Thomas Sherman, PhD, Associate Professor of Pharmacology & Physiology at Georgetown University School of Medicine, offers this commentary originally posted on the “Georgetown Food Studies” blog about the recently released Dietary Guidelines. Sherman teaches metabolism, nutrition and endocrinology to first-year medical students.
The Dietary Guidelines Advisory Committee released its Scientific Report for the 2015 Dietary Guidelines for Americans in mid-2015. After a “review,” the final Dietary Guidelines for Americans 2015–2020 (8th edition) were released to the public, and it is clear that the well-researched and evidence-based recommendations that became the Scientific Report have been passed through a political filter that fundamentally lessens the usefulness and impact of these guidelines; but there are positives.
Not surprisingly, the recently updated guidelines have received a tremendous amount of attention. You could be forgiven if your reaction to its public release was a resigned shrug after reading or listening to my many respected colleagues practically foam at the mouth in despair and frustration at the extent to which the Scientific Report proposal for the guidelines has been watered down and politically filtered to such an extent that it obfuscates its purported role to provide practical and useful nutritional advice to families.
- For example, Walter Willett and his colleagues of the Harvard T.H. Chan School of Public Health offer the succinct assessment and a more thorough written critique: “Clearly these Guidelines bear the hoof prints of the Cattleman’s Association and the sticky fingerprints of Big Soda.”
- More blunt still are the words of David L. Katz, MD of Yale University in his piece entitled 2015 Dietary Guidelines: A Plate Full of Politics. He says: “I won’t mince words: in my opinion, the 2015 Dietary Guidelines for Americans …. are a national embarrassment. They are a betrayal of the diligent work of nutrition scientists, and a willful sacrifice of public health on the altar of profit for well-organized special interests. This is a sad day for nutrition policy in America. It is a sad day for public health. It is a day of shame.”
- One final sample critique comes from Marion Nestle’s Food Politics blog. Dr. Nestle, of New York University, makes the case, as did many others, including Food Navigator USA, that the 2015 Dietary Guidelines are distributed online in an extremely confusing and frustrating manner – implementing many screens, drop down boxes, hyperlinks, etc, – which make it difficult or impossible to seek and obtain dietary advice.
The widespread frustration by nutrition and public health professionals is the realization of an opportunity lost, because the original Dietary Guidelines Advisory Committee Scientific Report was so promising! It was an evidence-based, scientifically rich report that made recommendations that were refreshingly clear and devoid of conflicts of interest. (See my earlier post on the report).
Make no mistake, it is a wasted opportunity, but part of my surprisingly sanguine attitude is that I harbored little expectation that the Advisory Committee Scientific Report would not be pulverized, put through a corporate filter that replaces scientific evidence with market-speak, and reconstituted as the 2015 Dietary Guidelines for America, a hollow shell of its former self.
That being said, it is not all doom and gloom, for there are nuggets of advice in the 2015 guidelines that represent true progress, including:
1. Limit Sugar to Less than 10 Percent of Calories
Many of the most progressive proposals in the Advisory Committee Scientific Report focused on our excessive appetite for sugar. “Higher sugar-sweetened beverage taxes may encourage consumers to reduce sugar-sweetened beverage consumption …” and promoted “using the revenues from the higher sugar-sweetened beverage taxes for nutrition health promotion efforts or to subsidize fruits and vegetables could have public health benefits.” Secondly, the report recommended adding a line for added sugars on Nutrition Facts panels, expressed in teaspoons as well as grams, and with a new Daily Value. Although neither of these proposals made it into the final guidelines, it does say state explicitly, however, that soda represents a significant source of added sugars:
Beverages account for almost half (47 percent) of all added sugars consumed by the U.S. population. The other major source of added sugars is snacks and sweets, which includes grain-based desserts such as cakes, pies, cookies, brownies, doughnuts, sweet rolls, and pastries; dairy desserts such as ice cream, other frozen desserts, and puddings; candies; sugars; jams; syrups; and sweet toppings. Together, these food categories make up more than 75 percent of intake of all added sugars.
And it recommends limiting sugar-sweetened beverage consumption:
Individuals have many potential options for reducing the intake of added sugars. Strategies include choosing beverages with no added sugars, such as water, in place of sugar-sweetened beverages, reducing portions of sugar-sweetened beverages, drinking these beverages less often, and selecting beverages low in added sugars. Low-fat or fat-free milk or 100 percent fruit or vegetable juice also can be consumed within recommended amounts in place of sugar-sweetened beverages.
2. Emphasizes a Pattern of Eating Whole and Real Foods
The guidelines state, for example:
A healthy eating pattern includes:
A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other
Fruits, especially whole fruits
Grains, at least half of which are whole grains
Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages
A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products
A healthy eating pattern limits:
Saturated fats and trans fats, added sugars, and sodium
Consume less than 10 percent of calories per day from added sugars
Consume less than 10 percent of calories per day from saturated fats
Consume less than 2,300 milligrams (mg) per day of sodium
Adopting an eating pattern as described above and limiting sugar intake are the two most important elements of the Dietary Guidelines, and if adopted generally, would contribute to significantly improved public health. These recommendations may not be that different from past guidelines, but to my eye, they do appear to be more emphasized.
My main complaint is one of clear corporate influence, and you can see it in the list above. For items that the guidelines recommend we eat more of, the items listed are real foods: vegetables, fruits, grains, etc. For items the guidelines recommend we eat less of, the listed items are nutrients, rather than foods: sugar, saturated and trans fats, sodium. Instead of explicitly recommending that we consume less red and processed meat, fewer processed foods, and for the majority of the report, fewer sugar-sweetened sodas, the pattern highlights saturated fat, sodium and sugar. This disconnect is not accidental and represents a successful effort by the meat, food and beverage industries to confuse the issue.
The average consumer has only a vague and incomplete understanding of what saturated fat is, or where sodium can be found; thus, eating a fat-free cookie distracts from the added sugars; eating a trans fat-free frozen dinner distracts from the saturated fat.
My second complaint is that my single favorite component of the Scientific Report – Sustainability – was almost immediately removed by Congress. Bummer.
There is much to be frustrated by, and there is much too much focus on the relaxed recommendations on cholesterol consumption and heavy coffee drinking, but if we spend some effort encouraging people to cook at home to regain control over what we eat, the 2015 Dietary Guidelines for Americans can be successful.
Source: Georgetown University Medical Center, Suite 120, 4000 Reservoir Road, N.W., Washington D.C. 20057, Phone: (202) 687.0100