by Marion Nestle

Search results: dietary guidelines

Feb 3 2011

Dietary Guidelines: Why we need them

In an article about fast food marketing, the Los Angeles Times explains as clearly as could be why Dietary Guidelines matter so much.  The article is titled “Eat less, U.S. says as fast-food chains super-size their offerings.”

Why would fast food chains want to offer hot dogs, hamburgers, and burritos ranging from 800 t0 1,600 calories each?  How’s this for a candid answer:

The bottom line is we’re in the business of making money, and we make money off of what we sell,” said Beth Mansfield, spokeswoman for CKE Restaurants Inc., which owns the Carl’s Jr. and Hardee’s chains. “If we wanted to listen to the food police and sell nuts and berries and tofu burgers, we wouldn’t make any money and we’d be out of business.

You want to help people stay healthy?  That makes you food police.

If you care about public health, you can expect to be called names.  But that shouldn’t stop you from trying to create a healthier food system.

And thanks to Sheila Viswanathan of the GoodGuide for sending the article.


Feb 1 2011

2010 Dietary Guidelines, deconstructed

I have now had time to look at the full report of the 2010 Dietary Guidelines–all 95 pages of what they are calling “the policy document.”

Oh no!  What happened to the Selected Messages for Consumers that I posted yesterday?  “Enjoy your food” is not in it and neither are any of the other clear, straightforward messages.  This is a big disappointment.

Nevertheless, the document is well worth reading.

It addresses my complaints about the executive summary.  It explains the meaning of the annoying SOFAS (solid fats and added sugars).  It discusses the need to improve the food environment.

Let me share a few thoughts about selected issues.


SOFAS

The report translates its advice (pages 62-68).   It translates  “Cut back on foods and drinks with added sugars,” a nutrition euphemism, as:

Drink few or no regular sodas, sports drinks, energy drinks, and fruit drinks.  Eat less cake, cookies, ice cream, other desserts, and candy.  If you do have these foods and drinks, have a small portion.

But it translates “Cut back on solid fats” in yet another euphemism:  “Select lean meats and poultry, and fat-free or low-fat milk and milk products.”  This, no doubt, is to avoid the politically impossible “eat less meat.”

Added sugars

The report lists synonyms for added sugars that you might find on a food label (page 75).  The 2005 Dietary Guidelines included “fruit juice concentrates” on that list.  The 2010 guidelines do not.  The Table lists “nectars” but not fruit juice concentrates.  How come?  It doesn’t say.

Food group patterns

The report describes healthy patterns for diets ranging from 1,000 to 3,200 calories a day.  For a diet containing 2,000 calories, you are only allowed 258 calories a day from SOFAS.  That’s all? One 20-ounce soft drink contains more than that and so does  one tablespoon of butter and a 12-ounce soft drink.  No wonder the guidelines don’t want to be specific about foods when they mean “eat less.”

Sodium

The recommendation to reduce sodium intake to 2,300 or 1,500 mg per day is addressed to the wrong people.  Individuals cannot do this on their own since most salt is already added in restaurant and processed foods.  The report recognizes this:

  • Consume more fresh foods and fewer processed foods that are high in sodium.
  • Eat more home-prepared foods, where you have more control….
  • When eating in restaurants, ask that salt not be added….

Vegetarian and vegan diets

The report includes diet plans for lacto-ovo vegetarians and vegans (pages 81 and 82).  Applause, please.  When I was on the dietary guidelines advisory committee in 1995, we tried to say something useful about vegetarian diets but were forced to add something about the nutritional hazards of such diets, minimal as they are.  Not having to do this is a big improvement.  But you too only get 258 calories for SOFAS.

How about changing the food environment?

The report makes it clear that the food environment strongly influences the food choices of individuals, and it urges efforts to

  • Improve access to healthy foods
  • Empower people with improved nutrition literacy, gardening and cooking skills
  • Develop policies to prevent and reduce obesity
  • And for kids, fix school meals, encourage physical activity, and reduce screen time

In short, there is plenty to work with here.  You just have to look hard and dig deep to find it.

