6 Reasons The U.S Dietary Guidelines For America Should Be Overhauled

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A lot has changed over the years. Everyone seems to have their own ideas about what you should and shouldn’t eat. We seem to have this amazing ability to put ourselves in a state of avoidance and denial about poor food choices.

For this reason, the government saw the need to have universal dietary guidelines for the public health of the nation and to provide the most up to date science about nutrition. Some of the recommendations can be beneficial, such as the recommendation to eat more fruits, vegetables, nuts and seeds. However, I’d like to make the argument that these are not the only foods that are good for us. Meat, poultry, fish and eggs have bio-available nutrients that are difficult to obtain from the typical American diet. It is likely that we are now beginning to see the results of these nutrient deficiencies in sectors of the American population.

It’s tempting to think that the governmental dietary guidelines do not matter. I mean, who actually pays attention to them anyway? We all know what’s good and bad don’t we? Isn’t the real reason that more than 1/3rd of the US adult population is obese is from eating too much and exercising too little?

In my personal experience, I have found the USDA Dietary Guidelines to have a profound effect on the way we think about nutrition. After being diagnosed with IBD and choosing to switch to a strict, healthy diet, I consume primarily fruits, vegetables, nut and seeds, however most people I meet seemed surprised when I tell them I also consume grass-fed red meat, organic butter, dark meat, liver and eggs on a weekly basis.

As a graduate of a public health degree and current nursing student, I realize that the overstated dangers of natural saturated fats and cholesterol is a much larger issue than I can tackle on my own; to this end, I decided to join forces with the Healthy Nation Coalition.

The Healthy Nation Coalition seeks to improve the quality of nutrition information disseminated through national nutrition policy. Through a team of scientists, nutrition experts, dietitians, doctors, health advocates and concerned citizens, the mission of The Healthy Nation Coalition is to let individuals know that the Dietary Guidelines are not appropriate for all people. There exists no one-size-fits all way of eating when it comes to a diverse set of individual nutritional needs.

The Healthy Nation Coalition recently sent a letter to the U.S. House and Senate Committees on Agriculture & Nutrition. These two committees are responsible for oversight of the USDA and HHS nutritional policy development, with the House committee recently conduction a hearing of the Secretaries of the USDA and HHS, the bigwigs of nutrition policy in the U.S.

This is an overview of their main points of contention:

1. The Dietary Guidelines for America do not achieve stated goals of prevention of chronic disease and promotion of healthy weight.

“While there are no goals specifically mandated in the legislation, the increases in the prevalence of obesity, diabetes, and related diseases such as non-alcoholic fatty liver, demonstrate that the DGA have not had the desired impact on the health of Americans. These increases should not come as a surprise: the food patterns in the DGA have ‘not been specifically tested for health benefits.” 

 The United States is in 8th place for most obese and overweight countries globally. One-third of American adults are categorized as obese. Since 1980 rates of obesity have doubled and rates of diabetes have tripled. (1, 2)

“Although we might surmise that the “goal” of the DGA from their inception was to reduce incidence of chronic disease, this has never been shown to be the case.”

To prove this, the graph below shows an increase in the rates of obesity (yellow line) after the first dietary guidelines in 1980.

 

Before I get a bunch of emails telling me that correlation does not mean causation, from an epidemiological standpoint, an increase such as this one shown above should warrant further investigation and be a starting point to start asking more questions about the effectiveness of an intervention. Is it clear that we are “first doing no harm?”

To ignore this national trend is to ignore the pattern of this pandemic. It is more akin to a massive outbreak of some sort. Could this alteration be blamed solely on behavior change?

2. The Dietary Guidelines for America are inappropriate for large sectors of the American population.

Rep. Rodney Davis raised his “most serious concern today is what I see as a lack of evidence to show that the recommended dietary patterns proposed by the DGA have been based on any evidence on children. According to citations in some previous advisory reports for recommendations, the recommended diet has been tested almost exclusively on middle age men and women whose nutritional needs obviously are very different from young people and growing children.

Here are just a few examples of some unique nutritional needs that are not accounted for by the Dietary Guidelines for America:

  • Vegetarians: According to the dietary reference intake, vegetarian diets maybe deficient in iron and zinc. Vegetarians may require twice the amount of zinc than non-vegetarian. (3)
  • Older Adults: 10 to 30% of older adults may poorly absorb food-bound vitamin B12. In addition, Older adults have higher protein needs. (4) The current guidelines for men and women according to MyPlate is 5 to 6 oz of daily protein foods a day. (5) However, according to the Braden scale, which is an assessment tool to determine how at risk an elderly patient is for a pressure ulcer (or bed sore), individuals that only get 3 servings of meat or dairy products a day are considered at “probably inadequate” to “Very poor” nutrition status and are at high risk of pressure ulcers. (6) Low of protein status puts the older population at risk for sarcopenia (loss of muscle tissue), osteopenia (loss of bone mass) which can have a detrimental role in contributing to hip fractures and falls. (7)
  • Pregnancy: Increased demands for choline and B vitamins. (7)

3. The Dietary Guidelines for America do not ensure that Americans meet essential nutrition needs.

“vitamin A, vitamin D, vitamin E, vitamin C, folate, calcium, magnesium, fiber, and potassium. For adolescent and premenopausal females iron also is a shortfall nutrient. Of the shortfall nutrients, calcium, vitamin D, fiber, and potassium also are classified as nutrients of public health concern because their under consumption has been linked in the scientific literature to adverse health outcomes. Iron is included as a shortfall nutrient of public health concern for adolescent females and adult females who are premenopausal due to the increased risk of iron-deficiency in these groups.”

