Search results: dietary guidelines

Really, the Dietary Guidelines Advisory Committee’s (DGAC) report shouldn’t be this controversial and shouldn’t be controversial at all (as I’ve said before).  But lots of people—the food industry, of course, but also some scientists and journalists—seem to have exceptionally intense opinions about the fat recommendations [Recall:  The DGAC report does not constitute the Dietary Guidelines; these are written by USDA and HHS and are not due out until the end of this year].

Now, we have the journalist Nina Teicholz, author of The Big Fat Surprise, repeating the themes of her book in the BMJ: The scientific report guiding the US dietary guidelines: is it scientific?.

The BMJ has also found that the committee’s report used weak scientific standards, reversing recent efforts by the government to strengthen the scientific review process. This backsliding seems to have made the report vulnerable to internal bias as well as outside agendas.

Teicholz’s interpretation of the science relating dietary fat to health has been thoroughly critiqued (see end of post).   The way I see it, these arguments are difficult to resolve outside the context of dietary patterns as a whole.

My hypothesis (note: hypothesis) is that for people who balance calorie intake with expenditure, the type of fat—or carbohydrate—matters much less than it does for people who overeat calories.  This hypothesis needs testing to confirm it.

What troubles me about Teicholz’s work is the certainty with which she presents her ideas.  She comes across as utterly convinced she is right, even in the face of substantial and substantive criticism of her statements and interpretations.

At least one error

Here, for example, is one statement in the BMJ article that I know from personal experience cannot be correct.

Much has been written about how industries try to influence nutrition policy, so it is surprising that unlike authors in most major medical journals, guideline committee members are not required to list their potential conflicts of interest.

I was a member of the 1995 DGAC and I was required to declare conflicts of interest.  So were members of the committees in 2000, 2005, and 2010, as shown in this excellent short video.

Later, discussing conflicts of interest among DGAC members, Teicholz says:

Still, it’s important to note that in a field where public research dollars are scarce, nearly all nutrition scientists accept funding from industry. [Nearly all?  I don’t, and I doubt this is correct].  Of far greater influence is likely to be bias in favor of an institutionalized hypothesis as well as a “white hat” bias to distort information for what is perceived as righteous ends.

The “white hat bias” comment refers to a paper by authors who themselves report food-industry funding:

Competing Interests. Drs. Allison and Cope have received grants, honoraria, donations, and consulting fees from numerous food, beverage, dietary supplement, pharmaceutical companies, litigators, and other commercial, government, and nonprofit entities with interests in obesity and nutrition including in interests in breastfeeding and NSBs. Dr. Cope has recently accepted a position with The Solae Company (St Louis, MO.).

Responses to the BMJ article

The DGAC wrote a rebuttal to Teicholz.  It is published on the BMJ website.

HHS also published a statement, reproduced by Mother Jones.

The British Medical Journal’s decision to publish this article is unfortunate given the prevalence of factual errors. HHS and USDA required the 2015 Dietary Guidelines Advisory Committee to conduct a rigorous, systematic and transparent review of the current body of nutrition science. Following an 19-month open process, documented for the public on DietaryGuidelines.gov, the external expert committee submitted its report to the Secretaries of HHS and USDA. HHS and USDA are considering the Scientific Report of the 2015 Dietary Guidelines Advisory Committee, along with comments from the public and input from federal agencies, as we develop the 2015 Dietary Guidelines for Americans to be released later this year.

Yoni Freedhoff’s Weighty Matters blog provides a handy summary of additional responses to the BMJ article.

• BMJ Publishes Error-Laden Attack on Dietary Guidelines Report – CSPI
• Medical journal’s bogus investigation could derail better dietary guidelines – The Verge
• Expert is as expert does: in defence of US dietary guidelines – The Conversation
• The DGAC’s official response to Teicholz’ accusations – The BMJ
• An Open Letter to the BMJ Regarding US Dietary Guidance – Dr. David Katz
• British Medical Journal (BMJ) gives low-carb journalist Nina Teicholz an outlet to blast the Dietary Guidelines Advisory Committee (DGAC) – U.S. Food Policy Blog
• Call for The BMJ to retract Teicholz article on Dietary Guidelines Committee and Science – Evelyn (CarbSane)

Scientific analysis of The Big Fat Surprise

Many of the scientific claims in this book seemed so far-fetched that they induced a nutritionist, Seth Yoder, to go over it line by line, read the references, and point out discrepancies.   These are posted on his website in two parts.