What is the food industry’s reaction?

Just for fun, I’ve been tracking some of the industry reactions.  The soy people love it.  The report mentions soy along with nuts and seeds in the USDA’s meal patterns (page 79), and soy has its own category in the vegetarian and vegan diets (page 81 and 82).

The meat people don’t love it so much.  They are a little worried that seafood is pushed more than meat, but the American Meat Institute is giving it a nice spin, pointing out that the overall meat recommendation has not changed since 2005.

And the Salt Institute?  “Dietary Guidelines on Salt Drastic, Simplistic, Unrealistic.”

I rest my case.

Jan 31 2011

The 2010 Dietary Guidelines: Enjoy your food, but eat less!

The 2010 Dietary Guidelines for Americans were just released.  Here are the take-home messages:

Balancing Calories

• Enjoy your food, but eat less.

• Avoid oversized portions.

Foods to Increase

• Make half your plate fruits and vegetables.

• Switch to fat-free or low-fat (1%) milk.

Foods to Reduce

• Compare sodium in foods like soup, bread, and frozen meals—and choose the foods with lower numbers.

• Drink water instead of sugary drinks.

I’m in shock.  I never would have believed they could pull this off.  The new guidelines recognize that obesity is the number one public health nutrition problem in America and actually give good advice about what to do about it: eat less and eat better. For the first time, the guidelines make it clear that eating less is as priority.

My two quibbles:

Quibble #1: They still talk about foods (fruits, vegetables, seafood, beans, nuts) when they say “eat more.”   But they switch to nutrient euphemisms  (sodium, solid fats and added sugars) when they mean “eat less.”

They say, for example: “limit the consumption of foods that contain refined grains, especially refined grain foods that contain solid fats, added sugars, and sodium.”

This requires translation: eat less meat, cake, cookies, sodas, juice drinks, and salty snacks.

That’s politics, for you.

Let’s give them credit for “drink water instead of sugary drinks.”  That comes close. But I listened in on the press conference and conference call and several people pushed federal officials about why they didn’t come out and say “eat less meat.”  The answers waffled.

Quibble #2: This is all about personal responsibility.  What about the “toxic” food environment?  Shouldn’t these guidelines be directed at the food and restaurant industries?  The Dietary Guidelines Advisory Committee made a big point of that.  Apparently, that’s in the full dietary guidelines report but I’ve only seen the executive summary.

For background, see my previous posts, one on the politics of this report, and one on the science of the dietary guidelines.

Overall, the new guidelines aren’t perfect but they are a great improvement.

Next: let’s see what they do to improve the implementation guide—the pyramid or its equivalent.  This, they say will come out in a few months.  Stay tuned.

Jan 27 2011

The 2010 Dietary Guidelines, coming Jan 31

Here’s what I’m going to be doing on Monday morning:

INVITATION TO KEY STAKEHOLDERS TO JOIN IN THE NATIONAL RELEASE OF THE 2010 DIETARY GUIDELINES FOR AMERICANS

The U.S. Departments of Agriculture and Health and Human Services Will Release the 2010 Dietary Guidelines for Americans at a Joint Press Conference Monday, January 31, 2011

On Monday, January 31, the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) will hold a joint press a conference at The George Washington University Jack Morton Auditorium to release the new 2010 Dietary Guidelines for Americans.

Agriculture Secretary Tom Vilsack and HHS Secretary Kathleen Sebelius will discuss the Guidelines and provide key insights into the new recommendations. Joining the Secretaries will be Dr. Robert Post, Deputy Director of USDA’s Center for Nutrition Policy and Promotion and Rear Admiral Penelope Slade-Sawyer, HHS Deputy Assistant Secretary for Health Disease Prevention and Health Promotion. Immediately following the presentations, the speakers will entertain questions from the press, stakeholders, students and others in attendance.

