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Work Under Way

Topics and Questions Under Review by the Committee

The 2020 Dietary Guidelines Advisory Committee is examining specific topics and supporting scientific questions identified by USDA and HHS. The questions are grouped by subcommittee below. Subcommittees review the evidence on questions and report on their work at the Committee meetings, which are open to the public. All deliberation and decisions are made by the full Committee at its public meetings.

The Committee is using three scientific approaches to examine the evidence: data analysis, food pattern modeling, and systematic reviews. Each approach has its own rigorous methodology. For each question, a specific protocol – or plan – is created to describe how the Committee will apply the methodology for one of those approaches to answer the question. Each protocol is created before the Advisory Committee examines any evidence, and is posted below for the public to view and better understand how a specific question will be answered.

Updates will be posted over the course of the Committee’s work, and progress is marked with the icons described below. A protocol may be updated after it is posted. The tables below include the date the protocol was posted or updated. Updates to protocols will be noted within the protocol document with rationale.

Note: Some topics are not included in the list below because they are addressed in existing evidence-based Federal guidance. You can learn more about these topics here.

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Review of this question is still to come. Check back for updates.
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The subcommittee is developing the plan for reviewing the evidence to answer the question. For systematic review questions, this includes defining terms, identifying inclusion and exclusion criteria, and determining databases to search. 
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The question is under review. For systematic review questions, this means the search, screening, and review have begun. For other approaches, this means analysis is under way. Over time, draft systematic review protocols will be updated to include search results and lists of included and excluded articles. 
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The subcommittee has developed a draft answer to the question. Draft conclusions are not considered final until they have been deliberated with and decided upon by the full Committee and published in the Committee’s report.

Pregnancy and Lactation Subcommittee

Dietary Patterns

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Status Question
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What is the relationship between dietary patterns consumed during pregnancy and risk of gestational diabetes?
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What is the relationship between dietary patterns consumed during pregnancy and risk of hypertensive disorders during pregnancy?
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What is the relationship between dietary patterns consumed during pregnancy and gestational age at birth?
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What is the relationship between dietary patterns consumed during pregnancy and birth weight standardized for gestational age and sex?
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What is the relationship between dietary patterns consumed during pregnancy and gestational weight gain? Up to date as of 9/19/2019
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What is the relationship between dietary patterns consumed during pregnancy and micronutrient status? Up to date as of 9/19/2019
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What is the relationship between dietary patterns consumed during lactation and human milk composition and quantity? Up to date as of 9/19/2019
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What is the relationship between dietary patterns consumed during lactation and infant developmental milestones, including neurocognitive development? Up to date as of 9/19/2019
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What is the relationship between dietary patterns consumed during lactation and post-partum weight loss? Up to date as of 9/19/2019

Maternal Diet During Pregnancy and Lactation and Risk of Food Allergy/Atopic Disease

Status Question
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What is the relationship between maternal diet during pregnancy and lactation and risk of infant and child food allergies and atopic allergic diseases? Up to date as of 9/19/2019

Complementary Foods and Beverages

Status Question
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What is the relationship between complementary feeding and micronutrient status?
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What is the relationship between complementary feeding and growth, size, and body composition?
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What is the relationship between complementary feeding and developmental milestones, including neurocognitive development?
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What is the relationship between complementary feeding and food allergies and atopic allergic diseases?
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What is the relationship between complementary feeding and bone health?

Alcohol

Status Question
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What is the relationship between alcohol consumption and growth, size, body composition, and risk of overweight and obesity?
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What is the relationship between alcohol consumption and risk of certain types of cancer?
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What is the relationship between alcohol consumption and risk of cardiovascular disease?
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What is the relationship between alcohol consumption and neurocognitive health?
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What is the relationship between alcohol consumption and all-cause mortality?
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What is the relationship between alcohol consumption during lactation and post-partum weight loss?
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What is the relationship between alcohol consumption during lactation and human milk composition and quantity?
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What is the relationship between alcohol consumption during lactation and infant developmental milestones, including neurocognitive development?

Added Sugars

Status Question
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What is the relationship between added sugars consumption and growth, size, body composition, and risk of overweight and obesity?
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What is the relationship between added sugars consumption and risk of cardiovascular disease?
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What is the relationship between added sugars consumption and risk of type 2 diabetes?
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What is the relationship between added sugars consumption during pregnancy and gestational weight gain?
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What is the relationship between added sugars consumption during lactation and post-partum weight loss?

Data Analysis and Food Pattern Modeling Cross-Cutting Working Group

Data Analysis Questions

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Status Question
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Describe/evaluate current dietary patterns and beverages. Up to date as of 9/19/2019
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Describe/evaluate current intakes of food groups and nutrients. Up to date as of 9/19/2019
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Describe/evaluate nutrients of public health concern. Up to date as of 9/19/2019
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Describe/evaluate prevalence of nutrition-related chronic health conditions. Up to date as of 9/19/2019
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How does dietary intake, particularly dietary patterns, track across life stages from the introduction of foods, into childhood, and through older adulthood? Up to date as of 9/19/2019
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What is the relationship between beverage consumption and achieving nutrient and food group recommendations?
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What is the relationship between alcohol consumption and achieving nutrient and food group recommendations?
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What is the relationship between added sugars consumption and achieving nutrient and food group recommendations?
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What is the relationship between the frequency of eating and achieving nutrient and food group recommendations?

Food Pattern Modeling Questions

Status Question
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[For 2 years and older] Are changes to the USDA Food Patterns needed based on the relationships identified [in the systematic reviews]? If so, how well do USDA Food Pattern variations meet nutrient recommendations for each stage of life? If nutrient needs are not met, is there evidence to support supplementation and/or consumption of fortified foods to meet nutrient adequacy?
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[For those under 2 years of age] Can USDA Food Patterns be established based on the relationships identified [in the systematic reviews]? If so, how well do USDA Food Pattern variations meet nutrient recommendations for infants and toddlers? If nutrient needs are not met, is there evidence to support supplementation and/or consumption of fortified foods to meet nutrient adequacy?
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How much added sugars can be accommodated in a healthy diet while still meeting food group and nutrient needs?

Note: Some topics are not included above because they are addressed in existing evidence-based Federal guidance. In an effort to avoid duplication with other Federal efforts, it is expected that these topics will be reflected in the 2020-2025 Dietary Guidelines by referencing the existing guidance. Thus, these topics do not require a review of the evidence by the 2020 Dietary Guidelines Advisory Committee. Examples of existing guidance include:

  • Food safety guidance
  • Guidance on the health risks of excessive alcohol use, including information on binge drinking, and the recommendation that women who are pregnant or might be pregnant not drink at all
  • Gestational weight gain guidance
  • Physical activity guidance
  • Dietary Reference Intakes, including sodium and potassium (completed March 2019)

1 The dietary patterns questions will consider the quantities, proportions, variety, or combination of different foods, drinks, and nutrients when examining relationships. Studies that examine a specific food group, but control for the other aspects of the dietary pattern, will also be considered.

2Complementary feeding is defined as the process that starts when human milk or infant formula is complemented by other foods and beverages. The complementary feeding period typically continues to 24 months as the young child transitions fully to family foods. Complementary foods and beverages are food and beverages (liquids, semisolids, and solids) other than human milk or infant formula provided to an infant or young child to provide nutrients and energy. Evidence related to dietary patterns consumed during the complementary feeding period will be considered as part of these questions.