A summary quote from Part 1:

What makes this particular book interesting is not so much that it is bad (which it is) or that it is extravagantly biased (which it also is). No, what really fascinates me about this book is that the author excessively and shamelessly lifts other people’s material.

And a quote from Part 2

The Big Fat Surprise (BFS) by Nina Teicholz is yet another book in a long line of books that informs the reader that everything you thought you knew about nutrition is wrong: saturated fat from animals is actually quite good for you, cholesterol isn’t really important, the government lied to you, nutritionists and dietitians lied to you, the American Heart Association lied to you, etc… Leaving aside that the concept of that kind of a conspiracy actually existing is really absurd, what I’m surprised about is that publishers can keep churning out books like this and people are gullible enough to keep buying them.

Caveat emptor.

Additions: 

• The Conversation, Australia: In defence of the US Dietary Guidelines
• New research published in the J Am College of Cardiology. “Conclusions:  Our findings indicate that unsaturated fats, especially PUFAs, and/or high-quality carbohydrates can be used to replace saturated fats to reduce CHD risk.”
• The Verge on the BMJ’s backtracking on the Teicholz piece

The USDA is asking for input on its plan to test educational messages in the forthcoming 2015 Dietary Guidelines and related products.

It wants the tests to involve about 57,000 respondents in

qualitative and possibly quantitative consumer research techniques, which may include focus groups (with general consumers or with specific target groups such as low-income consumers, children, older Americans, educators, students, etc.), interviews (i.e., intercept, individual, diads, triads, usability testing, etc.), and web-based surveys.

The purpose of the testing is to identify consumers’ understanding of the guidelines’ education messages and to obtain reactions to “prototypes of nutrition education products, including Internet based tools.” As USDA puts it, this information “will be formative and will be used to improve the clarity, understandability, and acceptability of resources, messages and products.”

USDA says this information

will be used to further develop the Dietary Guidelines and related communications. These may include: (1) Messages and products that help general consumers make healthier food and physical activity choices; (2) Additions and enhancements to ChooseMyPlate.gov; and (3) Resources for special population groups that might be identified.

This is interesting.  I don’t remember USDA asking for consumer input on nutrition education materials since the 1992 pyramid.

Let’s encourage USDA to do this.

Send comments to Dietary Guidelines Communications, Center for Nutrition Policy and Promotion, U.S. Department of Agriculture, 3101 Park Center Drive, Room 1034, Alexandria, VA 22302. Comments may also be submitted via fax to the attention of Dietary Guidelines Communications at 703–305–3300 or through the Federal eRulemaking Portal at http://www.regulations.gov. Follow the online instructions for submitting comments electronically.

Let’s review where we are on the 2015 Dietary Guidelines for Americans.  The Dietary Guidelines Advisory Committee (DGAC) filed its scientific report in February.  More than 25,000 people filed comments.  Now, USDA and Health and Human Services staff must deal with the comments and write the actual dietary guidelines, the policy document scheduled for release later this year (see Timeline).

Recall that the DGAC report caused much controversy when it linked agricultural to health policy by recommending a diet that promotes health and protects the environment—one that is largely plant-based.

Lobbyists for food companies affected by such recommendations went straight to Congress.

The result?  Congress used the appropriations process to set limits on what the guidelines could say.

House Agricultural Appropriations Bill 

SEC. 734. None of the funds made available by this Act may be used to release or implement the final version of the eighth edition of the Dietary Guidelines for Americans…unless the Secretary of Agriculture and the Secretary of Health and Human Services comply with each of the following requirements:

(1) Each revision to any nutritional or dietary information or guideline contained in the 2010 edition of the Dietary Guidelines for Americans and any new nutritional or dietary information or guideline to be included in the eighth edition of the Dietary Guidelines for Americans— (A) shall be based on scientific evidence that has been rated ‘‘Grade I: Strong’’ by the grading rubric developed by the Nutrition Evidence Library of the Department of Agriculture; and (B) shall be limited in scope to only matters of diet and nutrient intake.

