May 2024
Sarah Booth, PhD
Chair, 2025 Dietary Guidelines Advisory Committee
c/o Janet M. de Jesus, MS, RD
Office of Disease Prevention and Health Promotion (ODPHP)
Office of the Assistant Secretary for Health (OASH), HHS
1101 Wootton Parkway, Suite 420 Rockville, MD 20852
ATTN:
Deanna Hoelscher, PhD, RDN, LD, CNS, FISBNPA
Chair, Dietary Patterns and Specific Dietary Pattern Components Across Life Stages Subcommittee
Chris Taylor, PhD, RDN, LD, FAND
Chair, Food Pattern Modeling and Data Analysis Subcommittee
Jennifer Orlet Fisher, PhD
Chair, Diet in Pregnancy and Birth through Adolescence Subcommittee
Sameera Talegawkar, PhD
Chair, Health Equity Working Group
Re: 2025 Dietary Guidelines Advisory Committee
(Docket No. HHS-OASH-2022-0021-0001)
Dear Dr. Booth and Members of the 2025 Dietary Guidelines Advisory Committee (“DGAC,” “the Committee”),
The National Medical Association (NMA) appreciates the opportunity to submit comments for consideration in the important work of the 2025 DGAC.
Established in 1895, the NMA is the oldest and largest organization representing Black physicians in the United States (U.S.). This organization, which is comprised of more than 30,000 physicians, has a long history of promoting the health of underserved communities.
Due to a centuries-long legacy of racial and social injustice, Black experience the highest prevalence of chronic and debilitating health conditions throughout their life course compared to white populations.[i] While most of these inequities need to be addressed through state and national level efforts, there are also certain changes that can simultaneously be made at the individual, family, and community levels which hold massive potential for improving health and well-being across the life course.[ii] Specifically, improving the dietary patterns of Black populations is a major public health opportunity. The diets of Black Americans are generally less healthy, including chronic overconsumption of fast foods and sugar-sweetened beverages and lower consumption of nutrient-dense foods such as fruits, vegetables, whole grains, and dairy products.2 These types of dietary choices are tied to increased risk of disease, disability, and premature death among Black populations of all ages. This makes improving diet quality critically important to reducing the health inequities faced by this population, and it is imperative that we provide proper avenues to support healthy, affordable, accessible, and culturally-acceptable diets. For these reasons, we commend the DGAC for establishing the Health Equity Working Group (HEWG) to integrate various health equity principles into their evaluation process of updating dietary recommendations for Americans.
To support the critical work of the DGAC, we are pleased to share the following evidence-based findings for helping Black Americans at all life stages meet the food and nutrient recommendations within the Dietary Guidelines for Americans (DGA). These comments specifically reflect the scientific findings and conclusions from the “Special Issue: Dairy Intake and Health Among Black Americans,” published in the Journal of the NMA in April 2024 (Volume 116, Issue 2, Part 2), which is also provided as an accompanying attachment to these comments. Given the complex relationships that many Black individuals have with dairy foods, this new NMA publication summarizes the evidence for the most prominent health and disease outcomes for Black populations at each life stage and, where possible, conveys the research findings focused on different dairy food types (e.g., milk, yogurt, cheese) and subtypes (e.g., low-fat, fermented, vitamin D fortified) that are most consistently associated with reduced disease risk at each life stage.
Executive Summary
- Black Americans face greater nutrition and health disparities than any other racial/ethnic group, but improving diet quality can help close these gaps.
- Meeting national dairy intake recommendations (2 to 2.5 servings/day for young children; 3 servings/day for older children, adolescents, adults, and older adults) can help close nutrient gaps, improve diet quality, and reduce health disparities for Black Americans across all life stages.
- Although fat-free and low-fat dairy foods are primarily recommended in the current DGA, research indicates that whole-fat dairy foods may contain greater levels of beneficial lipids and lipid-soluble compounds and are generally associated with neutral or positive health outcomes for various populations.
- Dairy avoidance due to misinformation/disinformation or incorrect self-diagnosis of lactose intolerance may put Black populations at higher risk for inadequate intake of multiple micronutrients and several preventable chronic diseases.
