Dietary Guidelines 2015

 In Preventive Medicine Column

2015 Dietary Guidelines

The 2015 Dietary Guidelines were released on 1/7/16. Where these DGs are good, and there aren’t many places in the lengthy document, it’s where they preserved key components of the stellar 2015 Dietary Guidelines Advisory Committee report.  For example, the DGs respect the scientific recommendations about key nutrient thresholds, such as limiting saturated fat intake, not limiting total fat intake, and perhaps most importantly, limiting added sugar. They also preserve the idea, if not a sensible representation of it, of healthy dietary patterns, and provide examples to show that these are variations on a theme. I can give this very little bit of credit where so little credit is due.

Otherwise, as compared to the DGAC Report, the DGs represent a disgraceful replacement of specific guidance with the vaguest possible language. A term that recurs often, clearly intended to sound like something while saying next to nothing, is ‘nutrient dense foods.’ That replaces reference to specific foods that populate the original scientific report. It might mean broccoli, it might mean Total Cereal. I guess it might even mean pepperoni. We can’t tell, and that is clearly by design.

There is an astonishing effort to shoehorn in advice to keep consuming ‘all food groups.’ When is the last time we have even heard that term? Not only is this document a display of complete submission to special interests, it is a submission to special interests stuck in 1950! Seriously, eat from all ‘food groups’?

There is a disgraceful backtracking on clear recommendations in the scientific report on which the DGs are all-too-loosely based to eat less meat and more plants. The report advises particular age groups of men and boys to cut back somewhat on meat intake, but all this does is highlight the abandonment of the recommendation in the DGAC Report that “less” meat was advisable to the general population for the sake of people and planet alike.

There is overt hypocrisy on display as well. The DGs explicitly, even in the Executive Summary, emphasize the importance of physical activity. I am entirely in support of this recommendation. But how is this a “dietary” guideline? Congress decided, some months ago, that sustainability would NOT be included in these guidelines because it was beyond the mandate of the DGAC. Really? The ability to keep supplying the food recommended is not considered relevant enough, but a topic that isn’t about food at all –is? I really don’t think you even need to be able to spell hypocrisy to smell it here.

While the report talks about foods being emphasized over nutrients, recommendations about what NOT to eat (or, even, what to limit) are entirely cast in terms of nutrients. We are advised to limit our intake of saturated fat, for instance- but there is virtually no language, and none featured prominently, indicating what foods to avoid to achieve that. Much the same is true of added sugar.   Clearly advice about eating less of anything conflicts with the interests of some big industry sector the federal agencies and their bosses in Congress don’t want to upset. So, somehow, we are left to cut back on our intake of saturated fat and sugar while washing down our corned beef with Coca-Cola. Good luck, folks.

The 2015 Dietary Guidelines for Americans is, alas, a virtuoso display of linguistic contortionism to remove from the nation’s official nutrition policy document the actionable clarity of the DGAC at every opportunity. We are left with the notion that we can probably just eat whatever we want, and all will be well.

Except it won’t. We are awash in preventable chronic disease. We are eating away our own health. We are eating our children’s health, and their food, and drinking up their water. We are, into the bargain, devouring our very planet. Yet we are told here to keep on keeping on. That’s what you get when it is politics, rather than science, on the plate.

The good news- and there isn’t much this day- is that we don’t have to swallow this. Having chewed on it, and choked on it, we can just spit it out. I call on you to do just that. The 2015 DGAC Report is in the public domain. So, ignore the DGs, and turn to the DGAC Report for guidance instead. It is accessible to you, and it is about you- not the wealth of Congressional cronies. I call upon my colleagues in public health and science, as indeed I have done, to band together and express our views directly, and in a common voice, cutting out the political middleman. We have the capacity to do that, and the public has the opportunity to decide whom to trust.

The bad news is that our Dietary Guidelines are pretty awful. The good news is that guidance isn’t guidance if no one follows- and we don’t have to follow where this national embarrassment leads. We have been betrayed.  We have received a plate full of festering politics as usual.  But…we don’t have to eat it!

-fin Dr. David L. Katz;www.davidkatzmd.com; author, Disease Proof; founder, True Health Initiative

Dr. David L. Katz
DAVID L. KATZ MD, MPH, FACPM, FACP, FACLM, is the founding director (1998) of Yale University's Yale-Griffin Prevention Research Center, and current President of the American College of Lifestyle Medicine. He earned his BA degree from Dartmouth College (1984); his MD from the Albert Einstein College of Medicine (1988); and his MPH from the Yale University School of Public Health (1993). He completed sequential residency training in Internal Medicine, and Preventive Medicine/Public Health. He is a two-time diplomate of the American Board of Internal Medicine, and a board-certified specialist in Preventive Medicine/Public Health. He has received two Honorary Doctorates. Dr. Katz has published roughly 200 scientific articles and textbook chapters, and 15 books to date, including multiple editions of leading textbooks in both Preventive Medicine, and nutrition. Recognized globally for expertise in nutrition, weight management and the prevention of chronic disease, he has a social media following of well over half a million. In 2015, Dr. Katz established the True Health Initiative to help convert what we know about lifestyle as medicine into what we do about it, in the service of adding years to lives and life to years around the globe.
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