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The 2025-2030 Dietary Guidelines Advisory Committee did not make a recommendation about alcohol.  The agencies, HHS and USDA, will do that later based on two expert reviews.

I wrote about the first, from the National Academies, last week: Review of Evidence on Alcohol and Health.

I also wrote about the Surgeon General’s Advisory on Alcohol and Cancer Risk

Still to come is the report from the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD).

At issue is the amount of alcohol that is safe to drink, if any.

Just for fun, I did a summary of what the Dietary Guidelines say about alcohol from 1980 to 2020.  Note that the Moderation advice has not changed since 1990 (but then see the note on 2020).

                                      Alcohol recommendations: Dietary Guidelines for Americans

*From the 2020 Dietary Guidelines Advisory Committee report: “evidence points to a general rule that drinking less is better for health than drinking more. Therefore, the focus should remain on reducing consumption among those who drink, particularly among those who drink in ways that increase the risk of harms. The Committee concluded that no evidence exists to relax current Dietary Guidelines for Americans recommendations, and there is evidence to tighten them for men such that recommended limits for both men and women who drink would be 1 drink per day on days when alcohol is consumed.

Despite the language in the 2020 guideline, the agencies did not change the overall recommendation about moderate drinking.

Will the Surgeon General’s Advisory and the upcoming third report cause the agencies to suggest no more than one drink a day for men?  Or suggest that no level of alcohol intake is safe?

I’m looking forward to finding out.

Resource: the process for alcohol in the Dietary Guidelines

In its scientific report, the 2025-2030 Dietary Guidelines Advisory Committee recommends substituting plant proteins for animal proteins.

The Committee recommends that the proposed Eat Healthy Your Way Dietary Pattern emphasizes dietary intakes of beans, peas, and lentils while reducing intakes of red and processed meats….The Committee also proposes reorganizing the order of the Protein Foods Group to list Beans, Peas, and Lentils first, followed by Nuts, Seeds, and Soy products, then Seafood, and finally Meats, Poultry, and Eggs.

It did not take long for the meat industry to respond: Animal vs. Plant Protein: New Research Suggests That These Protein Sources Are Not Nutritionally Equivalent.

As is my habit, I went right to the study.

The study: Connolly G, Hudson JL, Bergia RE, Davis EM, Hartman AS, Zhu W, Carroll CC, Campbell WW. Effects of Consuming Ounce-Equivalent Portions of Animal- vs. Plant-Based Protein Foods, as Defined by the Dietary Guidelines for Americans on Essential Amino Acids Bioavailability in Young and Older Adults: Two Cross-Over Randomized Controlled Trials. Nutrients. 2023; 15(13):2870. https://doi.org/10.3390/nu15132870

Conclusions: “The same “oz-eq” portions of animal- and plant-based protein foods do not provide equivalent EAA content and postprandial bioavailability for protein anabolism in young and older adults.”

Funding: “This research was funded by the Pork Checkoff and the American Egg Board—Egg Nutrition Center. The supporting sources had no role in study design; collection, analysis, and interpretation of data; writing of the report; or submission of the report for publication.”

Conflicts of Interest: “When this research was conducted, W.W.C. received research funding from the following organizations: American Egg Board’s Egg Nutrition Center, Beef Checkoff, Pork Checkoff, North Dakota Beef Commission, Barilla Group, Mushroom Council, and the National Chicken Council. C.C.C. received funding from the Beef Checkoff. R.E.B. is currently employed by Archer-Daniels-Midland (ADM); the research presented in this article was conducted in a former role and has no connection with ADM. G.C., J.L.H., E.M.D., A.S.H. and W.Z. declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.”

Comment: Amino acids, the building blocks of protein, are the same whether they come from plants or animals (or us).  Food animals are closer to us evolutionarily than are plants; the animo acid composition of their proteins is more like ours than the amino acid composition of food plants.  That is why protein complementarity matters; mix and match the plants you eat and their amino acid compositions will complement each other and fill in the gaps.  This doesn’t even have to be done at every meal.  Overall, it’s easier to get the needed amino acids from animal foods but it’s not all that hard to get them from plants as long as they are varied and you eat enough of them.  So the study isn’t wrong; it’s just not telling the whole story.

Thanks to Kevin Mitchell for sending this one.

I.  Darius Mozaffarian, a nutrition professor at Tufts University, has an editorial in the American Journal of Clinical Nutrition:“The Dietary Guidelines for Americans—is the evidence bar too low or too high?”

He writes about an analysis of the systematic literature reviews SRs) that form the basis of science-based decisions in the guidelines.  His comments gives an insight into the Dietary Guidelines process worth seeing.

