HOW DIETARY GUIDELINES NEED TO CHANGE
For the past 35 years, we’ve been following the US Dietary Guidelines for Americans (“Guidelines”). During this time, there’s been a sharp increase in nutrition-related diseases, particularly obesity and diabetes, and childhood obesity and diabetes diagnoses have quadrupled. Rates of all nutrition-related diseases continue to rise, with no end in sight. Why is that? The answer is that in many cases, the Guidelines have been shown to be based on weak science, and the government’s evidence reviews have failed to comprehensively or systematically consider the best and most current science. This is to say: our nutrition policy is not evidence-based. The Guidelines are not giving people the right advice about how to eat to prevent obesity, diabetes, heart disease, Alzheimers, or cancer.
Don’t underestimate the influence of the Guidelines. They determine:
- Nutritional advice given by nearly all doctors, nurses, dieticians, and nutritionists working directly with the public, since medical societies directly cite the Guidelines for their nutritional guidance. This is true even of the American Diabetes Association, which recommends a diet high in carbohydrates for diabetics.
- The USDA feeding assistance programs, including the National School Lunch Program, feeding programs for the elderly, the Women, Infants, and Children (WIC) Food and Nutrition Service, SNAP for the poor, and others; Altogether, one in four Americans eat one of these USDA-funded meals every month.
- Military food, including rations (MREs);
- Nutrition education in schools nation-wide;
- All packaged foods, since food manufacturers, seeking to comply with the Guidelines, create products that follow them. The “healthy” label, as regulated by the FDA, is also based on the Guidelines;
- The entire U.S. food supply (i.e., in response to the Guidelines, most cattle have been bred to be leaner; processed foods are low in saturated fats; and most milk is now reduced in fat, etc.)
The need for change is great….
11 evidence-based REFORMS:
- Let the public know that the low-fat diet is over
Since 2015, the Guidelines clearly and definitely dropped the low-fat diet. They no longer recommend reducing total fat, since, as stated in the expert report, the low-fat diet is associated with “dyslipidemia”—meaning heart disease. Yet the government has not made this shift clear to the public.
→The Guidelines must clearly communicate to the public and health-care professionals everywhere that the low-fat diet is no longer recommended and that it can worsens heart-disease risk factors.
- Ease/lift caps on saturated fats
There are now at least 14 meta-analyses and systematic reviews of the scientific literature concluding that saturated fats are not associated with heart disease or have no effect on cardiovascular mortality, and given that the 2015 Dietary Guidelines expert committee did not comprehensively review this literature,
→ Caps on saturated fats should be eased or lifted. Saturated fats are part of many real, whole foods that contain needed nutrients.
- Offer low carbohydrate diets as one viable option for fighting chronic disease
Expert committees for the Guidelines have never reviewed the large body of research on low-carbohydrate diets, which now amounts to more than 70 clinical trials on altogether thousands of people, including several trials lasting 2-years, which is considered long enough to reveal any harmful side effects; and given that these trials demonstrate the safety and efficacy of this diet for combatting obesity, diabetes, and heart disease,
→The Guidelines should promote low-carbohydrate diets as one safe and effective intervention for people struggling with obesity, diabetes, and heart disease.
- Offer a true diversity of diets
The current Guidelines are still a one-size-fits-all diet, which is not appropriate for a general population in which nutritional needs vary by age, genetics, gender, race, metabolic health, and other factors,
→The Guidelines should offer a true range of diets that respond to the diverse nutritional needs of our populations.
- Make the Guidelines nutritionally sufficient
The current Guidelines recommend a diet that is nutritionally insufficient and further, advises people to obtain many key nutrients from artificially fortified refined grains,
→The Guidelines should ensure nutritional sufficiency, and those nutrients should preferably come from real, whole foods, not from artificially fortified refined grains or dietary supplements.
- Stop telling Americans to do aerobic exercise for weight loss
The most comprehensive expert review of data on exercise, published in 2008 by the government, concluded that aerobic exercise is largely ineffective for weight control.
→The Guidelines should stop recommending aerobic exercise for weight control.
- Stop recommending “lower is better” on salt
Three papers in major journals as well as a 2013 report by the Institute of Medicine all concluded that, in addition to an upper limit on sodium consumption (and possibly only for a hypertensive population), there is also a lower limit, below which increased risk of cardiovascular death is seen; and given that the current Guidelines do not incorporate this science but instead continue with a “lower is better” recommendation,
→The Guidelines should recognize the scientific controversy on salt and cease the blanket “lower is better” recommendation.
- Stop telling the public it’s as simple as “calories-in-calories-out”
The calorie-in-calorie-out (“energy balance”) model of obesity — which asserts that people get fat because they eat too much and exercise too little — oversimplifies the issue,
→The Guidelines should stop using any language suggesting that sustainable weight control can simply be managed by creating a caloric deficit. This advice is overly simplistic and is not supported by scientific evidence.
- Stop recommending vegetable oils
Large, government-funded controlled clinical trials on more than 50,000 people have demonstrated that replacing saturated fats with polyunsaturated vegetable oils does not reduce cardiovascular mortality and in quite a few trials, caused an increase in death rates from cancer and suicide.
→The Guidelines should discontinue its advice to replace saturated fats with polyunsaturated vegetable oils.
- Recommend regular meat and milk rather than the low-fat/lean versions
There is no clinical-trial data showing that “lean meat” or “low-fat” dairy are better for health than the more natural versions of these foods. Nor is there rigorous, clinical trial data showing any ill effects of red or processed meats.
→The Guidelines should discontinue its advice to eat low-fat versions of real, whole foods, nor should the Guidelines discourage consumption of red or processed meats.
- Don’t issue Guidelines unless there’s rigorous science to back them up
Experts developing the Guidelines have, in many cases, ignored relevant clinical trial data or improperly prioritized observational findings over the more rigorous trial data,
→The Guidelines should be based on a complete, comprehensive review of the most rigorous (randomized, controlled clinical trial) data available, and on subjects for which this more rigorous data is lacking, the Guidelines should remain silent.
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This manifesto will be used as a PETITION for change, to be sent to the new leadership at the US Depts. of USDA and HHS, which jointly issue the Guidelines.
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