Gabe Mirkin, M.D.
The Department of Nutrition at Harvard School of Public Health has criticized the United States Government's Dietary Guidelines for Americans (released January 31, 2011) because the Guidelines do not tell Americans to restrict sugary soft drinks, white bread, French fries, red meat and other American staples. This US government report was written by the Department of Agriculture whose job is to sell food products and, because of this, must not upset powerful food industry groups: *the Grocery Manufacturers Association, *the Sugar Association, *the National Milk Producers Federation, and *the National Cattleman's Beef Association and others.
Major problems with the report are:
* Continued fixation on 35 percent of calories from fat. The cap on fat can distort menus, since it means that a large intake of refined grains is still allowed.
* Too lax on refined grains. Though the new guidelines encourage Americans to cut back on refined grains and replace them with whole grains, they still suggest that it is okay to consume up to half of our grains as refined grains. That's unfortunate, since there's been even more research evidence in the past five years that refined grains, such as white bread, white rice, and white pasta, increase the risks of diabetes and heart disease. (1,2)
* Too lenient on mammal meat. The guidelines still continue to lump meat from mammals together with fish, poultry, eggs, nuts, seeds, beans, and soy products in one food group, newly termed the "protein foods" group. Though they highlight the benefits of replacing some meat or chicken with fish, they gloss over the substantial evidence that replacing red meat with poultry, beans, or nut, could help prevent heart disease, and that lowering red meat can lower the risk of diabetes. (3,4) The guidelines also don't provide adequate warning about processed meats, which have been most strongly linked with cardiovascular disease and diabetes, at least in part due to their high added sodium content.
* Too much dairy. The guidelines recommend increasing intake of low-fat milk and dairy products—recommendations that don't reflect the evidence. There is little, if any, evidence that eating dairy prevents osteoporosis or fractures, and there is considerable evidence that high dairy product consumption is associated with increased risk of fatal prostate and ovarian cancers. Based on the scientific evidence, the Healthy Eating Pyramid recommends limiting dairy products to one to two servings per day, or consuming a vitamin D and calcium supplement instead.
* Too little vitamin D. The guidelines, as expected, follow the lead of the Institute of Medicine (IOM) and recommend 600 IU of vitamin D a day for children and most adults, and 800 IU for adults over age 70—a recommendation that is too low. There is ample evidence that to reach adequate blood levels of vitamin D, most Americans need at least 1,000 IU of vitamin D per day—an amount that is hard, if not impossible, to achieve from food alone.
* Stopping short on sodium. Given that nearly 70 percent of U.S. adults should consume no more than 1,500 milligrams of sodium per day, (5) it's a shame that the Dietary Guidelines does not make 1,500 milligrams the daily sodium max for all Americans. Instead, the guidelines keep 2,300 milligrams as the upper limit for everyone except people in high risk groups.
The Dietary Guidelines for Americans does tell people to cut back on: sodium, saturated and trans fat, added sugars, and refined grains. Americans should increase: *vegetables, *fruits, *whole grains, *seafood, and *low-fat or fat-free milk and milk products. However the "guidelines still don't go as far as they could to promote eating patterns that lower heart disease, diabetes, and other chronic disease risk".
Walter Willett, chair of the Department of Nutrition at Harvard School of Public Health states: "The continued failure to highlight the need to cut back on red meat and limit most dairy products suggests that ‘Big Beef' and ‘Big Dairy' retain their strong influence within this department. Might it be time for the USDA to recuse itself because of conflicts of interest and get out of the business of dietary advice?"
Virtually all scientists do agree with the guidelines that recommend:
* Eat more foods from plants.
* Eat more fish in place of red meat or poultry.
* Replace foods high in saturated fat (meat, poultry, eggs and dairy) with nuts, beans and other plant proteins.
1. Sun Q, Spiegelman D, van Dam RM, et al. White rice, brown rice, and risk of type 2 diabetes in US men and women. Arch Intern Med 2010;170:961–9.
2. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr 2010;91:502–9.
3. Bernstein AM, Sun Q, Hu FB, Stampfer MJ, Manson JE, Willett WC. Major dietary protein sources and risk of coronary heart disease in women. Circulation 2010;122:876–83.
4. Aune D, Ursin G, Veierod MB. Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies. Diabetologia 2009;52:2277–87.
5. Application of lower sodium intake recommendations to adults—United States, 1999-2006. MMWR Morb Mortal Wkly Rep 2009;58:281–3.
March 2, 2011