by Marion Nestle

Currently browsing posts about: Dietary-Guidelines

May 19 2015

The 2015 Dietary Guidelines: the saga continues

I am indebted to Pro Politico Morning Agriculture for this tidbit:

HOUSE AG COMMITTEE PRIES INTO DGAC COMMENT REVIEW: The chairman and ranking member of the House Agriculture Committee have requested that the USDA and HHS supply an accounting of how they intend to review the more than 29,000 public comments on the 2015 Dietary Guidelines Advisory Committee’s report, as well as an accounting of the staff maneuvering that’s been required to review those thousands of comments in a timely manner.

In a letter sent by Reps. Michael Conaway and Collin Peterson, the committee has also requested more information on whether the departments will be able to deliver the final Dietary Guidelines for Americans document by the end of the year, as originally intended.

“Have you reconsidered that goal given the overwhelming number of comments that now need to be reviewed,” the letter states. “If not, do you intend to incorporate the review of the 29,000+ comments received into this work product, and how do you intend to complete that process?” You can read the full letter, which the lawmakers expect a response to by June 10, here: http://1.usa.gov/1EJcrSM

OK.  Let’s review the process here.

  • Congress, in its infinite wisdom, wants the Dietary  Guidelines reviewed and redone every five years.
  • We’ve had Dietary Guidelines every five years since 1980.  Their basic messages have not changed much.
  • The 2015 Dietary Guidelines Advisory Committee (DGAC) reviewed the research and issued a lengthy report.
  • The report was released for public comment.  More than 29,000 comments came in.
  • Now the agencies—USDA and HHS—must deal with the comments are write the actual Dietary Guidelines.

Until 2005, the DGACs wrote the actual guidelines with minimal editing from the agencies.  That was certainly how it worked in 1995 when I was on that committee.

We did the research and wrote guidelines based on that research.  The agencies published them pretty much as we wrote them.

That changed in 2005 under the Bush II administration.

By now, nutrition advice has become so politicized that the public—from individual consumers to corporations—has a say in them.

Which method helps the public eat healthier diets?

You decide.

I withholding judgment until I see how the agencies extract guidelines from the 650-page DGAC report and its 29,000 comments.

I’m guessing that after all this fuss, the guidelines will still basically say:

  • Healthy diets are based largely on foods from plant sources (eat your veggies)
  • Don’t eat too much sugar, salt, or saturated fat (avoid junk food)
  • Don’t gain excess weight if you can avoid it (balance calories)

Good advice.  Too bad that following it does not increase profits for the food industry.

Apr 30 2015

Due May 8: Comments on the 2015 Dietary Guidelines

You still have time to file comments on the 2015 Dietary Guidelines Advisory Committee report.

Here’s where and how.

I’ve just been sent the comments from

Yours don’t have to be lengthy, formal, or cover everything.

You just need to identify the issue, state your opinion, and indicate what you want the guidelines to do or say.

Your opinion counts.  Do it now!

Apr 13 2015

Write to Congress. File comments on the Dietary Guidelines.

Everyone I speak to in Washington, DC says the same thing: if you want policies to change in favor of healthy food systems, you must contact members of Congress and say what you think they should do.  If they get comments on issues, they listen.  If they don’t, nothing will change.

It’s not hard to send an e-mail or telephone your representatives.

Thanks to Jerry Hagstrom, who writes the invaluable Hagstrom Report, for producing instant guides and contact information to members of the Senate and House agriculture committees.

As for the contentious 2015 Dietary Guidelines: the comment period has been extended to May 8.  The agencies make it easy to file comments.  Do it here.

The comments don’t need to be long or complicated.  Just indicate identify yourself, state the topic you are concerned about, say what you’d like the guidelines to say, and if possible add a reference or two.

Do this and you will be encouraging the agencies to do the right thing.

If you don’t, who will?

Addition, April 14:  Here’s a video explanation of how to file comments on the dietary guidelines.

Mar 24 2015

My Plate, My Planet: Support Sustainability in Dietary Guidelines

I signed an today’s ad in the New York Times to encourage support for considering sustainability in the 2015 Dietary Guidelines.

Screenshot 2015-03-24 09.34.08

We need health policies that consider agriculture and agricultural policies that consider health.

Here are:

Feb 28 2015

Vilsack: Guidelines committee members are like 3-year-olds

Yesterday’s Hagstrom Report quotes USDA Secretary Tom Vilsack’s comments to the Commodity Classic on the Scientific Report of the 2015 Dietary Guidelines Advisory Committee:

The “folks who put those reports together … have freedom. They are like my 3-year-old granddaughter. She does not have to color inside the lines.”

His 5-year-old grandson, he said, “is learning about coloring within the lines.”

“I am going to color inside the lines,” Vilsack said.

Sounds like the USDA has no intention of doing what the DGAC recommends.

