Alternative Fa(c)ts

I’ve been meaning to blog about this for a while now, but as always:  grad school.  However, today in my inbox appeared a call to sign a petition sponsored by the Nutrition Coalition to have federal dietary guidance based on sound scientific evidence.  Now, I’m all for that–assuming of course, we could agree on what we mean by “sound” and by “scientific” and by “evidence” in the area of nutrition and chronic disease relationships.

Much to my surprise, the first reform that is called for is “to let Americans know that the low-fat diet is no longer officially recommended.”  This part makes sense, although it’s kind of old news (see below).  The Dietary Guidelines for Americans (affectionately  known as the DGA) haven’t recommended a “low-fat” diet since 1995.

But the petition goes on to say that “the DGA have quietly dropped previous limits on total fat.”  So what’s my problem?

Walter Willett and Frank Hu say the limits on fat are gone.

Nina Teicholz says the limits on fat are gone.

Great minds think alike, right?  Those pesky limits must be gone.

Inconveniently, the folks at the USDA and HHS say this:

An upper limit on total fat intake was not removed from the DGA.

I am less concerned about whether or not the upper limits on fat are officially gone (they aren’t), and more interested in why parties as diverse in their perspectives on diet as the dudes at Harvard and the dudettes at Nutrition Coalition would both agree that they are (when they aren’t).  I mean we’re talking about folks who know more than a little about nutrition and policy, and they can’t seem to figure out what the DGA actually say.

Could it be that the USDA and HHS are attempting to rhetorically distance themselves from limits on fat without the policy implications that come with making that official?  They’re willing to date the “no more low fat” thinking, but don’t want to put a ring on it?

After all, whether or not you think people followed low-fat guidance, or didn’t follow low-fat guidance, or we can’t tell one way or the other because everybody lies about what they eat anyway, using the authority of the federal government to prescribe a single dietary pattern to everyone over the age of two in the hopes of reducing the risk of every single chronic disease known to mankind–including obesity, which wasn’t even a disease until we made it one–simply did not work out the way we thought it would.

I’m not arguing here about whether or not a low-fat diet is a problem (I suspect it is for a lot of folks and not so much for others), but it seems low-fat dietary guidance is.

The folks who write the DGA seem to have recognized this issue 17 years ago.  In 1995, the guidance on fat in the DGA said “Choose a diet low in fat,” and specifically, to limit total fat intake to 30% of calories.  But then this happened:

  • In 2000, the DGA said, “Choose a diet that is moderate in total fat.”  But. The limit on total fat intake remained exactly the same:  30% of calories.  So rhetorically, no more low-fat diet; materially, same old, same old.
  • In 2005, both the “low fat” and “moderate fat” language are avoided.  In the meantime, the total fat intake limit is, quietly, raised, to 35% of calories.  Maybe they thought if they shifted the limit on total fat without actually saying anything about it, no one would notice.  And, it seems, pretty much no one did.
  • In 2010, the range for fat intake remains the same as in 2005:  20-35% of calories.
  • In 2015, without changing the upper limit, the lower limit on fat intake is moved.  The new recommendation is fat intake should be between 25-35% of calories.

In other words, it does look like the DGA have slowly been modifying–without completely relinquishing–their call for Americans not to eat a lot of fat. At the same time, language in the DGA–and in my correspondence with the USDA/HHS–makes it sound like the fat limits aren’t their fault.  They are just following (reinforcing, supporting, and promoting as policy) the limits set by the National Academies.

Which may explain why it did take some persistence on my part to get this info from the government.  (If a PhD program has taught me nothing else, it has taught me persistence.)

In my first email, I asked what I thought was a pretty straightforward question:

In the 2015 DGA policy document, is there a recommended limit on the percentage of calories in the diet that should come from fat, and if so, what is it?

I got this response:

Thank you for your email. The 2015-2020 Dietary Guidelines for Americans recommends following a healthy eating pattern that accounts for all foods and beverages within an appropriate calorie level. Key Recommendations describe the components of a healthy eating pattern and highlight components to limit. Additionally, supporting text acknowledges that healthy eating patterns should be within the Acceptable Macronutrient Distribution Ranges (AMDRs) for protein, carbohydrates, and total fats. For example, page 35 of the PDF states that “healthy eating patterns can be flexible with respect to the intake of carbohydrate, protein, and fat within the context of the AMDR,” and Table A3-1, which outlines the Healthy U.S.-Style Eating Pattern, one example of a healthy eating pattern, states that “calories from protein, carbohydrate, and total fats should be within the AMDRs.”

In other words, wtf?

I tried again:

Thank you so much for your reply.  But I’m not sure it answers my question in that the information that you point to seems to have been interpreted different ways.

The heading for the table which references the AMDR in the DGA document says this:  “Daily Nutritional Goals for Age-Sex Groups Based on Dietary Reference Intakes and Dietary Guidelines Recommendations.”  Beneath that it indicates that, except for children under the age of three, total dietary fat should be limited to no more than 35% of calories.  This, to me, sounds like a limit on total fat calories as as part of the official policy document that is the DGA.

But, the parts of the text you reference that point to the AMDR seem to have been interpreted by others as the AMDR recommending one thing, while the DGA recommend something else.

Dr. Frank Hu has said about the 2015-2020 DGA that, “Another important positive change is the removal of an upper limit for total dietary fat …”  Dr. Walter Willett has said, “The 2016 Dietary Guidelines are improved in some important ways, especially the removal of the restriction on percentage of calories from total fat …”

So, to put it quite simply, have the upper limits on percentage of calories from total fat been removed? Would it be possible to get an official “yes” or “no” answer to that question? 

And this is what I got back:

Thank you for your email. The 2015-2020 DGAs recommends total fat intake within the AMDRs. As you know, the AMDRs are set by the Health and Medicine Division (formerly the Institute of Medicine), not through the Dietary Guidelines process.

An upper limit on total fat intake was not removed from the DGA.

The AMDR for total fats for adults is 20-35% of total kcal.

So, long story long:  Have the “official” upper limits on total fat intake been lifted?  No.

Do the officials in charge of the “official” limits want to come right out and say this?  Um, well, uh … hmmm … perhaps maybe not in so many words.

And every 5 years. There are. So. Many. More. Words.

Length of DGA & obesity rates

Speaking strictly in terms of association, we could say that the number of words in the Dietary Guidelines are directly and strongly related to increases in rates of obesity.

Maybe the problem isn’t the fat that is or is not in the diet.  Maybe the problem is the words about fat that are–or are not, depending on your version of reality–in the guidelines.

And if you’ve made it this far and are interested in still more words on nutrition and rhetoric, I’ve had the pleasure of getting to chat with a number of different folks about my studies and where they are taking me.  If you want to know what I’m reading, writing, and thinking about in that never-ending PhD program I’m in, here it is:

Diana Rogers at Sustainable Dish:  We do a deep dive into social and political history behind the Dietary Guidelines, the price of meat in the 1970s, and how Diet for a Small Planet is not a low-fat cookbook.  Tune in and you can hear me talk about the “dietary imaginary” and how we’ve lost the ability to think for ourselves about food.