 Monday, January 31, 2011, 10 a.m. – 11 a.m. EST

The George Washington University

Jack Morton Auditorium

Media and Public Affairs Building

805 21st Street, NW

Washington, DC 20052

Stakeholders are invited to attend this event in person. Seating is limited and RSVP is required by 5 p.m. on Wednesday, January 26, by registering here.

Stakeholders may also view the event via webcast at www.usda.gov/live

Copies of the 2010 Dietary Guidelines for Americans will be available at www.DietaryGuidelines.gov immediately following the press conference.

Can’t wait!

Jul 9 2010

Dietary Guidelines hearings: Lobbying in Action

The Dietary Guidelines Advisory Committee held a hearing yesterday on its recent report (see my posts of June 28 on the politics of this report, and June 29 on its science).  I could not attend the hearing but am collecting second-hand reports from people who attended or testified.

Philip Brasher, who blogs at GreenFields.com, summarizes lobbyists at work:

  • National Pork Producers: “Lean meat is a vital source of high-quality protein and certainly should not be framed as a food to limit in the American diet….Urging Americans to shift to a more plant-based diet and consume only moderate amounts of lean meat implies they should decrease consumption of this vital, complete protein.”
  • Egg producers: “The average American could increase egg consumption and still be within the egg-a-day limit.”
  • The Sugar Association: Advice to reduce sugar is “impractical, unrealistic and not grounded in the body of evidence.”
  • The Salt Institute:  “Encouraging consumption of low-salt foods will encourage Americans to eat excessively to make up for the lack of taste….The guidelines have become far more a reflection of ideology than sound science.”

The Organic Trade Association testified that the scientific review, which found no significant nutritional differences between organic and conventionally produced foods, is:

Neither grounded in current science nor relevant to the mandate of the Dietary Guidelines….[it is] in direct conflict with the advice put forth by the recent President’s Cancer Panel report regarding ways to reduce environmental cancer risk….It is inconceivable and alarming that the very document that is the underpinning of our nation’s policies regarding food and nutrition would include a statement that directly contradicts these recommendations….As released, the guidelines confuse the consumer, contradict the President’s own Cancer Panel, and do not enhance dietary recommendations.

To repeat: The committee report is simply advisory.  So is the lobbying.  The sponsoring federal agencies, USDA and DHHS, now must deal with both as well as with written comments on the report’s statements and recommendations.

The agencies write the final guidelines. Will they include advice to cut down on added sugars and fatty meats?  Will they say anything positive about organic foods?

Maybe, if enough people weigh in with such opinions.  Comments are due by July 15.  Here’s how.

Addition, July 10: Amber Healy’s terrific account in Food Chemical News (July 12) summarizes the hearings as “largely boiling down to a single question: Is meat good or bad?” For example:

  • People for the Ethical Treatment of Animals, the Physician’s Committee for Responsible Medicine (PCRM), the Soyfoods Association of North America and Christina Pirello, the host of a cooking show on PBS: the guidelines should more clearly spell out the benefits of reducing meat consumption and take a stronger position on the need to reduce intake of processed meats.
  • Sally Fallon Morell, president of the Weston A. Price Foundation: the recommended reduction in intake of lean meat and protein from animal sources could “perpetuate the kind of nutrient deficiencies” that the guidelines try to avoid and even lead to lower fertility rates.
  • Betsy Booren of the American Meat Institute: If people try to consume the same amount of protein from plant-based foods, people could end up consuming more calories than if they had simply eaten some lean meat or poultry.

And, the National Dairy Council and the International Dairy Foods Association approved of the recommendation for three daily servings of low-fat or fat-free milk or dairy foods, but asked that the final guidelines acknowledge that flavored low-fat milk [i.e. chocolate] can encourage consumption among children.

Jun 29 2010

Dietary Guidelines Advisory Committee: The Science

With the politics out of the way (see yesterday’s post), let’s talk about what’s superb in the Dietary Guidelines Advisory Committee Report: the scientific review and analysis.

