Posts Tagged ‘nutrition’
By: Kimberly Leblanc, Ph.D.
Earlier this month, the Office of Disease Prevention and Health Promotion released the new nutritional guidelines, Dietary Guidelines for Americans, for 2015-2020. Many of the guidelines are familiar from previous versions, recommending a wide range of fruits and vegetables, at least 50% of grains being whole, fat-free or low-fat dairy, a variety of lean proteins, and limiting saturated fats, trans-fats, and sodium. One of the new recommendations was a stricter limit on sugar intake, with no more than 10% of daily calories coming from added sugar. The World Health Organization (WHO) has made similar recommendations, citing evidence that lowering added sugar could reduce the risk of obesity, heart disease, Type 2 diabetes and some types of cancer. In an article for Politico, Michael Jacobson, president of the Center for Science in the Public Interest (CSPI), said that the recommended limit is “a major step forward.” The biggest surprise in the guidelines was the recommendation that men and boys “reduce their overall intake of protein foods” such as meat, poultry and eggs, and add more vegetables to their diets.
The nutritional advice is updated every five years, and it has become mired in political controversy because of its impact on how the food industry does business and how Americans eat. Recommendations from the report guide decisions on the aims of food assistance programs, the content of school meals, the labeling and advertising of food products, and the advice given by health professionals. With billions of dollars at stake, food industry groups bristle at any potentially negative mention of their products. The interest groups unhappiest with the guidelines are likely to be sugar growers and food manufacturers, as a result of the government’s new recommended limit on added sugars. However, before the recommendations could make it to the new guidelines, they were met with strong opposition from a number of corporate and agricultural interest groups, the meat industry in particular.
One of the many recommendations made by the Dietary Guidelines Advisory Committee in their report that did not make it into the final version of the guidelines was for Americans to adopt a diet low in red and processed meat, which met with strong opposition from meat industry groups. The National Cattlemen’s Beef Association, the National Pork Producers Council, and the North American Meat Institute spent hundreds of thousands of dollars last year lobbying, with a part of their goal being “to get lean beef recognized in the final health dietary patterns statement.” “Those things should be part of, and remain part of a balanced diet, and there’s no reason to cut back,” said Dave Warner, spokesman for the National Pork Producers Council. That comment stands in stark contrast to the findings of the WHO last October, which classified the consumption of red meat as “probably carcinogenic to humans” and the consumption of processed meat as “carcinogenic to humans” based on “sufficient evidence in humans that the consumption of processed meat causes colorectal cancer.” The 2015 Dietary Guidelines Advisory Committee was more conservative in their report, stating, “moderate evidence reports inconsistent positive associations between colorectal cancer and the intake of certain animal protein products, mainly red and processed meat. Limited evidence shows that animal protein products are associated with prostate cancer incidence.”
Another recommendation that didn’t make the cut was the advice for Americans to consume more plant-based foods and less meat to help promote environmentally sustainable eating habits. That suggestion elicited intense lobbying and criticism from the food and meat industries, leading to a congressional hearing on the topic last year. In December of 2015, Congress passed a spending bill that contained a directive for the Obama administration to ignore environmental factors and focus solely on nutrients in the next revision of the guidelines. However, food production, and livestock in particular, has a significant negative impact on the environment. Livestock producers, which include meat and dairy farming, account for about 15% of greenhouse gas emissions around the world. That’s more than all the world’s cars, buses, boats, and trains combined. If you think regulating this would fall under the Environmental Protection Agency’s jurisidiction, think again. In December of 2015, Congress renewed a provision that prevents the EPA from requiring emission reports from livestock producers, making the meat industry the only major source of greenhouse gases in the country excluded from filing annual reports. Despite the evidence and the recommendations from the committee, the pressure from industry and farm state lawmakers has led USDA Secretary Tom Vilsack and HHS Secretary Sylvia Mathews Burwell to promise furious lawmakers that they would steer clear of recommendations concerning the environmental impact of the consumption of meat.