Peter Defty at Optimal Fat Burning:  We chat about the Dietary Guidelines, calories, and changing body size norms.  Tune in and you can hear me talk about how a post-menopausal body can turn even the best diet into body fat and a bad attitude.

Laura and Kelsey at The Ancestral RDs:  We talk about ethical problems associated with the Dietary Guidelines and how a feisty little start-up in Canada is working to make them irrelevant.

Speaking of that feisty little start-up in Canada, Approach Analytics, here’s some more about them and their work to “democratize the nutrition knowledge-making process.”

Please join me at AHS 2017, where–surprise–I’ll just keep on talking!  I’m looking forward to discussing the ideas behind democratizing nutrition knowledge-making and more about how “n of 1” nutritional approaches, together with the power of population-based information, can sidestep an information-gathering system that serves to maintain the status of mainstream dietary guidance, but does little to help the public.

Finally, if you missed AHS 2016 and you haven’t heard me yammer on enough about the 2015 Dietary Guidelines, now’s your chance.  Pull this up on YouTube and you’ll get see me do a couple of different versions of happy dance.

 

Sugar and Spite: Mark Hegsted and the Great Sugar Conspiracy

Well. This is awkward.

A big scoop blows the cover on how, back in the 1960s, some gullible Harvard researchers were funded by the Evil Sugar Industry to make sure that fat (and not sugar) took the fall as the cause of all of America’s problems, including the cancellation of Lost in Space.

One of those aforementioned oh-so-easily-corrupted scientists was none  other than Mark Hegsted, the mastermind behind the McGovern’s Dietary Goals (okay, the mastermind behind the Machiavegiann, Nick Mottern, who actually wrote the 1977 Dietary Goals¹), and, as we all know by now, this set the whole nation down the path to mainlining sugar whilst shunning perfectly good food like pork ribs.

So the scene is this:  Mark Hegsted (and his co-authors, McGandy and Stare) are sitting around their labs at Harvard, minding their own beeswax, fillin’ up test tubes, and lookin’ through microscopes.  Y’know, doin’ science.  Along comes Evil Sugar, waving big fat stacks of green under their noses.  Suddenly, Hegsted and company are payola zombies, mindlessly extolling the virtues of sucrose.

sugar-zombie

Sigh.

One of the reasons I love my life is I get to teach a class called “Introduction to Science, Technology, and Society” to a bunch of bright-eyed, smart, and exceptionally polite undergraduates at North Carolina State University.  Last week we did an activity to help them get a feel for the ways in which science is a social process.  One of the things we talked about were “interests,” including funding,  but we also discussed the fact that “follow the money” is almost always an inadequate explanation for how and what knowledge gets created in science.  My students figured out pretty quickly that scientists have multiple interests, biases, concerns, and limitations–and that these all compete for a place in the process of transforming bits of reality into the “facts” that are the outcomes of scientific knowledge production.

“Evil Sugar Corrupts Scientists” is an attention-grabbing headline, but the historical picture is a bit muddier.

Inconvenient historical moment part 1:  Let’s start with the fact that in 1965, Hegsted, McGandy, and Stare (and a nutrition instructor named Myers) published a paper entitled, “Quantitative Effects of Dietary Fat on Serum Cholesterol in Man.”²  In this article, the researchers–who used fats and oils supplied by Proctor & Gamble and milk and ice cream supplied by the Hood Milk Company–developed something that would come to be known as the Hegsted equation, which predicts the relationship between fats in the diet and serum cholesterol.  That they tested these fats and oils by incorporating them into “waffles, muffins, cakes, cookies, pie crust, biscuits, salad dressings, and spreads for bread” was beside the point; their focus of concern was fats in the diet and serum cholesterol. [Let me briefly remind you that part of the rationale behind their experiment was to contradict the conclusion stated by Ancel Keys a decade earlier, that dietary cholesterol does not have an effect on serum cholesterol.]

So, in 1967, when this same group of researchers (minus Myers) publishes a review entitled, “Dietary Fats, Carbohydrates, and Atherosclerotic Vascular Disease,” we already know which macronutrient they think is the most important contributor to heart disease, and we already know that they are more concerned about serum cholesterol than any other biomarker.  My guess is that the Evil Sugar Industry knew this as well, and that’s why this group of researchers was asked to write a review.  Most of the review consists of summarizing studies where dietary carbohydrate is held constant while the type of carbohydrate–sucrose, glucose, starch, etc.–was varied.  It’s not a big surprise to me, and it shouldn’t be to you, that they found, in most cases, sugar didn’t have a much different impact on total cholesterol than starches or other sugars. In a few cases, sugar/sucrose is found to increase triglycerides–and they duly note this.  This is Rhetoric of Science 101:  Determined critics can poke holes in any experimental system or rationale; those same scientists can find sound reasons to justify their own methods and thinking.   They don’t (necessarily) need funding from an involved industry to be motivated to do this.

Hegsted and company’s unsurprising conclusion is this:

“The major evidence today suggests only one avenue by which diet may affect the development and progression of atherosclerosis.  This is by influencing the levels of serum lipids, especially serum cholesterol …”

This is also a conclusion which would render the Hegsted equation central to determining what constitutes a healthy diet. How ’bout that?

They go on to add that limited evidence demonstrates a “slightly significant role for the kind and amount of dietary carbohydrate” in the regulation of serum lipids, the effects of which are “more pronounced when diets low in fat are consumed.”   From their perspective, they don’t think dietary carbohydrate is worth talking about, except in the context of a low-fat diet. And, if you read their 1965 paper, you already know that Hegsted and co. think type of fat is more important than overall amount because that’s where they said, “Dietary advice to lower the total fat intake is likely to be self-defeating.”

They end with this:

“Since diets low in fat and high in sugar are rarely taken, we conclude that the practical significance of differences in dietary carbohydrate is minimal in comparison to those related to dietary fat and cholesterol” (emphasis mine).

From their perspective, a diet low in fat does not imply a diet high in sugar. The most commonly used sugars at that time were cane and beet–complicated politics kept prices fairly high–and corn syrup had not yet achieved widespread use.

sugar-usage-in-1875-1975

They could not envision a future where sugar (as high-fructose corn syrup) would be a cheap replacement for fat. They could envision a future where vegetable oils would be a cheap replacement for saturated fat;  this, in fact, was already beginning to occur in some sectors of the food industry.

veg-oil-use-from-1977-goals

Both figures above are from the 1977 Dietary Goals for Americans. Which brings us to …

Inconvenient historical moment part 2: Yes, Hegsted was the scientist who was the primary supporter of McGovern’s 1977 Goals.  That much is true.   So let’s chase that lead.  In the first edition of the 1977 Goals, Goal Number 5 said: “Reduce sugar consumption by about 40 percent to account for about 15 percent of total energy intake.”   This doesn’t sound like the work of someone in cahoots with Evil Sugar.

1st-ed-1977-goals

1st edition Dietary Goals, February 1977

But wait, there’s more!  In the second edition of the 1977 Dietary Goals (the one where Michael Pollan whines about the meat people bullying the committee into revising the “reduce meat” statement to say “reduce saturated fat”), the “decrease sugar” goal has been moved up to Goal Number 3 and says, “Reduce the consumption of refined and processed sugars by about 45 percent to account for about 10 percent of total energy intake.”

