Studies in Dietary Guidelines Report do not Reflect U.S. diversity

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BECAUSE THE PREDOMINANTLY white population was used to establish the Dietary Guidelines for Americans, it may provide insufficient recommendations for communities of color according to an analysis by Food4Health Alliance.

More than 90 percent of the systematic reviews in the Scientific Report by the 2020 Dietary Guidelines Advisory Committee did not account for race, ethnicity, and/or socio-economic status. Moreover, they relied on predominantly white populations that are questionably generalized to the broader U.S. population. These findings come from an in-depth analysis by the Food4Health Alliance on the report’s 56 systematic review questions where the evidence was graded “Strong,” “Medium,” or “Limited.” (The findings do not include some 125 questions where there was insufficient evidence and the grade was “Not Assignable.”) The report is available for download by visiting [https://food4health.org/wp-content/uploads/2020/08/F4H-report-113p.pdf].

The disturbing implication is that the 2020-2025 Dietary Guidelines for Americans (DGA) will be questionably appropriate for historically disadvantaged populations.

“These guidelines are a great effort, but my concern is it appears the majority of evidence reviewed does not include the experiences of low-income Black and brown communities. These communities suffer most disproportionately from preventable, chronic health conditions often linked to inequitable access to foods that support long-term health and well-being. Before these guidelines are accepted as the national standard, the lack of data and insight for low-income, minority Americans should be addressed,” said Lisa K. Fitzpatrick MD, MPH, MPA, Founder and CEO of Grapevine Health.

Congress intended for the Dietary Guidelines for Americans (DGA) to be for the “general public,” which, today, is more than one quarter (26%) non-white, including nearly 13% Black/African American and 17.6% Hispanic/Latinx. Yet these populations are seldom included or accounted for in the studies reviewed in the Advisory Committee’s report.

“I appreciate that the Advisory Committee recognized the health inequities in the Hispanic community and acknowledged the lack of diversity in the studies they reviewed. But this is not enough. We must do better to meet the dietary needs of the general population, including Hispanic Americans, America’s largest minority group,” stated Dr. Elena Rios, MD, MSPH, FACP, President and CEO of the National Hispanic Medical Association.

In its public meetings, the 2020 Advisory Committee spoke frequently of the need to account for race and ethnicity in policy recommendations. Committee Chair Barbara Schneeman stated, “Flexibility is needed for different age groups, different ethnic groups, and the choices people make.”

At another point, she added, “Focus on patterns and food intake are especially useful as we think about dietary guidance that can apply across the life span, and that can be tailored for various racial/ethnic preferences and socioeconomic levels.” However, the Committee also recognized that in many cases they were working from an evidence base that was often limited in achieving these goals. This impression is confirmed by the Food4Health analysis.

Dietary Guidelines that do not reflect diversity in race, ethnicity or socio-economic status cannot be considered responsive to the needs of all Americans.

Food4Health also continues to object to the fact that the Dietary Guidelines exclusively address the needs of healthy Americans, as this narrow focus is not applicable to the 60% of Americans diagnosed with one or more chronic disease, such as diabetes, obesity, or hypertension. Because minorities are twice as likely to suffer from these diseases, Food4Health believes the Guidelines especially under- serve racial and ethnic communities in the United States.

For more information on the Alliance, please visit their website at [www.food4health.org].

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