The Role of Nutrition in Addressing Health Inequities Affecting Black Americans
Recent census data show that there are over 40 million Black Americans currently living in the U.S., making up approximately 13.6% of the population.[iii] However, Black Americans share greater burdens of discrimination, socioeconomic inequities, and health disparities than any other racial/ethnic group in the U.S.1 Black populations also experience more than twice the rate of food insecurity than the national average (21.7%, vs. 10.5%, respectively,[iv] and have an average lifespan that is nearly six years shorter than white Americans (70.8 years vs. 76.4 years, respectively).[v] This difference in lifespan can be directly attributed to a much higher prevalence of several chronic and debilitating health conditions (e.g., heart disease, hypertension, type 2 diabetes) among Black populations throughout their life course.[vi] For example, according to recent Centers for Disease Control and Prevention (CDC) data, more than 40% of adults in the United States (US) have obesity, and 60% live with one or more chronic diseases.[vii] [viii] These numbers are significantly worse for Black adults,[ix] [x] who are 30% more likely to have obesity compared to white adults, and have a significantly higher burden of chronic diseases with earlier onset and worse treatment outcomes.[xi],[xii],[xiii],[xiv]Diabetes also disproportionally affects people of color in the U.S., with 13.2% of non-Hispanic Black individuals diagnosed with diabetes compared to 7.6% of non-Hispanic white individuals.[xv]
Although nutrition is only one of many factors that influence health and well-being, a growing body of research shows that a healthy dietary pattern is one of the most dominant factors associated with increased longevity, improved mental health and immunity, body weight regulation, and decreased risk chronic disease.[xvi],[xvii],[xviii],[xix],[xx]
Dairy foods are nutrient-dense foods that contribute roughly a dozen essential nutrients to healthy dietary patterns and are associated with reduced risk for many of the diseases that disproportionately impact Black Americans. Therefore, NMA examined the relationships between dairy intake, disparities, and disease outcomes to assist health professionals and their patients of all life stages with diet-related advice for disease prevention and management. Below are key takeaways from NMA’s series of evidence reviews focused on opportunities to improve the health and well-being of Black Americans throughout the major life stages, including: 1) pregnancy, fetal development, and lactation, 2) birth to 4 years, 3) childhood and adolescence (5 to 17 years), 4) adulthood (18 to 59 years), and 5) older adulthood (60+ years).
- Pregnancy, Fetal Development, and Lactation:
Pregnancy and lactation are special life stages requiring unique nutrient and energy needs, and Black Americans are disproportionately impacted by health complications during this period. Specifically, Black Americans have a 36% higher rate of preterm births (defined as birth younger than 37 weeks old), and 53% higher rate of very early preterm births (which is younger than 34 weeks) compared to white Americans.[xxi] Black Americans are also at higher risk for preeclampsia, abnormal fetal growth, and spontaneous abortion during pregnancy.[xxii],[xxiii],[xxiv]
Adequate intake of nutrients that support parent and fetal health for Black Americans is therefore particularly significant. The current DGA recommends that those who are pregnant and lactating consume 3 servings of dairy per day.7 Consuming 3 or more servings of dairy per day during this life stage is associated with higher intakes of vitamin A, vitamin D, riboflavin, calcium, iodine, magnesium, potassium, and zinc. Adequate intake of these nutrients, particularly vitamin D, during pregnancy is associated with healthy gestational weight gain, reduced risk of gestational diabetes and pregnancy-related hypertensive disorders, low birth weight, small for gestational age, and a 33% reduced risk of preterm birth.[xxv],[xxvi] Higher dairy intake is also associated with lower blood pressure during pregnancy, which is important for prevention of preeclampsia and other pregnancy-related complications.[xxvii]
However, most do not achieve the recommended 3 servings of dairy a day during this critical life stage. On average, pregnant and lactating people consume fewer than 2 servings per day, putting them at risk for inadequate intake of multiple nutrients that are necessary for optimal maternal and offspring health. Black Americans of child-bearing age having the lowest average intake of dairy foods compared to other racial/ethnic groups.[xxviii] Nutrition interventions that improve diet quality during these vulnerable stages of life, and particularly, achieving recommended intake of dairy foods, may be a particularly impactful way to reduce intergenerational health disparities among this population.
- Birth to 4 Years
The first 1,000 days of life, the window from conception to 2 years of age, represents a time of both great potential and vulnerability. This period is marked by the brain’s rapid growth and its ability to grow and respond to its environment, and nutrition is crucial to supporting this brain growth for cognition, motor skills and socio-emotional development. The 1,000-day window offers a critical opportunity to impact lifelong learning and health. It is the foundational component of the fair start that every child deserves, impacting their future success in school, the workforce, society and even economic opportunities later in life.
