’s work. USDA and HHS made this decision considering:

    • 2018 NASEM/HMD report on the process to update the Dietary Guidelines for Americans (**see note below);
    • Processes used by other systematic review organizations, such as Cochrane and the Agency for Healthcare Research and Quality;
    • Staff experience in using and/or updating existing systematic reviews as part of previous systematic review projects, including the 2010 and 2015 Committees’ work;
    • Stakeholder feedback on the 2015 Committee’s process, obtained via public comments and listening sessions;
    • Thorough consideration of timeline and resources available to the 2020 Committee; and
    • The need for all reviews to meet criteria for relevance, timeliness, quality, and transparent documentation.

    The Committee’s systematic reviews were supported by USDA’s NESR. In its systematic reviews, the 2020 Committee considered all primary studies that meet the criteria the Committee establishes in its protocols for the scientific questions. The process of reviewing the evidence includes examination of original research conducted by scientists external to and independent from the Federal government and published in peer-reviewed journals.

    **Note: The development of de novo – new – reviews was addressed in the NASEM report conducted on the Dietary Guidelines process. Within the report the committee states, in full:

    “Overall, this National Academies committee believes that using existing high-quality systematic reviews whenever possible maximizes limited time and resources and reduces duplication of efforts. However, it is important to recognize that existing systematic reviews may not use the same inclusion and exclusion criteria, may be out of date, or have different outcomes (Smith et al., 2011; Whitlock et al., 2008). As a result, using existing systematic reviews may be more time and resource intensive than conducting de novo systematic reviews.”

  • A: Systematic review is one of three approaches the 2020 Committee used to conduct an independent review of the evidence for each of its scientific questions. Under this approach, the Committee:

    • Established all aspects of the protocol which presents the plan for how it will examine the scientific evidence, including the inclusion and exclusion criteria;
    • Reviewed all studies that meet the criteria they set;
    • Deliberated on the body of evidence for each question; and
    • Wrote and graded the conclusion statements included in the Scientific Report the 2020 Committee submitted to USDA and HHS.

    While the USDA and HHS are not required to have an advisory committee to help inform their development of the Dietary Guidelines, doing so has been a standing practice since 1985 with the express purpose of ensuring the Dietary Guidelines are grounded in scientific advice from independent experts. USDA and HHS respect and value the independent nature of the 2020 Committee’s scientific review, and similar to all previous Committees, staff have played an important role supporting the Committee in its review.

  • A: Some of the questions examined by the 2020 Committee were answered in the Pregnancy and Birth to 24 Months Project using NESR systematic reviews, which were published in 2019. The Committee considered the date range of the literature search used in each relevant existing NESR review to determine if it is timely, or if an update was warranted.

    The Committee determined the reviews reflect the current state of the science and are timely, because they include more than 35 years of evidence (published from 1980 to 2016 or 2017), and they were not aware of new evidence published since the completion of the reviews that would warrant an update at that time.

    During its fourth meeting, the Committee indicated that the public could comment on this decision via the public comment database, by, for example, indicating whether any studies published in the last few years could impact the conclusions from the existing reviews, and thus, warrant an update to the existing review.

  • A: As part of process of conducting a NESR systematic review, evidence was synthesized to develop a conclusion statement that answers the systematic review question. Each conclusion statement was graded by the Advisory Committee, based on an evaluation of the strength of evidence underlying that conclusion statement. The grade communicates the strength of the evidence supporting a specific conclusion statement to decision makers and stakeholders.

    Details about NESR’s grading methodology can be found on their website. In short, NESR has criteria based on five grading elements (i.e., risk of bias, consistency, directness, precision, and generalizability) that are used to evaluate and grade the strength of the evidence supporting each conclusion statement. The process also involves consideration of study design, so that the strengths and limitations of each study designs (e.g., randomized controlled trials, non-randomized controlled trials, observational studies) are thoroughly assessed and considered.

