Should the Dietary Guidelines for Americans include sustainability? A critical perspective

The move to include sustainability in the Dietary Guidelines for Americans (DGA) can seem like an obvious response to some of the biggest threats to all domains of sustainability: health, environment, economy, and society. But it has been controversial. This perspective paper describes the evolution of this idea, critically appraises the arguments for and against, and considers ways to move this conversation forward. Since the inception of this idea in 1986, it has always been a source of unresolved controversy fueled by categorical arguments rather than nuanced discussions. At the center of this controversy has been questions about the strength of the evidence for nutrition-sustainability relationships, whether the DGA is the appropriate venue to communicate this information to the public, and the policy implications for sectors outside of nutrition. This timeline has been punctuated by flash points along the way, notably the inclusion of sustainability in the 2010 DGA and the 2015 Dietary Guidelines Advisory Committee report, which led to intense partisan fallout. Sustainability has not been included in the DGA process since then, to the consternation of many nutrition professionals. What has been missing is a nuanced and critical discussion of the evidence base that links nutrition with sustainability, ways to communicate that evidence to the public, and approaches for developing integrated policies that reduce inertia. The relationship between nutrition and sustainability is characterized by tradeoffs that need to be acknowledged by scientists, clinicians, and policymakers. The federal government, which has responsibility for translating the scientific evidence into publicly accessible dietary guidance, is not currently well-positioned to communicate the nuances of nutrition-sustainability science to the general public. Most clinicians are not trained to do that either. In addition, the DGA has far-reaching implications for nondietary policy, which have not been fully considered yet. Until we, as nutrition professionals, can have productive conversations about the nuances related to science, messaging, and policy, a push to include sustainability in the DGA will be counterproductive.