Nutritional issues were also a bargaining chip in the spending bill that was passed in December. In recent years, reforms to the school lunch and breakfast programs have allowed the USDA to improve critical nutritional standards. A study published in JAMA Pediatrics earlier this month concluded that the nutritional quality of school meals has increased by about 30 percent, and an analysis by the Centers for Disease Control and Prevention (CDC) documents improvements, too. Yet the School Nutrition Association (SNA), which represents cafeteria directors and receives financial support from food companies, has lobbied Congress to relax some standards, complaining that the sodium standards would be “extremely difficult to achieve” and that stricter nutritional standards have led to cafeterias losing money. Their demands were met in the congressional directives that were attached to the bill, which prohibits the federal government from requiring less salt in school lunches until more research is done and allows schools to obtain exemptions from whole-grain requirements. This despite the fact that the CDC found in 2014 that 90% of school-aged kids eat too much sodium, and that the USDA reports that 97% of all schools are already meeting the 100% whole grain rich rules. As of January 20th, 2016, the Senate Agriculture Committee has voted in support of a compromise plan in the re-authorization of the Healthy, Hunger-free Kids Act, which incorporates the SNA’s demands to table the sodium recommendations and allow exemptions to the whole-grain requirement. The SNA had also asked to relax the fruit and vegetable requirement, but lawmakers didn’t budge on this key tenet of the standards.
Nutritional research is constantly evolving, and our guidelines should evolve with new evidence as it comes out. Debates over the scientific evidence for certain guidelines, such as the link between saturated fat and heart disease, are reasonable. That’s the point of having a Dietary Guidelines Advisory Committee made up of scientists and medical professionals review the evidence before submitting their recommendations. As a prime example, the committee reversed the recommended cholesterol limit of 300mg/day in the new guidelines “because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol.” However, scientific evidence isn’t the only factor influencing our guidelines. Agricultural and corporate interest groups, due to their size and financial incentives, have the power to shape the nutritional guidelines based on economic interests rather than scientific evidence. This power, and the desire of certain politicians to cater to these groups, is troubling, especially in a time when childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years and when type 2 diabetes accounts for 20% to 50% of new-onset diabetes case patients in youth.
By: Amanda Whiting, Ph.D.
Many Americans, at one point or another, have probably heard about the “food pyramid” and know that it has something to do with what the government says makes up a healthy diet. But have you ever wondered where those federal food and nutrition guidelines actually come from, or what information they’re based on, or just who gets to decide what is “healthy” for everyone?
The United States Department of Agriculture’s (USDA) Center for Nutrition Policy & Promotion (CNPP) is responsible for the general nutritional guidelines for Americans. The most recent nutritional icon, called “MyPlate,” was released on June 2, 2011 by First Lady Michelle Obama and USDA Secretary Tom Vilsack and replaced the previous “MyPyramid” model. The visual guide features a colourful plate divided into approximate portions for fruits, vegetables, grains, protein and dairy. The dinner table imagery is meant to help children, parents, and other adults prioritize their food choices at meal times to include all of the groups listed, as well as consume them in proportions relative to each other (e.g. half a plate of fruits and veggies) as a model diet to promote good health.
The nutritional recommendations behind the simpler MyPlate came from the 2010 Dietary Guidelines for Americans (DGA), a policy document jointly produced by the USDA’s CNPP and the United States Department of Health and Human Services (HHS) Office of Disease Prevention and Health Promotion. Since the publication of the first edition in 1980, the Guidelines have been updated every five years to reflect the most current knowledge on health and nutrition. A Dietary Guidelines Advisory Committee (DGAC), made up of 13 to 17 nationally recognized experts in the field of health and nutrition, meets in the year prior to each update to discuss what should be included, removed, or revised in the guidelines by conducting a thorough review of scientific and medical literature, as well as soliciting comments from the public. A scientific report is written and delivered to Secretaries of the USDA and HHS containing the DGAC’s recommendations for the next edition. The next revision to the guidelines is currently in process, with the final report due to the USDA and HHS by early 2015.
As with any guide that tries to cater to a population as large and diverse as the American public, MyPlate and the Dietary Guidelines are not without disagreements and multiple opinions. Everyone likes to think that how they eat is “healthy” – be it vegetarian, fruitarian, vegan, gluten-free, dairy-free, carnivore, paleo, primal, veggie-free, or what-have-you. In addition, MyPlate has been criticized for removing a reference to physical activity, another important contributor to good health, which was present on the MyPyramid icon as a person climbing stairs.
