What's Wrong with US Dietary Guidelines?

By Dr. Mercola

Every five years, the US Departments of Agriculture (USDA) and Health and Human Services (HHS) convene a 15-member panel – the Dietary Guidelines Advisory Committee (DGAC) – to update the nation's dietary guidelines.

The panel's mission is to identify foods and beverages that help you achieve and maintain a healthy weight, promote health, and prevent disease. In addition to guiding the public at large, the guidelines significantly influence nutrition policies such as school lunch programs and feeding programs for the elderly.

The problem is the guidelines have a long history of flawed and misguided advice, such as recommending Americans consume diets heavy in grains and low in healthy fats, which has helped to fuel the epidemics of obesity, diabetes, and other chronic diseases we're now seeing.

The upcoming 2015 US Dietary Guidelines, which are currently being reviewed by US health and agricultural agencies, have a chance to change that and set the record straight – and there had been some promising steps forward, such as a recommendation to remove warnings about dietary cholesterol.

However, with the latest guidelines set to be released this fall, a new report published in the journal BMJ has brought deserved criticism, including suggesting the guidelines are still not based on the latest science.

BMJ Report: Dietary Guidelines Not Based on Latest Science

The DGAC scientific report, which serves as the foundation for the development of the dietary guidelines, "fails to reflect much relevant scientific literature in its reviews of crucial topics and therefore risks giving a misleading picture," according to an investigation by the BMJ.¹

The report is authored by Nina Teicholz, an investigative journalist and author of The Big Fat Surprise: Why Butter, Meat, and Cheese Belong in a Healthy Diet. She continues:

"The omissions [in science] seem to suggest a reluctance by the committee behind the report to consider any evidence that contradicts the last 35 years of nutritional advice."

While past committees used the USDA's Nutrition Evidence Library (NEL) as a basis for collecting studies to form the guidelines, this year's committee looked elsewhere for data on 70 percent of the topics it covered.

That data came largely from professional organizations like the American Heart Association (AHA), which not only conduct literature reviews based on different standards but are also known to be heavily supported by food and drug companies.

In January 2009, for instance, the AHA published a "scientific advisory" recommending that Americans consume more omega-6 fats (mostly refined vegetable oils) and fewer saturated fats, as part of the "heart healthy" low-fat, low-cholesterol diet.

In spite of ALL scientific data to the contrary, this is the rubbish they recommended, completely ignoring the fact that the standard American diet is overloaded with omega-6 fats (and poor-quality ones at that), while being severely deficient in critical omega-3s.

And last year, the American Beverage Association (ABA), which includes members such as Coca-Cola, PepsiCo, and Dr. Pepper Snapple Group, announced a partnership with the Alliance for a Healthier Generation, an organization founded, in part, by the American Heart Association.

Relying heavily on data produced by these industry-beholden organizations was DGAC's first mistake… but there's more, too.

Guidelines on Saturated Fats Appear Significantly Flawed

In a surprise twist, the DGAC not only suggested eliminating warnings about dietary cholesterol, it also reversed nearly four decades of nutrition policy by concluding that dietary fats have no impact on cardiovascular disease risk.

Unfortunately, the DGAC didn't set the record straight with regard to saturated fats, as it makes no firm distinction between healthy saturated fats and decidedly unhealthy synthetic trans fats.

The guidelines committee concluded that evidence linking saturated fat to heart disease was strong, but for decades healthy fat and cholesterol have been wrongfully blamed for causing heart disease. Over 70 published studies overwhelmingly dispute this flawed notion.²

For starters, DGAC must have missed the 2014 meta-analysis published in the Annals of Internal Medicine that used data from nearly 80 studies and more than a half-million people.

It found those who consume higher amounts of saturated fat have no more heart disease than those who consume less. They also did not find less heart disease among those eating higher amounts of unsaturated fat, including both olive oil and corn oil.³

They must have also missed the 2015 meta-analysis published in the British Medical Journal (BMJ), which found no association between high levels of saturated fat in the diet and heart disease. Nor did they find an association between saturated fat consumption and other life-threatening diseases like stroke or type 2 diabetes.⁴

Suggesting Saturated Fats May Be Healthy Sends Nutrition World into a 'Tizzy'

The nutritional myth that saturated fat is bad for you continues to fall apart as a steady stream of new books and studies on this topic hit the media. Teicholz's book The Big Fat Surprise is among those works challenging the old dogma.

Teicholz pointed out the flaws in the original Ancel Keys study, how saturated fat has been a healthy human staple for thousands of years, and how the low-fat craze has resulted in excessive consumption of refined carbohydrates, which has resulted in increased inflammation and disease.⁵

Unfortunately, none of this important health information is reflected in the committee's report.

