Our Impact
The goal of the Nutrition Coalition has been to establish a solid scientific foundation for the US Dietary Guidelines for Americans. Before our work, not a single report by an established nutrition expert existed to examine the methodological issues of this highly influential policy. Now, we have 4 reports by the National Academies of Sciences, Engineering and Medicine as well as multiple papers in top journals by leading scientists, all reporting that the Guidelines do not reflect the best and most current science, are not the product of a rigorous methodological process, lack transparency, and have no advice for people with diet-related conditions. Regarding this last point, the implication is that the Dietary Guidelines are not appropriate for the 93% of American adults with cardio-metabolic conditions. Further, recommendations to cap saturated fat and effectively limit fat and cholesterol are not supported by the preponderance of the evidence, according to the USDA's own scientific reviews.
Our Work with Congress
Congress holds an unprecedented hearing on the US Dietary Guidelines for Americans.
Secretaries of both the Departments of Agriculture and Health and Human Services (USDA-HHS) testify for two hours. Key quotes:
- CONAWAY (R-TX): Serious questions have been raised about the overall oversight of the overall DGAC process… Hopefully, the next time the question will be asked: Are the guidelines themselves contributing to the problem? The emphasis on carbohydrates over the last 20 years and the impact it’s had on — on these issues that we’re talking about with obesity or diabetes, other things.
- D. SCOTT (D-GA): I’m very concerned that you’re not using the most relevant, basic, and the best science-related information in formulating these guidelines. You certainly did not use some of the most recent peer-reviewed and published nutrition and diet-related science. It was not even considered by the advisory committee and not even included in the evidence-based library to be considered by the advisory committee when they were finalized in the report. That’s a fact.
The Nutrition Coalition was responsible for developing an interest in Congress to mandate—and allocate more than $1M—for the first-ever outside peer-review of the Dietary Guidelines, by the National Academies of Sciences, Engineering, and Medicine (NASEM)
The National Academies release two reports (here & here) with numerous recommendations.
- Top-line conclusion: the Guidelines' process lacked scientific rigor and does not use any recognized or verified methodology for reviewing the science.
- “To develop a trustworthy DGA [Dietary Guidelines], the process needs to be redesigned”
- “The current DGA process for reviewing the science falls short of meeting the best practices for conducting systematic reviews.”
- The process lacks transparency and needs to disclose conflicts of interest.
The Nutrition Coalition worked with members of Congress to hold the USDA accountable, requiring the agency to report on its progress in responding to the National Academies recommendations:
- USDA required to report to Congress in 2018 (USDA-HHS Response to the National Academies of Sciences, Engineering and Medicine)
- Congress mandates a follow-up report by the NASEM, with another $1M allocation, to ascertain independently the degree of USDA compliance.
The National Academies issues two reports (here & here) concluding that the USDA had not fully implemented even one of the 11 recommendations from 2017.
- “...the proposed analytic and methodologic improvements to the DGA process had largely not yet been achieved.”
- The Nutrition Coalition produced a comprehensive summary of these reports here.
In sum, Congress has spent 7 years and $2 million dollars
trying to improve the rigor and transparency of the
US Dietary Guidelines for Americans
However, the USDA has not yet complied with the NASEM recommendations.
The Coalition will continue to work with Congress to ensure the Guidelines comply to the National Academies reports. It is crucial that the Guidelines are a trustworthy document based on a transparent, rigorous scientific process.
Our Work with the Scientific Community
The Nutrition Coalition has worked with leading academics who have authored a number of papers documenting methodological issues in the Dietary Guidelines. Until our work, not a single paper critically analyzing the guidelines had been published by a mainstream nutrition expert. These academics now includes 6 former members of previous Dietary Guidelines Advisory Committees (the experts who wrote the guidelines) and the former head of the World Heart Federation. These papers are:
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An analysis of the recent US dietary guidelines process in light of its federal mandate and a National Academies report
Cheryl Achterberg, Arne Astrup, Dennis M Bier, Janet C King, Ronald M Krauss, Nina Teicholz, Jeff S Volek, An analysis of the recent US dietary guidelines process in light of its federal mandate and a National Academies report, PNAS Nexus, Volume 1, Issue 3, July 2022, pgac107, https://doi.org/10.1093/pnasnexus/pgac107
Authors include 3 former members of US Dietary Guidelines Advisory Committees
Major findings:
- Recommendations for total fat and saturated fat are without evidence
- The USDA has ignored the science on low-carbohydrate diets
- The USDA has ignored the NASEM recommendations
-
Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based?
