What Are We Supposed to be Eating Now? (February 24, 2015)
One of the most entertaining things about modern medical science is the way they tell you one thing today and something entirely different tomorrow with an entirely straight face. The latest example of this is the advice being given by the Dietary Guidelines Advisory Committee, a group that meets once every five years in order to let you know that what it told you the last time that it met was all wrong. This year is no exception, although that since this year the major changes in the Guidelines provoked great distress on the part of the meat, dairy and beverage industries, I figure that they must be on the right track. (Ok, I know that science marches on and so does human knowledge, but somehow the most recent information is always presented as The Final Word -- so whenever that Word proves to be not so Final, I think we're entitled to snicker a little.)
Said Committee is a joint effort of the HHS and the USDA, both of whom appoint representatives to it, and it is tasked with examining the science (particularly the latest science) of nutrition and lifestyle and, based on such, making recommendations to the federal government as to what its policies should be. That is why the Guidelines are a big deal, because those policies are quite far reaching -- they determine what soldiers and what students eat, what is and isn’t on food labels, changes in industry requirements, which farmers get subsidized and which not, etc., etc.
Of course "government" always also means "politics", and depending on yours, official dietary guidelines tend to reflect either flagrant corporate cronyism or commie interference with our right to eat whatever we want. Fortunately over the last twenty years or so, with the evidence-based movement and close to total transparency in the setting of these guidelines, these things are less of a problem. That is a nice trend, and I hope it continues.
Regarding this particular set of Guidelines, there has been a lot of news recently about how they now acknowledge how great saturated fat is and how much more of it we need to be eating. Or so read most of the headlines on the subject. Which only goes to confirm my frequently-made point that if headlines are where you get your health advice, you are – or soon will be -- in serious trouble. (The other thing that you can do advice-wise that will get you into trouble is to slavishly follow whatever the Official Word is. That is because under the best of circumstances the Official Word is way behind the cutting edge of research. Happily this is another thing that is less of a problem with these particular Guidelines.)
I would like to say I read the entire thing, but I only lie when it’s absolutely necessary. I scanned the first 80 pages or so and then read several “secondary source” articles, as we call them in the biz, most of which I thought were pretty good despite the fact that each one seemed to feel it necessary to decorate the beginning of their article with a large picture of a fried egg. Despite this sad lack of creativity on the part of our internet journalists, it is a truth universally acknowledged that unless you are a genuine expert in a particular field, reading the opinions of people smarter than you are is the thing to do. So that is where the information I am presenting today came from.
The two most notorious portions of this report seem to be the relaxing of the prohibition on saturated fat as such and the bringing of cholesterol out of the shadows. Regarding saturated fat, it is true that several studies in the past few years, at least one of them quite large, did not find anywhere near the problems with its consumption that had been asserted it in the past. The Guidelines now have been changed to admit that there just might be such a thing as saturated fat that is good for you. Your brother-in-law on the Paleo diet, however, would probably think that the limits left in place by the Guidelines diets are still too stringent – they recommend that no more than 10% of your dietary calories come from saturated fat. Additionally, the report says that there is “moderate to strong evidence that higher intake of red and processed meat compared to lower is detrimental”. That’s a little fuzzy, but sometimes fuzzy is all we’ve got. Anyway, there goes the Atkins diet. Again.
Moving on, I have NEVER understood the demonizing of cholesterol. We’ve known for a good thirty years or so that dietary cholesterol emphatically does not raise blood cholesterol. Why did it take this long for the Guidelines to acknowledge this and remove the restrictions on cholesterol consumption? The (very lame) explanation for this is generally to the effect that most foods that contain cholesterol also contain a lot of fat. Which is true. Failure to distinguish cholesterol from saturated fat by the AHA back in the early 1960s is probably why cholesterol as such wound up on the nutritional blacklist in the first place. The thing is, even back then it was an irrational assumption to make. If foods that contain a lot of fat also come in colorful packaging, should we avoid colorful packaging in order to eat healthy? Ok, that’s a bad example, because actually avoiding “food” with colorful packaging is probably a good idea. But you get my point. Seafood, and most famously, eggs, contain a lot of cholesterol and thus by this extremely poor reasoning were to be avoided. Go figure.
There is a large section in the report on the differing diets recommended to prevent or minimize the effects of different diseases, which interestingly ALL had one recommendation in common – more fruits and vegetables. Running a very close second to that was the advice to eat more whole grains. I don’t see who could argue with those except maybe for Hostess.
They found that a number of nutrients are still deficient in our national diet, and the four of these that have been most strongly implicated in our health problems are vitamin D, calcium, potassium and fiber. (Iron for some, not all.) Sodium and saturated fat were both considered to be overconsumed to the point of being a health risk. Personally I’m still not sure about that sodium thing and there IS some genuine controversy on the subject.
The Guidelines newly recommend less than 10% of total calories from saturated fat, and for the first time a solid, similar recommendation was made for “added sugars”. The average American who eats 2000 calories a day is currently getting about 500 of those calories from sugar. The new guidelines would have you limit consumption to 10% or less of your daily calories, which would be quite a drop. Since one good-sized regular soda daily would use up that allotment, the beverage industry is in a tizzy. My suggestion is that they just go out and find a more respectable line of work, because the tide of history is against them on this.
Improving the quality of the foods we already eat was a nice recommendation, the idea being that you don't have to give up burgers; instead you can put a few more veggies on them, use leaner ground beef and serve them on genuinely whole grain buns. As an aside to this, you will find that if you start substituting real foods for processed foods in your diet, it isn't long before you find that if you try to go back to the old junk you thought you couldn’t live without, it seems inferior.
And that leads me into this last -- if there is one truly great thing about these Guidelines, it is their suggestion that maybe, just maybe, focusing on the consumption of specific nutrient categories is a mistake. That in fact people should just be focusing on eating real healthy foods and not worrying so much about the individual components of that food. This is a sea change in the area of official dietary advice and it is great because if you are eating real food, no matter what you are eating it's nutritious. As soon as you start worrying about what those foods break down into and start fooling around with them, you are on the road to eating processed stuff, which overall is probably the worst single change in our diet in the last century.
And my feeling is that these guys and their predecessors are at least partly responsible for the poor eating most of us do these days. Because they’ll tell you to avoid cholesterol, but unless you are eating processed junk with component parts that can be added and subtracted like Lego bricks, when they do that what they are really telling you is to avoid Food. When you stop eating eggs because of the cholesterol and eat bagels instead, you haven’t improved your diet or your health one whit. And my feeling that the "scientific" concentration on the component parts of food, rather than food itself, has to take a lot of responsibility for the unnatural way so many of us are now eating as a matter of course.
So eat real food, and not too much of it, as the poet said, and you'll be fine. THAT is something that has not changed at all in the many, many decades we've been analyzing, over-analyzing, and changing what we eat. I applaud the Dietary Guidelines Advisory Committee for hewing closer to that excellent advice than it ever has before.
--dr. diane holmes
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