In fact, the committee goes so far as to put saturated fats and sugar together in one category called "empty calories," which is not only misleading but scientifically inaccurate. TIME reported:⁶

"Teicholz says nutrition science doesn't support that classification, since saturated fats are consumed largely in foods like eggs, meat, and dairy which contain lots of vitamins and nutrients necessary for health.

'Saturated fat is not empty calories. Sugar is not empty calories,' says Dr. Robert Lustig, a professor of Pediatrics at the University of California, San Francisco, and co-founder and president of the Institute for Responsible Nutrition. 'Sugar is not dangerous because it's calories; sugar is dangerous because it is toxic calories.'"

Just the fact that Teicholz has dared to question the government's "expert" committee and their (flawed) opinion about saturated fat has "sent the nutrition world into a tizzy," as Politico put it. The media has been similarly flustered, with Politico reporting:⁷

"… [H]er [Teicholz's] take has now sparked a significant amount of national press coverage. CNN, Time, Newsweek, Yahoo, Mother Jones, and Medical Daily were among the media outlets to pick up the story. Reason went with the headline: 'U.S. Government Nutrition Advice Is Stuck in 1980s.'"

BMJ 'Clarifies' Dietary Guidelines Investigation

Following the media uproar over Teicholz's criticism of the dietary guidelines, BMJ issued two "clarifications."⁸ The update was featured on Retraction Watch even though, to be clear, the BMJ report was not retracted.⁹ The clarifications involved just two aspects of the investigation, one involving the phrase "deleting lean meat" and the other regarding the percentage of reviews conducted by the National Evidence Library. According to the BMJ update:¹⁰

"We are happy to clarify two aspects of Nina Teicholz's article.

1. Deletion of meat: The article sought to report how the DGAC has dropped lean meat from the list of foods recommended for a healthy diet. Although lean meats are recommended in the 2010 guidelines, they no longer appear in the committee's proposals for the updated 2015 guidelines.

The article says: 'New proposals by the 2015 report include not only deleting meat from the list of foods recommended as part of its healthy diets, but also actively counselling reductions in 'red and processed meats.' We accept that the article would have been clearer if it had used the phrase 'deleting lean meat' rather than 'deleting meat.'

2. Percentage of reviews conducted by the National Evidence Library: The article notes that the DGAC 'did not use NEL reviews for more than 70 percent of the topics.' Because some of the topics did not require reviews of the scientific literature, the article would have been clearer had the next sentence specified that we were referring only to those that did. The numbers provided by the report are contradictory, but it appears that the portion of questions requiring a systematic review that did not receive one is 63 percent."

Committee Misses Benefits of Low-Carb Diets

Unchanged is the fact that, while lambasting saturated fats, the committee is reluctant to point the finger at America's processed-carb addiction; instead they concluded only limited evidence exists on low-carbohydrate diets and health, so the topic is insufficiently reviewed in their recommendations. But as Teicholz wrote in the BMJ:¹¹

"… [M]any studies of carbohydrate restriction have been published in peer review journals since 2000, nearly all of which were in US populations…

A meta-analysis… concluded that low carbohydrate diets are better than other nutritional approaches for controlling type 2 diabetes, and two meta-analyses have concluded that a moderate to strict low carbohydrate diet is highly effective for achieving weight loss and improving most heart disease risk factors in the short term (six months).

… Given the growing toll taken by these conditions and the failure of existing strategies to make meaningful progress in fighting obesity and diabetes to date, one might expect the guideline committee to welcome any new, promising dietary strategies. It is thus surprising that the studies listed above were considered insufficient to warrant a review."

Committee Members Are Not Required to List Their Potential Conflicts of Interest

Unlike the authors published in most major medical journals, DGAC members are not required to list their potential conflicts of interest, leaving the door wide open for bias and influence from outside agendas and commercial interest. As Teicholz wrote: "Many experts, institutions, and industries have an interest in keeping the status quo advice, and these interests create a bias in its favor."¹²

Not surprisingly, even a cursory investigation revealed potential conflicts among committee members. According to the BMJ:¹³

"… [O]ne member has received research funding from the California Walnut Commission and the Tree Nut Council, as well as vegetable oil giants Bunge and Unilever. Another has received more than $10,000… from Lluminari, which produces health related multimedia content for General Mills, PepsiCo, Stonyfield Farm, Newman's Own, and 'other companies.'

