New Dietary Guidelines: The Good, the Bad, and the Downright Confusing

Today, the Dietary Guidelines Advisory Committee released its report on what Americans should eat. When finalized, the Guidelines will be the basis for all federal programs, including school lunches. And the report is a huge step forward in several ways:

1. The report singled out vegetarian diets as one of three healthful diet patterns. The other two healthy patterns were the Mediterranean diet and the “Healthy U.S.-style Pattern.” Vegetarian diets reduce the risk of obesity, diabetes, and other health problems and have gained greater prominence in each new edition of the Guidelines.
2. The report was a rebuke for those who have suggested that saturated (“bad”) fat, common in meat and dairy products, is somehow not a danger. The report emphasized saturated fat’s risks and maintained the previous limit that no more than 10% of calories should come from saturated fat.
3. The report deleted “lean meat” from its list of favored foods. Its authors were convinced by evidence showing that increased consumption of “lean meat” confers no health benefits.
4. The report breaks new ground in reporting on food’s relationship to environmental health, which in turn affects human health.

But for all its good points, the new report has trouble spots:

1. The report suggested that cholesterol in foods is not a major danger, contrasting with the Institute of Medicine, which found that cholesterol in foods does indeed raise blood cholesterol levels, especially in people whose diets are modest in cholesterol to start with. On this topic, the Dietary Guidelines Advisory Committee did no original research and instead deferred to a 2014 report by the American Heart Association and American College of Cardiology. However, the American Heart Association receives substantial cash payments for certifying food products, including cholesterol-containing food products as “heart healthy,” creating a financial incentive for discounting the relationship between dietary cholesterol and serum cholesterol.

   The Physicians Committee is concerned that exonerating dietary cholesterol will only confuse an already bewildered public. Most people do not differentiate fat from cholesterol, or dietary cholesterol from blood cholesterol. To suggest that cholesterol in foods is not a problem will lead many to imagine that fatty foods or an elevated blood cholesterol level carry no risk—two potentially disastrous notions.

   Accordingly, the Physicians Committee has petitioned the USDA and DHHS to disregard the Dietary Guidelines Advisory Committee’s findings on dietary cholesterol. The reliance on the American Heart Association document does not comply with the spirit of the Federal Advisory Committee Act, which sets standards for bias among federal advisory committees.

2. The Committee report recommends fish, despite frequent contamination with mercury and PCBs, and despite evidence that vegetarians who avoid fish and shellfish are slimmer and have less risk of diabetes, compared with people who eat fish.
3. The report continued to recommend dairy products, despite recent evidence that they do not “build strong bones” or protect against fractures.

Even with its flaws, the new Dietary Guidelines report is a major advance. The Physician Committee’s own recommendations, represented graphically in The Power Plate (www.ThePowerPlate.org), focus on whole grains, vegetables, fruits, and legumes as dietary staples. The Power Plate rests on hundreds of scientific studies showing that plant-based eating habits are associated with lower obesity rates and a reduced risk of heart disease, hypertension, and type 2 diabetes.