Currently browsing posts about: Dietary-Guidelines

I’ve saved this for Weekend Reading because it will take a weekend to get through it.  The report is a blockbuster: 37 authors, 47 pages, 357 references.

The Lancet commissioned this report from the EAT Forum, which brought together international experts on diet and health (most of whom I do not know) to define unifying dietary principles that best promote will promote the health of people and the planet.

Fortunately, the diet that is best for health is the same diet as is best for the planet.  The report defines it on page 5.

To summarize:

This report has many strengths:

• It is researched in depth and is now the reference source for information about needed dietary changes.
• It firmly links dietary health to environmental sustainability.
• Its findings are consistent with many previous reports on diet and health, including that of the 2015 Dietary Guidelines Advisory Committee DGAC).
• Its messages are unambiguous.
• The summary report is a big help
• The timing  is excellent; the 2020 Dietary Guidelines advisory committee, if it ever gets appointed, will have to pay close attention to the science reviewed in this report.
• It focuses on food, not nutrients (these meals meet the standards of recommended diets).

Does this report settle the questions?  Hardly.  Remember the fuss over sustainability (the “S-word?”) in the 2015 report of the DGAC?

• The meat industry does not like advice to eat less meat.
• The dairy industry doesn’t like it either.  Its trade associations emphasize its nutritional value and source of livelihood for a billion people.
• The food industry has lots of complaints.

There is lots to read and think about here.  Enjoy!

• The Lancet home page for the report (includes slides, links)
• The Lancet editorial accompanying the report
• The EAT Forum home page for the report (information about EAT, the launch, the commission members, etc)
• The EAT Forum summary report

I was surprised to read a recent paper in the American Heart Association journal arguing that dietary diversity may not be good for health:

“Eat a variety of foods,” or dietary diversity, is a widely
accepted recommendation to promote a healthy, nutritionally adequate
diet and to reduce the risk of major chronic diseases. However, recent
evidence from observational studies suggests that greater dietary diversity is associated with suboptimal eating patterns, that is, higher intakes of processed foods, refined grains, and sugar-sweetened beverages and lower intakes of minimally processed foods, such as fish, fruits, and vegetables, and may be associated with weight gain and obesity in adult populations.

Obviously, eating a variety of junk food is unlikely to improve health.  But the variety recommendation has never been intended to include junk food.

Here’s a summary of the variety recommendations of the Dietary Guidelines from 1980 to 2015:

These have increasingly specified healthy foods.

Eat your veggies!  Enjoy!

Remember the Dietary Guidelines?  Those pesky things that have to be revised every five years by order of Congress?

This time, the USDA is firmly in charge of the joint process with HHS.

It says the updating process is well underway.

The call has gone out for nominations of advisory committee members.  This is now closed and USDA expects to appoint the committee within the next few months.

And now it has put the official charter for the process out for comment.

It also has issued a Q and A.

And provides a schedule for public engagement.

A few aspects of this especially interest me:

• Nothing has been said about a new food guide (MyPlate is left over from the 2010 guidelines).
• USDA’s close control.  It says this is mandated by Congress.
• The level of scrutiny of the process will be exceptional, giving the fuss about the 2015 guidelines.
• Expect the process to be highly politicized.

This committee will have its work cut out for it.  Much appreciation to the brave souls willing to take this on.

I can’t wait to see who they are.

Stay tuned.

The USDA has issued a Call for Nominations for the 2020 Dietary Guidelines Advisory Committee

The independent advisory committee will review the scientific evidence to help inform the next edition of the Dietary Guidelines for Americans. The deadline to submit nominations for the Dietary Guidelines Advisory Committee is October 6, 2018, at 11:59 pm, Eastern Time.

Good luck with this. I don’t envy anyone serving on this committee.

The issues:

• The late start. By law, the guidelines are supposed to be submitted in 2020. The committee will be under pressure to move quickly.
• USDA’s dominance. The guidelines are supposed to be jointly produced by two agencies; the other is HHS. The absence of HHS from this announcement seems curious. USDA must be the lead this year and can be expected to allow politics to trump (pardon the expression) science.
• Science politics. Questions—qualitative and quantitative—about fat v. carbohydrates are hotly debated and not easy to resolve.
• Food industry influence. This is always a problem but this influence—on research and policy—is now under sharp scrutiny (my forthcoming book adds to the scrutiny, I hope).
• Government interference. The committee writes an advisory report. Then USDA and HHS take over and do what they please with what the committee produces.  And we know, because USDA said so, that this administration intends to take a more active role in setting the agenda and in committee discussions.
• Spotlight. Everything this committee does will be public and publicized on the front pages of newspapers and in social media.
• Courage. It will take plenty.