… And for the first time, the committee chair comes not from a university but from industry: Barbara Millen is president of Millennium Prevention, a company based in Westwood, MA, that sells web based platforms and mobile applications for self health monitoring. While there is no evidence that these potential conflicts of interest influenced the committee members, the report recommends a high consumption of vegetable oils and nuts as well as use of self-monitoring technologies in programs for weight management."

CSPI Blasts BMJ Article… Gets It Wrong Again

I've referred to the Center for Science in the Public Interest (CSPI) as the consumer group you need to stop listening to, and this case is no exception. The group released a statement calling Teicholz's BMJ report "distorted" and "error-laden," but CSPI is the group that's gotten it wrong, again.¹⁴

They point out that DGAC's advice is "consistent with dietary advice from virtually very major health authority," and then go on to list some of the most industry-beholden and misguided organizations in the health field, like AHA and the American Diabetes Association – the latter of which still recommends diabetics consume toxic artificial sweeteners and grains and does not recommend restricting fructose-containing added sugars to any specific level at all...

This isn't entirely surprising, since history shows CSPI is seriously misguided when determining what's in the public's best interest. In the 1980s, CSPI actually spearheaded a highly successful campaign against the use of healthy saturated fats, touting trans fats as a healthier alternative. It was largely the result of CSPI's campaign that fast-food restaurants replaced the use of beef tallow, palm oil, and coconut oil with partially hydrogenated vegetable oils, which are high in synthetic trans fats linked to heart disease and other chronic diseases.

In 1988, CSPI even released an article praising trans fats, saying "there is little good evidence that trans fats cause any more harm than other fats" and "much of the anxiety over trans fats stems from their reputation as "unnatural.'"¹⁵ In contrast, Teicholz was one the reporters who initially broke the story on the dangers of trans fats, more than 10 years ago, in an article for Gourmet magazine, so perhaps their critique of her BMJ piece is personal…¹⁶

The Recommended 'Low-Fat, High Carbohydrate' Diet Has Not Produced Better Health for Americans

Download Interview Transcript

While the committee members are standing by their report, even stating they thought they "nailed it," Congress is meeting to discuss concerns, including those related to the evidence used, in October 2015. In short, the committee report sticks largely to the status quo nutritional advice given for decades, that Americans should eat less fat and fewer animal products for better health (with one exception being that they recommended a cap be put on sugar intake). On the contrary, a diet high in healthy fats and vegetables and low in sugar and grain-based carbs is what many Americans need for optimal health. Teicholz told TIME:¹⁷

"I believe that the literature shows that the low-fat, high-carbohydrate diet has not produced better health for Americans since it was first introduced as official government policy in 1980… For healthy people, a reasonable recommendation would be simply to reverse out of the high-carb diet to the balance that Americans ate in 1965 before the obesity and diabetes epidemics: roughly 40 percent carbs, 40 percent fat.

For people who are struggling with obesity and diabetes, which is now an astonishing proportion of our population, I believe that carbohydrate restricted diets — less than 40 percent carbs — should be presented as a safe and viable option."

If you want to learn more, watch my interview with Nina Teicholz, above. Many people actually need to increase the healthy fat in their diet even more, to 50 to 85 percent of daily calories. This includes not only saturated fat but also monounsaturated fats (from avocados and nuts) and omega-3 fats.

But one of the most important points to remember is that you do not need to avoid saturated fats. Saturated fats were unfairly condemned in the 1950s based on very primitive evidence that has since been re-analyzed. The evidence now clearly shows that saturated fats do not cause heart disease. Moreover, your body needs saturated fats for proper function of your:

Cell membranes	Heart	Bones (to assimilate calcium)
Liver	Lungs	Hormones
Immune system	Satiety (reducing hunger)	Genetic regulation

"Another key piece of information is that a high-fat, carbohydrate-restricted diet looks healthier for losing weight and making your heart disease biomarkers and diabetes biomarkers look better. There's a real range in how much carbohydrates people will tolerate," Teicholz says.

What Does a Real Food Plan for Optimal Health Look Like?

Focusing your diet on raw, whole, and ideally organic foods rather than processed fare is perhaps one of the easiest ways to sidestep dietary pitfalls like excess sugar/fructose, harmful synthetic trans fats, an overabundance of processed grains, genetically modified organisms (GMOs), and other harmful additives, while getting plenty of healthy nutrients. The rest is just a matter of tweaking the ratios of fat, carbs, and protein to suit your individual needs.

One key, though, is to trade refined sugar and processed fructose for healthy fat, as this will help optimize your insulin and leptin levels. For more detailed dietary guidance, please see my optimal nutrition plan. It's a step-by-step guide to feeding your family right, and I encourage you to read through it. I've also created my own "food pyramid," based on nutritional science, which you can print out and share.