Conflicts between guidelines and evidence: Risks for balancing diets with diversified food and nutrient intake of individuals

A normal person, have no disease, is commonly guided to achieve and maintain proper health and nutritional status by consuming food or nutrients form diversified groups of foods as per recommendations. If some levels of discrepancies arise between recommendations and evidence-based data, then we need to focus on that issue and address it properly to narrow down the gaps to covey the right messages to the users of the data or guidelines. Failure to do that may be harmful for many of them for having hidden or unseen consequences such as food related stress while choosing and consuming foods, inappropriate caring practices by care givers, less or misuse of food or nutrients, less or excess intake of both healthy and unhealthy foods, etc.

Here we may take the opportunity to discuss few important and highly discussed or concerned food related evidence and guidelines. Thus, we may identify the conflicts, if any, to maximize the acceptability, effectiveness, sustainability and utilization of both evidence and guidelines.

a) Sugar (Naturally occurring sugar, added or free sugar):

In general sugar, particularly natural sugar and added sugar, is not harmful if consumed in small amount (1). On the other hand, too much added sugar (2) may unhealthy due to weight gain and other diseases or problems such as obesity, type 2 diabetes, heart disease, tooth decay, etc. (3,4,5). Sugar is considered poisonous or harmful (6,7,8,9). So, it is also recommended to say no to sugar. Still, we have few or many scopes to debate with few aspects.

Let’s consider following questions-

• How much is considered too much added sugars (10)?
• What’s the common recommendations about sugar intake?
• What’s the major health concerned about sugar intake?
• Is it good to avoid sugar?
• Is good to have artificial sweeteners instead of sugar?

Regulated intake of less or minimum (sparingly) sugar may be more beneficial than alternative options such as artificial sweeteners that needs more money which could be used for buying cheap and nutrition foods (11,12). Let’s learn about sugar intake recommendations:

Age groups: ≥ 2 years (<10% of Total calories/Day) (3) and < 2 years (No foods or beverages with added sugars) (3); Adult and children:  <10% of their total energy intake/Day (< 5% or roughly 25 grams/Day for greater benefits) (5); Men: ≤36 grams or 150 calories/day (13) and Women: ≤ 25 grams or 100 calories/day (13).

b) Egg:

For many years (1968-2015) egg consumption was restricted or limited (no more than 3 whole egg/week) for people especially for people suffering from CVDs. These were aimed to limit the consumption of dietary cholesterol (300 mg/day) (14,15). As a result, people were deprived of having quality and cheap proteins along with other beneficial effects. Here individual component (cholesterol) was focused more instead of considering egg as a food of diversified nutrients or components those have other beneficial effects with less harmful effects by cholesterol alone as expected and recommended. So, proper evidence-based data should be generated to overcome existing confusions, if any, to support the drive of egg consumption (15,16,17,18).

c) Foods causing allergy:

Peoples who are suffering from allergy may avoid diversified foods of the same or similar groups those may not be as responsive as others. So, it would be wise to try and decide about the amount and duration of intake and avoidance of specific food(s). These need to be adjusted based on individual needs (19) and evidence based updated data. For example, the early recommendation by The American Academy of Pediatrics (AAP) was withdrawn for egg introduction (age >2 years) for high-risk families. Now, it was also found important and beneficial if introduced early to both pregnant mother and kids. So, level of exposure and body’s gradual adaption is the key factors.

…….

So, continuous adjustment in food and dietary guidelines are key steps required to help and support human health and nutritional status. These would ultimately help us to learn about the composition as well as nutrient-nutrients interaction to address the issues of food related unhealthy effects. As a result, we would be able to include or adapt multiple options such as increased consumption of food or nutrients of beneficial contexts: natural and less or no processed foods, whole grain-based composite food, pre-biotics and pro-biotics (fermented food and non-fermented foods or ingredients), fortified or supplanted food or medicine with bio-active compounds and phytochemicals (functional foods/ingredients), etc.

Let’s make some small or big but very important changes in each scientific approaches to adjust or adapt existing or ongoing activities. These may promote or reduce or nullify food or nutrient mediated positive or negative effects on health and nutritional status of individual(s).

*(Continuing…)

*Featured image credit goes to https://www.pexels.com

If you are more interested, please visit the following links:

Guideline: sugars intake for adults and children

US Dietary recommendations timeline: 1980 – 2025 | Northwell Health

References:

1. Sugar 101 | American Heart Association
2. Added sugar: Where is it hiding? – Harvard Health
3. Get the Facts: Added Sugars | Nutrition | CDC
4. The sweet danger of sugar – Harvard Health
5. WHO calls on countries to reduce sugars intake among adults and children
6. The sweet danger of sugar – Harvard Health
7. The toxic truth about sugar | Nature
8. Sweet and toxic: Is sugar really ‘poison’?
9. White Poisons That You Should Start Avoiding Immediately – The Wellness Corner
10. Added Sugars on the Nutrition Facts Label | FDA
11. Dietary Guidelines brochure FF
12. New dietary guidelines urge Americans to eat less added sugars, saturated fat, and sodium | NHLBI, NIH
13. How Much Sugar Is Too Much? | American Heart Association
14. The Fifty Year Rehabilitation of the Egg – PMC
15. Dietary Intakes of Eggs and Cholesterol in Relation to All‐Cause and Heart Disease Mortality: A Prospective Cohort Study | Journal of the American Heart Association
16. Recommendations for the use of eggs in the diet – PubMed
17. Recommendations for the use of eggs in the diet – PubMed
18. Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis – PMC
19. Changes in food allergy recommendations: a spotlight on egg allergens – Egg Nutrition Center