Here’s what USDA says about factors to be considered in reviewing nominations:

• Educational background – advanced degree in nutrition- or health-related field, including registered dietitians, nutrition scientists, physicians, and those with public health degrees
• Professional experience – at least 10 years of experience as an academic, researcher, practitioner, or other health professional in a field related to one or more of the topics to be examined; consideration of leadership experience and participation on previous committees or panels
• Demonstrated scientific expertise – expertise related to one or more of the topics to be examined by the committee as demonstrated by number and quality of peer-reviewed publications and presentations
• Obligations under the Federal Advisory Committee Act – ensuring the Committee is balanced fairly in points of view and types of expertise
• Requirements regarding a balanced membership – including, to the extent possible, individuals who are minorities, women, persons with disabilities, and representatives from different geographic areas and institutions

More information is available on DietaryGuidelines.gov:

• See What to Include in a Nomination Package
• See the Topics and Scientific Questions to be Examined by the Committee
• Learn How USDA-HHS Will Establish the Committee
• Additional Resources

This tweet certainly got my attention:

It referred to Alex Kotch’s article in the International Business Times about how White House lawyer Donald McGahn has granted a waiver of conflict of interest rules to allow Kailee Tkacz, a former lobbyist for the Snack Food Association and, more recently, for the Corn Refiners Association, to advise the USDA about the forthcoming 2020 dietary guidelines.

Ms. Tkacz also was food policy director for the Corn Refiners Association, which represents producers of high fructose corn syrup (HFCS).

McGahn explained that this waiver would allow Ms. Tkacz “to advise the Secretary of Agriculture and other senior Department officials with respect to the Dietary Guidelines for Americans process.”

He says “it is in the public interest to grant this limited waiver because of Ms. Tkacz’s expertise in the process by which the Dietary Guidelines for Americans are issued every five years.”

The dietary guidelines historically have issued recommendations to consume less salt and sugar.  Snack foods are major sources of salt in U.S. diets.  Soft drinks sweetened with HFCS are major sources of sugars.

USDA is the lead agency for the 2020 guidelines.

Want to make some bets on what they will say about salt and sugar (a wild guess: the science isn’t firm enough to suggest eating less of either).

Secretary Sonny Perdue has released his blueprint for the 2018 farm bill.

Its goal is to “improve services while reducing regulatory burdens on USDA customers” [translation: Big Ag].

USDA, he says, supports legislation that will do a great many things for farm production, conservation, trade, food and nutrition services, marketing, food safety, research and education, and natural resources.

There are a lot of words here and it’s hard to know what they mean, even reading between the lines.

For example, here are USDA’s principles for SNAP (food stamps), with my [translations and questions]:

• Harness America’s agricultural abundance to support nutrition assistance for those truly in need.  [This sounds like a food distribution program, but I’m wondering how “truly in need” will be defined.]
• Support work as the pathway to self-sufficiency, well-being, and economic mobility for individuals and families receiving supplemental nutrition assistance.  [This means work requirements, but where will the jobs come from?]
• Strengthen the integrity and efficiency of food and nutrition programs to better serve our participants and protect American taxpayers by reducing waste, fraud and abuse through shared data, innovation, and technology modernization. [This means spending hundreds of millions a year on fraud prevention].
• Encourage state and local innovations in training, case management, and program design that promote self-sufficiency and achieve long-term, stability in employment.  [The jobs?]
• Assure the scientific integrity of the Dietary Guidelines for Americans process through greater transparency and reliance on the most robust body of scientific evidence.  [Weren’t they always based on the available science?  This sounds like a way to prevent the guidelines from suggesting eating less of junk foods].
• Support nutrition policies and programs that are science based and data driven with clear and measurable outcomes for policies and programs. [This one translates to you can’t set nutrition policies unless you can demonstrate beneficial outcomes—fine in theory, but policy-blocking in practice].

Reading through the other sections is equally non-reassuring.  Where is a vision for a farm bill that promotes health, sustainable agriculture, and small or mid-size farms, protects farm workers, and reduces greenhouse gases?

Maybe the next one?

Thanks to my colleague Lisa Young for taking this photo at the Magnolia Bakery in Manhattan.

You may recall that one result of the fuss over the highly controversial BMJ article attacking the Dietary Guidelines process was appointment of a committee to review that process.

It has just published the first of its reports, which deals only with the first of the four charges to the committee, which were to determine:

1. How the selection process for the Dietary Guidelines Advisory Committee (DGAC) can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints;
2. How the Nutrition Evidence Library (NEL) is compiled and used, including whether the NEL reviews and other systematic reviews and data analysis are conducted according to rigorous and objective scientific standards;
3. How systematic reviews are conducted on long-standing DGAC recommendations, including whether scientific studies are included from scientists with a range of viewpoints; and
4. How the DGA can better prevent chronic disease, ensure nutritional sufficiency for all Americans, and accommodate a range of individual factors, including age, gender, and metabolic health.

The committee identified values governing the committee selection process:

• Enhance transparency
• Promote diversity of expertise and experience
• Support a deliberative process
• Manage biases and conflicts of interest
• Adopt state-of-the-art processes and methods

Its recommendations:

• Employ an external third party to review the candidate pool for committee members.
• Make the list of provisional appointees open for public comment.
• Publicly disclose nominees’ biases and conflicts of interest; develop a plan for managing them; have them reviewed by a federal ethics officer; document all this in the advisory committee’s report.
• Adopt a system for continuous process improvement in the selection process.

Good recommendations and good luck with them.

I can hardly wait to see this committee’s report on the remaining charges.

In the meantime, it’s about time to start appointing the 2020 Dietary Guidelines Advisory Committee, no?