Dietary Guidelines 2010: Not Much to Write Home About

I see the new dietary guidelines as tiny steps in the right direction lost in a sea of "same old, same old" and not likely to make much of a dent in the eating habits of Americans.
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On January 31, the US government released the new, 2010 edition of the Dietary Guidelines for Americans.

And there's not much to write home about.

The basic messages to consumers are as predictable as a high school coach's half-time pep talk. Eat less food. Control your calories. Don't drink soda. Eat more vegetables. Eat less sodium. Drink more water. Switch to fat free milk. Can we all say "ho-hum" together now?

To their credit, the USDA did introduce a brand new acronym into the national dialogue about food and obesity: SOFAS (Solid Fats and Added Sugars). We're specifically told to avoid them. (More on that in a moment.)

Before we get into the specifics, it's important to point out that there's always an inherent conflict of interests involved with the Dietary Guidelines and it stems from the fact that the USDA has two potentially conflicting goals. One is to guide us in making better dietary choices. But the other is to relentlessly promote the "bounty" of manufactured food, in whatever form it happens to be made. "The USDA can succeed at its conflicting goals only by convincing us that eating manufactured food lower in SOFAS is "healthy," thus implicitly endorsing hyper-engineered junk food with added fiber, reduced and solid fats and so on, "food" that is often unimaginably far from its origins" says Mark Bittman(2) who writes about food for the NY Times. Bittman goes on to point out that telling us what products to avoid- like a 3,000 calorie fast-food "meal" or a box of low-fat chemical-laden crackers"--"would play badly with industry".

Indeed, I hardly expected to find an ally in my views on the Dietary Guidleines in as mainstream and conservative a publication as the Journal of the American Medical Assocation, but there it is. An excellent editorial written by Harvard's D. Mozaffarian and David Ludwig pointed out that classifying foods as "healthful" or "unhealthful" on the basis of their content of a small number of specific nutrients (sucah as fat, cholesterol or certain vitamins) may easily lead to dietary practices that defy common sense. For example, some low-fat processed foods are high in refined sugar. Shool nutrition guidelines specifiy a minimum number of total calories but a maximum proportion of fat calories, and foods like gelatin desserts and sugar-sweetened low-fat milk have been used to achieve those guidelines.

"Based primarily on the content of a few nutrients, a national obesity-prevention program categorizes whole-milk and cheese with dougnuts and French fries as foods to eat "occasionally". Sauteed vegetables and canned tuna packed in vegetable oil are categorized with processed cheese spread and pretzels as foods to eat "sometimes", and fresh fruits and vegetables are categorized with trimmed beef and fat-free mayonnaise as foods to eat almost anytime. The food industry adds a few selected micronutrients to highly processed foods such as refined cereals and sugar-sweetened beverages, and claims that these foods are nutritious", they write.

So let's look at what the Guidelines offer. And where they disappoint.

They did a decent job on sodium (though, predictably the Salt Institute is already spinning the recommendations as unfair, digging up some research showing how important sodium is in the diet. What a shock.)

The new guidelines recognize that for a large percentage of the population -- not all mind you, but enough -- lowering sodium has a good effect on blood pressure. The new guidelines call for 2300 mg a day of sodium (about the amount in a teaspoon of salt) but mention that certain groups for groups at risk for high blood pressure -- African Americans, individuals with hypertension, diabetes, or chronic kidney disease and individuals ages 51 and older- respond even more dramatically to sodium reduction, and for these groups the guidelines recommend no more than 1500 mg a day.

Wisely, the guidelines make note of the fact that most of the sodium in our diet does not come from salt added at the dinner table, but from processed foods. Consumers need to pay way more attention to added sodium (in canned foods, processed foods, deli meats) and- in my opinion- much less attention to how much fat is listed on the label. (I'm happy to say my view on the irrelevance of fat is beginning to get some mainstream traction. Recently, at the annual Food and Nutrition Conference of the American Dietetic Association, the chairman of the Harvard School of Public Health's nutrition department- the esteemed and unimpeachable Walter Willet, MD, PhD-- made the following statement: "The focus on fat in dietary guidelines has been a massive distraction...We should remove total fat from nutrition facts panels on the back of packs.")

Speaking of fat, there's not much new from here. The demonizing of saturated fat is the same as it's always been. But think it through for a moment: the only reason given to limit saturated fat is that is associated with higher levels of cholesterol, which everybody believes is a marker for heart disease risk. But we're increasingly finding that cholesterol is not the excellent predictor of heart disease we once believed it to be. Fully half of all heart attacks happen to people with normal cholesterol, and half the people with "elevated" cholesterol are fit and healthy as the proverbial fiddle.

Further, the report still uses the old division of "good" and "bad" cholesterol, despite the fact that we now know there are multiple sub-types of both HDL (so called "good" cholesterol) and LDL (so-called "bad cholesterol). Substantial research shows that it is the type of LDL- not the total amount- that matters. LDL cholesterol that is the "small particle" type is bad- "large particle" LDL is basically harmless. Saturated fat may raise LDL but it tends to have a beneficial effect on particle type, meaning it raises the large fluffy molecules of LDL (harmless), but lowers the small dense b-b gun pellet-type molecules (the "bad" kind of "bad cholesterol"). Your overall LDL may go up, but your cardiovascular risk has improved.