The continuing overemphasis on limiting cholesterol and saturated fats has led to exclusion of many high quality foods. For example, liver is rich in iron, B vitamins, vitamins A and D but is not recommended because of its high cholesterol content. (8)

Here are some of the nutrients we are most deficient in:

Vitamin D

According to the National Health and Nutritional Examination Study (NHANES), one of the largest nutrition studies that assesses health and nutrition status of Americans found that up to 31% of certain sub-populations were deficient in vitamin D and vitamin D levels have decreased 10% since 1994 (9, 10)

The foods that contain vitamin D, according to the CDC are “in only a few foods such as fish-liver oils, fatty fishes, mushrooms, egg yolks, and liver”. (11)

Choline

Choline is an essential nutrient for the normal function of all cells in the human body. Sufficient choline is essential during fetal development and can influence lifelong learning and memory.

As much as 50% of the population has genetic mutations that increase the requirements of dietary choline to prevent choline deficiency. Interestingly, one of the first signs of choline deficiency is nonalcoholic fatty liver disease. (12) In the U.S. 21.4 percent of the population has nonalcoholic fatty liver disease, and this percentage has been increasing. (13) Recent reports suggest that choline intake may plays a role in diabetes, cancer, heart disease, inflammation and cystic fibrosis. (14, 15)

In 1998 dietary choline was officially recognized as a required nutrient and establishment of an adequate recommended intake was recommended by the Food and Nutrition Board of the US Institute of Medicine.

According to NHANES only 10% of Americans met the adequate intake of choline.

Some of the richest sources of dietary choline are animal foods which the Dietary Guidelines would have us avoid such as livers and egg yolks. Chicken livers contain 5 times the amount of choline than whole wheat does. (16)

4. The Dietary Guidelines for America are out-of-step with our multicultural nation and diverse dietary practices.

“Unfortunately, the DGAC (Dietary Guideline Advisory Committee) Report does not consider this diversity when deciding on the three recommended dietary patterns: the Healthy U.S.-style Pattern, the Healthy Mediterranean-style Pattern, and the Healthy Vegetarian Pattern (Report: Part D. Ch 1. Line 2827). We ask that the USDA and HHS be required to consider the food ways of our immigrant and native populations when making population wide recommendations.”

The overly restrictive Dietary Guidelines in the U.S. do not allow for culturally-different diets. There are many surprisingly healthy diets around the world that would be considered unhealthy according to the constraints of the Dietary Guidelines in the U.S.

The current Guidelines prohibit or limit whole foods such as eggs, meat, butter, and full-fat dairy products, which are wholesome, nourishing foods that many Americans consider part of their traditional food culture.

The “French Paradox” is the observation that heart disease is very low in France in spite of the high consumption dietary fat and cholesterol. In fact the average energy supplied from fat in the French diet is anywhere from 36 to 39%. (17)

It is ludicrous to impose our American Dietary guidelines that restrict fat consumption to a population that has much better health outcomes than we do. (18)

Obviously human beings are multivariate and these epidemiological studies cannot control for everything, but if consumption of saturated fat alone caused heart disease, you would expect to see that association in other countries as well. If you have the time, I suggest you watch this video which tells about the bad science that has fueled our fear of saturated fat and cholesterol.

5. The Dietary Guidelines for America do not reflect the most up-to-date and comprehensive research findings.

Early on in my college career I took an intro to nutrition class. The class was assigned a project to monitor and measure our personal diet. At the time I was eating 4 eggs with the yolks in the mornings. I remember a comment from my professor saying something along the lines of “1000 mg of cholesterol in 1 day!?”

As a penniless college student, much of my diet consisted of pizza, crackers, Ramen noodles, sugar-filled energy drinks and cheap beer. Oddly enough, the component of my diet that stood out to my nutrition professor was the eggs.

Intuitively, I had a difficult time grasping the message that whole eggs were bad. Later I found out that there simply wasn’t evidence to support that cholesterol was harmful.

