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 best to prevent obesity, diabetes, heart disease, or Alzheimers.
Don’t underestimate the influence of the Guidelines! They are the single-most important determinant for how people eat around the world.
- Federal food programs providing millions of free meals every week to children, the elderly, and the poor, including the National School Lunch Program, the Women, Infants, and Children (WIC) Food and Nutrition Service, and the Supplemental Nutritional Assistance Program (SNAP); Altogether, these programs feed 1 in 4 Americans each month;
- Nutritional advice given by the vast majority of doctors, nurses, dieticians, and nutritionists working directly with the public, since guidelines issued by their professional societies are all pegged to the DGAs. This is true even of the American Diabetes Association, which recommends a diet high in carbohydrates (including refined sugar) for diabetics;
- Military rations (MREs) and food served at military institutions;
- Packaged foods, since food manufacturers seek to comply with the guidelines to achieve favorable “Nutrition Facts Labels” on the back of packages as well as to obtain the right to use a “healthy” label from the Food and Drug Administration;
- K-12 nutrition education in schools throughout the nation;
- Non-packaged foods, given that, in response to the guidelines, most cattle today have been bred to be lean, most milk is now reduced in fat, etc.
The need for change is great….
- →Undertake a communications campaign to let Americans know that the low-fat diet is no longer officially recommended.
Since 2015, the DGAs have quietly dropped previous limits on total fat, acknowledging that a low-fat diet is “associated with dyslipidemia”—meaning heart disease. Yet the government has yet to announce this important change to the public.
- →Ease or lift caps on saturated fats.
At least 14 meta-analyses and systematic reviews of the scientific literature now conclude that saturated fats are not associated with heart disease and/or have no effect on cardiovascular mortality. Saturated fats are part of many natural, unprocessed foods, such as meat and dairy, that contain needed nutrients.
- →Offer low-carbohydrate diets as a viable option for fighting chronic disease
Expert committees for the guidelines have never systematically 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 two-year trials considered long enough to reveal any harmful side effects. These trials demonstrate the safety and efficacy of this diet for combating obesity, diabetes, and heart disease.
- →Offer a meaningful diversity of diets.
Although the DGAs now feature three recommended “Dietary Patterns” – “US-style,” Mediterranean, and vegetarian — the current guidelines remain a one-size-fits-all diet, which is not appropriate for a general population in which nutritional needs vary by age, genetics, gender, race, and degree of disease state.
- →Make the DGA diets nutritionally sufficient, with nutrients coming from whole foods, not artificially fortified refined grains.
The current recommend DGA diets that are deficient in potassium, vitamin D, vitamin E, and choline, according to the DGAs’ own expert report. Further, to the extent that the DGA diets are nutritionally sufficient, they depend heavily on the 3-5 recommended daily servings of artificially fortified refined grains, which are high in refined carbohydrates and are not a natural source for these nutrients.
- →Stop telling Americans to do aerobic exercise for weight loss.
The most comprehensive expert review of data on exercise, published in 2008 by US Department of Health and Human Services and cited by the DGAs to inform its recommendation on exercise, concluded that aerobic exercise is ineffective for weight loss and only marginally effective for weight maintenance.
- →Stop recommending “lower is better” on salt
Three peer-reviewed studies in major journals in addition to a 2013 report by the Institute of Medicine all conclude that in addition to an upper limit on sodium consumption there should also be a lower limit, below which an increased risk of cardiovascular death is seen.
- →Stop telling the public that reaching and maintaining a healthy weight requires little more than choosing “an appropriate calorie level.”
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. Insulin and other hormones are among other factors also involved in determining weight.
- →Stop recommending vegetable oils for health.
Large, government-funded controlled clinical trials on more than 50,000 people have demonstrated that replacing saturated fats with polyunsaturated vegetable oils such as soybean and corn oil (but not olive oil), does not reduce cardiovascular mortality and in quite a few trials, caused an increase in death rates from cancer and suicides.
- →Recommend regular meat and milk rather than the low-fat/lean versions
There are 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 are there rigorous, clinical trial data showing any ill effects of red or processed meats.
- →Don’t issue guidelines based on weak, observational data;
Experts developing the guidelines have, in many cases, issued recommendations based on weak, observational data, while ignoring relevant clinical trial data and improperly prioritizing observational findings. 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 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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