by Marion Nestle

Currently browsing posts about: Dietary-Guidelines

Jan 4 2016

Politico Pro Agriculture’s pick of top 2015 food policy stories

Jason Huffman, Helena Bottemiller Evich, and Jenny Hopkinson of Politico Pro Agriculture have published their end-of-year assessment of game-changing events in food and agriculture policy last year.  Here’s their list:

  • Avian flu blew up the U.S. egg industry.
  • The Trans-Pacific Partnership deal got done.
  • The battle over the Dietary Guidelines turned even nastier.
  • The FDA banned most uses of trans fat.
  • The FDA said a genetically engineered fish is safe to eat.
  • The EPA released its final Waters of the U.S. rule, inciting the wrath of multiple industries, states and lawmakers.
  • A federal judge sent peanut company executives to jail for decades for their part in a giant salmonella outbreak.
  • The FDA released major rules to promote the safety of produce and imports.
  • The FDA doubled down on added sugars on food labels, proposing daily values for the listings.

I’ve discussed most of these on this site (all except Waters of the US).

I can’t wait to see what this year brings—more of the same, for sure, but what else?  Stay tuned.

Dec 16 2015

House Appropriations Bill Affects 2015 Dietary Guidelines

The bill just passed by the House contains this language:

SEC. 734. None of the funds made available by this or any other 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 U.S.C. 5341), unless the Secretary of Agriculture and the Secretary of Health and Human Services ensure that each revision to any nutritional or dietary information or guideline contained in the 2010 edition of the Dietary Guidelines for Americans and each new nutritional or dietary information or guideline to be included in the eighth edition of the Dietary Guidelines for Americans.

(1) is based on significant scientific agreement; and

(2) is limited in scope to nutritional and dietary information.

SEC. 735.

(a) Not later than 30 days after the date of the enactment of this Act, the Secretary of Agriculture shall engage the National Academy of Medicine to conduct a comprehensive study of the entire process used to establish the Advisory Committee for the Dietary Guidelines for Americans and the subsequent development of the Dietary Guidelines for Americans, most recently revised pursuant to section 301 of the National Nutrition Monitoring and Related Research Act of 1990 (7 U.S.C. 5341). The panel of the National Academy of Medicine selected to conduct the study shall include a balanced representation of individuals with broad experiences and viewpoints regarding nutritional and dietary information.

(b) The study required by subsection (a) shall include the following:

(1) An analysis of each of the following:

(A) How the Dietary Guidelines for Americans can better prevent chronic disease, ensure nutritional sufficiency for all Americans, and accommodate a range of individual factors, including age, gender, and metabolic health.

(B) How the advisory committee selection process can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints.

(C) How the Nutrition Evidence Library is compiled and utilized, including whether Nutrition Evidence Library reviews and other systematic reviews and data analysis are conducted according to rigorous and objective scientific standards.

(D) How systematic reviews are conducted on longstanding Dietary Guidelines for Americans recommendations, including whether scientific studies are included from scientists with a range of viewpoints.

(2) Recommendations to improve the process used to establish the Dietary Guidelines for Americans and to ensure the Dietary Guidelines for Americans reflect balanced sound science.

(c) There is hereby appropriated $1,000,000 to conduct the study required by subsection (a).

Comment:  I continue to be astonished that the House of Representatives would take such an intense interest in the science of nutrition when it is so uninterested in the science of climate change.  And I am puzzled as to why the House thinks that nutrition scientists appointed by the Academy of Medicine (formerly Institute of Medicine) would have views any different from those of the current Dietary Guidelines Advisory Committee.

Will the USDA and HHS release the 2015 Dietary Guidelines before the Senate passes its version of the Appropriations bill?

I’m in Geneva this week and am hoping they wait until I get back.

Oct 7 2015

The bizarre saga of the 2015 Dietary Guidelines: Continued

Two events yesterday:

#1.  USDA and HHS announce that sustainability will not be part of the Dietary Guidelines.

This year, we will release the 2015 edition, and though the guidelines have yet to be finalized, we know they will be similar in many key respects to those of past years. Fruits and vegetables, low-fat dairy, whole grains and lean meats and other proteins, and limited amounts of saturated fats, added sugars and sodium remain the building blocks of a healthy lifestyle.

…In terms of the 2015 Dietary Guidelines for Americans (DGAs), we will remain within the scope of our mandate in the 1990 National Nutrition Monitoring and Related Research Act (NNMRRA), which is to provide “nutritional and dietary information and guidelines”… “based on the preponderance of the scientific and medical knowledge.”  The final 2015 Guidelines are still being drafted, but because this is a matter of scope, we do not believe that the 2015 DGAs are the appropriate vehicle for this important policy conversation about sustainability.

OK, but see Michele Simon’s analysis of the legal issues related to sustainability in the guidelines, and My Plate My Planet’s analysis of the comments filed on the sustainability question.

As my analysis shows, the USDA and HHS would be well within its legal authority to include sustainability. In summary:

    • A plain reading of the statute does not preclude sustainability;
    • The Congressional intent was to further a broad agenda on health;
    • Previous DGA versions included issues beyond “nutrition and diet”.

And also see Kathleen Merrigan et al’s argument in favor of sustainable dietary guidelines in Science Magazine.

So this is about politics, not science.

#2.  A coalition of critics of the Dietary Guidelines is attempting to block their release.

Yesterday’s Hagstrom Report and, later, Politico (both behind paywalls) reported that this group is calling on  USDA and HHS to turn over the guidelines to a committee of the National Academy of Sciences Food and Nutrition Board for reexamination before releasing them to the public.

The issues?  The meat and beverage recommendations.

The group is funded by philanthropists Laura and John D. Arnold, who fund Nina Teicholz’s work.

Teicholz is on the board of the group as is Cheryl Achterberg, dean of the Ohio State University College of Education, and John Billings, who directs the Wagner School’s Health Policy and Management Program at NYU (why they agreed to do this is beyond me).

Hagstrom notes that coordinating support is coming from Beth Johnson, a former undersecretary for food safety at USDA who has her own consulting firm with clients apparently including the National Restaurant Association and the National Cattlemen’s Beef Association.

Other members of the advisory board include several scientists who do research funded by food companies.

The Coalition’s website is here.

This morning’s Politico Pro Agriculture has a long piece on the funding behind the coalition.

In the lead up to congressional hearings on the proposed 2015 dietary guidelines, the Arnolds are spending an initial $200,000 to communicate that critique and to advocate for changes that they say would improve the process. They have funded the new political action group, called The Nutrition Coalition, whose well-placed lobbyists have helped Teicholz score face-to-face meetings with top officials in Congress and the White House to push for an independent review of the guideline process. The team helped persuade lawmakers to insert language in the fiscal 2016 House agriculture spending bill to direct the National Academy of Medicine to conduct such a review.

Really? Eating fruits and vegetables and not overeating calories requires this level of lobbying?

This too is about politics.

The mind boggles.

Addition

The Hagstrom Report is keeping track of the testimony at today’s congressional hearing on the guidelines.

Sep 28 2015

Never a dull moment: the BMJ’s attack on the Dietary Guidelines Advisory Committee report

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.

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: 

Aug 24 2015

USDA wants to pre-test Dietary Guidelines’ messages. Good idea!

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.

Jul 23 2015

Congress continues to intervene in Dietary Guidelines

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.

Jun 24 2015

Let’s stop Congress from interfering with the dietary guidelines, please

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:

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.”

May 19 2015

The 2015 Dietary Guidelines: the saga continues

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.