Journal doubles down on research faulting federal dietary guidelines

This year is already proving to be an interesting year politically. Politics in the world of nutrition might not be too far behind.

In 2015 the British Medical Journal published a refereed research article showing that the science behind the U.S. Department of Agriculture’s Dietary Guidelines is weak. This caused a group of academics and physicians to sign a petition demanding retraction of the article.

In response, the journal submitted the article for additional peer review by two more experts (an uncommon practice). In early December it was decided that the article written by Nina Teicholz would not be retracted. Fiona Godlee, the British Medical Journal’s editor in chief, indicated the reviewers supported Teicholz’s contention that the group’s methods were “out of date and lacking sufficient detail, which could have introduced bias.”

Godlee added that “nutrition is perhaps one of the most important and neglected of all health disciplines, traditionally relegated to non-medical nutritionists rather than being, as we believe it deserves to be, a central part of medical training and practice.”

Godlee is understating this in relation to the U.S. medical system. The nutrition component of most medical education programs is minimal. Physicians can obtain the Physician Nutrition Specialist credential from the National Board of Physician Nutrition Specialists, but there are fewer than 200 of these specialists, according to the board’s online directory.

This might just seem like a few academics bickering. However, since 1980 the Dietary Guidelines have been the foundation of nutrition messages on what to eat and what not to eat. Nutrition textbooks and health promotion efforts have strongly pushed eating more fruits, vegetables and whole grains, while concern for meeting essential nutrient needs took a back seat.

While the weight of the nation kept increasing, instead of reviewing the science behind the guidelines, the nation’s weight problem was blamed on fast food, large portions and people being too lazy.

QUESTION: Have Americans followed the U.S. Dietary Guidelines?

ANSWER: The guidelines indicate that we should eat more fruits, vegetables and whole grains. USDA food disappearance data, an indicator of what the nation is eating, indicates we are eating more of these foods.

Whole-fat milk consumption has gone down, and low-fat milk has increased along with other lower-fat dairy products. Consumption of eggs, butter and lard has gone down, and that of vegetable oils has increased. Poultry consumption is increasing, and since the 1970s red meat consumption has decreased.

Q: Where did the guidelines go wrong?

A: One problem is that they idealized plant-based foods and somewhat demonized many animal foods. Avoiding lean animal foods makes it more difficult to meet essential nutrient needs and requires the consumption of more calories to meet the needs for nutrients like protein, iron and zinc.

The guidelines also contributed to a focus on “good” and “bad” foods instead of emphasizing an overall “healthy diet.”

Q: What is a “healthy diet”?

A: A healthy diet is one that meets the more than 30 essential nutrient requirements within a person’s calorie needs. We recommend the best way to accomplish this is by getting rid of the “good and bad” food lists and enjoying a wide variety of all foods.

Certainly, include fruits, vegetables and whole grains, but consume reasonable amounts of food from the meat/protein and dairy-product food groups.

Of course, don’t forget exercise.

Alan Titchenal, Ph.D., C.N.S., and Joannie Dobbs, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa. Dobbs also works with University Health Services.