Search results: dietary guidelines

Yesterday, I got a last-minute invitation to listen in on a USDA conference call announcing the release of the report of the joint USDA-DHHS Dietary Guidelines Advisory Committee (see www.dietaryguidelines.gov).

The call was remarkable for how little information it produced.  It was scheduled for half an hour, but started 12 minutes late.  Officials used most of the time to talk about how the committee was appointed, how the committee process worked, how transparent everything was, and how staff of USDA’s new Evidence-Based Nutrition Library (NEL) provided much of the research basis for the guidelines.  This left hardly any time for asking questions, and only five got asked.

From what I heard, the committee report says pretty much what previous accounts said it would (see my post on this).  If my notes on the call are correct, the committee report will recommend:

• Maintain appropriate body weight through diet and physical activity
• Shift to a more plant-based diet
• Eat more seafood; eat more low-fat dairy products; limit meat intake
• Eat less solid fats; eat less of added sugars
• Reduce sodium; eat fewer refined grains
• Follow physical activity guidelines

Is this news?  Isn’t this always what the dietary guidelines say?  Here, just for fun, are the first set of guidelines that came out in 1980.

The main difference seems to be the way the evidence was judged and in some of the details: the target for saturated fat is 7% and for sodium a gradual reduction to 1500 mg/day.

If so, that’s a lot of trouble to go through to get to basically the same place.  I summarized that place in What to Eat as “Eat less, move more, eat plenty of fruits and vegetables, and don’t eat too much junk food.”  Michael Pollen did it even more succinctly: “Eat food.  Mostly plants.  Not too much.”

So why would two federal agencies and 13 committee members go to all this trouble?

The quick answer is that the agencies have to.  Congress says they have to review the guidelines every five years.

The longer answer, which I discuss in Food Politics and What to Eat, is that every word of the dietary guidelines is fraught with politics.

According to Food Chemical News (June 14),

The document is frequently the source of much controversy in the food industry because of the way it is used to promote certain ingredients and eating habits…Observers expect some controversy this year over recommendations made with regard to salt, a subject discussed frequently in committee meetings, as well a possible suggestion to replace two servings of grain with two servings of vegetables.

Another controversy is brewing in regards to the information on which the report was based. On Friday, the American Meat Institute, the National Cattleman’s Beef Association, the Grocery Manufacturer’s Association and the Grain Foods Foundation were among 23 groups that asked USDA and HHS to provide access to the Nutrition Evidence Library, which contains all the research used by the Dietary Guidelines committee when making their recommendations. “Without access to the data from which the DGAC drew its conclusions and recommendations, the public may not be able to provide meaningful comments,” the letter states.

Right. And now let’s see what the agencies do with this report (here’s the USDA press release on what happens next and how to comment).  This report is, after all, merely advisory. Now, the real politics begins!

Additions:

Here is all the information about the Advisory Committee’s report, and the report itself (but why didn’t they put it in one easy pdf file?).

And here is USA Today’s take on it: “Panel: obesity is century’s greatest public health threat.”

Further addition, June 16: Thanks to Daniel Green (Cornell) for putting the report together in one enormous (19MB) file.

By congressional fiat, federal agencies must revise the Dietary Guidelines every five years. This is one of those years.   The 2010 Dietary Guidelines Advisory Committee has been meeting for a couple of years and is now nearly done.

Some unnamed person from the American Society of Nutrition must be attending meetings.  The society’s Health and Nutrition Policy Newsletter (April 22) provides a report.

From the sound of it, this committee is doing some tough thinking about how to deal with “overarching issues” that affect dietary advice:

• The high prevalence of overweight and obesity among all Americans
• The need to focus recommendations on added sugar, fats, refined carbohydrates, and sodium (rather than the obscure concept of “discretionary calories” used in the 2005 guidelines)
• The benefits of shifting to plant-based, rather than meat-based, diets
• The need to help individuals achieve physical activity guidelines
• The need to change the food environment to help individuals meet the Dietary Guidelines

Applause, please, for this last one.  It recognizes that individuals can’t do it alone.