For the 2025–2030 DGAC, I served as a peer reviewer for the SR on UPFs…I felt that the SR’s question, design, and planned methods were appropriate, but that its implementation and conclusions were weakened by important deviations from these standards. For example, contradicting its stated eligibility criteria, the SR included numerous studies that did not appropriately or adequately define or assess UPF. Following inclusion of such heterogeneous studies, the SR concluded that the scientific evidence on UPF was limited due to many studies having serious concerns around exposure misclassification as well as evaluating dietary patterns not directly varying in amounts of UPF. This demonstrated a circular and dismaying reasoning: the SR included studies it should not have that had heterogeneous and poorly characterized assessments of UPF, and then concluded that heterogeneous and poorly characterized assessments of UPF limited the strength of the evidence.

He observes:

Most importantly, the DGA and SR requirements make clear that guiding Americans toward a healthier diet is an unfair fight from the start. The food industry can do almost anything it wishes to our food, combining diverse ingredients, additives, and processing methods with virtually no oversight or required evidence for long-term safety  In contrast, the DGAs and other federal agencies can only make recommendations to avoid certain foods or limit certain manufacturing methods when there is extensive, robust, and consistent evidence for harm. In this severely imbalanced playing field, industry wins again and again.

II.  Senator Bernie Sanders posted on Facebook Sanders Statement on How to Make America Healthy Again.  Among other issues, he’s taking on the food industry.

Reform the food industry. Large food corporations should not make record-breaking profits addicting children to the processed foods which make them overweight and prone to diabetes and other diseases. As a start, we must ban junk food ads targeted to kids and put strong warning labels on products high in sugar, salt and saturated fat. Longer term, we can rebuild rural America with family farms that are producing healthy, nutritious food.

III.  California Governor Gavin Newsom “issues executive order to crack down on ultra-processed foods and further investigate food dyes.”

The food we eat shouldn’t make us sick with disease or lead to lifelong consequences. California has been a leader for years in creating healthy and delicious school meals, and removing harmful ingredients and chemicals from food. We’re going to work with the industry, consumers and experts to crack down on ultra-processed foods, and create a healthier future for every Californian.

Comment

Mozaffarian offers these opinions despite disclosing financial ties to food companies.  Sanders is a welcome addition to the handful of legislators concerned about food issues.  Newsom is making it easier for other states to take similar steps.

Maybe there’s a glimmer of hope for coalition building among advocates for healthier food systems.  Maybe this really is a movement!

How’s that for a cheery thought for 2025.  Happy new year everyone!

How did a nice girl like me end up in New York Magazine’s MAHA issue?  I was amazed to find myself in this.

MAHA is the Trump Administration’s Make America Healthy Again campaign.

For the record: I’m totally for making America healthy, and especially for doing everything possible to reduce risks from chronic disease.  I’m for some of what RFK, Jr wants to do (reduce intake of ultra-processed foods, get toxins out of the food supply, reduce conflicts of interest) but by no means all.

Oh well, I didn’t want you to miss this. Enjoy (?).

Here’s what the FDA says about Use of the Term Healthy on Food Labeling.

To meet the updated criteria for the claim, a food product needs to

1. contain a certain amount of food from at least one of the food groups or subgroups (such as fruit, vegetables, grains, fat-free and low-fat dairy and protein foods) recommended by the Dietary Guidelines for Americans, and
2. meet specific limits for added sugars, saturated fat and sodium.

To qualify, a breakfast cereal, bread, or any other grain food would need to have 3/4 ounce of whole grains, and have less than 10% of the Daily Value for added sugars (5 grams per serving), less than 10% for sodium (230 mg per serving), and less that 1 gram of saturated fat (5% DV).

On this basis, kids cereals won’t qualify.

Oh.  And the FDA is still working on the symbol.

Resources

• Use of the Term Healthy on Food Labeling | FDA
• FDA Finalizes Updated “Healthy” Nutrient Content Claim | FDA
• Constituent update
• FDA’s Updated “Healthy” Claim Definition: Fact Sheet
• Federal Register: https://public-inspection.federalregister.gov/2024-29957.pdf
• New York Times: What Are ‘Healthy’ Foods? The F.D.A. Updates the Labeling Terms
• The Hill: FDA updates definition of ‘healthy’ on food labels for first time in 30 years

What are we to make of this?

