by Marion Nestle

Currently browsing posts about: Dietary-Guidelines

Aug 8 2011

It’s time for some Q and A’s

I’ve just turned in the copy-edited manuscript of Why Calories Count: From Science to Politics (pub date March 2012) and now have time to catch up on some questions:

Q. I was recently given to read a book titled “The China Study” which is based on research conducted in 1970’s in China by Dr. Colin Campbell. His main conclusion is that eating dairy and meat causes cancer. His resolution is that a plant-based diet (i.e. vegan) is the (only?) healthy diet for humans. This book has made strong enough of a point to convince several of my friends to “convert” to a vegan diet in order to save their health. Could you share some comments on the validity of the research and conclusions this book presents with regards to detrimental effects of dairy and meat on human health?

A. Campbell makes a forceful argument based on his interpretation of the research and on case studies of people whose diseases resolved when they became vegans. And yes I’ve seen Dr. Campbell’s new movie, Forks over Knives. The first half is a terrific introduction to how the current food environment promotes unhealthy eating.  The second half promotes Dr. Campbell’s ideas about the hazards of meat and dairy foods.

Whether you agree with these ideas or not, the film is well done and worth a look.

Some scientists, however, interpret the research as demonstrating that people are healthier when they eat dairy foods.  For example, the enormous consensus report on diet and cancer risk from the American Institute for Cancer Research and the World Cancer Research Fund concluded in 2007 that eating lots of red meat and processed meat is convincingly associated with an increased risk of colorectal cancer (but no others).

On the other hand, they found dairy foods to be associated with a decrease in the risk of colorectal cancer.  They found limited and less convincing evidence that dairy foods might decrease the risk of bladder cancer but increase the risk of prostate cancer.

How to make sense of this?  These are two food groups in the diets of people who consume many kinds of foods and who do many things that might increase or decrease cancer risk.  Given this complexity, one food or food group seems unlikely to have that much influence on cancer when considered in the context of everything else people eat and do.

Nutrition research, as I am fond of saying, is difficult to do and requires interpretation. Intelligent people can interpret the studies differently depending on their point of view.

The new Dietary Guidelines say to cut down on saturated fats. Those are most plentiful in meat and dairy foods (plant foods have them, but in smaller amounts). Pretty much everyone agrees that plant-based diets promote health/  But whether they have to be 100% plant-based is highly debatable.

The new USDA MyPlate food guide suggests piling plant foods—fruit, vegetables, and grains—on 75% of your plate so the argument is really about what goes on the remaining 25%, what USDA calls the  “Protein” section. You can put beans in that quarter if you don’t want to eat red meat, poultry, or fish.

Q. I’d love to hear your take on the recent walnut flap [accusations that the FDA now considers walnuts to be drugs].  I suspect walnuts got caught with such offenders as Pom, Froot Loops, and Juicy-Juice, but I’d love to find out what the FDA actually said about this. For some odd reason I don’t believe the article is presenting the whole truth.

A. This is a health claims issue. The FDA is not saying walnuts are drugs. It is saying that Diamond Walnut is claiming walnuts as drugs on package labels. How so?

The labels say the omega-3 fatty acids in walnuts may help lower cholesterol; protect against heart disease, stroke and some cancers (e.g. breast cancer); inhibit tumor growth; ease arthritis and other inflammatory diseases; and even fight depression and other mental illnesses. These are disease claims for which the FDA requires scientific substantiation.

The company’s petition did not provide that substantiation so the FDA issued a warning letter. In general, you should be skeptical any time you see a nutritional factor advertised for its ability to prevent or treat such a broad range of problems.

Q. A question about sugar and how it is counted: My books say: 4 g = 1 teaspoon = 15 calories. My Illy Caffe says 10 g of sugar, but 50 calories. Ingredients: coffee, sugar, potassium bicarbonate, potassium citrate. If the drink is 50 calories, shouldn’t it say 12 g or more for the sugar listing?

A. Sugar should be the only ingredient that has calories in this coffee but I’ve seen calorie lists that say 5 calories per gram for sugars. Food companies have some leeway in the way they compute calories. Illy may be using a method that gives 5 rather than 4. But the difference between 40 and 50 is hardly measurable and I wouldn’t worry about amounts this small, annoying as imprecise figures may seem.

Jun 26 2011

Eat French fries, gain weight?

A reader, Thibault H writes:

So Harvard University came out with a study that news reporters are saying tells us that those who tend to eat more potatoes gain x amount of weight over 10 years…What do you make of this?…could it be possible that potatoes themselves are not the culprit and rather those who tend to eat more potatoes have a fattier diet or perhaps more sedentary lifestyle.