So once again the powers that be have demonized saturated fat, but not- and this is important- not because it directly leads to a single case of heart disease or a single death, but because in some cases it raises a blood marker which is increasingly being shown to be of minimal importance in heart disease.

The report recommends lowering our dietary intake of cholesterol. This piece of advice is so past its expiration date that I never expected to see it again, even in as conservative a document as the dietary guidelines, but there it is, blatantly ignoring the facts of cholesterol biochemistry which are these: The liver makes most of the cholesterol in your body. Eat less, and your body makes more. Eat more, your body makes less. And for 99 percent of the population, dietary cholesterol has virtually no effect on blood cholesterol. This recommendation is just going to make people continue to fear egg yolks, a big mistake since they are incredibly rich in nutrients (like choline, lutein and zeaxnthin) and a wonderful source of protein.

The report does make mention of the problem of added sugars in our diet, noting that at present they account for an amazing 16% of calories in the American diet. These sugars include high fructose corn syrup, white sugar, brown sugar, corn syrup, corn syrup solids, raw sugar, malt syrup, maple syrup, pancake syrup, fructose sweetener, liquid fructose, honey, molasses, anhydrous dextrose and crystal dextrose. The report also notes that the major sources of these added sugars are soda, energy drinks, sports drinks, grain-based desserts, sugar-sweetened fruit drinks, dairy-based desserts, and candy. And the guidelines recommend lowering the consumption of these drinks, a brave move given the incredibly lobbying and spin machines of both the Sugar Association and the Beverage Assocation. Look for their "rebuttal" spin, coming soon to a theatre near you. Oh wait, it's here. And here.

In fact, you could almost hear the committee hedging their bets. Shortly after the recommendation to reduce these added sugars they state that "foods containing solid fats and added sugars (SOFAS) are no more likely to contribute to weight gain than any other source of calories in an eating pattern that is within calorie limits". In other words, it's all about the calories, so it's perfectly OK to eat sugar right out of the bowl as long as you don't go over your calorie allotment.

This, I'm sorry to say, is nutritional "wisdom" that is well past it's expiration date.

Sure, there's a lot of research showing that calories overall are what matters but there's also a lot of research- and clinical experience- that shows that high carb high sugar diets produce metabolic reactions that make it fiendishly difficult to lose weight by contributing to cravings and blood sugar fluctuations. Minimizing the documented effect on your hormones by certain types of calories and concentrating instead only on the total number of calories is a missed opportunity, and more of the "same-old, same-old" For goodness sake, even Weight Watchers recently revised its program in recognition of the fact that all calories don't affect the human body in the same way. Get with the program, USDA.

There is some good news, however.

For the first time, the dietary guidelines actually suggest limiting refined grains (especially refined grains that contain solid fats, added sugars and sodium). This is a really good idea which I wholeheartedly support. The guidelines also specifically say to keep trans fat consumption as low as possible and wisely makes the distinction between man-made trans fats (hydrogenated and partially hydrogenated oils) and naturally occurring trans fats like the CLA found in the meat of grass-fed cows. The new dietary guidelines also explicitly say that half your plate should be taken up with fruits and vegetables, something even a low-carber like me can totally support. And finally the recommendation to limit alcohol to two drinks a day for men and only one for women- is wise and in keeping with the research.

When all is said and done, it's helpful to remind ourselves who actually issues these guidelines (the combined effort of two agencies.. the US Department of Agriculture and the Department of Health and Human Services).

But let's remember that the USDA isn't some impartial, scientific group detached from industry input or economic considerations. For years, investigative reporters have pointed out the very close ties between the agency and the meat and dairy industries, pointing to the USDA's dual and conflicting mandates to both regulate the safety of beef and also to promote its sale. And the influence of industry lobbyists on food policy is undeniable and has been chronicled in loving detail by such writers as Marion Nestle in her excellent book "Food Politics".

But I digress.

All in all, I see the new dietary guidelines as tiny steps in the right direction lost in a sea of "same old, same old" and not likely to make much of a dent in the eating habits of Americans.

May I humbly suggest instead a simpler, low-tech set of guidelines: Eat from the Jonny Bowden Four Food Groups: Food you could have hunted, fished, gathered or plucked. Avoid trans-fats like the plague and get plenty of omega-3's. Don't worry about saturated fat from whole foods. Forget low-fat and no-fat, but stop eating sugar and for gods sake stop drinking sodas. If it doesn't have a bar code, it's probably good for you. If it spoils when you leave it out, so much the better. If you're an average American, eat about half of what you're eating now. Don't drink soda, don't use sugar, and read your labels for sodium (look for less) and fiber (look for more). Shop for color. Throw out most white stuff (except cauliflower, chicken and fish).

And shop the outer aisles of the supermarket.

I'll put those dietary guidelines up against the governmental guidelines any day of the week. And if you don't like mine, try this deservedly famous mandate from whole food advocate Michael Pollan:

Eat food. Not too much. Mostly plants.

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