Breastmilk is recommended as the primary source of nutrition in the first 6 months of life. While breastmilk supplemented with vitamin D, or dairy-based infant formulas for those who are not breastfed, is recommended as the primary source of nutrition in the first 6 months of life, foods begin to play a role in complementary nutrition thereafter.7 Black children, however, are at greater risk for health disparities due to lower breastfeeding rates, earlier discontinuation of breastfeeding, age-inappropriate complementary feeding patterns, nutrient inadequacies, food insecurity, and a host of associated health challenges – including higher childhood obesity and infant mortality rates – compared to almost all other racial/ethnic groups.2
Upon the introduction to complementary foods, dairy foods become some of the most important contributors to key nutrients and bioactive compounds that are important for musculoskeletal, immunological, gastrointestinal, and neurocognitive health and development for toddlers and young children. Adequate early-life intake of vitamin A, vitamin D, vitamin B12, choline, and iodine – nutrients found in dairy foods – are associated with brain health and cognitive development.[xxix] In fact, dairy foods during the first 1,000 days of life provides 7 of the 14 nutrients that the American Academy of Pediatrics identifies as critical to support brain and neurocognitive development.20 While fermented dairy foods such as yogurt and cheese are suitable complementary foods starting around 6 months of age, cow’s milk is not recommended until around 1-year of age due to its high nutrient density (which may be difficult for the infant digestive tract to handle) and its potential for allergenicity.7 After the first year of life, however, whole cow’s milk is ideal when breastfeeding is not possible, as it is more similar in nutrient and bioactive composition to human milk than any other food source.7,[xxx] Because Black Americans are twice as likely to be born prematurely than white Americans,13 adequate intake of dairy foods are even more of a priority for providing the necessary nutrients and bioactive compounds to support ‘catch up’ growth among this young and vulnerable population.
On average, U.S. toddlers (12-23 months) of all racial/ethnic groups are meeting or exceeding the dairy recommendations (2.6 servings/day for white toddlers, 1.8 servings/day for Black toddlers).[xxxi] This pattern changes, however, as children age. While young white children (2 to 4 years) continue to meet their dairy recommendations of 2 to 2.5 servings/day, young Black children are falling short (1.6 servings/day, respectively). Young Black children are also falling behind white children on two nutrients supplied in dairy foods: calcium and vitamin D, with approximately 26% not receiving enough calcium, and nearly 95% not receiving enough vitamin D.22 Interventions to help Black children meet dairy intake recommendations and keep up with their white peers are important to support proper growth and development and to set them up for a healthy life ahead.
- Childhood and Adolescence (5 to 17 Years)
Adequate nutritional intake is critical during this period of rapid growth to help ensure lifelong musculoskeletal, metabolic, and immune health. However, instead of improving diet quality during this time of immense physical, emotional, and reproductive maturation, current dietary intake data shows that diet quality worsens into adolescence, drifting further from recommendations in the DGA.7
These dietary gaps are especially critical to address, as over 40% percent of children and adolescents in the U.S. are overweight or obese, and the prevalence is higher among Black youth than for white youth. Overweight and obese youth are at increased risks for developing chronic diseases – and these risks often remains elevated throughout their lifetime.7 Additionally, about 20% of children and adolescents in the U.S. currently have a diagnosed mental, behavioral, and/or emotional disorder, and major disparities in the prevalence and treatment of mental health disorders exist. For example, an estimated 77% of Black youth have unmet mental health needs, and only 13% of them report that they are receiving mental health services.[xxxii]
Black children are particularly vulnerable for falling short on dietary recommendations for several food groups, including dairy foods. This trend is worse for adolescent females compared to males,21 and for Black youth compared to white youth in the U.S. In addition to under-consuming dairy foods, Black youth are also under-consuming calcium and vitamin D, while simultaneously overconsuming sweetened beverages, added sugars, and calories. The body of evidence on dairy intake and health outcomes in these populations shows that regular intake, especially of fermented and vitamin D fortified products, is associated with better outcomes related to bone health, body composition, and oral health, and may also have promising benefits for mental health.[xxxiii],[xxxiv],[xxxv],[xxxvi],[xxxvii] Specifically, increased dairy intake is associated with a 38% reduced risk of childhood overweight or obesity and an 8% increase in bone mineral density. It’s also associated with 40% lower odds of depression and 38% lower odds of social anxiety. Further, while the 2020-2025 DGA recommends low-fat and fat-free dairy foods, a growing body of research shows little to no differences between whole-fat and low-fat dairy intake on body composition and cardiometabolic health in this population.[xxxviii],[xxxix] Rather, most studies demonstrate neutral or mildly protective effects of whole-fat dairy intake on obesity, especially when whole-fat dairy replaces the consumption of energy-dense and nutrient-poor options, such as convenience foods and sugar-sweetened beverages.