This is why it’s so important to file comments @ www.DietaryGuidelines.gov by April 8.  You can also register there for the public meeting in Bethesda, Maryland, on March 24.

Addition, March 10: Secretary Vilsack’s speech and press conference remarks are here.

 

Feb 23 2015

Dietary guidelines shouldn’t be this controversial

The uproar caused by the release of the Scientific Report of the 2015 Dietary Guidelines Advisory Committee (DGAC) has been even noisier than I predicted, so noisy that USDA Secretary Vilsack appears to have pulled back on it.  He told Jerry Hagstrom (HagstromReport.com) that:

He wants people to realize that the process of writing the dietary guidelines “is just beginning today,” and that he and [HHS Secretary] Burwell will consider input from federal agencies and the general public. He said he wants to be sure that people “know that I know my responsibility.”

In this, Vilsack was referring to the directive by Congress in the 2015 appropriations bill blocking him from considering sustainability in the guidelines.

As for the DGAC report: It concluded:

…the U.S. population should be encouraged and guided to consume dietary patterns that are rich in vegetables, fruit, whole grains, seafood, legumes, and nuts; moderate in low- and non-fat dairy products and alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and beverages and refined grains.

Predictably, this did not go over well with the meat industry or, for that matter, other industries affected by such advice or groups funded by such industries.

Less predictably, the New York Times published an Op-Ed by Nina Teicholz, the journalist author of “The Big Fat Surprise,” a work based on her own review of the science of fat.  In her view, mainstream nutritionists have badly misinterpreted this science to the great detriment of public health.

Her conclusion:

…we would be wise to return to what worked better for previous generations: a diet that included fewer grains, less sugar and more animal foods like meat, full-fat dairy and eggs.

But Teicholz’ book has been the subject of a line-by-line analysis by Seth Yoder (whom I do not know personally).  Mr. Yoder did what graduate students in science are trained to do: read the references.

He looked up and examined the references Teicholz cites in the book as the basis of her views.  He documents an astonishing number of situations in which the references say something quite different from what Teicholz gets out of them.  At the very least, his analysis raises serious questions about the credibility of her views on the science of fat.

Let’s grant that the science of nutrition is difficult to do and complicated.  The New York Times should know this, which is why I’m surprised that it would give Teicholz so prominent a platform without countering them with point-counterpoint views of a respected nutrition scientist.

It does little to foster the health of the public to make nutrition science appear more controversial than it really is.

The basic advice offered by 2015 Dietary Guidelines Advisory Committee boils down to plain common sense:

  • Eat plenty of foods from plant sources
  • Eat foods from animal sources in moderation
  • Balance calories
  • Avoid overeating junk food

Unfortunately, this kind of advice doesn’t make headlines or, apparently, merit op-ed space in the New York Times.

Feb 20 2015

The 2015 Dietary Guidelines Advisory Committee releases its courageous report

The 2015 Dietary Guidelines Advisory Committee (DGAC) issued its more than 500-page report yesterday.

Before I say anything about it, please note that this report informs, but does not constitute, the Dietary Guidelines. The agencies—USDA and HHS—write the actual Guidelines and are not expected to do so until the end of this year.

Here are what I see as the highlights (these are direct quotes)

  • A healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and drinks and refined grains.
  • A diet higher in plant-based foods…and lower in calories and animal-based foods is more health promoting and is associated with less environmental impact than is the current U.S. diet.
  • It will take concerted, bold actions…to achieve and maintain the healthy diet patterns, and the levels of physical activity needed to promote the health of the U.S. population. These actions will require a paradigm shift to an environment in which population health is a national priority and where individuals and organizations, private business, and communities work together to achieve a population-wide “culture of health” in which healthy lifestyle choices are easy, accessible, affordable, and normative.

Some facts and statements from the report (not direct quotes).

  • Half the energy intake in U.S. diets comes from a combination of burgers and sandwiches (~14%), desserts and sweet snacks (8.5%), sugary beverages (6.5%), mixed dished made with rice, pasta, and other grains (5.5%, savory snacks (~5%), pizza (4.3%), and meat, poultry and seafood mixed dishes (~4%).
  • Nearly half of total sugar intake comes from beverages other than milk and 100% fruit juice

The report comments on issues under current debate.