2nd edition Dietary Goals, December 1977

This was still on Hegsted’s watch.  How do we reconcile the increase in sugar restrictions with this (particular) conspiracy theory?

Aside from anachronistic analyses and inconsistencies that can’t be explained simply by pointing to a funding source, the current media spin on the Hegsted/Evil Sugar story suggests some pretty problematic assumptions:

  • Hegsted was completely neutral on the topic of fats and carbohydrates in the diet until sugar industry money came along.
  • Hegsted is a “dupe” and has no morals or backbone as a scientist.
  • The article would have (somehow) been different without sugar industry money.

My students know better.  I know this because all of the comments just above came from them when I asked them if they could think of any problems with the way the issue was being characterized in the media.  Folks feeding the media frenzy should know better too.

Blaming Big Food money for everything that is wrong with nutrition science and policy suggests it was all was just-fine-thank-you until Big Food came along and messed it up.

One of the problems with this view is that it encourages us to believe there is no such thing as ideological (or other) biases in science, just money.  So when Walter Willett calls research that contradicts his own “a pile of rubbish,” are we to assume that his belief that even the slightest bit of weight gain will cause you to die badly is the result of his being secretly funded by Jenny Craig?  After all, the “pile of rubbish” research (which suggests that maybe overweight and even obesity are not so horrible) was funded by the government.

And, in the current media framework, government funding is without bias, just ask the mustachioed man himself:

“Most contemporary researchers, including Willett, also acknowledge that publicly funded studies are preferable. ‘Ideally, all research would be publicly funded, so there would not be any conflict of interest,’ he says.”

Pointing the finger at Big Food money to explain away the problems in nutrition science and policy posits a particularly wild assumption:  government funding = no conflict of interest. But, as Marion Nestle’s favorite diversionary tactic, it does work to steer the conversation away from how the federal government funded plenty of its own reviews that emphasized fat and dismissed the involvement of sugar in the development of heart disease.  Nestle worked on one herself.³

Blaming the involvement of Big Food money for flaws in the scientific process is the same as blaming Big Food for obesity.  They are both simply indirect ways of blaming individuals for their bad behavior:  When Evil Sugar waved that bag of money under Hegsted’s nose, he didn’t have to take it, now did he?

Should anyone think I’ve gone off the deep end–I did just finish my written exams, so this is a distinct possibility–I’m not defending the sugar industry.  I am, however, defending the reputation of Mark Hegsted.

Why is it is that, on the one hand, we insist on characterizing nutrition science as unquestionably sound and definitive and nutrition scientists as inherently neutral and objective, and on the other hand, we assume that nutrition scientists will sell every bit of their scientific integrity to the highest bidder at the drop of a bundle of cash and create fishy science–which no one finds the least bit fishy until we hear about this transaction?

If we are willing to accept a more nuanced view, we might consider this:

Government is as “interested” in particular outcomes from science as is any corporation. They provide support for preferred views in terms of funding as well as other resources that corporations don’t necessarily have, such as public platforms, training, positions of authority, and access to important information or policymakers. Government funders back nutrition scientists who reliably produce results they like–but that’s a conversation Marion Nestle doesn’t want to have.

For their part, scientists are human and biased in ways that can’t always be accounted for–and that might be more powerful than funding.  Nutrition science, in particular, is full of a priori reasoning and lousy methodology propped up only by time and reputation–but that’s a conversation Walter Willett doesn’t want to have.

The field of nutrition science is massively overrun with weak associations, contradictory results, and experiments that incorporate preconceived notions about the relationships between food and health into the methods used to test those relationships.  Instead of positioning Hegsted and his fellow investigators as dupes of Evil Sugar who then pulled the strings that poisoned America, we might ask why Willett and Nestle want to make sure that problems in nutrition science and policy are framed by a narrative that excludes their part in them.

***********************************************************************

  1. Actually, according to Nick Mottern himself, he’s not a vegetarian.
  2. If you would like a copy of this article–or any other article I refer to in this post–for your personal use as a nutrition researcher, let me know.
  3. Hegsted’s work definitely influenced this document–in the form of the Hegsted equation which is reprinted therein.  His sugar review is nowhere to be found.

Will the real Dietary Guidelines please stand up?

I don’t say this very often (or ever).  I was wrong.  I think.

Here I’ve been laboring under the assumption that the 2015 Dietary Guidelines tell the American public to eat a diet lower in fat (because we eat “too much” of it now) and higher in carbohydrate (especially from whole grains like whole wheat–because we don’t eat “enough” of those now), to eat less salt, and to “eat as little dietary cholesterol as possible.” But according to a document recently released from a source at the Center for Nutrition Policy and Promotion (CNPP) that isn’t what the Guidelines say.  Or at least not exactly. Maybe.

The good folks at CNPP were asked to respond to Kris Gunnar’s list of  “20 Mainstream Nutrition Myths (Debunked by Science)”  with the idea being that the Guidelines are about as “mainstream” as nutrition advice gets.  The hope was that, if the good folks at CNPP could explain why their advice is ostensibly “backed by science” and yet is “debunked by science,” we would all sleep a little better at night, even if we still insisted on eating bacon and eggs in the morning.

The good folks at CNPP rose to the challenge and cleared things right up.  But, to quote the inimitable if soporific Crosby, Stills and Nash, “just beneath the surface of the mud, there’s more mud.  Surprise.”

Below, I’ve restated their responses as dietary guidance arranged in an order that I found amusing.  The number of the corresponding “Myth” from Kris Gunnars is given as well, so that those of you with split screens or dual monitors can play along at home.

According to the good folks at CNPP, the 2015 Dietary Guidelines for Americans:

  • do not recommend Americans eat a diet low in total fats or high in carbohydrates, particularly from grains. (Myth 1)
  • do not encourage eating low-fat foods. (Myth 12)
  • do not suggest avoiding saturated fat.(Myth 16)1
  • do not say saturated fat raises LDL cholesterol. (Myth 6)2
  • do not suggest Americans should avoid egg yolks, nor do they suggest that dietary cholesterol is linked to heart disease. (Myth 4)3
  • do not suggest eating red meat raises risk of disease. (Myth 13)4
  • do not say seed and vegetable oils lower cholesterol levels. (Myth 20)5
  • do not recommend the population restrict sodium intake (Myth 2)6
  • acknowledge there may be more to weight management and diet-related diseases than calories in-calories out. (Myth 15) 7
  • do not state sugar is harmful. (Myth 19)8

I know what you’re thinking.   Adele’s mind has finally blown a gasket from reading all those big words they have in grad school.  I’m not going to argue that point, but you can check the CNPP’s response for yourself right here.

This response also acknowledges that current scientific evidence regarding the reduction of full-fat dairy is contradictory (Myth 10) and that a variety of eating patterns can produce weight loss (Myth 8).  It also says that  3-5 cups of coffee a day can be part of a healthy diet (Myth 7)–hallafreakinlujah– but whole wheat products?  Meh (Myth 5).

I can see the helpful public health messages now:

You should not avoid egg yolks, but you should eat as little dietary cholesterol as possible, even though dietary cholesterol consumption is not linked to heart disease.

You don’t need to choose low-fat foods, just choose fat-free or low-fat milk, yogurt, and cheese even though it might not actually help you avoid chronic disease .

