An evidence-based approach for establishing dietary guidelines.

Although all agree that diet is important to health, for Americans, compliance with dietary guidelines is poor. This may be because socioeconomic, cultural, and political factors influencing food habits were given little consideration when the guidelines were derived. In 2005, the Dietary Guidelines Advisory Committee was advised to focus their analysis on scientific evidence linking diet and health. Although this approach strengthened the scientific rationale behind the guidelines, factors from the "real world" affecting compliance received little attention. The research base for the guidelines needs to be expanded to include studies of barriers to compliance as well as randomized controlled trials of whole diets. Also, the process for formulating the guidelines needs to be expanded to include input from the diverse group of users and stakeholders. Possibly, a 3-step process involving a technical analysis, user appraisal, and federal formulation, all coordinated by a Standing Dietary Guidelines Committee, would broaden assessment of relevant data and better integrate conflicting uses and applications.