https://www.mdpi.com/2072-6643/13/10/3305
Astrup, A.; Teicholz, N.; Magkos, F.; Bier, D.M.; Brenna, J.T.; King, J.C.; Mente, A.; Ordovas, J.M.; Volek, J.S.; Yusuf, S.; Krauss, R.M. Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based? Nutrients 2021, 13, 3305.
Authors include 3 former members of US Dietary Guidelines Advisory Committees and the former Chair of the American Heart Association Nutrition Committee
Major findings:
- The USDA recommendation on saturated fat is not supported by the evidence
- 88% of the evidence reviewed by the USDA in 2020 did not support a continued limit on saturated fat, yet the USDA concluded the opposite
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Saturated Fats and Health: A Reassessment and Proposal for Food-Based Recommendations: JACC State-of-the-Art Review
https://www.jacc.org/doi/abs/10.1016/j.jacc.2020.05.077
Astrup A, Magkos F, Bier D, et al. Saturated Fats and Health: A Reassessment and Proposal for Food-Based Recommendations. J Am Coll Cardiol. 2020 Aug, 76 (7) 844–857.
Authors include 4 former members of US Dietary Guidelines Advisory Committees
Major findings:
- There is insufficient evidence for a continued 10% of calories cap on saturated fats.
- Note: this “State of the Art Review” is the highest-level paper on this topic, published in a prestigious and influential journal. The paper was named by the Editor-in-Chief as one of the top ten published in 2020.
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Alternative Dietary Patterns for Americans: Low-Carbohydrate Diets
https://www.mdpi.com/2072-6643/13/10/3299
Volek, J.S.; Phinney, S.D.; Krauss, R.M.; Johnson, R.J.; Saslow, L.R.; Gower, B.; Yancy, W.S., Jr.; King, J.C.; Hecht, F.M.; Teicholz, N.; Bistrian, B.R.; Hamdy, O. Alternative Dietary Patterns for Americans: Low-Carbohydrate Diets. Nutrients 2021, 13, 3299. https://doi.org/10.3390/nu13103299
Authors include the Medical Director of the Obesity Clinic Program and Inpatient Diabetes Program at Joslin Diabetes Center.
Major findings:
- Sufficient evidence exists for the USDA to establish a low-carbohydrate “Dietary Pattern” as an option for people with chronic diseases.
- Currently, there is no option in the guidelines for the 60% of people diagnosed with one or more of these diseases.
- Clinical trials on low-carbohydrate diets have demonstrated proven efficacy for reversing hypertension, heart disease, type 2 diabetes, and obesity.
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Conflicts of interest for members of the U.S. 2020 Dietary Guidelines Advisory Committee
Mialon, M., Serodio, P., Crosbie, E., Teicholz, N., Naik, A., & Carriedo, A. (2022). Conflicts of interest for members of the U.S. 2020 Dietary Guidelines Advisory Committee. Public Health Nutrition, 1-28. doi:10.1017/S1368980022000672
First-ever systematic review of conflicts of interest on any Dietary Guidelines Advisory Committee worldwide.
Major findings:
- 95% of committee members had a tie to a food or pharmaceutical company
- Half of the 20-person committee had 30 such ties or more
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Cover Story: The scientific report guiding the US dietary guidelines: is it scientific?
Teicholz N. The scientific report guiding the US dietary guidelines: is it scientific? BMJ 2015; 351 :h4962 doi:10.1136/bmj.h4962 https://www.bmj.com/content/351/bmj.h4962
First major critical review of the US Dietary Guidelines. A BMJ cover story.
Major findings:
- “There is a minuscule quantity of evidence supporting the USDA Dietary Patterns.
- The USDA has ignored all the major, NIH-funded clinical trials on the low-fat diet and on the question of whether replacing saturated fats with vegetable (seed) oils prevent heart disease. The NIH spent billions of dollars to conduct these trials, with the aim of informing dietary policy, yet they were ignored.
Our work continues!
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