Opinion | Healthcare

New dietary guidelines still show signs of industry influence

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The U.S. Departments of Agriculture and Health and Human Services recently released the 2020-2025 Dietary Guidelines for Americans. The new guidelines ignore an expert panel's recommendation to lower suggested alcohol intake limits for men (to no more than one drink per day on days when alcohol is consumed). Despite this missed opportunity, however, the guidelines do significantly improve on previous editions' treatment of alcohol, offering hope for sensible alcohol policy reforms and better public health in the near future.

Importantly, the guidelines put to rest the notion that drinking alcohol may be good for you.

The previous edition of the guidelines stayed silent on the health impacts of "moderate alcohol consumption," but the 2020-2025 DGAs are unambiguous: "If adults age 21 years and older choose to drink alcoholic beverages, drinking less is better for health than drinking more." This contradicts dietary guidelines issued as recently as 2010, which cited "strong evidence" that "moderate alcohol consumption is associated with a lower risk of cardiovascular disease." 

Already in 2015, researchers had demonstrated that the studies purporting to show positive health impacts from alcohol failed to account for several confounding variables. However, the 2015-2020 dietary guidelines stopped short of refuting its previous advice. Not so with the guidelines issued last week.

This reflects in part the power of new "genetic epidemiology" techniques, which have helped put to rest claims that moderate drinking boosts health. The new guidelines' stricter stance is also rooted in "emerging evidence" that "even drinking within the recommended limits may increase the overall risk of death from various causes, such as from several types of cancer and some forms of cardiovascular disease." In particular, the new guidelines note: "Alcohol has been found to increase risk for cancer, and for some types of cancer, the risk increases even at low levels of alcohol consumption (less than 1 drink in a day)."

Given that the new guidelines recognize that even a small amount of alcohol is bad for you, and that drinking less is better for health, why do they persist with the recommendation to limit men's consumption to two drinks per day, rather than following the expert panel's recommendation to lower it to one? The answer is simple: politics.

Following publication of the expert panel's recommendations - the "Scientific Report of the 2020 Dietary Guidelines Advisory Committee" - alcohol industry lobbyists persuaded 28 members of Congress to sign a letter to Secretaries Perdue and Azar, arguing that the panel's recommendation on alcohol failed to consider the "preponderance of scientific evidence." As consumer and public health groups pointed out, the expert panel based its recommendation on a review of 60 studies, not just one or two cherry-picked papers, as opponents claimed. The panel cited research on cancer to support its conclusion as well.

Nevertheless, the federal agencies rejected the recommendation on changing "quantitative limits" because "[t]he emerging evidence noted in the Committee's report does not reflect the preponderance of evidence at this time." Notably, the research informing this edition of the dietary guidelines was narrowly constrained by USDA and HHS in an unprecedented manner, resulting in many studies on alcohol and cancer, for example, falling outside of the committee's purview.

Regardless of the evidence cited in the expert committee's report, however, the agencies' conclusions are hard to reconcile. If "drinking less is better for health than drinking more," why say that drinking two drinks in a day, rather than just one, will "minimize risks associated with drinking"? Clearly it does not, but thanks to the power of the alcohol industry, consumers will have to figure that out for themselves.

Thomas Gremillion is the director of Food Policy at the Consumer Federation of America.

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