    Based on this process, the Committee assigned one of four overall grades to each conclusion statement:

    • Strong: The conclusion statement is based on a strong body of evidence as assessed by risk of bias, consistency, precision, directness, and generalizability. The level of certainty in the conclusion is strong, such that if new evidence emerges, modifications to the conclusion are unlikely to be required.
    • Moderate: The conclusion statement is based on a moderate body of evidence as assessed by risk of bias, consistency, precision, directness, and generalizability. The level of certainty in the conclusion is moderate, such that if new evidence emerges, modifications to the conclusion may be required.
    • Limited: The conclusion statement is based on a limited body of evidence as assessed by risk of bias, consistency, precision, directness, and generalizability. The level of certainty in the conclusion is limited, such that if new evidence emerges, modifications to the conclusion are likely to be required.
    • Grade Not Assignable: A conclusion statement cannot be drawn due to either a lack of evidence, or evidence that has severe limitations related to risk of bias, consistency, precision, directness, and/or generalizability.

    The process described above reflects updates made by NESR prior to the 2020 Committee’s work. Updates to the process were made based on consideration of:

    • 2018 NASEM/HMD report on the process to update the Dietary Guidelines for Americans (**see note below);
    • Institute of Medicine (IOM) Standards for conducting systematic reviews; and
    • Processes used by other systematic review organizations, such as GRADE and the Agency for Healthcare Research and Quality.

    **Note: Methods for grading the strength of evidence was addressed in the NASEM report conducted on the Dietary Guidelines process. Within the report the committee states:

    "Conduct of original systematic reviews will need to be transparent and follow state-of-the-art methods, such as the GRADE approach and the AHRQ Evidence-based Practice Centers Program approach. However, this National Academies committee believes the [NESR] and [Advisory Committee] need to have the flexibility to align with appropriate standards or methods and does not recommend any one standard be adopted, which may be subject to change and evolve over time."

  • A: The 2020 Dietary Guidelines Advisory Committee was tasked with answering a set of topics and supporting scientific questions identified by USDA and HHS.  To answer those questions the Committee used three approaches to examine the evidence: systematic reviews, data analysis, and food pattern modeling. Each of the scientific approaches has its own rigorous methodologies. In addition, for each of these approaches, a protocol was created that described how the Committee planned to apply the methodology of one of the approaches to answer a specific scientific question. The protocol is developed before the Committee conducts its evidence review and was posted online for the public to view to better understand how the Committee planned to use the approach to answer a specific scientific question.

    The Committee discussed the protocols during its meetings – all of which were open to the public – and updates to the protocols were provided throughout the course of the Committee’s work.  

  • A:  A conclusion statement describes the state of the science for the specific, individual question examined. A conclusion statement should not be interpreted as dietary guidance nor as the 2020 Dietary Guidelines Advisory Committee’s advice to USDA and HHS. The Committee looked across all of the conclusion statements – the totality of their scientific review – to develop overarching advice for USDA and HHS to consider as the Departments develop the 2020-2025 Dietary Guidelines. The Committee’s conclusion statements and overarching advice to the Departments is now available through the Scientific Report page.

  • A:  The Committee’s conclusion statements and overarching advice to the Departments is now available through the Scientific Report page.

  • A:  As with every Committee in the recent past, the 2020 Committee prioritized the questions to complete in the time available and some questions won’t be completed. The Committee provided more information on the prioritization in the Scientific Report of the 2020 Dietary Guidelines Advisory Committee. For context, the 2020 Advisory Committee has had about the same length of time as the 2015 Committee had to review the science, and answered about the same number of questions on diet and health.

Background

  • A:  The Dietary Guidelines are the cornerstone of Federal nutrition policy and nutrition education activities, providing food-based recommendations to promote health, help prevent diet-related disease, and meet nutrient needs. USDA and HHS jointly publish the Dietary Guidelines every 5 years.

  • A: Relied on by Federal agencies, the Dietary Guidelines serve as a central source of guidance that nutrition programs within the government can use to inform their food and nutrition programs and initiatives while tailoring their efforts for their specific audiences, like women and children. The Dietary Guidelines also support the development of science-based nutrition education messages and consumer materials for the general public, as well as for special audiences. Additionally, outside organizations and companies use the Dietary Guidelines in the private sector.

  • A:  The Dietary Guidelines were first released in 1980. In 1990, Congress passed the National Nutrition Monitoring and Related Research Act, which mandates in Section 301 that USDA and HHS jointly publish the Dietary Guidelines every five years. The law requires that the Dietary Guidelines are based on the preponderance of current scientific and medical knowledge. The 2015-2020 Dietary Guidelines is the current edition until the next edition is released.

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