  • Saturated fat: “replacing SFA with unsaturated fats…significantly reduces total and LDL cholesterol…Strong and consistent evidence…shows that replacing SFA [saturated fatty acids] with PUFA [polyunsaturated fatty acids] reduces the risk of CVD [cardiovascular] events and coronary mortality…For every 1 percent of energy intake from SFA replaced with PUFA, incidence of CHD [coronary heart disease] is reduced by 2 to 3 percent. However, reducing total fat (replacing total fat with overall carbohydrates) does not lower CVD risk.”
  • Sugars: “Strong and consistent evidence shows that intake of added sugars from food and/or sugar sweetened beverages are associated with excess body weight in children and adults…Strong evidence shows that higher consumption of added sugars, especially sugar-sweetened beverages, increases the risk of type 2 diabetes among adults and this relationship is not fully explained by body weight.[Theae findings are] compatible with a recommendation to keep added sugars intake below 10 percent of total energy intake.”
  • Food labels: “Consumers would benefit from a standardized, easily understood front-of-package (FOP) label on all food and beverage products to give clear guidance about a food’s healthfulness.” [This refers to the recommendations of the Institute of Medicine that I’ve written about previously; they disappeared without a trace.]
  • Soda taxes: “Economic and pricing approaches, using incentives and disincentives should be explored to promote the purchase of healthier foods and beverages. For example, higher sugar-sweetened beverage taxes may encourage consumers to reduce sugar-sweetened beverage consumption.”
  • SNAP: “Policy changes within the federal Supplemental Nutrition Assistance Program (SNAP), similar to policies in place for the WIC program, should be considered to encourage purchase of healthier options, including foods and beverages low in added sugars. Pilot studies using incentives and restrictions should be tested and evaluated.”

The DGAC recommends (these are direct quotes but not necessarily complete):

  • Establish local, state, and Federal policies to make healthy foods accessible and affordable and to limit access to high-calorie, nutrient-poor foods and sugar-sweetened beverages in public buildings and facilities.
  • Set nutrition standards for foods and beverages offered in public places.
  • Improve retail food environments and make healthy foods accessible and affordable in underserved neighborhoods and communities.
  • Implement the comprehensive school meal guidelines (National School Lunch Program) from the USDA that increase intakes of vegetables (without added salt), fruits (without added sugars), and whole grains.
  • Limit marketing unhealthy foods to children.
  • Make drinking water freely available to students throughout the day.
  • Ensure competitive foods meet the national nutrition standards (e.g., Dietary Guidelines for Americans).
  • Eliminate sugar-sweetened beverages [from schools].
  • Nutrition Facts label should include added sugars (in grams and teaspoons).

And for all federal nutrition programs, the DGAC recommends:

  • Align program standards with the Dietary Guidelines for Americans so as to achieve the 2015 DGAC recommendations and promote a “culture of health.”

Congratulations to this committee for its courageous recommendations.

Why courageous?  See my previous comments on the objections to such advice.

The next step: public comment:

The public is encouraged to view the independent advisory group’s report and provide written comments at www.DietaryGuidelines.gov for a period of 45 days after publication in the Federal Register. The public will also have an opportunity to offer oral comments at a public meeting in Bethesda, Maryland, on March 24, 2015. Those interested in providing oral comments at the March 24, 2015, public meeting can register at www.DietaryGuidelines.gov. Capacity is limited, so participants will be accepted on a first-come, first-served basis.

Here’s your chance to support this committee’s excellent ideas and demonstrate public approval for diets that promote the health of people and the planet.

Note: the reactions to the report are pouring in and I will deal with them next week.  Enjoy the weekend!

Feb 12 2015

What’s up with the cholesterol guideline?

The Washington Post says that the 2015 Dietary Guidelines Advisory Committee is about to drop the long-standing guideline about restricting dietary cholesterol.

The 2010 Dietary Guidelines said “Consume less than 300 mg per day of dietary cholesterol.”

This is about the amount in one egg.

I have no idea what’s going on.  The Advisory Committee report has not yet been released so I don’t know what it says (I’ve heard rumors that it is to be released this week, which could mean late Friday afternoon on a holiday weekend).

Recall: no matter what the Advisory Committee says in its report, it does not write the Dietary Guidelines.  The agencies—USDA and HHS—do whatever they choose with the committee’s research report.

If the Committee really is dropping the guideline, I’d like to see its research rationale.

I’m wondering if research sponsored by the egg industry could have anything to do with this.

See, for example, this recent study concluding that people with coronary heart disease don’t have to worry about eating eggs.

We found no evidence of adverse effects of daily egg ingestion on any cardiac risk factors in adults with CAD over a span of 6 weeks.

You have to read the study carefully to find the funding source (these are usually at the end of articles, but this one is in the middle):

Disclosures. This study was conducted with funding from the Egg Nutrition Center/American Egg Board and the Centers for Disease Control and Prevention (Grant
No. 5U48DP001945-05).

And you have to read the tables carefully to find out that 90.6% of the subjects in this study were taking statins, nearly 90% were taking drugs to lower blood pressure, and nearly 80% were taking aspirin.  The discussion, however, does not mention this point making this study a classic example of the problems with conflicts of interest in research.

If the Advisory Committee is dropping the cholesterol recommendation, could it be because so many people are taking statins that dietary cholesterol doesn’t appear to matter so much anymore?

This story is getting a lot of press.  Here’s one from USA Today that quotes me and changes my name as it goes along (they have now fixed that).

Can’t wait to see what the report really says.

 

 

 

 

 

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