It could indeed.  The study, which came out in the New England Journal of Medicine last week, looked at the weight gained by more than 100,000 people who had filled out diet questionnaires in 1986 or later.  It correlates what people said they ate with weight gained over periods of 4 years:

The results show that people who said they habitually ate potato chips, potatoes, or fries—as well as the the other foods in the top part of the diagram—were more likely to gain weight.

People who reported frequent eating of the foods in the lower part of the diagram were likely to have lost weight.

What fun!  The study assigns pounds of weight gained or lost to specific foods.

The study also did a more detailed analysis.  This showed that French fries were linked to the greatest weight gain: 3.35 pounds over a 4-year period.  If you habitually eat French fries, you may have a hard time controlling your weight.

No surprise.  I recently ordered a side of fries in an excellent restaurant and was floored by the size of the order Eat a small handful: no problem.  But this order surely hit 800 calories.  Fortunately, there were four of us to share it.

Here’s how I explained the study to Katherine Hobsen of the Wall Street Journal (June 23):

Marion Nestle, New York University professor of nutrition and public health, expressed surprise that potato products were linked with more weight gain than desserts like cake, cookies and doughnuts, which contribute the most calories to the American diet, other research shows. She says she suspects people who eat potato chips and fries also tend to eat too much in general, making these foods markers for a diet leading to weight gain.

The new Dietery Guidelines “policy document” has a particularly entertaining chart of the leading sources of calories in U.S. diets.  Here are the top six, in order:

  • “Grain-based” desserts (translation: cakes, pies, cookies, cupcakes, etc)
  • Breads
  • Chicken and chicken mixed dishes (translation: fingers)
  • Sodas, energy, and sports drinks
  • Pizza
  • Alcoholic beverages

Potato chips are #11 and fries are #17.

This new study provides evidence supporting what everyone surely ought to know by now: eat your veggies!

P.S.  Here’s Andy Bellatti’s take on this study.  His point: it’s not the carbs, it’s calories.

 

 

 

Apr 10 2011

Dietary Guidelines, 1861 (they haven’t changed much….)

I’m at a meeting in Washington DC of the American Society of Nutrition. At the exhibits, David Schnackenberg, who runs a website on the history of military nutrition, gave me these dietary guidelines from 1861. They are from a monograph by Dr. John Ordonaux, “Hints on the Preservation of Health in the Armies: for the Use of Volunteer Officers and Soldiers.”

  • Soldiers should be fed a mixed diet of animal and vegetable substances.
  • A variety of foods are needed to avoid monotony and increase assimilation.
  • A healthy diet must conform to the physiological requirements of the season with less animal fats in the summer dietary, and more starch, vegetables, and fruits.
  • Fresh fruits are always preferable to dry or preserved ones.
  • Farinaceous vegetables are more nourishing than roots or grasses.
  • The best soldiers in the world are fed on dark colored bread.
  • French army dietaries provide nutritious soups made with meat or vegetables.
  • The woody fibre of the vegetable provides bulk as well as nourishment.
  • Each company should have at least one educated cook.
  • Beans, unless thoroughly cooked, are only fit for horses. When half-cooked, they will provoke indigestion and diarrhea.
  • Ardent spirits are not necessary for health and the soldier is better off without them.
  • Soldiers must be well fed to bear the fatigues of marching, to encounter unaffected the changes of climate, and to develop a high muscular tone.

As I keep saying, basic nutrition advice has, in fact, not changed much over the years.  The big change in the last 150 years is the invention of junk foods. Dr. Ordonaux did not have snacks and sodas to contend with, nor today’s extensive obesity among army recruits.

Feb 25 2011

UK health agency: limit red and processed meats to 3 ounces a day

The UK Department of Health issued a warning today to eat less red and processed meat.

  • Red meat means beef, lamb and pork as well as minced meat and offal from these animals.
  • Processed meat means ham, bacon, luncheon meat, corned beef, salami, pâté, sausages and burgers.

The warning is based on a new report from the independent Scientific Advisory Committee on Nutrition (SACN).  Its report evaluated the effects of iron on health. Because red meat is a primary source of dietary iron, the committee looked at evidence on the links between red meat and processed meats and bowel cancer.

The report concludes that the link “probably” exists and that:

Adults with relatively high intakes of red and processed meat (around 90 g/day or more) should consider reducing their intakes. A reduction to the UK population average for adult consumers (70 g/day cooked weight) would have little impact on the proportion of the adult population with low iron intakes.

