The National Academy of Medicine (NAM) began in August the first-ever major peer review of the the Dietary Guidelines for Americans (DGA) since they were launched more than 35 years ago. Congress, concerned about the ever-rising tide of obesity and diabetes, mandated this review in large part to see if alternative solutions and approaches to combating these nutrition-related diseases might be found. However, any hopes that the NAM review might do meaningful work have already dimmed, as the panel has been appointed by–and stacked with–government insiders with an interest in preserving the status quo.
The latest panelist to be appointed to the NAM panel is Susan B. Roberts, Ph.D., from Tufts University’s Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA), one of only six human nutrition research centers funded by USDA. Tufts has long been inextricably intertwined with the DGAs: HNRCA’s current director, Alice Lichtenstein, served on the last two DGA advisory committees, most recently, in 2015, as its vice-chair. And HNRCA’s former director, Robert Russell, was just appointed the chair of the NAM panel. The long shadow of the USDA Tufts center now extends even further, with the appointment of another of its members, Dr. Roberts.
Congress, in its authorizing language for the NAM review, stated specifically that the NAM panel should seek “a wide range of viewpoints” including those “which challenge current dietary recommendations.” Yet even with the addition of Dr. Roberts, balance has clearly not been achieved. All of the members are long-time supporters of the high-carbohydrate, grain-based approach to preventing chronic disease, even though this approach has obviously failed.
Although the late-hour appointment of Dr. Roberts was intended to provide needed balance to the committee, her selection is a disappointment. She is also self-evidently entrenched in the conventional, status quo view on nutrition. In fact, she has a branded, commercial weight loss program, called iDiet, which recommends a low-fat and low-calorie diet which mirrors the DGAs.
The fundamental problem with this status-quo approach is that it ingores a large and fast-growing body of knowledge predicated on the idea that nutrition-related diseases are driven primarily by an excess of circulating insulin. Insulin spikes upon eating carbohydrates, such as grains, pasta, sugar and even fruit. Thus, when carbohydrates are reduced (or not eaten as frequently), insulin drops, leading to improvements in all measures of metabolic health (obesity, diabetes, and most heart disease risk factors). This “insulin hypothesis” is now supported by a vast body of rigorous, clinical trial research, including several trials of 2-years duration, which are considered long enough to reveal any negative side effects (This entire body of literature was ignored by the 2015 DGA advisory committee.)
Dr. Roberts appears to be not just ignorant of this approach but indeed, actively hostile to it. Last year, when a paper critical of low-carbohydrate diets was published in Cell Metabolism, Roberts wrote an enthusiastic accompanying editorial entitled, “One Strike against Low-Carbohydrate Diets.”
“I love this paper!” Dr. Roberts gushed to NPR News, “This is a really good high-quality study that helps get rid of some of the confusion.” In fact, Hall’s paper was merely a pilot study, on only 19 adults following two different diets (low-fat vs. low-carb), for only six days each. This study aimed to investigate only the feasibility of whether this type of investigation, in barometric chambers, could successfully be carried out. Nothing could be concluded from it. Yet low-fat defenders, including Dr. Roberts, have championed the study as if it were the nail in the low-carb coffin. Meanwhile, they ignore the NIH-funded clinical trial literature on more than 65,000 people, in experiments lasting many years, demonstrating that the low-fat diet is ineffective for fighting obesity, diabetes, or heart disease. The fact that Dr. Roberts and her colleagues celebrate a tiny pilot study while ignoring this much larger body of research reveals a clear bias.
The NAM panel was supposed to wrest power away from entrenched interests and bring sunlight to the murky and non-rigorous process of creating the Dietary Guidelines. “Questions have been raised about the scientific integrity of the process in developing the dietary guidelines,” said Congress in their instructions for the NAM review. “The entire process used to formulate and establish the guidelines needs to be reviewed before future guidelines are issued.” Point Number #1 in the scope of the review is: “How the Dietary Guidelines for Americans can better prevent chronic disease, ensure nutritional sufficiency for all Americans, and accommodate a range of individual factors, including age, gender, and metabolic health.”
But neither Dr. Roberts nor anyone else on the committee shows any openness to newer approaches to nutrition. The latest science changes what we think we know about diet and nutrition. A great many scientists are engaged in a new, more finely nuanced understanding of how differing combinations of protein, fat, and carbohydrates, based on how hormones, especially insulin, affect these conditions. This new approach may very well be the best hope for helping to fight chronic diseases.
Congress gave a million dollars to review the DGA creation process, correct it, and make sure that the DGAs reflects the best and most rigorous science possible. But the assignment of fourteen conventional thinkers like Dr. Roberts who all represent the status-quo will never produce any result other than to rubber stamp the existing, failed advice.
Can someone who earns money from their low-fat iDiet commercial diet plan also have an objective view of the latest science? Can someone so categorically dismissive of new research in nutrition add useful advice and guidance to the NAM panel?
If you think so, do nothing. If you think not, write your concerns to the panel immediately since the comment period on Roberts’ nomination runs out November 14th.
As Albert Einstein said, “We can’t solve problems by using the same kind of thinking we used when we created them.”
Make your comments at:
 Teicholz, The BMJ, 2015.
 Teicholz, The BMJ, 2015.