This was based on reviews produced by the Nutrition Evidence Library (NEL), which apparently recruited dozens of people to identify articles, assess their quality by uniform criteria, and rank the overall evidence as limited, moderate, or strong and consistent or inconsistent.

I particularly like the way the report organizes the research review by questions (of which there are 56, if I counted right).  The questions cover a great range of topics.  Examples:

  • What nutrients and dietary components are overconsumed by the general public?
  • Can a daily multivitamin/mineral supplement prevent chronic disease?
  • What is the role of prebiotics and probiotics in health?
  • What are health effects related to consumption of nuts?
  • What are the health effects related to consumption of chocolate?
  • How do the health outcomes of a vegetarian diet compare to those of a diet which customarily includes animal products?
  • How are non-caloric sweeteners related to energy intake and body weight?
  • What amount of water is recommended for health?

Questions are followed immediately by Conclusions, Implications, and Review of the Evidence. All of this is written with great clarity, accompanied by thoughtful comments, and packed with useful information.

Here is just one example (I’ve emphasized the evaluative words):

What is the Relationship between Vegetable Protein and/or Soy Protein and Selected Health Outcomes? Few studies are available, and the limited body of evidence suggests that vegetable protein does not offer special protection against type 2 diabetes, coronary heart disease, and selected cancers. Moderate evidence from both cohort and cross-sectional studies show that intake of  vegetable protein is generally linked to lower blood pressure. Moderate evidence suggests soy protein may have small effects on total and low density lipoprotein cholesterol in adults with normal or elevated blood lipids, although results from systematic reviews are inconsistent. A moderate body of consistent evidence finds no unique benefit of soy protein on body weight. A limited and inconsistent body of evidence shows that soy protein does not provide any unique benefits in blood pressure control.

Readers may disagree with the committee’s research interpretations, but its conclusions deserve serious consideration.

And, if anyone wants to know the state of the available science on any of a large number of questions in nutrition, this report is the place to look first.

Student alert: I will be using this report in classes.

Jun 28 2010

Dietary Guidelines Advisory Committee: The Politics

I’ve heard rumors that some members of the Dietary Guidelines Advisory Committee (DGAC) believe that commentators did not give a fair shake to their recently released report (see previous post).

I complained that the DGAC report is difficult to read because its pieces are presented online in a great many individual pdf files that must be downloaded separately.  Fortunately, Cornell student Daniel Green created a single Web-based file.

I have now read the report, or at least browsed through its 699 pages, and I agree that it is better than it first appeared and deserves a revisit (which I am doing in two parts, the second tomorrow).

As with previous Dietary Guidelines, both politics and science underlie this report.  The science components of this report are stunning—as good as such things get—and make this document an invaluable resource.

Why did everyone, including me, miss this?  Politics, of course.  The politics appear unchanged from previous versions (for that, see Food Politics).

The science in this report gives clear guidance for action.  But the report obfuscates its most important messages.

The Executive Summary makes the advice seem dull. The Summary is the part everyone reads first and often the only part anyone reads.  Try this:

The 2010 DGAC report concludes that good health and optimal functionality across the life span are achievable goals but require a lifestyle approach including a total diet that is energy balanced and nutrient dense…SoFAS (added sugars and solid fats) contribute approximately 35 percent of calories to the American diet….Reducing the intake of SoFAS can lead to a badly needed reduction in energy intake and inclusion of more healthful foods into the total diet.

Obesity, it says, is a big problem.  The food environment is a big problem.  What to do about them?  SoFAS.

The report introduces a new euphemism, SoFAS (Solid Fats and Added Sugars).  The meaning of added sugars is obvious.  But what are solid fats?  For that, you must wait until page 183 (on the Daniel Green file):

Solid fats are fats that are solid at room temperature. Solid fats come from many animal foods and can be made from vegetable oils through hydrogenation. Some common solid fats are butter, beef tallow (tallow, suet), chicken fat, pork fat (lard), stick margarine, and shortening. Foods high in solid fats include many cheeses, creams, ice cream, well-marbled cuts of meats, regular ground beef, bacon, sausages, poultry skin, and many baked goods (such as cookies, crackers, donuts, pastries, and croissants).

