by Marion Nestle

Search results: dietary guidelines

Feb 23 2024

Weekend reading: FAO calls for food systems-based dietary guidelines

The U.N.’s Food and Agriculture Organization (FAO) is taking the lead on bringing dietary guidelines into the 21st Century.

It is calling for national dietary guidelines not only to be nutrient-based and food-based, but food systems-based.

Food systems-based guidelines extend beyond food-based guidelines that “provide advice on foods, food groups and dietary patterns to provide the required nutrients to the general public to promote overall health and prevent chronic diseases.”

Food system-based guidelines not only address health and nutritional priorities but also consider sociocultural, economic, and environmental sustainability factors.  This means

context-specific multilevel recommendations that enable governments to outline what constitutes a healthy diet from sustainable food systems, align food-related policies and programmes and support the population to adopt healthier and more sustainable dietary patterns and practices that favour, among other outcomes, environmental sustainability and socio-economic equity.

This is a huge advance.  It means that sustainability issues are essential components of dietary advice.

From now on, dietary guidelines that do not consider sustainability are out of date.

Note: By order of Congress, the 2015-2020 Dietary Guidelines did not consider sustainability in its meat recommendations and sustainability was off the table for the 2020-2025 Dietary Guidelines and also for the 2025-2030 version now underway.  This means the new guidelines issues in 2025 will be dated and largely irrelevant to the modern era.

Unless the Advisory Committee gets to work.  I hope it does.

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Oct 17 2023

US Right to Know reports on conflicts of interest in members of the 2025 Dietary Guidelines Advisory Committee

I received an emailed press release from Gary Ruskin at US Right to Know: Report: Nearly Half of Dietary Guidelines Advisory Committee Have Conflicts of Interest.

Nine out of 20 members of the Dietary Guidelines Advisory Committee have conflicts of interest with food, pharmaceutical, or weight loss companies or industry groups with a stake in the outcome of the guidelines, according to a new report published today by the nonprofit public health research group U.S. Right to Know. An additional four members had possible conflicts of interest. The report found that Abbott, Novo Nordisk, National Dairy Council, Eli Lilly, and Weight Watchers (WW) International had ties to two or more DGAC members.

My immediate reaction: Only 9?  Last time, it was 19 out of 20.

Some background

The agencies responsible for the guidelines, HHS and USDA, issued aggregated disclosures of committee members relationships with industry. These treated real conflicts (Mars, Egg Nutrition Center, Novo Nordisk) with non-conflicts (National Science Foundation, Ohio Department of Medicaid) as if they were equivalent; they are not.

The sponsoring agencies have always argued that it is impossible to find nutrition experts without industry ties.  I disagree.  It’s just that people like me who are careful to avoid industry ties are considered too biased to serve on such committees (or so I’ve been told, repeatedly—I’ve not been asked to serve on a federal committee since Food Politics came out).

Do industry ties influence the report?  This is less of a problem than it used to be.  When I was on the DGAC in 1995, our committee set the research questions, did the research, wrote the research report, and wrote the actual Dietary Guidelines.  The agencies did light editing.

That changed in 2010 (administration of Bush II) when the agencies took over writing the guidelines.

In 2020, the agencies wrote the research questions, and they did so again this round.

This means that the only thing left for the DGAC to do is to review the research on questions determined by the agencies.

What is US Right to Know?

This group has initiated and “co-authored 15 peer-reviewed public health studies revealing how the food and beverage industries and industry-funded groups try to influence public opinion, scientific research, public health conferences and government policies related to diet and nutrition.”

A reader, Leah Murphy, wrote me questioning USRTK’s funding (see Appendix D in the report).

“Funding for the report was provided by Feed the Truth, a 501c3 non-profit that is funded by the Lubetzky Family Foundation.”

Daniel Lubetzky is the founder of KIND, a food company.  My point is that a food company funds the non-profit that funded the report. And that seems to undermine the credibility of their report and could qualify under their definition as a COI.

Ordinarily, I would agree that this could be a problem, but not in this instance.  In a previous post on Feed the Truth, I say:

 I was part of a team that suggested names for members of the group’s board.  Once Lubetzky set up the funding, he has had nothing further to do with the group.

From what I’ve been told, that is still true.  Feed the Truth does not have a website, in part because it is closing shop and not giving out more grants.  You can read about its earlier stages in Influence Watch,  Cause IQ, and Cision PR Newswire, but these are now out of date.

USRTK is doing important work and lots of it.  It’s worth following it.

Resources

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May 30 2023

Mexico’s terrific new dietary guidelines. Yes!

Mexico has issued new dietary guidelines.

https://www.gob.mx/cms/uploads/attachment/file/826673/Gui_as_Alimentarias_2023_para_la_poblacio_n_mexicana.pdf

  1. Breastfeed babies for the first 6 months and then continue until age 2 along with other nutritious foods.
  2.  Eat more vegetables and fruits.
  3. Eat beans.
  4. Choose whole grains.
  5. Eat less beef and processed meats.
  6. Avoid ultra-processed foods.
  7. Drink water.
  8. Avoid alcohol.
  9. Be physically active.
  10. Enjoy meals with family and friends.