Therefore, helping Black children meet current dairy intake recommendations could be an effective strategy for mitigating multiple health disparities (especially related to body weight and mental health) and helping to improve health equity in this population.
- Adulthood (18-59 Years)
Adulthood is a life stage that encompasses a range of new experiences, opportunities, and responsibilities that impact health and well-being. Unfortunately, the majority of Americans are not meeting one or more of their nutritional requirements,7 and 38% of Black adults have obesity compared to 30% of White adults.[xl],[xli],[xlii],[xliii],[xliv],[xlv] Black Americans also have a greater number of nutritional inadequacies, comorbidities, earlier chronic disease onset, worse treatment outcomes, and nearly twice the mortality rates as White Americans.
Of the major food groups recommended by the 2020-2025 DGA, dairy foods have a nutrient profile that most closely matches the nutrients that Black Americans are commonly under-consuming, and these foods are associated with lower rates of most chronic diseases. Systematic reviews and meta-analyses focused on dairy food intake and risks for major disease outcomes in adult populations have largely found that higher intake of nutrient-rich dairy foods (≥3 servings per day) is likely to be more beneficial for overall health and well-being than lower dairy intake (<2 servings per day). Specifically, higher dairy intake is associated with a reduced risk for type 2 diabetes, 25% lower risk of obesity, 25% lower risk of chronic kidney disease, and up to 10% lower risk of breast cancer. Even increasing consumption by as little as 1 serving of milk or dairy food per day can reduce risk for metabolic syndrome by up to 13%.[xlvi],[xlvii],[xlviii],[xlix],[l]
Although the 2020-2025 DGA continues to recommend low-fat dairy over whole-fat options, there has been a growing consensus that the unique array of fats in dairy foods, especially in fermented dairy foods, are not harmful to overall health and instead may provide numerous benefits for neurocognitive health and lowering chronic disease risk.[li] Several randomized controlled trials (RCTs) and mechanistic studies also indicate that higher intake of whole-fat dairy foods, within the context of a healthy eating pattern, are generally associated with neutral to mildly beneficial impacts on cardiometabolic, inflammatory, gastrointestinal, and neurocognitive health outcomes.42,[lii]
Currently, Black adults tend to consume only half of the recommended daily servings of dairy foods, demonstrating that higher intake of dairy foods – including whole-fat dairy – may support an improvement in nutrition status in Black Americans, may beneficially impact their health and well-being, and may therefore help shrink the health equity gap.
- Older Adulthood (60+ Years)
The transition to older adulthood is generally marked by progressive alterations in energy and nutrient needs, and detrimental changes in body composition, metabolism, cognitive function, and immunity.[liii] These changes are among the most impactful age-related factors associated with declining health and the development of chronic disease.44 In the U.S., the prevalence and severity of age-related chronic disease is significantly higher in older Black Americans than in White Americans.[liv] According to the “Weathering Hypothesis”, early-life exposures to racial/ethnic and socioeconomic stressors appear to have lasting effects, and the negative biological burden (i.e., allostatic load) of one’s early- and mid-life history tends to continuously impact their health and well-being throughout their later life stages.[lv] For Black Americans, this often shows up in the form of an accelerated aging process that impacts both body and brain.[lvi] Therefore, not only do Black Americans tend to have higher rates of most common chronic diseases, but they also tend to develop them earlier in life compared to White Americans – meaning that when Black Americans transition to older adulthood, they have already been living with certain diseases and their complications for much longer.9 Additionally, as the U.S. population ages and becomes more diverse, the burden of age-related chronic disease are expected to disproportionately impact minority groups such as Black Americans in both prevalence and severity.3
Overall, the evidence reported in multiple systematic reviews and/or meta-analyses shows that higher dairy intake among older adults is associated with better musculoskeletal health8,[lvii],[lviii],[lix],[lx],[lxi] – especially when consumed in conjunction with healthy lifestyle practices, such as habitual exercise.[lxii] The limited body of evidence on higher dairy intake and neurocognitive and immune outcomes is less clear, but does show promise for benefitting the aging population – especially when fermented and vitamin D-fortified dairy products are regularly consumed as part of an anti-inflammatory dietary pattern.
