Government Guidelines and Faulty Food Pyramids

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On July 31, 2014, the Huffington Post published an article by its health diretor, Meredith Melnick, and a politics reporter, entitled “What The Government Got Wrong About Nutrition — And How It Can Fix It” (http://www.huffingtonpost.com/2014/07/31/usda-dietary-guidelines-diabetes_n_5635554.html). Now, two years later, we may well ask to what degree it has indeed “fixed it.”

The article begins by observing that “For decades, the U.S. government had a simple message on diet: To avoid chronic illnesses like diabetes, obesity and heart disease, Americans should cut back on saturated fat, cholesterol, sugar and sodium. Yet today, we’re sicker than ever…. ‘I’d like to see the guidelines move away from nutrient targets and … toward true, food-based evidence,’ said Dr. Dariush Mozaffarian, dean of Tufts University’s Friedman School of Nutrition Science and Policy.”

In its new Dietary Guidelines for Americans, 2015-2020 Edition (http://health.gov/dietaryguidelines/2015/ ) the U.S. Department of Health and Human Services and U.S. Department of Agriculture do indeed seem to have moved somewhat toward “food-based evidence,” but whether that evidence is true, according to the very latest sound scientific findings, is open to question.

The Dietary Guidelines for Americans Scientific are supposed to be broadly based on the Report of the 2015 Dietary Guidelines Advisory Committee (http://health.gov/dietaryguidelines/2015-scientific-report/PDFs/Scientific-Report-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf), first printed February, 2015. Here’s one example from that report (p. 15), citing Dr. Mozaffarian himself: “Emphasizing the benefits of replacement of saturated with polyunsaturated fats, Mozaffarian et al., 2010 found in a MA of 8 trials (13,614 participants with 1,042 CHD [coronary heart disease] events) that modifying fat reduced the risk of myocardial infarction or coronary heart disease death (combined) by 19 percent …, corresponding to 10 percent reduced CHD risk … for each 5 percent energy of increased PUFA [Polyunsaturated Fatty Acids].” Based (in part) on those findings, the new Dietary Guidelines (published in December, 2015) recommend that “Individuals should aim to shift food choices from those high in saturated fats to those high in polyunsaturated and monounsaturated fats.” So while the Guidelines no longer trumpet low-fat diets in general for weight loss or health (Dr. Muzaffarian says “There are no health benefits to it”), they do discriminate against saturated fats.

In the light of the comprehensive review led by Dr. Rajiv Chowdhury and published in the Annals of Internal Medicine in March, 2014, of which he was one of the main authors, Dr. Mozaffarian radically changed his mind: “Current evidence does not support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats (cited in the book by Mark Human, MD, Eat Fat, Get Thin, published in February, 2016). The new Dietary Guidelines ignore this  abrupt “about face,” and base their recommendation on Dr. Mozaffarian’s previous affirmation.

So what about the government’s traditional recommendation to “cut back on saturated fat, cholesterol, sugar and sodium”? Regarding sugar, it is more valid than ever. The same is true to a certain degree of sodium, mainly as found in processed foods – although the recommended limits on salt consumption have recently been raised, and moderate consumption of healthy types like sea salt or Himalayan pink salt seems to be OK, provided processed foods are avoided (a real food diet). Regarding cholesterol, the new guidelines state (p. 55) that “Adequate evidence is not available for a quantitative limit for dietary cholesterol ….” While they no longer recommend a low fat diet, they do insist that all age groups should get 10% of less of their calories from saturated fat. Considering that “One study of 60,000 people in Japan showed that higher intakes of saturated fat led to a reduced risk of stroke” (cited in Human, p. 97), maybe they should revise that figure substantially upward or eliminate it altogether!

Their food-based recommendations for putting this limit into practice (p. 77) seem mostly wide off the mark: “Because solid fats are the major source of saturated fats, the strategies for reducing the intake of solid fats parallel the recommendations for reducing saturated fats. These strategies include choosing packaged foods lower in saturated fats; shifting from using solid fats to oils in preparing foods; choosing dressings and spreads that are made from oils rather than solid fats; reducing overall intake of solid fats by choosing lean or low-fat versions of meats, poultry, and dairy products; and consuming smaller portions of foods higher in solid fats or consuming them less often.” Quite the contrary, we should avoid packaged foods artificial salad dressings and spreads and vegetable oils for cooking altogether, and not worry much about choosing lean or low-fat versions or consuming smaller portions of saturated fats – unless they happen to be from the “mixed dishes, snacks and sweets” (Guidelines, p. 57) typically found in supermarkets and fast food restaurants nowadays.

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