(2) The Secretaries shall release a preliminary draft of the eighth edition of the Dietary Guidelines for Americans, including a list of all the scientific studies and evidence supporting each revised or new nutritional or dietary information or guideline, for a period of public comment of at least days.

(3) Following the end of the public comment period, the Secretaries shall provide a period for agency review of public comments of at least 60 days.

Senate Agricultural Appropriations Bill 

SEC. 733. None of the funds appropriated in this Act may be used to issue, promulgate, or otherwise implement the 2015 Dietary Guidelines for Americans edition unless the information and guidelines in the report are solely nutritional and dietary in nature; and based only on a preponderance of nutritional and dietary scientific evidence and not extraneous information.

The White House Office of Management and Budget objected to the House provision:

The Administration strongly objects to using the appropriations process for objectionable language provisions that are wholly unnecessary to the operation of the nutrition programs…The Administration is also concerned with objectionable language that interferes with evidentiary standards, limiting the ability of USDA and the Department of Health and Human Services to develop dietary recommendations based on the preponderance of the strongest available scientific evidence, as is current practice. The language would also delay the availability of updated guidelines.

The appropriations bills have not yet been reconciled or sent to the President.  Let’s hope Congress decides to leave nutrition advice to people who know something about it and stay out of it.

Politico Morning Agriculture reports today on an unprecedented move by the 2015 Dietary Guidelines Advisory Committee (DGAC).  The committee sent a letter to members of Congress to protest legislative interference with its scientific process.

Recall: The DGAC’s research report alarmed meat producers when it said that sustainability needed to be considered in developing dietary guidelines.

Of course sustainability should be considered in developing dietary guidelines.  Agricultural policy needs to be linked to health policy, and it’s high time we did so.

But industry protests and letters from Congress induced USDA Secretary Tom Vilsack to assure Congress that the 2015 guidelines will focus only on nutrition.

That was not enough.  Industry groups induced the House of Representatives to put this rider in the 2016 Agricultural Appropriations bill:

SEC. 734. None of the funds made available by this Act may be used to release or implement the final version of the eighth edition of the Dietary Guidelines for Americans, revised pursuant to section 301 of the National Nutrition Monitoring and Related Research Act of 1990 (7 20 U.S.C. 5341), unless the Secretary of Agriculture and the Secretary of Health and Human Services comply with each of the following requirements:

(1) Each revision to any nutritional or dietary information or guideline contained in the 2010 edition of the Dietary Guidelines for Americans and any new nutritional or dietary information or guideline to be included in the eighth edition of the Dietary Guidelines for Americans shall be based on

(A) scientific evidence that has been rated ‘‘Grade I: Strong’’ by the grading rubric developed by the Nutrition Evidence Library of the Department of Agriculture; and

(B) shall be limited in scope to only matters of diet and nutrient intake.

Politics in action!

As I told Politico Morning Agriculture, I’ve never heard of a DGAC writing directly to Congress.  But I understand its frustration.  The committee was asked by USDA and HHS to review and consider the science of diet and health and did so. It reported what its members believe the science says. Some segments of the food industry don’t like the science so they are using the political system to fight back. The idea that some members of Congress would go along with this is shameful.

CSPI has organized a letter-writing campaign to defeat the rider and provides these tools:

• Fact Sheet
• Talking points
• Memo
• Sign on letter

Let’s keep Congress out of the dietary guidelines process.  The process may not be perfect but scientific committees do the best they can to advice the public about dietary practices that are best for health—and, at long last, the environment.

Political interference with this process is not in the best interest of public health, and should be strongly discouraged.  If you agree with this view, CSPI makes it easy for you to say so.  Sign on now.

Update, June 25: Politico Morning Agriculture reports today that the Senate bill reads: “None of the funds appropriated in this Act may be used to issue, promulgate, or otherwise implement the 2015 Dietary Guidelines for Americans edition unless the information and guidelines in the report are solely nutritional and dietary in nature; and based only on a preponderance of nutritional and dietary scientific evidence and not extraneous information.”