I’m looking forward to reading a case study on how the public health institute got these through the political process.

If people follow these guidelines, these industries will be in trouble:

  • Infant formula
  • Beef
  • Processed meats
  • Ultra-processed foods
  • Sugar-sweetened beverages
  • Alcohol

People will be healthier!  These industries will also be in trouble.

  • Pharmaceutical drugs
  • Private medicine
  • Insurance companies? (you might think they would benefit, but they make so much money on illness—this one is complicated)

I hope the new U.S. Dietary Guidelines will find these inspiring.

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May 16 2023

Dietary Guidelines Advisory Committee: conflict of interest disclosed, sort of

In a strange partnership, the Nutrition Coalition and the Center for Science in the Public Interest (CSPI) are jointly complaining about the way the USDA and HHS have “disclosed” conflicts of interest among members of the 2025-2030 Dietary Guidelines Advisory Committee.

Why strange?  Because the Nutrition Coalition has long urged relaxations on advice about dietary fat, whereas CSPI has long urged restrictions.

Why “disclosed” in quotes?  Because the agencies’ disclosure statement lists the combined conflicts for the entire group, not for individual members of the committee.

Here’s the committee, courtesy of a tweet from Christopher Gardner.

Here is a small part of what the disclosure list looks like.

 

 

 

 

 

 

 

 

Because these are all jumbled together, you have to look hard to pull out the genuine conflicts—-relationships of committee members with food companies with vested interests in the outcome of the guidelines.

The Nutrition Coalition points out that USDA and HHS are failing to:

  • Comply with a National Academies of Science report calling for publicly posting financial and nonfinancial biases and conflicts of interest of committee members.
  • Fully adopt the National Academies’ 11 recommendations.
  • Recognize the significance of the first-ever systematic review of a DGAC’s financial ties. This review found 95% of the 2020 DGAC members had at least one tie with a food or pharmaceutical company and half had 30 such ties or more.

In its statement, CSPI says that it, the Coalition, and 13 other groups are calling on the federal government to disclose potential financial conflicts of interest, including sources of research funding, speakers’ fees, and other relationships.

Press coverage, the statement says, “has already uncovered one 2025 Dietary Guidelines Advisory Committee member with a conflict of interest that seems relevant to their role.”

Comment:  I agree that the credibility of the committee and the guidelines depends on transparency, but it’s hard to know how much of a problem this is.

I wanted to compare the disclosure list to the research questions set by the agencies for the committee, but I can no longer find them online.

This reminds me that’s it’s hard to know how much influence the committee will have, in any case, now that the agencies set the research questions and write the actual guidelines.

The advisory committee is just that, advisory.  The agencies do not have to take its advice.

I will be following this closely.  Stay tuned.

Additions, May 17 (thanks to Jerry Mande)

 

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May 3 2023

The 2025-2030 Dietary Guidelines: an update

Personally, I can’t believe we are going through this again since the result will certainly not differ much from previous versions, except in details (see my previous post on this).
But here we are, so let’s get to it.

ODPHP must be in charge this round (leadership passes back and forth between ODPHP and USDA’s nutrition policy office).  It says:

You can get involved by:

  • Attending virtual meetings: View the recording of the first meeting held in February 2023, and register to view the livestream of the second meeting on May 10th on DietaryGuidelines.gov.
  • Providing public comments: Comments may be submitted online.
  • Subscribing to email updates: Stay informed on each step of the process by registering for updates.

More details on the Dietary Guidelines development process can be found at DietaryGuidelines.gov.

What to expect?

  • Investigative reports on conflicts of interest among members of the Dietary Guidelines Advisory Committee (members must report conflicted interests but the agencies do not make the reports public)
  • Nothing about sustainability (Off the table; the agencies said there will be a separate report on that.  When?)
  • Nothing about meat (Off the table)
  • Debates about the significance of ultra-processed foods (but only with respect to heart disease)
  • Other issues, surely

My prediction: after an enormous amount of work, the guidelines will say, as they mostly do:

  • Balance calorie intake with expenditure
  • Eat more plant foods (foods)
  • Don’t eat too much salt, sugar, saturated fat (nutrients)
  • And, if we are lucky, minimize or avoid ultra-processed foods

Stay tuned.

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Jan 24 2023

Oh no not again. The 2025-2030 Dietary Guidelines process begins

USDA announced the members of the new 2025 Dietary Guidelines Advisory Committee last week.

It also set up the places where you can:

Why my “oh no not again?”

I was on the Advisory Committee for the 1995 Guidelines, have followed them closely since 1980, and have written about them repeatedly in Food Politics but also more recently on this site.