You should shift to lower sodium consumption without restricting your intake of sodium.

What’s going on here?

Good question.  Perhaps the good folks at CNPP didn’t actually read the Dietary Guidelines this time around.  Who, except for me, has that kind of time?  Or maybe they had a hard time finding them. Once you get to the health.gov/dietaryguidelines/ site, you have to click through 3 menus or links before you get to the actual guidelines (try it), which are a swarm of footnotes and “see more” hyperlinks.  Even Marion Nestle complained about how hard all those “annoying drop-down boxes” are to navigate.  It’s possible the good folks at CNPP just assumed that the other good folks over at DHHS–responsible for Guidelines online labyrinth–were paying attention so they didn’t have to.

Or maybe it means that it’s actually really hard to get words to say what you want them to say without them saying other things that you don’t want them to say.  And this is especially difficult when you are asked to make sweeping recommendations based on a weak scientific evidence base that both supports and contradicts past guidance, which you can’t contradict even when you can’t support it, because, then what?

No wonder the good folks at CNPP are having a hard time getting their story straight.

To tell the truth, I have a lot of sympathy for the message-makers there at the USDA.  We created the Dietary Guidelines 35 years ago assuming zero potential negative consequences.  True, the scientific evidence didn’t strongly support the recommendations, but whatever.  Whether they followed the recommendations or not, hey, the health trajectory of Americans couldn’t get any worse, could it?  We knew the Guidelines would significantly impact the food industry, but that could only be a good thing, right?  And we meant for Guidelines to set the direction for nutrition research, but since science is only about facts and never about politics or funding, any errors or biases in our original rationale would be quickly discovered and corrected, no?

Now it seems pretty clear that we might have spent a little more time thinking through the whole “Let’s make sweeping dietary recommendations that are meant to apply to every single American alive over the age of 2 as a method of preventing every single major chronic disease known to humankind “ thing before shrugging our shoulders and saying “Oh, no worries.  It will all work out.”  Now the folks at the USDA have used up their wishes and are left trying to stuff the genie back in the bottle with nothing but semantics and poor website design.

Will the real Dietary Guidelines please stand up?

If only they had a leg to stand on.

***************************************************************************

 

 

1.  They just want you to reduce your intake of saturated fat without actually avoiding it.

2. They do recommend limiting saturated fats based on the notion that somehow this will reduce risk of heart disease. But let’s leave LDL cholesterol levels out of this. What did they ever do to you?

3.  But Americans still should eat as little dietary cholesterol as possible, just fyi.

4.  Eating red meat does not raise risk of disease, but not eating red meat lowers it. Um.  Weird, right?

5.  But you should eat vegetable oils instead of animal fats, because, well, because.

6. They do want you to shift to lower sodium consumption, just not by restricting your intake.

7.  Although they remain singularly obsessed with calories in and out, there’s apparently no need for you to be.

8.  But you shouldn’t eat very much of it anyway, because, well, because.

Walter Willett and the Terrible, Horrible, No Good, Very Bad Data

One of the major problems in nutritional epidemiology is that we have a hard time measuring things that we are supposed to be measuring in order to say anything meaningful about relationships between diet and chronic disease. You know, things like how much people are actually eating or how much physical activity they really do get.

Today I had the opportunity to hear Walter Willett, king daddy of the field of nutritional epidemiology, speak on just this dilemma (and yes, he still has that sweet ‘stache).  Introduced as having received “too many awards to mention,” W began his talk–“Energy Balance and Beyond:  The Power and Limits of Dietary Data”–by addressing the recent unpleasantness raised by  researchers who have suggested that the dietary data that we collect simply isn’t worth analyzing (Archer, Pavela, & Lavie 2015; Dhurandhar et al. 2015).

Having been recently immersed in my rhetoric of science readings, I noted that W started right off with some perfunctory boundary work, as way of indicating who was “in” and who was “out” when it came to credibility:  He noted that the investigators questioning the value of dietary self-reports are “funded by Coca-cola,” and even the ones that are “pretty good scientists” are “not epidemiologists” and therefore “a little bit naive.”  So much for evaluating the data and the arguments on their own merits.

Then he trotted out the “slippery slope” argument:  If we throw out self-reported dietary data because it is wildly inaccurate, then not only do we have to “throw out the Dietary Guidelines” (heaven forfend!), but we’d have to throw out occupational safety and drug trial data also–because these are often based on self-reports.  Certainly, there’s very little difference between reporting on events in your workplace or what side effects you might have in response to a pill you’re taking and reporting on what you remember eating over the course of the past year.

Then he got down to the nitty-gritty.  The reason your Average American is fat is, to put it bluntly, because of math:

2500 kcals/day x 1% = 25 kcals/day

25 kcals/day x 365 days/year = 9125 kcals/year

9125 kcals/year  = about 1kg of weight gain/year

Of course, the Average American only gains (on average) about 0.5 kg/year, but  W easily explained the discrepancy:  We gain weight, but then we have to expend more energy dragging our fat asses around–my words, not his–so we don’t gain as much weight as we would, but then the increased energy expenditure makes us hungry, so we eat more, so we gain weight, ad infinitum, only not, because we seem to plateau, but then, well, there’s that.

So here’s the $64,000 (or really a few hundred million in grant money) question:  How good are we at measuring the 1% (or less) difference between “energy in” and “energy out” that we see expressed as weight gain in the population?

The answer, according to the man himself?  Not very.

W then showed a comparison of a set of methods to measure “energy in,” along with their coefficient of variation (you can get the technical explanation here, but it is–simplistically–a measure of the amount of variability in your data; long story short:  larger numbers = more variability, less precision and smaller numbers = less variability, more precision).

It looked something like this:

Method Co-efficient of variation
Food frequency questionaire (FFQ) 15%
Diet record 13%
24-hour diet recall interview 28%
Doubly-labeled water (DLW) 9%
Weight 3%

What W made clear is that, if you want to know whether–or to what extent–Americans are indeed eating more and moving less, you can’t measure “energy in” using FFQs, diet records, and interviews and expect to get anywhere near that “1% of calories” accuracy you’re looking for.  You can’t even rely on doubly-labeled water, typically considered to be a biomarker measurement with a high degree of precision.  In fact, W made the point that DLW samples sent out to different labs would come back with results that differed by up to 50%.

W went on to explain that we have similar difficulties measuring “energy out,” with our very best measurements having a coefficient of variation of nearly 20%.

So in other words, or actually in W’s exact words:

“Weight is the best measure of energy balance.”

Wait? Weight?

As far as I can figure it, using weight as a way of “measuring” (and I use that term loosely) energy balance creates a theoretical–if not a methodological–situation that is, in a word, unfalsifiable. Or–in another word–bogus.

“Weight gain results when the things that we think cause weight gain happen, thus proving that those things have happened.” 

At least one of the reasons for attempting to measure “energy in” and “energy out” is to find out whether or not it makes sense to attribute weight gain (or loss) to the differences between them. Instead, W is saying, we can know all we really need to know about how much people eat or move or both, because, voila, weight.

This is like saying, even though traces of tooth fairy fingerprints, footprints, or fiber samples are extremely difficult to obtain, we can reliably determine the existence of tooth fairies by the presence of quarters under your pillow.

