Editorial: Racial Bias in Food Guidelines
When doctors or dietitians advise patients about what they ought to be eating, they often model their recommendations on the Food Guide Pyramid, the government graphic that favors grains, vegetables, and fruits, but also includes two to three daily servings of both meat and dairy products. School lunches use the same tool, as do food assistance programs. The Pyramid is based on the Dietary Guidelines for Americans, a slim booklet that is updated every five years amidst heavy lobbying by the food industry.
When the Pyramid was unveiled in 1992, it was already out of date. People who ignored its recommendations for meat and dairy, eating none of these products at all, were healthier than those who followed them. Diets conforming to the Pyramid make artery blockages worse, not better, and do nothing at all to prevent cancer. We also knew, from Dr. Dean Ornish’s studies published two years earlier, that skipping the meat and dairy groups and following other healthy lifestyle changes could help the arteries begin to clean themselves out.
We all pay a price for bad nutritional advice, but some groups suffer more than others. The most obvious example is the recommendation for milk. What is the point of recommending two to three servings of milk every day for the 70 percent of African Americans who are lactose intolerant? If the idea was to prevent osteoporosis, African Americans have much less risk of the disease than whites, yet are much more likely to have pain, bloating, and gas from milk consumption.
The Pyramid reflects the outdated idea that lactose intolerance was rare. In 1965, scientists in Baltimore discovered it to be the norm among African Americans, and the same soon emerged for those of Asian, Hispanic, or Native American ancestry. In fact, the only racial group that typically tolerates milk sugar is Caucasians, 85 percent of whom carry a genetic mutation that causes the lactase enzymes to persist throughout life. That may be no advantage, however, because when lactose is digested, it releases galactose, a smaller sugar that is under investigation for its role in cataracts, infertility, and ovarian cancer.
The Pyramid also pushes regular meat consumption. Along with the products in the dairy group, meat perpetuates the epidemics of hypertension, prostate cancer, and other conditions that take a disproportionate toll among minorities. Prostate cancer, in particular, is an urgent problem. It is clearly linked to meat consumption, and takes an extraordinary toll among African American men.
Who needs this Pyramid, anyway? What family arriving in the U.S. from Asia with a taste for rice and vegetables needs to pack fat and cholesterol into its diet by following the Pyramid’s recommendations? If a Mexican American or Native American preferred to stick with traditional corn, beans, and other plant foods, could the Pyramid do anything other than compromise a healthy diet?
Of course, stores sell milk with an enzyme additive that breaks lactose sugar into galactose and glucose, preventing stomach upset. Likewise, pharmaceutical manufacturers sell drugs for diabetes, high blood pressure, prostate cancer, and other epidemics that are aided and abetted by fatty, meat-based diets.
There is a better solution: let’s change the meat and dairy groups from daily requirements to, at most, options. Meat and dairy are the equivalent of cigars, coffee, and liquor—some people like them, but nobody needs them. And there is compelling evidence that we are better off leaving animal products off our plates entirely.
Does this mean that we should be dictating to all population groups what they should be eating? No. But it does mean that those who choose to follow a healthy diet should not be discouraged from doing so by out-of-date government guidelines.
All population groups pay a price for nutrition guidelines that are out of date and clearly ineffective. But the price is appreciably higher among those groups that are hardest hit by illness.
Neal D. Barnard, M.D.
President of PCRM