  • Reason #1.  They don’t change enough from one edition to another to have to go through all this fuss.  The 1980 Guidelines said eat more vegetables and fruit; balance calories; and eat less saturated fat, salt, and sugar.  As did the current Guidelines.  Want to make a bet?  The new ones will too.
  • Reason #2:  The committee no longer gets to do much.  When I was on the committee, we chose the research questions, reviewed the research on them, and wrote the Dietary Guidelines.  We did it all.  This committee will only review the research.  The agencies have already chosen the research questions (as I explained previously).  The agencies will write the guidelines.
  • Reason #3: The Dietary Guidelines get longer, more complicated, and more obfuscating every year.  The original ones came as a 24-page small pamphlet.  They’ve been expanding ever since.  The most recent is 149 pages online.
  • Reason #4: What they say has to be a result of political compromise.  The last time USDA was in charge, Congress instructed the Secretary not to allow any discussion of diet and sustainability.  As if it didn’t matter.

Well, here we go again.  Let’s wish the committee the best of success.  Here’s its chance to say something about ultraprocessed foods (not mentioned in the current version), clarify the meat situation, insist on taking environmental issues and sustainability into consideration, and giving clear, unambiguous advice about diet and health.  Enjoy!

More Dietary Guidelines resources:

  • The history of the Dietary Guidelines is here.
  • Previous Editions of the Dietary Guidelines are here.
  • How they are developed is here.
  • Online historical documents related to the Guidelines are here.

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Jan 10 2023

Chile’s new dietary guidelines

Twitter still has its uses.  It’s how I found out about about Chile’s new dietary guidelines.

Even without speaking Spanish, you can see what they do that the US Dietary Guidelines do not.  They emphasize:

  • Sustainability (the forbidden word in the 2020-2025 US Guideines)
  • Fresh, minimally processed foods–“Avoid products ultra-processed and labeled as “high in” (“ultra-processed is not mentioned in the US Guidelines)
  • Home cooking
  • Respect for traditional cultural values
  • Farmers’ markets
  • Recycling

One odd message: “Consume làcteos en todas las etapas de la vida,” which I translate as “Consume dairy foods through all stages of life.”

I’m wondering how that got in there and guessing that Chile must have a powerful dairy industry.

But I hope the new, soon to be appointed, I’m told, 2025-2030 Dietary Guidelines Advisory Committee will pay attention to Chile’s version.  It has much to teach us.

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Aug 18 2022

The Dietary Guidelines process: an analysis

For those of us who have observed the Dietary Guidelines since they first came out in 1980, everything about them is a source of endless fascination, if not exhausting.  They engender enormous fuss, but the basic dietary advice stays the same, year after year.  It just gets presented in ways that are increasingly lengthy and complicated.

I have a vested interest in all this.  I was a member of the 1995 Dietary Guidelines Advisory Committee.

Critics of the 2015 guidelines got Congress to order a review of the process by the National Academies of Sciences, Engineering, and Medicine (NASEM), which produced two reports.  The 2017 report recommended seven improvements to the process.  Congress then mandated an evaluation of how well USDA and HHS had implemented the recommendations.

NASEM has just published the first of what will be two evaluation reports: Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report.  This one responds to the first of three questions and part of the second.

  • Question #1: How did the process used to develop the Dietary Guidelines for Americans, 2020–2025, compare to the seven recommendations included in the 2017 National Academies report?
  • Question #2: Did the criteria used to include scientific studies used to inform the Dietary Guidelines for Americans, 2020–2025, ensure that the evidence base was current, rigorous, and generalizable or applicable to public health nutrition guidance?

My reading of this report is that the agencies and their advisory committee did a pretty good job of producing the 2020-2025 guidelines, given the tight time schedule, the lack of resources, and the fundamental difficulties of producing solid evidence for the effects of diet on disease risk.  The report’s conclusion (p. 106):

Finally, the committee identified many instances of partial implementation of the recommendations from the 2017 National Academies report. Some of these (e.g., recommendation 6) were minor concerns. Many other concerns that might, individually, seem minor represent a more substantial concern  when considered together. For example, the many seemingly small deviations from committee-identified practices for systematic reviews together reduce the quality and utility of this important element of the evidence used to develop the DGA. Moreover, the combined effect of recommendations for which there were substantial concerns with those that were not implemented at all represents a continuing risk to the integrity of the DGA process.

The report, by the way, is 295 pages.

Do we really need all this?  The guidelines stay pretty much the same from edition to edition: eat more fruits and vegetables (plant foods); don’t eat much salt, sugar, saturated fat; maintain healthy weight.  Or, as Michael Pollan famously put it, “Eat food.  Not too much.  Mostly plants.”

The food industry has the biggest stake in dietary guidelines, which is why we have to go through all this.

As I like to put it, I’ve made a career of criticizing dietary guidelines, and I’m not the only one.  I’m ready to move on.  If only.

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