How much is 90 grams?  It is only three ounces of cooked meat.

The UK Health Department advises:

  • People who eat a lot of red or processed meat – around 90g or more of cooked weight per day – are at greater risk of getting bowel cancer;
  • Cutting down to the UK average of 70g a day can help reduce the risk; and
  • This can be achieved by eating smaller portions or by eating red and processed meat less often.

The Department points out that cooked meat weighs about 70% of its uncooked weight (it has less water). So 3 ounces of cooked meat is equivalent to about 4 ounces of uncooked meat.

Expect to hear lots of reactions like “red meat can still be enjoyed in moderation as part of a healthy balanced diet.”

And where are the US Dietary Guidelines on the subject of red and processed meats?  Buried in euphemisms, alas:

  • Choose lean meats
  • Choose seafood instead of some meat
  • Reduce calories from solid fats

No wonder Americans are confused about diet and health.

Feb 9 2011

FoodNavigator.com’s collected wisdom on the Dietary Guidelines

The 2010 edition of the dietary guidelines appeared on January 31.  Since then, FoodNavigator-USA, an online daily newsletter for the food industry, says it has been gathering reactions and taking a look at how the guidelines are likely to affect food and beverage companies.   Here are its reports.

‘Eat less': A difficult message for industry: The new dietary guidelines give the food industry the clearest map yet of what is necessary for a healthy diet – but no one is fooled by assertions that industry is already in line.

2010 Dietary Guidelines: Opportunity for continued industry innovation: In this guest article, Melissa Musiker of the Grocery Manufacturers Association says that the 2010 Dietary Guidelines are an opportunity for industry to find better ways to innovate, as part of a collective responsibility to improve American diets.

How the 2010 guidelines affect food technologists:  The 2010 Dietary Guidelines’ new focus on reducing energy intake will present major reformulation challenges for food technologists, says the Institute of Food Technologists’ (IFT) president-elect.

Politics too influential in new Dietary Guidelines, says nutrition expert [that would be me]:  The new Dietary Guidelines for Americans are still too heavily influenced by political interests – but the initial consumer messaging was ‘fantastic’, according to nutrition and public policy expert Marion Nestle.

‘Total diet’ in the 2010 Dietary Guideline: The latest version of the Dietary Guidelines for Americans includes a new focus on the importance of total diet. FoodNavigator-USA spoke to Cynthia Harriman of Oldways to get the perspective of the organization behind the Mediterranean diet pyramid.

USDA releases 2010 Dietary Guidelines for Americans: The US Department of Agriculture (USDA) has updated the Dietary Guidelines for Americans for the first time since 2005, with a number of small changes that could make a big difference for the food industry.

Industry welcomes USDA Dietary Guidelines supplements shift: The US dietary supplements industry has welcomed the 2010 Dietary Guidelines for Americans which demonstrated a thawing in attitude toward supplements use from a Guidelines committee that has previously balked at recommending them.

Feb 7 2011

More on Dietary Guidelines: San Francisco Chronicle

I write a monthly first-Sunday column for the San Francisco Chronicle. This one is on the latest Dietary Guidelines.

Dietary Guidelines try not to offend food industry

Sunday, February 6, 2011

Q: What do you think of the new Dietary Guidelines that were announced earlier this week? Is there anything very new or different? And how important are these guidelines, anyway?

A: I was stunned by the first piece of the 2010 Dietary Guidelines for Americans that I saw online (dietaryguidelines.gov): “Enjoy your food, but eat less.”

Incredible. The federal government finally recognizes that food is more than just a collection of nutrients? It finally has the nerve to say, “Eat less?”

But this statement and others directed to the public do not actually appear in the guidelines. That document repeats the same principles that have appeared in dietary guidelines for decades.

The 2010 guidelines just state them more clearly. (For the news story on the guidelines, go to sfg.ly/gdgsc0.)

Obesity prevention

Its 23 recommendations are aimed at obesity prevention. They focus on eating less and eating better. “Eat better” guidelines suggest eating more vegetables, fruits, whole grains, low-fat milk, soy products, seafood, lean meats and poultry, eggs, beans, peas, nuts and seeds – all are foods.

But the “eat less” advice is about nutrients: sodium, saturated fat, cholesterol and trans fats. The guidelines even coin a new term for the “eat less” nutrients of greatest concern: “solid fats and added sugars,” annoyingly abbreviated as SoFAS.

