The Dietary Guidelines for Americans (DGAs) have long served as a road map for dietitians and nutritionists to promote positive nutrition and public health outcomes in the U.S. As a nutritionist with over three decades of experience, I've dedicated my career to cutting through the clutter and sharing science-based information to promote health. It is with great concern that I call attention to the recent proposal by the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD) to conduct an “Alcohol Intake and Health” study as part of the 2025 DGAs review process.
The U.S. government reviews the Dietary Guidelines for Americans every five years. The DGAs follow a long-established protocol to review the body of high-quality scientific evidence on moderate alcohol consumption in the context of healthy dietary patterns. To determine what the committee will evaluate, the U.S. Department of Health and Human Services (HHS), and the U.S. Department of Agriculture (USDA) conduct a yearlong process to gather extensive information.
However, the ICCPUD protocol deviates from this rigorous approach, introducing uncommon methodologies that introduce potential biases. Moreover, there has been a lack of transparency regarding how the ICCPUD study’s topics and questions were determined and there is no justification for implementing these unprecedented methodologies.
The DGAs are statutorily mandated to provide “advice on what to eat and drink to promote health and reduce the risk of chronic disease.” The ICCPUD study’s protocol, however, is not aligned with this mandate. The ICCUD study plans to include non-health outcomes, such as motor vehicle crashes, which fall outside the scope of “nutritional and dietary information.” Research has shown that moderate alcohol consumption, within the context of healthy dietary patterns like the Mediterranean Diet, is associated with reduced risks of all-cause mortality, cardiovascular disease, and Type 2 diabetes.
Previous DGAC reviews on adult alcohol consumption have included individuals with specific expertise in nutrition and diet whereas the ICCPUD subcommittee and its Scientific Review Panel lack credentialed experts. The panel members share similar backgrounds and there was no public nomination further reducing the diversity of perspectives.
Every DGA recommendation since the first edition in 1980 has included guidance on moderate alcohol consumption, defining moderation as up to two drinks per day for men and one per day for women. The 2020 DGAC reaffirmed this definition, and the Secretaries of Agriculture and Health and Human Services concluded that there was not enough evidence to change this guidance. A concurrent study on adult alcohol use and health is already underway by the National Academies of Science, Engineering, and Medicine (NASEM), mandated by Congress. This study uses previously vetted questions and methodologies to update the systematic review of adult alcohol use and health.
The ICCPUD study is unnecessary and inappropriate for developing dietary guidance for adults who choose to drink in moderation. To ensure the best and most current evidence is reflected in the DGAs, USDA and HHS should reconsider the ICCPUD study’s membership and methodology, increase transparency, and provide meaningful opportunities for public consultation, comparable to the DGAC process.
As we continue to build and maintain healthy dietary patterns, it is crucial our guidance be grounded in rigorous, transparent, and scientifically sound processes. Only then can we ensure that the DGAs continue to serve as a reliable roadmap for promoting positive nutrition and public health outcomes in the U.S.
Kathleen Zelman, MPH, RDN, LD is a nutrition expert and former director of nutrition at WebMD. She serves as an advisor to the Distilled Spirits Council.
