by Marion Nestle

Currently browsing posts about: Dietary-Guidelines

Feb 7 2018

Food industry lobbyists running the dietary guidelines?

This tweet certainly got my attention:

It referred to Alex Kotch’s article in the International Business Times about how White House lawyer Donald McGahn has granted a waiver of conflict of interest rules to allow Kailee Tkacz, a former lobbyist for the Snack Food Association and, more recently, for the Corn Refiners Association, to advise the USDA about the forthcoming 2020 dietary guidelines.

Ms. Tkacz also was food policy director for the Corn Refiners Association, which represents producers of high fructose corn syrup (HFCS).

McGahn explained that this waiver would allow Ms. Tkacz “to advise the Secretary of Agriculture and other senior Department officials with respect to the Dietary Guidelines for Americans process.”

He says “it is in the public interest to grant this limited waiver because of Ms. Tkacz’s expertise in the process by which the Dietary Guidelines for Americans are issued every five years.”

The dietary guidelines historically have issued recommendations to consume less salt and sugar.  Snack foods are major sources of salt in U.S. diets.  Soft drinks sweetened with HFCS are major sources of sugars.

USDA is the lead agency for the 2020 guidelines.

Want to make some bets on what they will say about salt and sugar (a wild guess: the science isn’t firm enough to suggest eating less of either).

Jan 25 2018

USDA Secretary issues guiding principles for farm bill

Secretary Sonny Perdue has released his blueprint for the 2018 farm bill.

Its goal is to “improve services while reducing regulatory burdens on USDA customers” [translation: Big Ag].

USDA, he says, supports legislation that will do a great many things for farm production, conservation, trade, food and nutrition services, marketing, food safety, research and education, and natural resources.

There are a lot of words here and it’s hard to know what they mean, even reading between the lines.

For example, here are USDA’s principles for SNAP (food stamps), with my [translations and questions]:

• Harness America’s agricultural abundance to support nutrition assistance for those truly in need.  [This sounds like a food distribution program, but I’m wondering how “truly in need” will be defined.]
• Support work as the pathway to self-sufficiency, well-being, and economic mobility for individuals and families receiving supplemental nutrition assistance.  [This means work requirements, but where will the jobs come from?]
• Strengthen the integrity and efficiency of food and nutrition programs to better serve our participants and protect American taxpayers by reducing waste, fraud and abuse through shared data, innovation, and technology modernization. [This means spending hundreds of millions a year on fraud prevention].
• Encourage state and local innovations in training, case management, and program design that promote self-sufficiency and achieve long-term, stability in employment.  [The jobs?]
• Assure the scientific integrity of the Dietary Guidelines for Americans process through greater transparency and reliance on the most robust body of scientific evidence.  [Weren’t they always based on the available science?  This sounds like a way to prevent the guidelines from suggesting eating less of junk foods].
• Support nutrition policies and programs that are science based and data driven with clear and measurable outcomes for policies and programs. [This one translates to you can’t set nutrition policies unless you can demonstrate beneficial outcomes—fine in theory, but policy-blocking in practice].

Reading through the other sections is equally non-reassuring.  Where is a vision for a farm bill that promotes health, sustainable agriculture, and small or mid-size farms, protects farm workers, and reduces greenhouse gases?

Maybe the next one?

Aug 28 2017

Thought for the week: muffin v. cupcake

Thanks to my colleague Lisa Young for taking this photo at the Magnolia Bakery in Manhattan.

Feb 8 2017

Review committee says Dietary Guidelines process needs a fix

You may recall that one result of the fuss over the highly controversial BMJ article attacking the Dietary Guidelines process was appointment of a committee to review that process.

It has just published the first of its reports, which deals only with the first of the four charges to the committee, which were to determine:

1. How the selection process for the Dietary Guidelines Advisory Committee (DGAC) can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints;
2. How the Nutrition Evidence Library (NEL) is compiled and used, including whether the NEL reviews and other systematic reviews and data analysis are conducted according to rigorous and objective scientific standards;
3. How systematic reviews are conducted on long-standing DGAC recommendations, including whether scientific studies are included from scientists with a range of viewpoints; and
4. How the DGA can better prevent chronic disease, ensure nutritional sufficiency for all Americans, and accommodate a range of individual factors, including age, gender, and metabolic health.

The committee identified values governing the committee selection process:

  • Enhance transparency
  • Promote diversity of expertise and experience
  • Support a deliberative process
  • Manage biases and conflicts of interest
  • Adopt state-of-the-art processes and methods

Its recommendations:

  • Employ an external third party to review the candidate pool for committee members.
  • Make the list of provisional appointees open for public comment.
  • Publicly disclose nominees’ biases and conflicts of interest; develop a plan for managing them; have them reviewed by a federal ethics officer; document all this in the advisory committee’s report.
  • Adopt a system for continuous process improvement in the selection process.