The 2020-2025 DGA recommends that older adults consume 3 servings of dairy per day, to meet their unique dietary needs, which includes lower calorie requirements along with higher demand for protein, calcium, potassium, vitamin B12, and vitamin D.7 Dairy foods are recognized for supplying several of the nutrients that are inadequately consumed by older Black Americans, with more liquid forms of dairy foods (e.g., milk and nutrition supplement drinks) also listed as ideal options for improving hydration status in geriatric populations.7 Whey protein supplements and other dairy protein-based functional beverages have been shown to be particularly effective for reducing age-related muscle loss and improving nutrient status.21 When compared to other protein- and nutrient-rich foods such as meat, seafood, and eggs, dairy foods tend to be more cost-effective and require less preparation (i.e., cooking, seasoning, cleaning), making them both affordable and practical options for helping older adults meet their lifestyle and dietary needs.[lxiii]
Due to their higher nutritional needs, older Black populations that limit or avoid dairy food intake due to lactose intolerance, restrictive dietary patterns, low appetite, or for other reasons, are likely under-consuming multiple essential nutrients that support healthy aging. Fermented dairy foods, which are generally nutrient-rich and low in lactose, are an optimal delivery system for live and active cultures (e.g., lactic acid bacteria, bifidobacteria) that can benefit both physical and mental health, indicating that the daily intake of fermented dairy foods provides an ideal foundation for a diet focused on healthy aging.[lxiv],[lxv],[lxvi],[lxvii]
Barriers to Meeting Dairy Intake Recommendations
About 70-75% of Black Americans are lactose non-persistent, meaning they do not genetically produce adequate levels of the lactase enzyme into adulthood. A large percentage of this population avoids dairy foods because they have been either diagnosed with lactose intolerance by a medical professional or they perceive themselves to be lactose intolerant without obtaining a valid medical confirmation. True lactose intolerance prevalence is not known because healthcare providers do not routinely measure for it, and no standardized assessment method exists. However, recent studies using self-reported rates of lactose intolerance indicate rates are much lower than lactose non-persistence prevalence rates. A 2009 study that determined self-reported lactose intolerance prevalence rates found that 19.5% of Black Americans considered themselves lactose intolerant.[lxviii] A study addressing self-reported incidence of lactose intolerance and its impact on dairy intake among Black Americans found similar rates (24%) in this group as well.[lxix] It is worth noting that individuals with lactase non-persistence may still possess the ability to tolerate 12-15 grams of lactose at a time (about 1 serving of milk) without presenting gastrointestinal symptoms.[lxx],[lxxi] This is because the ability to digest lactose greatly varies between individuals and is dependent on several biological factors not just on genetic production of the lactase enzyme. Unfortunately, a large percentage of the U.S. population (including many Black Americans) may be unnecessarily avoiding dairy foods due to incorrect self-diagnosis of lactose intolerance or a lack of awareness of all the easily accessible management options.59 Because dairy avoidance for these reasons is so common, and may result in heightened nutrient insufficiencies and disease risk, the National Institutes of Health recognizes that dairy avoidance due to self-diagnosed lactose intolerance is a public health problem for this population.[lxxii]
Despite the high frequency of Black Americans avoiding dairy due to fear of or misconceptions around managing lactose intolerance, research shows that Black Americans understand that dairy is healthful and believe that dairy is a staple food in the American diet.62 In fact, Black Americans report having an affinity for dairy, and while many consume a variety of dairy products, they are more likely to prefer lactose-free products.[lxxiii] There are many lactose-free and lower-lactose dairy products available on the market for these consumers, including lactose-free milks, yogurts, kefirs, cheeses, and specialty products such as infant formulas and protein powders. These lactose-free dairy products contain a full spectrum of dairy nutrients and bioactive compounds, making them a responsible management tool for individuals with lactose intolerance.
Another dietary modification that can help reduce or eliminate the symptoms of lactose intolerance is only consuming small or moderate amounts of lactose at a time. Given that Black Americans tend to opt out of dairy milk altogether rather than reducing quantity, this is a strategy that can be elevated amongst this population.62 Strategies like this that simultaneously target misconceptions around lactose intolerance and help improve dairy intake among Black adults remain critical for helping to reduce chronic disease risk in this population and improving public health.