Here is one SoFAS guideline: “Limit consumption of … refined grain foods that contain solid fats, added sugars, and sodium.”

Nutrient-based guidelines require translation. You have to delve deeply into the 95-page document to find the food translations. Eat fewer solid fats? This means cakes, cookies, pizza, cheese, processed and fatty meats, and, alas, ice cream. Less sugar? The major sources are sodas, sports drinks, energy drinks and fruit drinks.

Why don’t the guidelines just say so? Politics, of course.

Official policy

Dietary guidelines are an official statement of federal nutrition policy. They influence everything the government says and does about food and nutrition. The guidelines determine the content of school meals, the aims of food assistance programs and the regulation of food labeling and advertising.

But their most powerful effect is on the food industry.

Why? Because advice to eat less is very bad for business.

Banal as their recommendations may appear, dietary guidelines are hugely controversial. That is why I was so surprised by “Enjoy your food, but eat less.”

Consider the history. In 1977, a Senate committee chaired by George McGovern issued dietary goals for the United States. One goal was to reduce saturated fat to help prevent heart disease. To do that, the committee advised “reduce consumption of meat.”

Those were fighting words. Outraged, the meat industry protested and got Congress to hold hearings. The result? McGovern’s committee reworded the advice to “choose meats, poultry and fish which will reduce saturated fat intake.”

This set a precedent. When the first dietary guidelines appeared in 1980, they used saturated fat as a euphemism for meat, and subsequent editions have continued to use nutrients as euphemisms for “eat less” foods.

Then came obesity. To prevent weight gain, people must eat less (sometimes much less), move more, or do both.

This puts federal agencies in a quandary. If they name specific foods in “eat less” categories, they risk industry wrath, and this is something no centrist-leaning government can afford.

Eat less, move more

So the new guidelines break no new ground, but how could they? The basic principles of diets that protect against chronic disease do not change. Stated as principles, the 2010 dietary guidelines look much the same as those produced in 1980 or by the McGovern committee.

In my book, “What to Eat,” I summarize those basic principles “eat less, move more, eat plenty of fruits and vegetables, and don’t eat too much junk food.” Michael Pollan manages this in even fewer words: “Eat food. Mostly plants. Not too much.”

Everything else in the guidelines tries to explain how to do this without infuriating food companies that might be affected by the advice. And the companies scrutinize every word.

The soy industry, for example, is ecstatic that the guidelines mention soy products and fortified soy beverages as substitutes for meat and as protein sources for vegetarians and vegans.

The meat industry is troubled by the suggestion to increase seafood, even though the guidelines suggest meal patterns that contain as much meat as always.

The salt recommendation – a teaspoon or less per day, and even less for people at risk for high blood pressure – is unchanged since 2005, but stated more explicitly. The salt industry reacted predictably: “Dietary guidelines on salt are drastic, simplistic and unrealistic.”

In a few months, a new food guide will replace the old pyramid. Thanks to a law Congress passed in 1990, dietary guidelines must be revisited every five years. Expect the drama over them to continue.

But for now, enjoy your food.

Marion Nestle is the author of “Food Politics,” “Safe Food,” “What to Eat” and “Pet Food Politics,” and is a professor in the nutrition, food studies and public health department at New York University. E-mail her at food@sfchronicle.com, and read her previous columns at sfgate.com/food.

This article appeared on page H – 3 of the San Francisco Chronicle

Feb 1 2011

2010 Dietary Guidelines, deconstructed

I have now had time to look at the full report of the 2010 Dietary Guidelines–all 95 pages of what they are calling “the policy document.”

Oh no!  What happened to the Selected Messages for Consumers that I posted yesterday?  “Enjoy your food” is not in it and neither are any of the other clear, straightforward messages.  This is a big disappointment.

Nevertheless, the document is well worth reading.

It addresses my complaints about the executive summary.  It explains the meaning of the annoying SOFAS (solid fats and added sugars).  It discusses the need to improve the food environment.

Let me share a few thoughts about selected issues.


SOFAS

The report translates its advice (pages 62-68).   It translates  “Cut back on foods and drinks with added sugars,” a nutrition euphemism, as:

Drink few or no regular sodas, sports drinks, energy drinks, and fruit drinks.  Eat less cake, cookies, ice cream, other desserts, and candy.  If you do have these foods and drinks, have a small portion.

But it translates “Cut back on solid fats” in yet another euphemism:  “Select lean meats and poultry, and fat-free or low-fat milk and milk products.”  This, no doubt, is to avoid the politically impossible “eat less meat.”