Then 4 years later this report came out:

“Dietary Guidelines for Americans recommended that cholesterol intake be limited to no more than 300 mg/day. The 2015 Dietary guideline advisory committee will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol, consistent with the conclusions of the AHA/ACC report Cholesterol is not a nutrient of concern for over-consumption

A lot of people don’t know that the Dietary guidelines report in 2015 actually removed the cholesterol limit. It is conveniently located in the middle of a 571 page report and is not promoted to the public in plain English. (19)

Experts believe dietary cholesterol may not be bad for us after all. Here is what some of the latest research is telling us about eggs, the highest source of dietary cholesterol for most individuals

Do eggs increase the risk for heart disease?

  • Egg consumption does not seem to influence the risk of heart disease in male physicians. (20)
  • A high-egg diet can be included safely as part of the dietary management of type 2 diabetes, and it may provide greater satiety. (21)
  • In 2 randomized controlled trials (the gold standard) showed that whole eggs actually improved metabolic syndrome, improved the HDL (good) cholesterol and decreased the LDL (bad) cholesterol. Insulin resistance (marker of diabetes) also improved. (22)

Do saturated fats increase the risk for heart disease?

  • Meta-analyses (the gold standard in research) shows no link between saturated fat consumption and risk for heart disease. (23, 24)
  • “Investigators often seem to have a particular bias against saturated fats. One report showed that red meat alone was not significantly associated with colorectal cancer.”
  • Replacing the saturated fat with carbohydrates may increase the risk of heart disease. (25)
  • Natural Saturated fat may lower risk of type 2 diabetes. (26)
  • Saturated fat per se is not increasing heart attacks, but other factors may be, such as preservatives used in processed meats or other dietary substances that are being consumed in conjunction with processed meats. (27)

Okay if its not the saturated fat, cholesterol, red meat and eggs that is making us all sick and overweight then what is? And how might the dietary guidelines have contributed to this?

6. The Dietary Guidelines for America may be contributing in part to our nation’s health problems.

Every 5 years, from 1980 to 1995, the Dietary Guidelines consistently recommended restrictions on intake of all fats. This recommendation continued in subsequent editions, although as mentioned earlier foods high in cholesterol now get a free pass depending if you read the 571 page report. (28)

Did we lower fat consumption?

You bet we did. Take a look at this graph.

Did our health improve?

Nope, in fact it got worse. As I’m sure you already know, we got much worse.

When the dietary guidelines recommended that Americans lower fat consumption, 2 main components in the American diet increased. Processed vegetable oils and sugar.

Sugar

The food companies jumped on board with the new low fat dietary guidelines and began making all sorts of low fat foods.

Food companies know that if you remove the fat from a product it tastes terrible, so in response to that, they added more sugar to make it palatable.

As you can see below sugar consumption and obesity rates skyrocketed.

Research suggests that consumption of sugar is associated with obesity, cancer, aging and obesity related conditions such as type 2 diabetes, cardiovascular disease risk and non-alcoholic fatty liver disease. Numerous mechanisms have been suggested to explain the association between sugar sweetened beverages and negative health outcomes. These include:

  • A drop in blood sugar that happens after consuming sugar that increases hunger.
  • Sugar seems to bypass hormones that regulate hunger.
  • A failure for individuals to compensate for the increased calories in sugar. (28)
  • Sugar induces reactive oxygen species and cellular aging. Interpretation: it literally ages your cells. (29)

Processed vegetable oil

After the low fat dietary recommendations, butter, lard and cream were shunned because they contained “artery clogging saturated fat”. These were replaced with highly processed vegetable oils (soy, corn, safflower, and cottonseed, peanut, sunflower). Most of these vegetable oils are high in omega 6 which can lead to inflammation if in too high amounts. (30)

These vegetable oils are very unstable and oxidize when heated, especially when heated repeatedly like they do in deep fryers. (31, 32)

Butter was then replaced with, “heart healthy” margarine aka trans-fat, which is now known to increase risk of heart disease. In fact some cities have now banned trans-fats for this very reason. (33) One study found that those who consumed the most trans-fat were 34% more likely to die from any cause and 28% more likely to die from heart disease. (34) Think about that before you reach for that big creamy ball of salty stuff they indiscriminately call “butter” when they bring out your rolls at the restaurants. Hint: it’s most always margarine, which means it contains unhealthy trans-fats. If you don’t believe me ask your waiter next time you go out to eat. (35)

So, we have a situation where we removed something (real butter) that arguably has no negative impact on health or heart disease risk and replaced it with something (margarine) that is now universally accepted to be unhealthy. While these recommendations had good intentions, the addition of trans-fat to the American diet was a complete disaster and continues to have a negative impact on Americans health.

There are profound ethical problems with taking research based from a small sector of the population and applying it to a diverse group of individuals.

The personal responsibility argument has gotten us nowhere. Telling under-nourished yet overweight individuals to just eat less and exercise is a disservice at best. The failure of the Dietary Guidelines cannot be placed on the individual.

It’s time for those of us who have improved our health by abandoning the USDA approach in favor of a traditional whole foods diet to speak up and influence policy makers.

Can we continue on this path? Can we afford to pay for half the country with diabetes? (36)

Categories: Paleo Diet

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