Not only does this completely disregard the ever-growing list of things that may also contribute to weight gain/loss over time,* but it contradicts W’s own assertion just moments later that–even though we can’t do it very accurately–a good reason for attempting to measure total energy intake is that it can act as a “crude measure of physical activity.”

One the one hand, W is saying we can estimate how active you are by finding out how much you eat because people who eat more are also likely to be more active–that’s why they eat more–and people who eat less are typically less active–that’s why they don’t eat as much–with the implication being that “energy in” and “energy out” are positively related; as one changes, the other changes in the same direction.

On the other hand, he’s saying these two variables are completely independent of each other. Eating more doesn’t imply you move more; moving less doesn’t imply you eat less. And the way we know that these two variables are disconnected in any given Average American is, voila again, weight.

At this point, it was hard not to be completely distracted by the cognitive dissonance ringing through the room.

I did hang on long enough to hear W say that we shouldn’t really be worried about energy intake anyway because what really matters is diet quality, which, by the way, we can’t measure accurately either.

With all due respect, all I could think of is that while Emperor W may not be completely without clothes, he was definitely down to boxer shorts today.

emperor needs clothesIn an auditorium full of really smart people, I cannot have been the only person thinking that W and his data looked a little over-exposed. But–as we saw with the circumstances revealed by the Ramsden and Zamora paper last week–it can be hard to contradict a famous colleague, and in nutritional epidemiology, no one is famouser than W. It may be even harder, I suppose, when he is an invited guest and an apparently nice fellow. The Q&A was respectful and polite. Difficult as it is to believe, even I kept my mouth shut.

I know science sometimes advances one funeral at a time, and I truly wish W a long and happy life. But maybe he’ll start to get a little chilly there in his boxers and start thinking about retiring someplace warm. Soon.

************************************************************************

*Genetic factors

Epigenetic factors

Gut microbiome

Environmental toxins

Medications/drug use

Hormonal status

Lifestage

Health status

Infection

Inflammation

Sleep patterns

Stress levels

Non-exercise  activity levels

Smoking status/history

Alcohol consumption

Other unknown factors

Put away the tinfoil hats–but, still, WTF?

I’m not a conspiracy theorist.  Really. But as I wade through the thicket of science studies and rhetoric of science readings I have on my desk, I am more and more impressed with the power of paradigmatic thinking to distort how scientific knowledge is produced and disseminated.

Daisy Zamora and company have once again climbed in their wayback machine to reanalyze data from the Minnesota Coronary Survey, which began in 1968.  The vegetable oil intervention reduced saturated fat intake by about half and cholesterol consumption by about two-thirds, while nearly tripling the intake of polyunsaturated fat. Surprise, surprise–they found that although the vegetable oil intervention reduced cholesterol levels, the intervention also led to more heart attacks and increased risk of death. [The press release on the study is here; the study itself is here.]

Let me just add that the original study outcomes–which did not support the diet-heart hypothesis even then–were not published until many years after the study ended, in fact, after its primary investigator retired.

So, we’ve seen something like this with a red-meat-causes-cancer publication, a low-carb-more-calories-more-weight-loss one, and one of Zamora’s earlier studies, which she had to move mountains to get published.

Zamora and her team’s previous trip in the wayback machine turned up some interesting findings then too, which suggested that vegetable oils, far from being the “healthy” alternative to butter, might actually be contributing to increased risk of death from heart disease.

Zamora and her co-investigators politely refer to these sort of anomalies as “incomplete publication,” as in:

“… incomplete publication of important data has
contributed to the overestimation of benefits – and the underestimation of potential risks – of replacing
saturated fat with vegetable oils rich in linoleic acid.”

All I want to say, before going back and burying my head once again in my books, is that

1) Daisy Zamora and Christopher Ramsden are rockstars, and

2) “incomplete publication” of results from diet-heart trials is part of the reason that the folks at the USDA and DHHS have published guidelines where “oils” get to have their own category.

They aren’t trying to kill us on purpose.  Really.

***********************************************************************

Update:  You know you’ve increased the amount of sunshine in the world when your work gets Walter Willett to offer up yet another snotty comment (see here for previous peevishness) about any research that doesn’t align with his: “Walter Willett, the chairman of the nutrition department at the Harvard T.H. Chan School of Public Health, called the research ‘irrelevant to current dietary recommendations’ that emphasize replacing saturated fat with polyunsaturated fat.”

He’s right of course. Any science that doesn’t uphold the orthodoxy really is irrelevant to current dietary recommendations.

Keeping it Simply Stupid: Marion Nestle’s “Rogue Guidelines”

One of the things I do to irritate myself into a state of incoherence is read the comments section on interwebz articles that propose to address our national concerns about food and health. A constantly recurring theme about eating a “healthy diet”–100% guaranteed to appear in any comment section–is “It’s so simple. Just [do this thing].”*

I blame the Dietary Guidelines (but then I blame the Dietary Guidelines for everything–when my car won’t start, it’s those damn  Guidelines again).  They began the long proud tradition of over-simplifying nutrition guidance to the point of uselessness, a tradition that Michael Pollan, and now Marion Nestle, has taken to new levels of banality. This oversimplification not only displays an unholy disregard for any sort of cultural, economic, or metabolic differences between humans, but–when you get down to the details (the main ingredients of which are always devilish)–it “simply” doesn’t say much of anything.

Marion Nestle and Tamar Haspel wrote a whole long article about the “6 easy steps” to eating better, reproduced in the boxes below.  Ranting in regular type?  That’s me.

Go through the fine print of the omnibus spending bill just passed by Congress, and you’ll see that the 2015 Dietary Guidelines, scheduled for release in — you guessed it — 2015, have been pushed out to 2016. You wouldn’t think that the government’s efforts, every five years, to help Americans eat more healthfully would turn into a political football. But when its appointed scientists reviewed the literature on meat and health, for example, they did something quite radical. They said what they meant with no equivocations: Americans should eat less meat.

In order to keep things simple, it’s best if you ignore any historical facts that might add nuance–or reality–to your story.  Like the fact that this 38-year-old “radical” idea to “eat less meat” arrived in the first edition of the 1977 Dietary Goals.  Yes, this statement was changed in the 2nd edition of the 1977 Goals, but not–as Marion Nestle and Michael Pollan would have it–due to the fact that Evil Meat ran roughshod over the science. Of course the meat folks were upset; this call to “eat less meat” had about as much science behind it as similar suggestions at the time that vegetable oil could cause health problems, which is to say, not enough to justify public health policy. Yet, due to reasons more social, political, and economic than scientific, the prohibitions about meat are still with us, while concerns about vegetable oil have faded out of mainstream nutrition

Numerous physicians and scientists represented in the 1977 Dietary Goals for the United States: Supplemental Views, point out that (as McGovern himself and one of his primary supporters, Dr. Mark Hegsted, admit) the case against meat had never been proven. They go on to argue that suggesting that Americans remove/reduce an important source of nutrition in their diet (meat) may have unforeseen negative consequences. Norton Spritz (NYU School of Medicine) states: “… there are serious nutritional problems that affect many Americans that are clearly related to dietary inadequacies particularly of high quality protein …” George M. Briggs (Professor of Nutrition at UC-Berkeley) states: “There is good evidence that those who consume meat at the average level or more have as good health records and freedom from chronic disease as those who do not.”