Good recommendations and good luck with them.

I can hardly wait to see this committee’s report on the remaining charges.

In the meantime, it’s about time to start appointing the 2020 Dietary Guidelines Advisory Committee, no?

Mar 29 2016

Some food guides are unafraid of sustainability

I’ve just heard about the new Netherlands food guide.  It emphasizes sustainability.  According to an article in National Geographic’s The Plate,

The Netherlands Nutrition Centre says  it is recommending people eat just two servings of meat a week, setting an explicit limit on meat consumption for the first time [but see added comment below].

Here’s what the Netherlands food guide looks like.

Capture

Google translator calls this a pyramid, and explains: “Moreover, the Pyramid helps you eat more environmentally friendly broadly.”

Ours, of course, looks like this.  I’m guessing the USDA is working on a new food guide in response to the 2015 Dietary Guidelines.  These do not mention sustainability at all—the S word.

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If you want to check out food guides m other countries, see FAO’s pages on food-based dietary guidelines.  You can search the site by regions and countries.  Fun!

Added comment: A reader from Amsterdam, who obviously speaks Dutch better than Google translator, and who also is well versed in the Dutch nutrition scene, writes:

Sustainability is indeed an important concern in the new Dutch food guide. However, the recommendation for meat is not ‘two servings per week’, but two servings of red meat and two servings of white meat (chicken), for a total of four per week. One serving is 100 gram or 3.5 oz. of meat. Diehards may add a third serving of red meat; 300 g of red meat (11 oz) plus 200 g of chicken (7 oz) per week is considered the absolute limit.

The fish advice has been reduced from twice to once a week because environmental concerns were thought to outweigh the small health benefit of a second weekly serving of fish.

Feb 20 2016

Weekend reading: Three books about eating: 1. First Bite

You might think that eating is one of those things that comes naturally, but for the next three weeks I’m going to be posting books telling us how.  Here’s the first:

Bee Wilson.  First Bite: How We Learn to Eat. Basic Books, 2015.

Bee Wilson speaks from experience.  She once was a picky eater bordering on having an eating disorder.  Simply eating when hungry and stopping when full is a challenge for many of us.  Wilson explores how food preferences are acquired or made and how culture and environment turn biological needs into obesity-promoting hazards.  Her advice boils down to aphorisms, for example:

  • No one is too busy to cook.
  • Eat soup.
  • Rethink what counts as a main course.
  • Regular exercise definitely helps.
  • If you want your children to eat better, don’t tell them what to do: eat better yourself.
Jan 11 2016

The 2015 Dietary Guidelines’ hidden advice about sugary drinks: definitely there, but hard to find 

I’m indebted to Maria Godoy of NPR’s The Salt for pointing out where in the new 2015 Dietary Guidelines you can find advice about cutting down on sugary drinks.  As she puts it, this is easy to miss.

Here’s my wonky analysis.

In my post about the 2015 Dietary Guidelines, I noted that they are unambiguous about the need to reduce added sugars to 10% or less of calories.  But what they say about cutting down on sugary drinks—the leading source of sugars in US diets—is buried deep in the text.  Fortunately, Deborah Noble of slowfoodfast.com has performed a great public service by producing the 2015 Dietary Guidelines in a searchable pdf format.Here’s where to find advice about cutting down on sugary drinks:

The Executive Summary: See under “Cross-Cutting Topics of Public Health Importance:”

Similarly, added sugars should be reduced in the diet and not replaced with low-calorie sweeteners, but rather with healthy options, such as water in place of sugar-sweetened beverages.

Figure 2-10 explains:

The major source of added sugars in typical U.S. diets is beverages, which include soft drinks, fruit drinks, sweetened coffee and tea, energy drinks, alcoholic beverages, and flavored waters.

Reading the Figure tells you that beverages comprise a whopping 47% of added sugars (closer to half if you add in sweetened milks, teas, and coffees).  The text following the Figure says:

Shift to reduce added sugars consumption to less than 10 percent of calories per day: Individuals have many potential options for reducing the intake of added sugars. Strategies include choosing beverages with no added sugars, such as water, in place of sugar-sweetened beverages, reducing portions of sugar-sweetened beverages, drinking these beverages less often, and selecting beverages low in added sugars.

Strategies?  How about just saying: “Cut down on sugary drinks” or “Drink water instead of sugary drinks.”

Figure ES-1 in the Executive Summary illustrates the 2015-2020 Dietary Guidelines for Americans at a Glance.  All it says is:

Limit calories from added sugars…Consume an eating pattern low in added sugars…Cut back on food and beverages higher in these components to amounts that fit within healthy eating patterns.

Figure 3.2 shows Implementation of the Guidelines through MyPlate: “Drink and eat less…added sugars,” but nothing about sugary drinks.

