Why Sustainability Belongs in the Dietary Guidelines: A Q&A with Miriam Nelson

It was Miriam Nelson who urged the Dietary Guidelines Advisory Committee to look into sustainability—for the first time, and controversially. She ended up chairing the sustainability subcommittee. A longtime EatingWell advisory board member, Nelson recently became the director of the Sustainability Institute at the University of New Hampshire after more than 30 years as a nutrition professor at Tufts University. Here, Georgina Gustin, who teamed with FERN and Eating Well to cover the debate over the federal dietary guidelines, asked Nelson about her thoughts on the process and outcome.

Why did you think sustainability should become part of the guidelines?

Sustainability relates to food security, which has been a long-enduring theme of the guidelines. I feel strongly that the guidelines should be progressive, and when I say that, I mean they should be progressive with the science.

One of the criticisms of your subcommittee was that you weren’t qualified to evaluate sustainability science.

Similar to another subcommittee, we brought on two nationally recognized food-sustainability experts to help collaborate in the process. They went through the same rigorous vetting process we did to be on the committee.

How and why did you select the papers you reviewed?

We decided there were two focus areas: One was to focus very narrowly on dietary patterns and the confluence of healthy eating and sustainable diets. The other area was around seafood. We had a framework we used, with exclusionary and inclusionary criteria, then we put that through the Nutrition Evidence Library. It’s a very systematic and careful way to do a review, and it came up with 15 studies. The process followed the most rigorous, highest standard for reviewing the science to develop conclusions for the questions posed.

Behind each recommendation in the report there’s a grade based on the strength of the science. Why did you give your conclusions a “moderate” rather than “strong” rating?

That’s a really good question. I would say that the committee overwhelmingly felt the science was strong enough to give it a “strong” recommendation, but this was a new area for the dietary guidelines and the research is mostly in the last 10 to 12 years. As scientists we’re all very conservative, so we felt that for that reason it warranted a “moderate” strength. We originally had it as “strong,” because all the studies came up with very similar conclusions.

Before the final dietary guidelines were released, Congress passed a spending bill that included a requirement that the National Academy of Medicine (NAM) conduct an external review of the dietary guidelines process. Will that review yield anything constructive?

I’m an optimist. I’ve been on three different federal advisory boards and I believe that it’s important to review processes like this. This is very expensive, it’s taxpayer money, and we can always make this better. I believe Congress was motivated because they felt the private sector needed to have a voice. The problem is that many in the private sector have a conflict of interest. We need to make sure we keep a focus on the public’s health. Although I’m disappointed that the recommendations to eat less meat, especially red meat and processed meat, and the work on sustainability did not make it into the final guidelines, I do believe the final guidelines promote public health.

Is there hope for sustainability making its way into dietary advice in the future?

There are certain things that are really exciting. One is the unprecedented public engagement we saw this time around sustainability and the dietary guidelines—by advocates, the private sector, individuals, the NAM. We need that engagement to move this forward. We also need to continue expanding the science base, and we need to make a legal and business case for why it’s in our best interest to consider sustainability. And we need to build consumer demand for this type of information.