The National Academies of Sciences, Engineering, and Medicine’s Review of Evidence on Alcohol and Health says moderate drinking

• Reduces all-cause mortality (moderate certainty)
• Reduces the risk of cardiovascular disease (moderate certainty)
• Increases the risk of breast and colorectal cancer (but can’t decide about others)

The Surgeon General, Vivek Murthy, says in his Advisory on Alcohol and Cancer Risk

• Consuming alcohol increases the risk of developing at least 7 types of cancer.
• The causal relationship between alcohol consumption and cancer is firmly established.

Let me try some context.

That alcohol is a risk factor for cancer has been known since the 1980s.

The Surgeon General’s conclusion is especially noteworthy for its lack of ambiguity.  He says flat out: alcohol causes cancer, and 7 kinds no less.

In contrast, the NASEM report talks about low and moderate certainty for its conclusions.

Presumably, both reports were based on the same data.

Here’s what this is about.

At issue: what the 2025-2030 Dietary Guidelines will say about how much alcohol is safe to drink (if any).

Since 1990, Dietary Guidelines have said two standard drinks a day for men and one for women could be considered low risk.

But the 2020-2025 Dietary Guidelines Advisory Committee, based on recent research indicating harm from any level of alcohol intake, said only one drink a day for both men and women was probably OK.

This alarmed the alcohol industry and other industries that profit from drinking.  They convinced Congress and federal agencies to revisit the effects of moderate drinking.

Yet another report on moderate drinking and health, this one from federal agencies, is expected any day now.

The bottom line

While all this is going on, the moral is pretty clear: the less alcohol, the better.

Resources

NASEM report press release

Industry pressure to make sure Dietary Guidelines to not toughen alcohol restrictions

New York Times: What is Moderate Drinking?

Example of alcohol industry pressure on Dietary Guidelines

Rani Rabin has been right on top of this fuss.  See, for example

• Surgeon General calls for cancer warnings on alcohol
• The battle over what to tell Americans about drinking
• US diet panel adds another researcher with alcohol industry ties
• Major study of drinking will be shut down

Let’s start the new year off with a classic industry-funded study with predictable results.

Beef Consumption and Cardiovascular Disease Risk Factors: A Systematic Review and Meta-analysis of Randomized Controlled Trials.  Sanders, Lisa M et al. Current Developments in Nutrition, Volume 8, Issue 12, 104500

Background: Results from observational studies suggest associations of red meat intake with increased risk of cardiovascular disease (CVD); however, RCTs have not clearly demonstrated a link between red meat consumption and CVD risk factors. Further, the specific effects of beef, the most consumed red meat in the United States, have not been extensively investigated.

Objectives: This study aimed to perform a systematic review and meta-analysis of RCT data evaluating the effects of minimally or unprocessed beef intake on CVD risk factors in adults.

Methods: A search of the literature was conducted using PubMed and CENTRAL databases.

Results: Beef intake did not impact blood pressure or most lipoprotein-related variables, including total cholesterol, HDL-cholesterol, triglycerides, non–HDL-cholesterol, apolipoprotein A or B, and VLDL-cholesterol. Beef consumption had a small but significant effect on LDL-cholesterol (0.11; 95% CI: 0.008, 0.20; P = 0.03), corresponding to ∼2.7 mg/dL higher LDL-cholesterol in diets containing more beef than that in low-beef or -o beef comparator diets. Sensitivity analyses show this effect was lost when 1 influential study was removed.

Conclusions: In summary, the results of this analysis showed no meaningful effect of daily unprocessed beef intake, compared with diets with less or no beef, on circulating lipoprotein lipids, apolipoproteins, and blood pressures, except for a small effect to increase the LDL-cholesterol concentration by ∼2.7 mg/dL. Given that unprocessed beef has minimal to no impact on these CVD risk factors but is a significant source of highly bioavailable protein as well as iron, zinc, and selenium, its inclusion in the diet may help improve dietary nutrient profiles without significantly affecting lipids or blood pressures.

Funding: This study was supported by the Beef Checkoff. The funding sponsor provided comments on early aspects of the study design. A report was shared with the sponsor prior to submission. The final decision for all aspects of the study and the manuscript content were those of the authors alone.

Comment:  As I said, an instant classic of the genre.  The USDA-managed Beef Checkoff had input into the study design and got to comment on the results and conclusions before the article was submitted for publication.  The sponsor exerted influence at the two places bias is most often found: the study design and the interpretation of the results.  Hence, industry influenced and predictable.

More to come.  Happy new year!

I’ve just been sent the copy-edited manuscript of my forthcoming book, What to Eat Now, the new and almost entirely revised edition of What to Eat to be published in fall 2025 (Picador Press).  I will be working on that over the holidays, will have more to say about it next year, and will return to the daily updates on January 6.

Have wonderful holidays.  Happy new year!