This circumspection is weird.  Clear, straightforward advice to cut down on sugary beverages has plenty of historical precedent.

Both Figures ES-1 and 3.2 are most certainly derived from a USDA graphic on the MyPlate website (dated January 2016).  This says flat out:

Drink water instead of sugary drinks.

This statement, in turn, derives from:

  • The precepts issued with the 2010 Dietary Guidelines in January 2011
  • The statements issued with the MyPlate graphic in June 2011

myplate

  • The USDA’s May 2012 tip for making better beverage choices.

The 2015 DGAC (Dietary Guidelines Advisory Committee) repeatedly urged limits on consumption of sugar-sweetened beverages.  Statements like this one, for example, appear throughout the document:

To decrease dietary intake from added sugars, the U.S. population should reduce consumption of sugar-sweetened beverages.

Why did the USDA and HHS writing committee choose to waffle about his point?

This cannot be an accident.  It must be deliberate.  And it can have only one explanation: politics.

Jan 7 2016

The 2015 Dietary Guidelines, at long last

The 2015 Dietary Guidelines are out.

Picture1

They are now online in a version that takes up dozens of screens with annoying drop-down boxes.  It’s hard to navigate, and if it’s searchable, I can’t figure out how (OK, it’s searchable but doesn’t work all that well).

First the good news.  These Dietary Guidelines—for the first time—attempt to focus on foods and dietary patterns:

Previous editions of the Dietary Guidelines focused primarily on individual dietary components such as food groups and nutrients. However, people do not eat food groups and nutrients in isolation but rather in combination, and the totality of the diet forms an overall eating pattern.

They almost succeed in this mission.  The Guidelines say:

  • Follow a healthy eating pattern across the lifespan [Pattern].
  • Focus on variety, nutrient density, and amount [Pattern].
  • Limit calories from added sugars and saturated fats and reduce sodium intake [Oops: Nutrients].
  • Shift to healthier food and beverage choices [Pattern].
  • Support healthy eating patterns for all [Pattern].

A healthy eating pattern, they say:

  • Includes foods from various groups [Pattern].
  • Limits saturated fats, trans fats, added sugars, and sodium [Oops: Nutrients].

As for (Oops) Nutrients:

  • Less than 10% of calories from added sugars [this is new, but consistent with many other reports such as the one from WHO]
  • Less than 10% of calories from saturated fats [in the Guidelines since 1990]
  • Less than 2,300 mg sodium [no change from 2010]

Why Oops?  Because these Dietary Guidelines, like all previous versions, recommend foods when they suggest “eat more.”   But they switch to nutrients whenever they suggest “eat less.”

In the 2015 Dietary Guidelines,

  • Saturated fat is a euphemism for meat.
  • Added sugars is a euphemism for sodas and other sugar-sweetened beverages.
  • Sodium is a euphemism for processed foods and junk foods.

If the Guidelines really focused on dietary patterns, they wouldn’t pussyfoot.  They would come right out and say:

  • Eat less meat [OK, they do but only under the euphemism of “protein” and only for males. “Some individuals, especially teen boys and adult men, also need to reduce overall intake of protein foods (see Figure 2-3) by decreasing intakes of meats, poultry, and eggs and increasing amounts of vegetables or other underconsumed food groups.”  But what about processed meats?  Not a word that I can find.
  • Cut down on sugary drinks [OK, it says “drink water instead of sugary drinks,” but good luck finding that statement without knowing where it is].
  • Eat less processed and junk food.

Why don’t they?  Politics, of course.

Recall that Congress weighed in with an Appropriations Bill that called for an investigation of the scientific basis of the Guidelines and granted $1 million to the National Academy of Medicine to take them over.

Recall also that the secretaries of USDA and HHS said that the Guidelines would not say anything about sustainability as a rationale for advising eating less meat.

So let’s count the 2015 Guidelines as a win for the meat, sugary drink, processed, and junk food industries.

Other concerns, nutritional and otherwise:

  • Calories: The Guidelines deemphasize calories.  They dropped the information about food sources of calories from the 2010 edition, even though calorie balance remains a—if not the—major public health nutrition problem (an Appendix gives calorie needs).
  • Portion sizes: the best way to control calorie intake is by eating smaller or moderate portions. If the Guidelines talk about portion size, it must be well hidden.
  • 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.
  • Protein: My pet peeve.  The Guidelines use this as yet another euphemism for meat.  “Protein” lumps meat together with seafood, poultry, eggs, nuts, seeds, and soy.  But grains and dairy also have protein, so using this term makes no nutritional sense and obfuscates the message to eat less meat.
  • Seafood: the document recommends 8 ounces a week of seafood high in omega-3s but low in methylmercury. That pretty much means salmon and sardines (anchovies are too salty).

I might have more to say when I can look at a document that is easier to read.

Full disclosure: I was a peer reviewer on an earlier version of this document.

Documents and commentary

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