Earlier (p. 24), the report listed the principal food sources of SoFAS:

Solid fats (percent of solid fat intake)

  • Grain-based desserts, including cakes, cookies, pies, doughnuts, and granola bars (10.9%)
  • Regular cheese (7.7%)
  • Sausage, franks, bacon, and ribs (7.1%)
  • Pizza (5.9%)
  • Fried white potatoes, including French fries and hash browns (5.5%)
  • Dairy-based desserts, such as ice cream (5.1%)

Added sugars (percent of added sugars intake)

  • Soda (36.6%)
  • Grain-based desserts (11.7%)
  • Fruit drinks (11.5%)
  • Dairy-based desserts (6.4%)
  • Candy (6.2%)

The report does not say to eat less of these foods; it talks about nutrientsIn various places in the report, the report says [with my comments in brackets]:

  • Significantly reduce intake of foods containing added sugars and solid fats because these dietary components contribute excess calories and few, if any, nutrients. In addition, reduce sodium intake and lower intake of refined grains, especially refined grains that are coupled with added sugar, solid fat, and sodium. [Nutrients, not foods].
  • Eat less of these: calories from SoFAS, added sugars, solid fats, refined grains, sodium, saturated fat. [Ditto]
  • Significantly lower excessive calorie intake from added sugars, solid fats, and some refined grain products. [Ditto]
  • Strategies to prevent childhood obesity should include efforts to reduce surplus energy intake, especially energy from foods and beverages that provide empty calories from added sugars and solid fats. [Ditto]
  • Intake of caloric beverages, including SSB [sugar-sweetened beverages], sweetened coffee and tea, energy drinks, and other drinks high in calories and low in nutrients should be reduced in consumers needing to lower body weight.  [Only overweight people need to worry about these foods?]

Only once does the report say the clear and simple: “Avoid sugar-sweetened beverages” (p. 65).  Nowhere does it explicitly say to eat less steak, hamburger, French fries, pizza, cookies, or ice cream.

Like previous editions of the Dietary Guidelines, this one talks about foods in the context of eat more (fruits and vegetables).  For eat less advice, it switches to nutrients.  I’d call this obfuscation (and politics).

But the report—for the first time—emphasizes environmental influences on obesity:

The 2010 DGAC recognizes that the current food environment does not adequately facilitate the ability of Americans to follow the evidence-based recommendations outlined in the 2010 DGAC Report. Population growth, availability of fresh water, arable land constraints, climate change, current policies, and business practices are among some of the major challenges that need to be addressed in order to ensure that these recommendations can be implemented nationally.

What business practices?  It doesn’t say.  It does, however, recommend:

  • Improve foods sold and served in schools, including school breakfast, lunch, and afterschool meals and competitive foods so that they meet the recommendations of the IOM report on school meals….
  • Increase comprehensive health, nutrition, and physical education programs and curricula in US schools and preschools, including food preparation, food safety, cooking, and physical education classes and improved quality of recess….
  • Remove sugar-sweetened beverages and high-calorie snacks from schools, recreation facilities, and other places where children gather.
  • Develop and enforce responsible zoning policies for the location of fast food restaurants near schools and places where children play….

This is excellent advice.  But how about some suggestions about what individuals might do about it?

The report says little about food marketing.  Beyond “Develop and enforce effective policies regarding marketing of food and beverage products to children…,” the report says virtually nothing about the well documented impact of food marketing on children’s food choices, dietary intake, and health.  Unless I missed it someplace, the research review does not cite the Institute of Medicine’s 2006 landmark report, Food Marketing to Children and Youth: Threat or Opportunity.

It buries the need for policy changes in long wordy lists.  It states the needs for low-income Americans to have access to and afford healthier foods; to produce fruits, vegetables, and grains sustainably; to ensure household food security; to promote sustainable aquaculture; and to encourage the food service industry to serve healthier foods and smaller portions.  It does not—and perhaps cannot—recommend policy changes to achieve these important goals.

