Search results: dietary guidelines

Nutritional Viewpoints on Eggs and Cholesterol. by Michihiro Sugano and Ryosuke Matsuoka.  Foods 2021, 10(3), 494; https://doi.org/10.3390/foods10030494

Opinion:  This review says that although Japanese people eat more eggs than Americans, they may be protected against higher cholesterol levels due to the differences in everything else they eat (more seafood, for example?).

Conclusion: “Although randomized controlled trials with long-term follow-up are required to evaluate the association between consumption of eggs and human health, available information, at least from the nutritional viewpoint, suggests that egg is a healthy and cost-efficient food worldwide.”

Conflicts of interest: “M.S. declares no conflicts of interest, and R.M. is an employee of Kewpie Corporation. There are no other patents, products in development, or marketed products to declare. Kewpie Corporation has no conflicts of interest with this research.”

Comment: Really?  No conflicts of interest?  But Kewpie is Japan’s #1 mayonaise company.  Kewpie says that it “uses about four billion eggs a year. Recognizing that eggs contain all the necessary ingredients for creating life, we continually study ways of effectively utilizing such ingredients and manufacture fine chemicals for use in a broad range of food, cosmetic, and pharmaceutical applications.”

One of those ways, apparently, is to get its employees to write opinion pieces like this.

With that said, concerns about eggs and cholesterol have diminished in recent years.  The 2020 Dietary Guidelines for Americans says not a word about eggs and cholesterol; it just recommends eggs as a source of protein.  A study in the American Heart Association Journal finds no association between eggs and heart disease mortality.

The American Heart Association notes that eggs are the leading source of dietary cholesterol but their negative effects may be confounded by the fact that they are so often eaten with bacon and sausage.  The AHA egg recommendations:

• Vegetarians (lacto-ovo) who do not consume meat-based cholesterol-containing foods may include more dairy and eggs in their diets within the context of moderation discussed herein.
• Patients with dyslipidemia, particularly those with diabetes mellitus or at risk for heart failure, should be cautious in consuming foods rich in cholesterol.
• For older normocholesterolemic patients, given the nutritional benefits and convenience of eggs, consumption of up to 2 eggs per day is acceptable within the context of a heart-healthy dietary pattern.

And even with that said, the authors should have disclosed Kewpie’s evident conflicted interests.

The Pan-American Health Organization (PAHO) has produced a report on soda taxes in the region.

What’s happening with soda taxes in Latin America is impressive.

Soda taxes, no matter where they are, seem to be doing what they are supposed to:

Latin America is a model for Dietary Guidelines (Brazil) and front-of-package warning labels (Chile).

Wish we could do these things.

Here’s another nutrition question that doesn’t go away.

This new study is just out: Egg and cholesterol consumption and mortality from cardiovascular and different causes in the United States: A population-based cohort study.

Its conclusion:

In this study, intakes of eggs and cholesterol were associated with higher all-cause, CVD, and cancer mortality. The increased mortality associated with egg consumption was largely influenced by cholesterol intake. Our findings suggest limiting cholesterol intake and replacing whole eggs with egg whites/substitutes or other alternative protein sources for facilitating cardiovascular health and long-term survival.

This gets right into the funny business of the 2015 Dietary Guidelines.  As I explained,

the recommendation to limit cholesterol has been dropped [from the 2015 Guidelines], but the document says, confusingly, that “this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns. As recommended by the IOM, individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern.”  Could the dropping of the limit have anything to do with egg-industry funding of research on eggs, the largest source of dietary cholesterol, and blood cholesterol?  The Physicians Committee for Responsible Medicine has just filed a lawsuiton that very point.

Well, here we go again.  My thoughts:

This is association, not causation.  The paper gives this caveat: “At baseline, participants with higher whole egg consumption had a higher BMI and lower household income. They were less educated, less physically active, more likely to smoke and have a high cholesterol level, and less likely to take aspirin. They also had higher red meat intake; lower intakes of fruit, dairy products, and sugar-sweetened beverages; and lower HEI-2015 score.”

