The Nation’s Nutrition Guidelines
The Dietary Guidelines for Americans (DGA) are the country’s go-to source for nutrition advice. The objective of these guidelines is to “provide evidence-based food and beverage recommendations aimed at promoting health, preventing chronic disease, and helping people reach and maintain a healthy weight.” (1)
Needless to say, the DGA have a significant impact on nutrition in the United States. Public health agencies, health care providers, and educational institutions all rely on the DGA recommendations and strategies. Additionally, the DGAs form the basis of federal nutrition policy and programs.
Something Is Wrong
A quick look at the trend of rising obesity in the US, however, would suggest that these guidelines are not having their intended effect. Since the DGAs were first introduced in 1980, the percentage of US adults that are overweight or obese has been rising steadily, reaching what many describe as “epidemic” proportions. It is worth asking: is this only a correlation, or might there be something amiss in the guidelines?
What Is Going On?
According to The Nutrition Coalition (TNC), the correlation between rising obesity levels and the publication of the DGAs is not a coincidence. And, their concern is that the opportunity to course correct is fast closing, as the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) will soon be issuing the new guidelines that will cover the next 5 years.
TNC describes itself as a non-partisan, non-profit organization that aims to ensure the Dietary Guidelines are based on the best and most rigorous science. Most of their funding comes from billionaire John Arnold, a former hedge fund manager who is now focused on philanthropic efforts with his wife Laura. Nutrition education is one of their priorities. As Laura Arnold puts it:
"Our issue with the Dietary Guidelines is to pose the question of whether or not these guidelines are as definitive as they sound, and whether the science behind them is as definitive as it should be."
The Arnolds also fund the Nutrition Science Initiative, which is dedicated to research that tests fundamental assumptions about the metabolic and hormonal causes of obesity and related disorders.
The Nutrition Coalition’s (TNC) Concerns About The Guidelines
Earlier this summer, in an open letter to the secretaries of Agriculture and Health and Human Services, Nina Teicholz, TNC’s Executive Director summarized the issues with the approach being utilized to review the guidelines for 2021-2025.
The key objections are:
- Lack of adherence to established methodology for scientific reviews.The USDA has mostly ignored recommendations that the DGAs adopt “state-of-the-art systematic review methods...to maximize scientific rigor” in order to arrive at credible, trustworthy guidelines. Importantly, the National Academies of Sciences, Engineering, and Medicine (NASEM)—who made these recommendations report—were commissioned by Congress after substantive concerns were raised with the process used to develop the Guidelines the last time around.
- One size-fits all approach does not address the obesity crisis.The 2020 DGA report is focused exclusively on “Healthy Americans,” thereby excluding the 60% of Americans diagnosed with one or more diet-related chronic conditions. In doing so, the DGAs are going against their stated objective of making “primary prevention of obesity and related risk factors…the single most powerful public health approach to reversing America’s obesity epidemic over the long term.”
- Ignoring the most recent nutritional science.By law, the DGAs must reflect the “scientific and medical knowledge which is current at the time the report is being prepared.” But the 2020 DGAs did not meet this requirement in many of the reviews it conducted. According to Teicholz:
“The science underpinning the Dietary Patterns, which comprise the core of the DGA recommendations about what to eat, is based on systematic reviews only through 2015, and indeed these 2015 reviews depend in part on science going back to 2010.”
- For example, the DGA ignored the results of at least 65 clinical trials on low carbohydrate diets, as identified by an advocacy group called the Low-carb Action Network. This is important, considering that there is increasingly mounting evidence that low-carbohydrate diets can be very helpful in treating and reversing Type 2 Diabetes.
- The DGA review on saturated fats “excludes the last 10 years of science.” In the last decade, many scientists around the world have been reassessing the data on saturated fats. There are now many systematic review papers that have concluded that ”caps on saturated fats are no longer warranted.” However, the new DGAs are expected to maintain their recommendation of capping saturated fats at 10% of calories. Considering that there is also mounting evidence that high-fat, ketogenic diets can help address many of the conditions that result from obesity, this seems to be a big miss.
What Should You Do?
Now that you know about some of the flaws in the processes used to define the Dietary Guidelines, be careful when you consider using them. In particular, if you are overweight or are suffering from weight-related chronic diseases such as diabetes, you should invest the time to get better informed and engage in discussion with your health care provider as to what might be the most adequate diet for you. As a way to get started, one of the top go-to experts on this topic is Dr. Jason Fung.