Replacing dairy foods with plant-based alternatives may be viewed as an acceptable alternative in some cases, but the regular substitution of dairy foods with alternatives should be approached with caution due to the nutrient imbalances commonly associated with removing nutrient-dense animal-sourced foods from the diet.[lxxiv] Plant-based foods and beverages are processed and fortified in an attempt to mimic the flavors, textures, and nutrient composition of dairy foods, which generally results in products with lower nutrient density, higher sugar content, and lower fiber compared to the plant foods they were derived from.[lxxv] They also tend to contain several added ingredients such as sweeteners, stabilizers, and flavors that are included for improving consistency, palatability, and shelf-life and may negatively impact health.62 Additionally, plant-based alternatives are more expensive than dairy milk, potentially adding to the financial stress that many families experience. While an eight-ounce serving of milk costs just $0.30, the same size serving of soy, almond, and oat beverages cost $0.51, $0.46, and $0.69, respectively.[lxxvi]
Compared to dairy foods, these alternatives also tend to contain lower levels of protein, calcium, iodine, zinc, vitamin B12, and vitamin D, and have higher levels of antinutrients such as oxalates, phytates, and tannins that can negatively impact nutrient absorption.[lxxvii],[lxxviii],[lxxix],69 Suboptimal levels of iodine are especially concerning amongst individuals of childbearing age, as it has been linked to reduced cognitive development in offspring.19 Further, plant-based alternatives cannot replicate the unique food matrices of dairy foods, which involve an interconnected networked structure of carbohydrates, fat, proteins, vitamins, minerals and bioactive compounds. Several researchers have reported that severe nutritional deficiencies and negative health outcomes can occur when inappropriately substituting nutrient-poor plant-based alternatives in place of nutrient-rich dairy products.[lxxx],[lxxxi],[lxxxii],[lxxxiii]
In recent years, there has been a push from special interest groups for the DGA to lower its dairy recommendations and instead promote greater consumption of plant-based alternatives. These groups typically cite a racial/ethnic bias since most underrepresented populations in the U.S. – including Black Americans – have higher rates of lactase non-persistence than White Americans.59 However, from a medical perspective, the consequences of under-consuming or avoiding dairy foods far outweigh the benefits, and could have serious negative health impacts across the life course.[lxxxiv],[lxxxv] Unnecessary dairy avoidance is a critical issue for the health and well-being of Black Americans since most of this population is chronically under-consuming multiple nutrients of public health concern that are most prominently found in dairy foods.[lxxxvi],[lxxxvii] Moreover, dairy foods are some of the most affordable and accessible sources of nutrition, and therefore a practical option for Black Americans, especially since many options are low or free of lactose, such as lactose-free milk, yogurt, kefir, and cheese..
Conclusion
Major health disparities exist between Black and white Americans at all life stages, and the risks for diet-related diseases such as obesity, cardiometabolic disease, and certain cancers are also elevated in Black populations. Because improving diet quality is a modifiable and effective factor for improving health across the lifespan, it is an important intervention that can help reduce health.
Specifically, research consistently shows that higher intake of nutrient-rich dairy products is associated with reduced risk for many of the most common chronic diseases affecting Americans, and disproportionately impacting Black Americans.[lxxxviii],[lxxxix] Therefore, evidence-based and culturally appropriate strategies for addressing barriers to healthy eating are needed – especially for dairy foods, which can help reduce the nutrient deficiencies and chronic diseases affecting Black populations.[xc],[xci]
Despite the best of intentions, following DGA guidelines may be challenging for many Black Americans who experience food insecurity at twice the rate as the national average, and may lack awareness of the health impacts of dairy foods or dairy alternatives.61,[xcii] As such, it is important to recognize that Black Americans may require culturally appropriate nutrition education to recognize that dairy foods can be affordable, accessible and culturally relevant; that there are dairy options for people living with lactose intolerance (e.g., lactose-free milk, yogurt, kefir, and cheese); and these options are important for achieving adequate nutrition to support a healthy eating pattern.
We appreciate the DGAC’s consideration of these evidence-based comments as you work to improve the health and well-being of diverse populations, including Black Americans, across the life course.
Thank you for the opportunity to submit these comments. NMA appreciates the agencies’ dedication to seeking public comment for the development of the DGA, and we are available for any additional information, as needed.
Sincerely,
Yolanda Lawson, MD
President, NMA
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