The committee’s key findings and recommendations:

• Vegetable protein and soy protein: little evidence for unique health benefits, but there are benefits, such as added dietary fiber intake, from diets high in vegetable and soy proteins.
• Carbohydrates: a consistent relationship between soft drink intake and weight gain. Overweight and obese children should reduce overall energy intake, especially from added sugars (and especially in the form of soft drinks and sugar-sweetened beverages).
• Fats: mono and polyunsaturated fats, when replacing saturated fats, decrease the risks of heart disease and Type 2 diabetes in healthy adults. No benefit from increased intakes of omega-3 fatty acids above 250-300 mg a day.  Adults should eat two servings of fish per week to obtain omega 3 fatty acids.
• Sodium: decrease sodium intake to 2,300 mg sodium per 2,000 calorie diet to lower blood pressure in adults and children. Since 70 percent of the population is hypertensive, the goal for most individuals should be 1,500 mg per 2,000 calorie diet.
• Potassium: because higher intakes of potassium are associated with lower blood pressure, adults should increase intake to 4,700 mg daily.

Translation: more fruits and vegetables, fewer processed foods, and changes in the food environment to make it easier for everyone to follow this advice.

Next steps: the committee is supposed to complete its report by May 12 and send it to USDA and DHHS. The agencies post the report in June for public comment. Then, agency staff write the guidelines and publish them by the end of the year.

Historical note: prior to 2005, the committee wrote the guidelines.  I was on the 1995 committee and we drafted guidelines that the agencies hardly touched (except to tinker with the alcohol guideline, as I discussed in Food Politics and What to Eat).  The guidelines have always been subject to political pressures, but with the agencies writing them, expect even more.

Let’s hope the committee’s sensible ideas will survive the process.  I will be paying close attention to how the 2010 guidelines progress.  Stay tuned.

Oh no, not again!  Merrill Goozner of the Integrity in Science project at Center for Science in the Public Interest (CSPI) writes that six of the 13 members of the 2010 Dietary Guidelines committee, including the chair, get research support  or consulting fees from food or drug companies with vested interests in what the guidelines say.  CSPI had to dig up this information, as the sponsoring agencies did not disclose these potential conflicts of interest. 

According to Food Chemical News, November 3 (which, alas, only subscribers can read online), the first meeting of the 2010 Dietary Guidelines committee began with speeches from the agency sponsors.  FCN quotes Penelope Slade Royall, deputy assistant secretary of health in HHS’s Office of Disease Prevention and Health Promotion (an office in which I worked from 1986-88):

“even when the new guidelines are approved and released in 2010, there’s nothing the committee can do to change people’s behavior…There are very dedicated people across the country working on these [guidelines] and I don’t understand why we’re not more successful.”

Really?  I can make some guesses.  Why not start by making the guidelines clear, direct, and unambiguous?  How about “eat less sugar,” “eliminate sugary drinks,” “eat less fast food,” “eat less often,” and “eat smaller portions.”   Or just the mantra of What to Eat: “Eat less, move more, eat fruits, vegetables and whole grains, and don’t eat too much junk food.”

The government must have announced the members of the committee that will develop the 2010 Dietary Guidelines for Americans, because the American Society of Nutrition (I am a member) has issued a press release congratulating the nine (of 13) appointees who are ASN members.  Who are the other four?  We will find out next week when the committee starts meeting.  Stephen Clapp interviewed me about the Guidelines for Food Chemical News (October 27).  Here’s my part of his article, subtitled, “Keep it simple, stupid!” 

“Not everyone is happy with the 2005 guidelines. Marion Nestle, a high-profile nutritionist who teaches at New York University, favors scrapping the current advice in favor of something much simpler. She served on the 1995 Dietary Guidelines Advisory Committee, an experience she described in her book Food Politics. She hasn’t been invited back.

“I would hope for an enormous reversal of the last set of guidelines,” she told FCN. “They’re unteachable and incomprehensible. Buried in the 41 recommendations is the basic advice: eat less, move more, eat more fruits and vegetables and whole grains, and don’t eat too much junk food.