The switch in language in the 2nd edition of the 1977 Goals to decreasing “saturated fat” intake rather than “meat” in general was not because there was more conclusive science to support that approach, but because it was politically more tenable.  Meat producers could try to–and did–breed animals with a reduced amount of the ostensible evil food component, saturated fat, in their product. But saturated fat wasn’t really the problem now, was it?

F.A. Kummerow (Director, The Burnsides Research Laboratory, University of Illinois, Urbana-Champaign) points out: “Your data indicates that animal fat consumption has decreased 24 pounds and vegetable fat consumption has increased 34 pounds/capita from 1940 to 1974. Yet, coronary disease has increased during a time period that this change took place. Why blame animal fats?” (See Nina Teicholz’s neato graph for a visual of the trend.) Well, because they come from animals, and there are all sorts of social and cultural reasons that some people are opposed to eating animals, that’s why. Why these people got to make the rules for the rest of us is a story for a different day.

Scientists voiced a number of valid concerns about the wisdom of telling Americans to eat less meat in 1977, many of which are still valid today:  over 40% of Americans, mostly females,  have inadequate protein intake.  But that complicates the narrative, doesn’t it?

As if that were not radical enough — previous committees had pussyfooted with such euphemisms as “choose lean meats to reduce saturated fat” — this committee insisted on an additional reason beyond health: environmental considerations.

 The result? Uproar.

Why have an uproar about a group of nutrition scientists (for the rigors of nutrition science, see below) making declarations about environmental issues? Perhaps next year, we can have the EPA make dietary recommendations.

Arguments like the ones over the Dietary Guidelines, fueled by lobbyists, politicians and agenda-driven groups, make diet advice seem maddeningly inconsistent, but the fundamentals haven’t changed much at all.

Sigh.  “Fundamentals”? Really?  Which fundamentals would you be talking about now?  The “fundamentals” of 1955 when more than half of our calories came from meat, eggs, milk, cream, fats and oils? Oh, and adult diabetes was virtually unheard of.

eat like your grandmother

 

It’s time to take back the process, so we’re going rogue and issuing our own Dietary Guidelines, untainted by industry lobbying, unrestricted by partisan politics. Here, in six easy steps, is our advice for the new year: what we think dietary guidelines ought to say.

Really?  Untainted by industry lobbying? Because wheat and vegetable oil interests never lobby–only Evil Meat.  That’s why the bottom of Marion Nestle’s beloved Food Pyramid ended up being ALL MEAT. Wait?  No?  Nevermind.

1. Eat more plants. You heard it from your grandmother. You heard it from Michael Pollan. Now you hear it from us: Eat your vegetables. Add fruits, beans and whole grains, and the wide-ranging plant category should make up most of your diet. Variety is the key. Plants offer us such an astonishing range of roots, stems, leaves, flowers, buds and seeds that there is bound to be something even the most jaded vegetable skeptic can love.

It’s just so simple.  Eat more plants. The biggest increase in calories during the rise in obesity and diabetes in America came from flour, cereal, and vegetable oils.  That’s right.  Plants.

Food supply changes calories

As for your grandmother (or great-grandmother), she ate at least 10% of her calories from vegetables and fruit, and so should you (see above).

2.  Don’t eat more calories than you need. Although on any given day it’s hard to tell whether you’re doing that, over the long term, your scale is a sure-fire indicator. If the pounds are going up, eat less.

It’s just so simple.  Don’t eat more calories than you need, whatever that means.  You can’t really tell when you’ve overeaten–until after the fact–at which point you should eat less.  If you’re hungry when you “eat less,” tough luck.  Suck it up, you wuss, you’ve already had more calories than you “need.”

Let’s pause here for the good news. If you follow our first two guidelines, you can stop worrying. Everything else is fine-tuning, and you have plenty of leeway.

That was the “good news”?

3. Eat less junk. “And what’s junk?” we hear you asking. We have faith that you know exactly what junk is. It’s foods with lots of calories, plenty of sugar and salt, and not nearly enough nutritional value. It’s soda and sugary drinks. It’s highly processed, packaged foods designed to be irresistible. It’s fast food. You know it when you see it. When you do, don’t eat too much of it.

It’s just so simple.  Eat less “junk.”  And since we know that it’s really mostly minorities and poor people who eat all the “junk” food, we should start by eliminating all the  poor people by giving them more money so they don’t go around being poor.  After that we should encourage a massive influx of people of color into the U.S. so minorities won’t be minorities anymore and will therefore stop eating junk food.  Problem solved.

4.  Eat a variety of foods you enjoy. There is research on the health implications of just about any food you can think of. Some — such as fish — may be good for you. You should eat others — such as meat and refined grains — in smaller amounts. The evidence for most foods is so inconsistent that you should never force yourself to eat them if you don’t want to, or deny yourself if you do. If you love junk foods, you get to eat them, too (in moderation, of course). You have bought yourself that wiggle room by making sure the bulk of your diet is plants and by not eating more than you need.

It’s just so simple.  And by plants you mean flour, cereal, and vegetable oil, right?  And by “not eating more than you need” you mean, well, you don’t know what you mean and neither do we.

This is an appropriate place to talk about a phrase that has been thrown around a lot in the Dietary Guidelines brouhaha: “science-based.”

As a journalist (Tamar) and a scientist (Marion), we’re very much in favor of science. But in this situation, the food industry’s frequent calls for “science-based” guidelines really mean, “We don’t like what you said.”

So, let me see if I understand this?  When the food industry calls for “science-based” guidelines, that’s a bad thing?  But if a bunch of (mostly) scientists call for “science-based” guidelines** that’s a good thing? This is getting a little confusing.

Arriving at truths about human nutrition isn’t easy.

But wait, you said these are “6 easy steps”?  Ooooooh.  Light bulb moment.  You’re not actually planning on telling us any “truths about human nutrition,” are you?  Ah, this is all beginning to make sense.

We can’t keep research subjects captive and feed them controlled diets for the decades it takes many health problems to play out. Nor can we feed them something until it kills them. We have to rely on animal research, short-term trials and population data, all of which have serious limitations and require interpretation — and intelligent people can come to quite different opinions about what those studies mean.

Which is why “eat some if you like it” isn’t a wishy-washy cop-out. It acknowledges science’s limitations. We do know that plants are good, and we do know that junk foods aren’t, but in between is an awful lot of uncertainty. So, eat more plants, eat less junk, and eat that in-between stuff moderately. That is exactly the advice science demands.

“We do know that plants are good.”  Which plants are you talking about? Corn, wheat, soy = plants, right?  And how do we know these plants (whichever plants you mean) are “good”?  Surely not through the vagaries of nutrition science, with all of its “serious limitations.”  You’ve just made the case that nutrition science is a poorly disciplined loudmouth whose “demands” we might very well ignore.  Oh wait. Right.  This is the part about not exactly telling us any “truths about human nutrition.”

What we eat and how we eat go hand in hand. We’ve all been there, sitting in front of a screen and finding that, all of a sudden, that bag, box or sleeve of something crunchy and tasty is all gone.