Added sugars

The report lists synonyms for added sugars that you might find on a food label (page 75).  The 2005 Dietary Guidelines included “fruit juice concentrates” on that list.  The 2010 guidelines do not.  The Table lists “nectars” but not fruit juice concentrates.  How come?  It doesn’t say.

Food group patterns

The report describes healthy patterns for diets ranging from 1,000 to 3,200 calories a day.  For a diet containing 2,000 calories, you are only allowed 258 calories a day from SOFAS.  That’s all? One 20-ounce soft drink contains more than that and so does  one tablespoon of butter and a 12-ounce soft drink.  No wonder the guidelines don’t want to be specific about foods when they mean “eat less.”

Sodium

The recommendation to reduce sodium intake to 2,300 or 1,500 mg per day is addressed to the wrong people.  Individuals cannot do this on their own since most salt is already added in restaurant and processed foods.  The report recognizes this:

  • Consume more fresh foods and fewer processed foods that are high in sodium.
  • Eat more home-prepared foods, where you have more control….
  • When eating in restaurants, ask that salt not be added….

Vegetarian and vegan diets

The report includes diet plans for lacto-ovo vegetarians and vegans (pages 81 and 82).  Applause, please.  When I was on the dietary guidelines advisory committee in 1995, we tried to say something useful about vegetarian diets but were forced to add something about the nutritional hazards of such diets, minimal as they are.  Not having to do this is a big improvement.  But you too only get 258 calories for SOFAS.

How about changing the food environment?

The report makes it clear that the food environment strongly influences the food choices of individuals, and it urges efforts to

  • Improve access to healthy foods
  • Empower people with improved nutrition literacy, gardening and cooking skills
  • Develop policies to prevent and reduce obesity
  • And for kids, fix school meals, encourage physical activity, and reduce screen time

In short, there is plenty to work with here.  You just have to look hard and dig deep to find it.

What is the food industry’s reaction?

Just for fun, I’ve been tracking some of the industry reactions.  The soy people love it.  The report mentions soy along with nuts and seeds in the USDA’s meal patterns (page 79), and soy has its own category in the vegetarian and vegan diets (page 81 and 82).

The meat people don’t love it so much.  They are a little worried that seafood is pushed more than meat, but the American Meat Institute is giving it a nice spin, pointing out that the overall meat recommendation has not changed since 2005.

And the Salt Institute?  “Dietary Guidelines on Salt Drastic, Simplistic, Unrealistic.”

I rest my case.

Jan 31 2011

The 2010 Dietary Guidelines: Enjoy your food, but eat less!

The 2010 Dietary Guidelines for Americans were just released.  Here are the take-home messages:

Balancing Calories

• Enjoy your food, but eat less.

• Avoid oversized portions.

Foods to Increase

• Make half your plate fruits and vegetables.

• Switch to fat-free or low-fat (1%) milk.

Foods to Reduce

• Compare sodium in foods like soup, bread, and frozen meals—and choose the foods with lower numbers.

• Drink water instead of sugary drinks.

I’m in shock.  I never would have believed they could pull this off.  The new guidelines recognize that obesity is the number one public health nutrition problem in America and actually give good advice about what to do about it: eat less and eat better. For the first time, the guidelines make it clear that eating less is as priority.

My two quibbles:

Quibble #1: They still talk about foods (fruits, vegetables, seafood, beans, nuts) when they say “eat more.”   But they switch to nutrient euphemisms  (sodium, solid fats and added sugars) when they mean “eat less.”

They say, for example: “limit the consumption of foods that contain refined grains, especially refined grain foods that contain solid fats, added sugars, and sodium.”

This requires translation: eat less meat, cake, cookies, sodas, juice drinks, and salty snacks.

That’s politics, for you.

Let’s give them credit for “drink water instead of sugary drinks.”  That comes close. But I listened in on the press conference and conference call and several people pushed federal officials about why they didn’t come out and say “eat less meat.”  The answers waffled.

Quibble #2: This is all about personal responsibility.  What about the “toxic” food environment?  Shouldn’t these guidelines be directed at the food and restaurant industries?  The Dietary Guidelines Advisory Committee made a big point of that.  Apparently, that’s in the full dietary guidelines report but I’ve only seen the executive summary.

For background, see my previous posts, one on the politics of this report, and one on the science of the dietary guidelines.

Overall, the new guidelines aren’t perfect but they are a great improvement.

Next: let’s see what they do to improve the implementation guide—the pyramid or its equivalent.  This, they say will come out in a few months.  Stay tuned.

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