I am indebted to Pro Politico Morning Agriculture for this tidbit:

HOUSE AG COMMITTEE PRIES INTO DGAC COMMENT REVIEW: The chairman and ranking member of the House Agriculture Committee have requested that the USDA and HHS supply an accounting of how they intend to review the more than 29,000 public comments on the 2015 Dietary Guidelines Advisory Committee’s report, as well as an accounting of the staff maneuvering that’s been required to review those thousands of comments in a timely manner.

In a letter sent by Reps. Michael Conaway and Collin Peterson, the committee has also requested more information on whether the departments will be able to deliver the final Dietary Guidelines for Americans document by the end of the year, as originally intended.

“Have you reconsidered that goal given the overwhelming number of comments that now need to be reviewed,” the letter states. “If not, do you intend to incorporate the review of the 29,000+ comments received into this work product, and how do you intend to complete that process?” You can read the full letter, which the lawmakers expect a response to by June 10, here: http://1.usa.gov/1EJcrSM

OK.  Let’s review the process here.

• Congress, in its infinite wisdom, wants the Dietary  Guidelines reviewed and redone every five years.
• We’ve had Dietary Guidelines every five years since 1980.  Their basic messages have not changed much.
• The 2015 Dietary Guidelines Advisory Committee (DGAC) reviewed the research and issued a lengthy report.
• The report was released for public comment.  More than 29,000 comments came in.
• Now the agencies—USDA and HHS—must deal with the comments are write the actual Dietary Guidelines.

Until 2005, the DGACs wrote the actual guidelines with minimal editing from the agencies.  That was certainly how it worked in 1995 when I was on that committee.

We did the research and wrote guidelines based on that research.  The agencies published them pretty much as we wrote them.

That changed in 2005 under the Bush II administration.

By now, nutrition advice has become so politicized that the public—from individual consumers to corporations—has a say in them.

Which method helps the public eat healthier diets?

You decide.

I withholding judgment until I see how the agencies extract guidelines from the 650-page DGAC report and its 29,000 comments.

I’m guessing that after all this fuss, the guidelines will still basically say:

• Healthy diets are based largely on foods from plant sources (eat your veggies)
• Don’t eat too much sugar, salt, or saturated fat (avoid junk food)
• Don’t gain excess weight if you can avoid it (balance calories)

Good advice.  Too bad that following it does not increase profits for the food industry.

You still have time to file comments on the 2015 Dietary Guidelines Advisory Committee report.

Here’s where and how.

I’ve just been sent the comments from

• Dr. Mary Bassett, Commissioner of the New York City Department of Health and Mental Hygiene (these are an excellent model)
• Ridge Shinn of the Sustainable Livestock Farmers (they are collecting signatures on theirs)

Yours don’t have to be lengthy, formal, or cover everything.

You just need to identify the issue, state your opinion, and indicate what you want the guidelines to do or say.

Your opinion counts.  Do it now!

Everyone I speak to in Washington, DC says the same thing: if you want policies to change in favor of healthy food systems, you must contact members of Congress and say what you think they should do.  If they get comments on issues, they listen.  If they don’t, nothing will change.

It’s not hard to send an e-mail or telephone your representatives.

Thanks to Jerry Hagstrom, who writes the invaluable Hagstrom Report, for producing instant guides and contact information to members of the Senate and House agriculture committees.

• Senate Agriculture Committee
• Senate Agriculture Appropriations Subcommittee
• House Agriculture Committee
• House Agriculture Appropriations Subcommittee

As for the contentious 2015 Dietary Guidelines: the comment period has been extended to May 8.  The agencies make it easy to file comments.  Do it here.

The comments don’t need to be long or complicated.  Just indicate identify yourself, state the topic you are concerned about, say what you’d like the guidelines to say, and if possible add a reference or two.

Do this and you will be encouraging the agencies to do the right thing.

If you don’t, who will?

Addition, April 14:  Here’s a video explanation of how to file comments on the dietary guidelines.

I signed an today’s ad in the New York Times to encourage support for considering sustainability in the 2015 Dietary Guidelines.

We need health policies that consider agriculture and agricultural policies that consider health.

Here are:

• The  press release
• A fact sheet about the dietary guidelines
• Fact sheet on environmental impact of industrial food animal production