“The idea that this document is for policymakers is ridiculous,” she continued. “You could boil it down to a single recommendation: ‘Drink fewer sodas and juice drinks.'”

Nestle said in 1995 the advisory committee was told to interpret nutrition science for the public. In 2005 the panel was told to make “science-based” recommendations, she said, which she interprets as code for “We won’t let you say anything unless the science is incontrovertible.”

Basing the guidelines on Dietary Reference Intakes (DRIs) is a “huge mistake,” Nestle says, because the DRIs are “incomprehensible” and set too high for calcium and potassium, resulting in a recommendation to eat two or three servings of dairy products daily. “If the Dietary Guidelines have to be based on the DRIs, it’s too much food,” she says.

Nestle says nutrition science is unusually subject to interpretation and bias because it’s difficult to link specific nutrients to chronic diseases. “My biases are open,” she says. “Everyone else has biases, too, but they may not want to disclose them. The public is deeply confused — you should just give the best advice you can. Just take into consideration all the research available and don’t worry about the impact on one industry or another.”

Now wouldn’t it be useful if they took my advice?  I will be following this story with great interest.

Update 10/28: Here’s the USDA’s announcement of the full list of committee members.

The USDA and Department of Health and Human Services are requesting nominations for the committee that will prepare the version of the Dietary Guidelines for Americans to be published in 2010. NutraIngredients.com points out that the committee’s first task is to decide whether the current guidelines need revision. That, of course, is a joke. What’s the point of appointing a committee if it doesn’t do anything. And in this case, the Dietary Guidelines badly need revision. What started out as a simple pamphlet with advice about healthy eating is now a 70-page textbook. The new committee will have some serious pruning to do. How to nominate someone to the committee? Both links explain.

I wouldn’t even ask such a silly question if the American Journal of Preventive Medicine wasn’t going to publish a paper arguing just this point. Along with one of the editors of that journal, I wrote an editorial commenting on the paper, to which its authors added a rebuttal to our editorial. The authors argue that the government has no business issuing advice based on weak evidence. I would agree except that evidence will never be as good as we wish it would be because research on human nutrition is really, really hard to do. And when it comes to diet, dietary guidelines are not exactly radical; the basic advice hasn’t changed in 50 years. I summarize it like this: “eat less, move more, eat plenty of fruits and vegetables, and don’t eat too much junk food.” Michael Pollan gets it down to 7 words: “Eat food. Not too much. Mostly plants.” The Dietary Guidelines published in 2005 may take 70 pages, but in general, they say pretty much the same thing.

I always thought fiber had a simple definition: complex carbohydrates in food plants impervious to enzymes in our digestive tract.

OK, bacterial enzymes complicate the definition a bit.   But the real complication comes from what food companies toss into products to increase their apparent fiber content on food labels.

Now the FDA has issued guidance to industry about what companies can use to boost their products’ fiber content.  In FDA-speak:

We intend to exercise enforcement discretion for the declaration of dietary fiber, pending completion of a rulemaking regarding revising our regulations, if the declaration includes one or more of the following eight isolated or synthetic non-digestible carbohydrates, when present in a food and included in the amount of dietary fiber declared on the Nutrition or Supplement Facts label:

• mixed plant cell wall fibers
• arabinoxylan
• alginate
• inulin and inulin-type fructans
• high amylose starch (resistant starch)
• galactooligosaccharide
• polydextrose
• resistant maltodextrin/dextrin

What this means is that food manufacturers can use these to count as fiber.

Here, for example, is a happy announcement from Sensus, a company that manufactures “Frutafit” and “Frutalose” chicory root fibers.  It

welcomes the announcement that the US Food and Drug Administration (FDA) recognizes inulin-type fructans derived from chicory root as dietary fiber for the new nutrition facts label. The recognition consolidates the fiber status of chicory root fiber in the US and supports further opportunities for healthy food applications in the US.

The Sensus announcement explains that this decision came about as a result of a “joint citizen petition,” one in which you can bet this company was involved.

This decision is about marketing.

If you want fiber in your diet, the best sources are still foods: fruits, vegetables, beans, whole grains, nuts.