We’re so focused on what to eat that how to eat gets short shrift. So: 

5.  Find the joy in food. Eat mindfully and convivially. One of life’s great gifts is the need to eat, so don’t squander it with mindless, joyless consumption. Try to find pleasure in every meal, and share it with friends, relatives, even strangers.

Just remember that your mindful, joyful consumption should be Mostly Plants.  Thank goodness flour, cereal, and vegetable oils are Mostly Plants, so that I may mindfully and joyfully eat those Strawberry PopTarts.  It’s just so simple.

Poptarts are Mostly Plants

 

Learn to cook. The better you cook, the better you eat. There are days when cooking feels like a chore, but there are also days when you find profound satisfaction in feeding wholesome homemade food to people you love.

“Learn to cook.”  It’s just so simple.

  1. First, use your copious spare time to chillax with some Ina Garten YouTube videos.
  2. Once you “know” how to cook, assemble some easy-to-prepare menu ideas that will meld seamlessly with your work schedule, your workout schedule, your partner’s work schedule, your partner’s workout schedule, and your kids’ soccer/ trombone/tap dancing schedule.  Or maybe your two-jobs and day-care and public transportation schedule. Or any variation on the above in your oh-so-simple life.
  3. Then go shopping and buy all the stuff you need (this step requires money, just FYI). Don’t forget to take your reusable hippie bags.
  4. Carry all the stuff home in the back of your Prius, or on the bus, or if the scale is telling you that you’ve had more calories than you “need,” you can just hoof it home, fatso.
  5. Put all of your groceries away. Try to find a place where the food won’t spoil, and your kids/partner/roommate won’t eat it before it becomes dinner. Recycle your plastic bags since your forgot to use your hippie ones.
  6. At the appointed hour, begin. Chop. Stir. Sauté. All the things.
  7. Call those “people you love” to the table.
  8. Search your soul for that “profound satisfaction” you’ve been promised when the “people you love” use this opportunity to gripe about flavor, color, consistency, and smell of the lovingly prepared food that sucked up hours of your life, which they then proceed to snarf down in 7 minutes flat before bolting from the table in order to escape your nonstop bitching about what a thankless task cooking is.

[Snarky aside:  This advice about cooking?  It just applies to poor slobs like you and me.  As for Marion Nestle herself, she’d prefer not to:  “I eat out a lot and don’t cook much for myself.” ]

And foods you make at home are worlds apart from foods that manufacturers make in factories. No home kitchen ever turned out a Lunchable.

In her “home kitchen,” my mom used to make us bologna and processed cheese food sandwiches on Wonder Bread.  As a special treat, she would sometimes leave the red plastic strip on the bologna.  Extra fiber.  But, most assuredly, not a Lunchable.

If you go out in the world armed only with these guidelines, you’ll do great. Sure, there’s much more to know, if you want to know it. We’ve forged careers writing about food and nutrition, and either one of us could talk micronutrients until your eyes glaze over. But these few basics are all you need to make good food decisions. Choose foods you like — heavy on the plants, light on the junk — cook them and enjoy them.

 It really is that simple.

Simple. Simply useless.  And not exactly “rogue” either.  The 2010 Dietary Guidelines include some form of every single one of these “rogue” guidelines–including the directive to cook and eat at home, preferably with your family, whether you like them or not–even if the 2015 ones don’t.

The only truly “rogue” statement Haspel and Nestle make is in the headline, and it is one with which I concur:

Forget government guidelines.

Simple.

*******************************************************************************

*Nowadays, when I see an online nutrition article with a comment section, I get out my FATSO card & see how many comments it takes for me to score a FATSO.  FATSO is like BINGO, only renamed in honor of America’s moral panic over body size.

**But not too science-based. According to the two letters sponsored by Center for Science in the Public Interest (motto: “Transfattingforming the American diet”), the members of the Dietary Guidelines Advisory Committee and a number of other nutrition-related organizations both opposed the notion that “Any new recommendations or changes to the 2010 Guidelines must be based on conclusions rated “Grade 1: Strong” by the Nutrition Evidence Library (NEL) rubric.”  In other words, the scientists–not the food industry–would like to have Guidelines based on weak conclusions from a scientific field whose methodology is already pretty weak.  Nice one, scientists.

The slick “new” Dietary Guidelines

Because never changing the recommendations means never having to say you’re sorry for 35 years of crappy advice, the 2015 (really 2016, but who’s counting?) Dietary Guidelines repeat the same old-same old “whole grains, fruitsandvegetables, low-fat/fat-free dairy, fish, nuts, and (if you must) lean meat” guidance from years past. Only difference: The new Guidelines are now oozing with vegetable oil.

In the list of recommended foods to include in “a healthy eating pattern,” “oils” now have their own category.
Oil its own food group
For the most part, we are talking Big Oil: canola, corn, peanut, safflower, soybean, and sunflower. Oils that have been chemically extracted, de-gummed, bleached, and deodorized (y’know, stuff you do to dirty diapers). And good luck finding them at your local farmers market.

Big Oil is big business for the U.S. agricultural economy and for the nutrition science academic industry. Alice Lichtenstein, of the 2015 Dietary Guidelines Advisory Committee, has found more creative ways to feed all kinds of oil to hamsters, rats, and people than probably anybody on earth. Corn, canola, soybean, safflower, sunflower, margarine and shortening, even rice bran oil–you name the oily food substance and Alice Slicktenstein has built her career on getting funding for studying it. Most of her work is done at–and funded through–the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts, which is supported by money from, you guessed it, the USDA.  Her research is also supported by numerous grants from the NIH branch of HHS. However, this has nothing to do with the shiny new prominence of oily stuff in the USDA’s and HHS’s new Dietary Guidelines.

To be sure, oil oil everywhere is not the only thing slick about the new Guidelines. The language is pretty slippery too. There’s been a lot of cheering from the press about the “new” direction of the Guidelines, and indeed, some of the things being reported are actually in the Guidelines: The Guidelines have gotten rid of the ridiculous (and possibly dangerous) “1/2 teaspoon of salt a day” limits on sodium for some subpopulations–although the no-more-than 2300 mg (yes, a Whole Teaspoon!) limit should still be–wait for it–taken with a grain of salt.

Despite all arguments otherwise, nutrition–the politics and the science of it–is complicated. In a number of cases, trying to make the ugly stepsister foot of a “consistent public health message” squeeze into the glass slipper of inadequate and contradictory science has the Guidelines talking out of both sides of its oleaginous mouth. Here’s a closer look at what is going on:

1. Limits on cholesterol are gone.
Eh. Sorta kinda not really. It would appropriate to say “numerical” limits on cholesterol are gone, but the language of the DGA is still pretty limiting. As in:

“individuals should eat as little dietary cholesterol as possible”

What’s fun about this is that the Vegamanics are celebrating this as “cholesterol still sucks” while the SatFat Redeemers are all about “Eat them eggs, y’all.” They’re both right.  Or wrong.  Hey, this is nutrition! You don’t really expect a straight answer now, do you?