While some people might be of the opinion that what the federal government says is “good food” and “healthy” isn’t all that important (because they’re going to eat however they want anyway), the Dietary Guidelines for Americans does play an important role in public health. In addition to consisting of guidelines for the general public’s own consumption, the DGA is a policy document that is used to set policy related to nutrition within the government. In the USDA, the dietary guidelines are used to set standards for school lunch and other feeding programs such as Supplemental Nutrition Assistance Program (SNAP) and Women Infants and Children (WIC) program. Within HHS, the DGA is used by parts of the National Institutes of Health (NIH) to produce consumer information materials supporting healthy lifestyles for various diseases (such as hypertension), while the Food and Drug Administration (FDA) uses parts of the DGA as the basis for the Nutrition Facts information guides found on all packaged food. Thus, it is important that the final DGA and the recommendations made by the DGAC are firmly based on rational, scientific facts and arguments and are not unduly influenced by groups with their own interests at heart.
This influential effect on other governmental policies is what makes the content of the DGA itself very political. It seems that every step forward in terms of recommendations based solely on scientific evidence for advancing optimal human health, is met head on by opposition from groups with powerful incentives to make money and/or preserve a status quo. As one example, it is likely that the 2015 DGA will include a recommendation that sugar be limited to no more than 10% of a person’s daily calories. All previous editions of the DGA have not included a recommendation for an upper limit on daily sugar consumption, which is why there is no number for % daily value (%DV) for sugar on any food product nutrition label. Meanwhile, the World Health Organization (WHO) is currently in the process of updating their guidelines on sugar consumption. This guidance, expected to be published in early 2015, suggests that a reduction in sugar consumption from less than 10% of total energy intake per day (the current 2002 guideline) to below 5% would have additional health benefits on body mass and tooth decay. For an average adult, the 5% mark would be equivalent to approximately 25 g of sugar per day or less. The American public currently consumes an average of 126 g of sugar per day, with much of that coming from added sugars in processed foods, and specifically, from sweetened beverages. Success in this one single area – reducing American’s consumption of sugar-sweetened beverages – could have a significant impact on the overall health and body mass of Americans. Not surprising, the beverage industry has issued some pushback for the inclusion of any specific limits on added dietary sugar (among other concerns) in the newest DGA. The American Beverage Association has submitted public comments for the DGA, suggesting that the WHO-commissioned review lacked scientific evidence and that the setting of Dietary Reference Intakes (DRIs) is not the responsibility of the DGAC and therefore should be done by other organizations. Similar arguments have been made by the Grocery Manufacturers Association, the Juice Products Association, the National Council of Farmer Cooperatives and the Sugar Association among others.
Other groups have tried to take the politics out of what we should eat and focus just on what the science of nutrition says. “Unfortunately, like the earlier U.S. Department of Agriculture pyramids, MyPlate mixes science with the influence of powerful agricultural interests, which is not the recipe for healthy eating,” said Walter Willett, professor of epidemiology and nutrition and chair of the Department of Nutrition at the Harvard School of Public Health (HSPH)1. HSPH released its own version of MyPlate known as the “Healthy Eating Plate”. This plate featured even more vegetables compared to fruit, an even split between grains and healthy protein, an emphasis on drinking water over dairy, and indicated that healthy oils should also be consumed. It also included a direction to “Stay Active” as a part of a healthy lifestyle. The goal of the Healthy Eating Plate is to give more specific information for a healthy diet in a way that is as clear and intuitive to follow as the MyPlate icon, without influence from the food industry or agricultural policies.
What one eats (and what one does) on a daily basis has a profound impact on one’s overall health and quality of life. “One of the most important fields of medical science over the past 50 years is the research that shows just how powerfully our health is affected by what we eat. Knowing what foods to eat and in what proportions is crucial for health,” said Anthony Komaroff, a professor of medicine at Harvard Medical School and editor in chief of Harvard Health Publications1. It will be interesting to see what the recommendations for the 2015 update to the Dietary Guidelines are and what recommendations actually make it into the final document. At the end of the day, what you choose to eat is up to you. However, everyone is entitled to accurate information about the health consequences of their personal food choices. Regardless of how you eat or what diet you follow, we are all human and the basic principles for good health and longevity remain the same for everyone. Like it or not, you are what you eat.