SOURCE: Mozaffarian D, Ludwig DS. The 2015 U.S. Dietary Guidelines: Lifting the ban on total dietary fat. JAMA 2015;313:2421-2422.

In March 2015, the Dietary Guidelines Advisory Committee (DGAC) released its report for review by the secretaries of Agriculture and Health and Human Services. The 2015 Dietary Guidelines for Americans will be derived from the DGAC report, and some clinicians may be surprised at new directions suggested by the DGAC.

For instance, dietary cholesterol has been eliminated as a “nutrient of concern” based on recent data clarifying the lack of a relationship between dietary cholesterol and cardiovascular (CV) events. Similarly, previous guidance suggested an upper limit on total dietary fat consumption; in contrast, the current DGAC report neither restricts dietary fat nor lists fat as a “nutrient of concern,” based on the observation that reducing total fat has not been shown to improve CV outcomes.

Earlier guidance, which suggested limiting fat in the diet, often resulted in substitutions with increased amounts of carbohydrates, resulting in dietary modifications that commonly contained highly processed carbohydrates (such as added sugar.)

The new report includes advice that Americans consume excessive amounts of refined grain produces, such as white bread chips, white rice, crackers, and bakery goods. The U.S. populace has had more than a decade to ingrain the concept that dietary fats are “the bad guy.” It will likely take a substantial amount of additional effort to clarify that replacement of fats with refined carbohydrates is not a healthful tradeoff.