Overall, the report contains plenty of material for food, nutrition, and health advocates to work with, but you have to read between the lines to find it.

Recall the process.  This committee’s report is advisory. From 1980 through 2000,  dietary guidelines advisory committees actually wrote the final Dietary Guidelines.   No more.  Since 2005, the sponsoring agencies decide what the Dietary Guidelines will say.

The report is open for public comment until July 8.  If you think the Dietary Guidelines should provide clear, unambiguous advice about how people should eat to avoid obesity and how we can create a healthier food environment, now would be a good time to express your opinion.  Here’s how.

Tomorrow: The reason why this report is an invaluable resource—its science review.

Jun 15 2010

Dietary Guidelines Advisory Committee files report

Yesterday, I got a last-minute invitation to listen in on a USDA conference call announcing the release of the report of the joint USDA-DHHS Dietary Guidelines Advisory Committee (see www.dietaryguidelines.gov).

The call was remarkable for how little information it produced.  It was scheduled for half an hour, but started 12 minutes late.  Officials used most of the time to talk about how the committee was appointed, how the committee process worked, how transparent everything was, and how staff of USDA’s new Evidence-Based Nutrition Library (NEL) provided much of the research basis for the guidelines.  This left hardly any time for asking questions, and only five got asked.

From what I heard, the committee report says pretty much what previous accounts said it would (see my post on this).  If my notes on the call are correct, the committee report will recommend:

  • Maintain appropriate body weight through diet and physical activity
  • Shift to a more plant-based diet
  • Eat more seafood; eat more low-fat dairy products; limit meat intake
  • Eat less solid fats; eat less of added sugars
  • Reduce sodium; eat fewer refined grains
  • Follow physical activity guidelines

Is this news?  Isn’t this always what the dietary guidelines say?  Here, just for fun, are the first set of guidelines that came out in 1980.

The main difference seems to be the way the evidence was judged and in some of the details: the target for saturated fat is 7% and for sodium a gradual reduction to 1500 mg/day.

If so, that’s a lot of trouble to go through to get to basically the same place.  I summarized that place in What to Eat as “Eat less, move more, eat plenty of fruits and vegetables, and don’t eat too much junk food.”  Michael Pollen did it even more succinctly: “Eat food.  Mostly plants.  Not too much.”

So why would two federal agencies and 13 committee members go to all this trouble?

The quick answer is that the agencies have to.  Congress says they have to review the guidelines every five years.

The longer answer, which I discuss in Food Politics and What to Eat, is that every word of the dietary guidelines is fraught with politics.

According to Food Chemical News (June 14),

The document is frequently the source of much controversy in the food industry because of the way it is used to promote certain ingredients and eating habits…Observers expect some controversy this year over recommendations made with regard to salt, a subject discussed frequently in committee meetings, as well a possible suggestion to replace two servings of grain with two servings of vegetables.

Another controversy is brewing in regards to the information on which the report was based. On Friday, the American Meat Institute, the National Cattleman’s Beef Association, the Grocery Manufacturer’s Association and the Grain Foods Foundation were among 23 groups that asked USDA and HHS to provide access to the Nutrition Evidence Library, which contains all the research used by the Dietary Guidelines committee when making their recommendations. “Without access to the data from which the DGAC drew its conclusions and recommendations, the public may not be able to provide meaningful comments,” the letter states.

Right. And now let’s see what the agencies do with this report (here’s the USDA press release on what happens next and how to comment).  This report is, after all, merely advisory. Now, the real politics begins!

Additions:

Here is all the information about the Advisory Committee’s report, and the report itself (but why didn’t they put it in one easy pdf file?).

And here is USA Today’s take on it: “Panel: obesity is century’s greatest public health threat.”

Further addition, June 16: Thanks to Daniel Green (Cornell) for putting the report together in one enormous (19MB) file.