Eggs, it seems, track with other unhealthful dietary behaviors.

The egg situation is a mess to sort out because the egg industry funds so many studies in its own defense and these invariably show no effect.

But eggs are one food in complicated diets and it’s really hard to look at them independently of everything else in the diet and lifestyle.

What to do?  Moderation is always good advice.

This report documents how government policies—in the U.S. and internationally—promote and protect makers of booze, wine, and beer, despite the demonstrably harmful effects of those products on health and society.

How do governments do this?

• Development assistance
• Tax breaks
• Tax rebates
• Marketing deductions
• Production subsidies
• Trade agreements

Why do they do this?  Lobbying and tax revenues.

If you want to understand why the USDA and HHS “found no evidence” for reducing the alcohol recommendation in the 2020 Dietary Guidelines, read this report.

If you are a marketer of fruit juice, you have a problem.  Fruit juice has a lot of sugar and retains little of the fiber of whole fruit.  Dietary recommendations increasingly suggest limits on the amounts consumed, especially for children.

But according to the trade group, the Juice Products Association, “The 2015 Dietary Guidelines for Americans and the American Academy of Pediatrics (AAP) concur that 4 to 6 ounces of 100% fruit juice per day is appropriate for young children. For children age 7 and older, the AAP recommends a daily serving of 8 to 12 ounces per day.”

No it does not!  The American Academy of Pediatrics suggests a limit to that amount.  Big difference.

Juice should not be introduced into the diet of infants before 12 months of age unless clinically indicated. The intake of juice should be limited to, at most, 4 ounces/day in toddlers 1 through 3 years of age, and 4 to 6  ounces/day for children 4 through 6 years of age. For children 7 to 18 years of age, juice intake should be limited to 8 ounces or 1 cup of the recommended 2 to 2.5 cups of fruit servings per day.

What about adults?  Adults do not need more sugars or the calories they provide.   They too would be better off eating fruit.

Juice trade associations to the rescue.

The study:  100% Fruit juice intake and cardiovascular risk: a systematic review and meta-analysis of prospective and randomised controlled studies. Lanfranco D’Elia, et al.  European Journal of Nutrition (2020)

Methods: This is a meta-analysis of prospective studies and randomized controlled trials (RCTs) examining the relationship between consumption of 100% fruit juice (FJ) and the risk of cardiovascular disease (CV).

Conclusions: “The results of these analyses indicate that 100%FJ consumption is not associated with higher CV risk. A non-linear inverse dose–response relationship occurs between 100%FJ consumption and CV disease, in particular for risk of stroke, probably mediated by the decrease in blood pressure.”

Funding: “Open access funding provided by Università degli Studi di Napoli Federico II within the CRUI-CARE Agreement. This project was funded by the European Fruit Juice Association (AIJN) via an unrestricted grant. AIJN was not involved in the design, conduction, analysis and interpretation of the results.”

Comment: Why would anyone think that fruit juice, of all things, would be associated with heart disease risk?  You would have to be drinking a lot of it —at the exclusion of healthier foods—for it to make  a significant difference.  The only point of this study is to try to convince adults to drink more juice.  When I was a kid, fruit juice was expensive and we drank it in 4-ounce glasses.  If you drink fruit juice at all, that’s still a good idea.

Rebecca Earle.  Feeding the People: The Politics of the Potato.  Cambridge University Press, 2020.

The historian Rebecca Earle uses the potato as an entry point into investigations of some of the most important political issues of our time: immigration, free-market capitalism, and globalization.  As she puts it, her book

offers a deep history of the concept of food security and fresh account of how eating became part of modern politics.  It also helps to explain our own fraught relationship with dietary guidelines by showing how healthy eating became embedded within a neoliberal framework valorising personal responsibility and choice rather than state-led intervention” (p. 3).

