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Proposed Topics and Scientific Questions Posted for Public Comment

For the first time, the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) identified topics and scientific questions prior to establishing the 2020 Dietary Guidelines Advisory Committee. The public comment period was open from February 28 - March 30, 2018. 

The proposed topics and scientific questions posted for public comment focused on life stages from birth through older adulthood. The 2014 U.S. Farm Bill mandated that starting with the 2020-2025 edition, the Dietary Guidelines provide guidance for women who are pregnant, as well as infants and toddlers from birth to 24 months. In addition to a focus on life stages, the topics and supporting questions for public comment reflected a continued focus on patterns of what we eat and drink as a whole, on average and over time. 

The proposed topics and scientific questions were grouped by life stage as shown below. 

Infants and toddlers from birth to 24 months (healthy, full-term infants)

Topic

Question(s)

Recommended duration of exclusive human milk or infant formula feeding

What is the relationship between the duration of exclusive human milk or infant formula consumption and 1) growth, size, and body composition; 2) food allergies and other atopic allergic diseases; and 3) long-term health outcomes?

Frequency and volume of human milk and/or infant formula feeding

What is the relationship between the frequency and volume of human milk and/or infant formula consumption and 1) micronutrient status; and 2) growth, size, and body composition?

Dietary supplements (e.g., iron, vitamin D, vitamin B12)

What is the relationship between specific micronutrient supplements for infants fed human milk and/or infant formula and 1) micronutrient status; and 2) growth, size, and body composition?

Complementary foods and beverages*: Timing of introduction, types, and amounts

*Beverages (cow’s milk, water, 100% fruit juice, sugar-sweetened beverages, milk alternatives)

What is the relationship between complementary feeding and 1) micronutrient status; 2) growth, size, and body composition; 3) developmental milestones; 4) food allergies and other atopic allergic disease; and 5) bone health?

What is the relationship between complementary feeding, including foods and beverages, and achieving nutrient and food group recommendations of infants and toddlers?

Note: Evidence related to dietary patterns (including beverage patterns) consumed during the complementary feeding period will be considered as part of these questions.

Children and adolescents, ages 2-18 years old (with data reviewed by age group)

Topic

Question(s)

Dietary patterns to promote health and normal growth and meet nutrient needs

What is the relationship between specific dietary patterns (Dietary Guidelines-related, Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH), vegetarian/vegan, and low-carbohydrate diets) consumed during childhood and adolescence and 1) growth, size, and body composition; and 2) bone health?

Are changes to the USDA Food Patterns needed based on the relationships identified? If so, how well do USDA Food Pattern variations meet nutrient recommendations for children and adolescents?

Beverages (cow’s milk, water, 100% fruit juice, sugar-sweetened beverages, milk alternatives, caffeinated beverages)

What is the relationship between beverage consumption during childhood and adolescence and achieving nutrient and food group recommendations?

Added sugars

What is the relationship between added sugars consumption during childhood and adolescence and achieving nutrient and food group recommendations?

How much added sugars can be accommodated in a healthy diet during childhood and adolescence while still meeting food group and nutrient needs?

Adults, ages 19-64 years old (with data reviewed by age group)

Topic

Questions

Dietary patterns to promote health, prevent disease, and meet nutrient needs

What is the relationship between specific dietary patterns (Dietary Guidelines-related, Mediterranean-style, Dietary Approaches to Stop Hypertension [DASH], vegetarian/vegan, and low-carbohydrate diets) consumed during adulthood and 1) body weight or obesity; 2) risk of cardiovascular disease; 3) risk of type 2 diabetes; and 4) risk of certain types of cancer?

Are changes to the USDA Food Patterns needed based on the relationships identified? If so, how well do USDA Food Pattern variations meet nutrient recommendations for adults?

Beverages (cow’s milk, water, 100% fruit juice, sugar-sweetened beverages, milk alternatives, caffeinated beverages)

What is the relationship between beverage consumption during adulthood and achieving nutrient and food group recommendations?

Added sugars

What is the relationship between added sugars consumption during adulthood and achieving nutrient and food group recommendations?

How much added sugars can be accommodated in a healthy diet during adulthood while still meeting food group and nutrient needs?

Saturated fats

What is the relationship between saturated fats consumption (types and amounts) during adulthood and risk of cardiovascular disease?

Pregnancy and lactation

Topic

Question(s)

How additional calorie needs should be met during pregnancy and lactation

What is the relationship between specific dietary patterns (Dietary Guidelines-related, Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH), vegetarian/vegan, and low-carbohydrate diets) consumed among women who are pregnant and 1) risk of gestational diabetes; 2) risk of hypertensive disorders during pregnancy; 3) gestational age at birth; and 4) birth weight standardized for gestational age and sex?

What is the relationship between specific dietary patterns (Dietary Guidelines-related, Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH), vegetarian/vegan, and low-carbohydrate diets) consumed among women who are lactating and human milk composition and quantity?

Are changes to the USDA Food Patterns needed based on the relationships identified? If so, how well do USDA Food Pattern variations meet nutrient recommendations for women who are pregnant or lactating?

Dietary supplements (e.g., iron, folate, vitamin D)

What is the relationship between micronutrient supplements consumed during pregnancy and lactation and 1) micronutrient status; 2) birth outcomes; and 3) human milk composition and quantity?

Diet during pregnancy and lactation and risk of food allergy in the infant

What is the relationship between maternal diet during pregnancy and lactation and risk of infant allergies and other atopic allergic disease?

Seafood

What is the relationship between seafood consumption during pregnancy and lactation and neurocognitive development of the infant?

Beverages (cow’s milk, water, 100% fruit juice, sugar-sweetened beverages, milk alternatives, caffeinated beverages)

What is the relationship between beverage consumption during pregnancy and lactation and 1) achieving nutrient and food group recommendations; 2) birth outcomes; and 3) human milk composition and quantity?

Alcoholic beverages

What is the relationship between maternal alcohol consumption during lactation and human milk composition and quantity?

Older adults, ages 65 years and older (with data reviewed by age group)

Topic

Question(s)

Dietary patterns to promote health, prevent disease, and meet nutrient needs

What is the relationship between specific dietary patterns (Dietary Guidelines-related, Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH), vegetarian/vegan, and low-carbohydrate diets) consumed across the lifespan and 1) body weight or obesity; 2) risk of cardiovascular disease; 3) risk of type 2 diabetes; 4) risk of certain types of cancer; and 5) risk of osteoporosis?

What modifications to dietary patterns are effective in preventing or reversing declines in muscle mass or bone density in older adults?

Are changes to the USDA Food Patterns needed based on the relationships identified? If so, how well do USDA Food Pattern variations meet nutrient recommendations for older adults, age 65-80 years and those age 81+ years?

Specific nutritional needs related to older adults

What modifications to food and beverage choices promote meeting nutrient needs in older adults with impaired dentition, dry mouth, or other aspects of aging that interfere with food and beverage consumption?