2. Red meat gets a pass.

It’s true that [lean] meat has not disappeared altogether, and that language about a “sustainable diet” (whatever that means) is not in the Guidelines. At the same time, the Guidelines recommend “lower intakes of meats, including processed meats,” lumping them in the same category as sugar-sweetened food and refined grains. So like the cholesterol issue above, this is getting played as “Evil meat lobby wins” on one side of the debate, and “Meat justice prevails” on the other.

The meat industry is happy to proclaim its support the Guidelines–as long as its product is still in them. If I were the meat folks though, I’d be working to shut the whole process down. If meat is still in the Guidelines, it is not for lack of 35 years of trying to get it out.

3. Limits on fat are gone.
Nope. Limits on “fat” are still there. If you’ve been hearing rumors that we are at the end of the “low-fat” era, and you thought that meant that the Guidelines were going to give the green light to fats–natural fats, fats that you could find at your local farmers market–you would be sadly, profoundly mistaken.

Just like all squares are rectangles, but only some rectangles are squares, all oils are fats, but only some fats are oils. The new Guidelines have been credited with saying, “Hey we’re okay with rectangles” but they are only okay with those rectangles that are squares.  You can eat fat, but only if it’s oil.

Evil fats

So: Fat–as in “saturated fat”– is still evil. But lower limits on “oil” are eased–with the exception of a few oils that the DGA folks still don’t like because their fatty acids are mostly saturated. Lower limits on oils in the diet have shifted from no less than 20% of calories to no less than 25%. But make no mistake: The upper limit on dietary “oil” as a macronutrient remains at 35% of calories, as it has been since 2005. Only by keeping limits on “oil” low can we manage to cram in the Guidelines’ requisite 45%-65% of calories of carbohydrate into our diets and still have room for protein.

In other words, the USDA hasn’t discarded the “low-fat” diet. They’ve discarded the “low oil” diet and actually, not even that. Now you are allowed a whopping 27 grams (about 5 teaspoons) of highly processed and refined, probably not local or within your foodshed, oily oil. Cheers!crisco oil
4. The DGA limits sugar intake.
Nope. It limits “added sugar” intake. That means that a bottle of orange juice, which “naturally” has as much sugar as a bottle of soda, is “good,” while soda is “bad.” Yeah yeah yeah. I hear you out there: “But but but. Orange juice has Vitamin C.” So add some Vitamin C to soda–same difference. Puh-leeze. Sugar is sugar. (I’ll save my “starch is sugar too” rant for another day.)

And all this talk about how Americans “typically exceed” recommendations for added sugar intake? Go look through the past 35 years of Dietary Guidelines. This is the first time ever that there has been an official numerical limit on sugar in any form–added or otherwise. I’m not sure how we could “exceed” something that wasn’t defined in the first place. However, the “Americans don’t follow the Guidelines” story is the best way to avoid confronting the fact that the Guidelines have not worked as intended. USDA/HHS can pretend that all would have been well if those fat stupid Americans had just done the stuff they were (actually not) told to do! Secretary Burwell suggested at the hearings in October that without the Guidelines the rapid rise in obesity rates might have been even rapider …

“We are on the wrong trajectory, but would the trajectory have been worse?”

… though it is hard to see how.  Fat lazy Americans can only cram so many Double Whoppers with Cheese down their gullets at a time, and besides Netflix wasn’t even invented until, like, 1997.

For a bit of perspective, although the 10% cap on “added sugars” is being hailed as some nutrition revolution, the USDA says Americans typically consume 13% of their calories from “added sugars” now. The radical new cap on “added sugars” heralds a (potential) whopping 3% decline in their consumption.  To be replaced by “naturally occurring sugars”? Or possibly more artificial sweeteners? Maybe, beer?

One thing is true about the Guidelines, though. Pretty much everyone hates them. Doesn’t matter where on the nutrition dogma spectrum you look–Marion Nestle or Nina Teicholz–everyone’s complaining.

I don’t like them either, but for reasons I don’t hear about in the press:

“All segments of society—individuals, families, communities, businesses and industries, organizations, governments, and others—can and should “align with the Dietary Guidelines.”

What this means:  The Guidelines have not worked as intended in the past and haven’t changed significantly in this edition, but this isn’t because the whole idea of having a single dietary prescription that will reduce risk of virtually every chronic disease in all Americans no matter their race, gender, age, genetics, lifestyle, etc. etc. etc. is patently ludicrous.  The Guidelines haven’t worked because we haven’t “aligned with” them.

As some snarky person once said, this is all about enforcing your right to eat what the folks behind the Guidelines have determined is good for you. 

“Aligning with the Dietary Guidelines by taking these actions is powerful because it can help change social norms and values and ultimately support a new prevention and healthy lifestyle paradigm that will benefit the U.S. population today as well as future generations.”

What this means:  Making certain behaviors the “norm” through public health dictum is a tried-and-true way for privileged classes to impose their values on the less-privileged.  “Aligning with” the Guidelines will help make eating (and exercising) like rich white people the morally superior choice for everyone.

To paraphrase how one brainless “expert” on public consumption put it many years ago, “Let them eat kale!”

For the rest of us, well, Marion Nestle is right when she says that the Guidelines are a “win” for the processed food industries.  She should know.  She was managing editor of the 1988 Surgeon General’s  Report on Nutrition and Health, which said that processed food created to fit the prevailing definition of “healthy” is exactly what the public needs:

“Food manufacturers can contribute to improving the availability of palatable, easily prepared food products that will help people to follow the [low-fat, high-carbohydrate] dietary principles outlined here.”

The 2015-20120 Dietary Guidelines continue this line of reasoning:

“During the past few decades, food products and menus have notably evolved in response to consumer demands and public health concerns. The food and beverage and food service sectors and settings have a unique opportunity to continue to evolve and better align with the Dietary Guidelines.”

Which means that there is one group that always LUVS the Dietary Guidelines. As Food Navigator-USA puts it:

“The 2015 Guidelines released Jan. 7 create a marketing opportunity for savvy manufacturers and industry stakeholders to promote their products through educational materials that help consumers better understand how to meet the report’s recommendations.”

The Dietary Guidelines have been helping sell “healthy food” to consumers since 1980, just as “healthy food” manufacturers have been helping sell the Guidelines to consumers.  But “healthy food” doesn’t always lead to “healthy people.”  Moronically enough, the new Guidelines recognize that calls for “healthy processed food” might end badly (flashback to CSPI campaigning to add trans fats to food):

“In [developing and reformulating “healthy” products], care should be taken to assess any potential unintended consequences so that as changes are made to better align with the Dietary Guidelines, undesirable changes are not introduced.”

That means when the onslaught of oily, whole-grain, artificially sweetened and flavored food products fails to improve the health of Americans or (heaven forfend!) makes things worse, we know who to blame.

We can blame the American public for not following the Guidelines.  We can blame policymakers for not enforcing them.  And we can blame food manufacturers for introducing “undesirable changes” into the food supply.  But we can’t blame the Guidelines.

They’re too slick for that.

***********************************************************************************

PS.  I do plan on continuing the conversation started by Jennifer Calihan’s guest post “Low Fat, High Maintenance:  How money buys lean and healthy–plus an alternative path to both.”  If you haven’t read it already, you should (and the comments–good stuff there too). But, I just gotta get a couple of Dietary Guidelines rants out of my system.