A couple more excerpts to give you an idea where she is headed with this.  Malthus, she says, had a “dismal vision of catastrophic population increase.”  With this vision

came pessimism about the potato’s capacity to contribute to national well-being.  Far from increasing trade and boosting economic exchange, the potato bcame an obstacle to modernity, because it helped sustain precisely the sectors of the population that capitalism aimed to eradicate” (p. 141).

Later, she describes the Peruvian International Potato Center (its Spanish acronym is CIP):

Peru is not alone in its gastronational celebration of local potato varieties.  A number of countries, from Denmark to Ecuador, have likewise established national potato days, or sought to protect specific varieties under international legislation…International regulatory structures thus help to nationalise potatoes by according them formal status as part of the national patrimony.  Its long history as an overlooked, localised food resource now enables the potato to toggle between the global food system and notions of culinary heritage, in a way that other major commodities such as sugar or maize have largely failed to do (pp. 197-198).

I read a report in the Washington Post discussing a study done by Neal Barnard and his colleagues associated with the Physicians Committee for Responsible Medicine, a group advocating for plant-based diets and animal welfare.

More than 85 percent of the studies in Barnard’s meta-analysis, whether funded by industry or not, showed that eggs have unfavorable effects on blood cholesterol. Industry-funded studies, Barnard found, were more likely to play down these findings.

The study, a meta-analysis, reviewed 153 studies examining the effects of eggs on blood cholesterol levels.  It found the proportion of egg studies funded by the egg industry to have increased since 2010, and the industry-sponsored results to be spun—no surprise—in favor of the benefits of eggs.

This matters because advice in the 2015-2020 Dietary Guidelines for Americans is unhelpful about eggs.

Here’s how I explained the confusion in my January 7, 2016 post:

Cholesterol: the recommendation to limit cholesterol has been dropped, but the document says, confusingly, that “this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns. As recommended by the IOM, individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern.”  Could the dropping of the limit have anything to do with egg-industry funding of research on eggs, the largest source of dietary cholesterol, and blood cholesterol?  The Physicians Committee for Responsible Medicine has just filed a lawsuit on that very point.

The lawsuit was about undue influence of the egg industry, but the judge threw the suit out of court because no legal standard exists for undue influence.  Oh.

What to do about eggs?  I vote for moderation, of course.

This one was sent to me by a reader who wishes to remain anonymous (thanks!).

The Study: Dairy Fat Consumption and the Risk of Metabolic Syndrome: An Examination of the Saturated Fatty Acids in Dairy.  Allison L. Unger,Moises Torres-Gonzalez, and Jana Kraft.  Nutrients 2019, 11(9), 2200; https://doi.org/10.3390/nu11092200

The review argues: “it is likely that the diverse array of SFA [saturated fatty acid] constituents within full-fat dairy foods contributes to favorably modulating cardiometabolic health.”

It concludes: “In summary, previous work on the impact of dairy-derived SFA consumption on disease risk suggests that there is currently insufficient evidence to support current dietary guidelines which consolidate all dietary SFA into a single group of nutrients whose consumption should be reduced, regardless of dietary source, food matrix, and composition.”

Funding and Conflicted Interests (my emphasis): “The work involved for this manuscript was funded by National Dairy Council….M.T.-G. is employee of National Dairy Council. J.K. has received research funding from National Dairy Council.

Comment: This purpose of this dairy-funded review is to demonstrate that contrary to contradictory information, the saturated fatty acids in dairy foods are not only benign, but beneficial. The dairy industry would love that to be true.

This particular sponsored review is exceptionally well organized and illustrated.  I especially appreciated the timeline of dietary recommendations for saturated fat from 1977 to the present.  This is the bottom half:

This is a classic industry-funded review arriving at the desired conclusions.  In essence, it is a dairy industry advertisement and should be understood as such.

Why do this?  The dairy industry is in serious economic trouble these days, as I will discuss tomorrow.