1st Dietary Guidelines Meeting: Policy is only for “Healthy Americans”
New Amer. Diabetes Assoc. Review Highlights Carb Restriction
New Salt Recs by Nat'l Academies Return to “Lower is Better”
Can a Low-Fat Diet Reduce Deaths from Breast Cancer?
Dietary Guidelines are only for Healthy Americans?
The advisory committee for the 2020 Dietary Guidelines recently held its kick-off meeting in Washington, D.C., and we learned that the Guidelines are only for healthy Americans. This means that the 60% of the population diagnosed with obesity, diabetes, etc.--will be ignored. Yet the Guidelines are applied equally to everyone, sick and well alike. And the law authorizing the Guidelines states that the policy should apply to the “general public.” Since the majority of the public is now overweight and/or suffering from some kind of metabolic disease, could this mean that the Guidelines' narrow focus is possibly illegal? It seems tragic for the government to be spending nearly $13 million on a policy that is relevant to only a minority of Americans—and will therefore do nothing to reverse the epidemics of disease we now face. Read a recent op-ed by the Nutrition Coalition’s Executive Director Nina Teicholz on this topic in the Washington Post here.
Dietary Guidelines’ Process Lacks Rigor from the Start
The kick-off meeting for the Guidelines revealed a number of disturbing aspects about the lack of scientific rigor in the Guidelines’ process, such as: (1) a lack of prioritization of clinical trials over other, weaker forms of evidence, (2) a lack of protocols for reviews of the science, (3) the use of “hand searches” for scientific papers, a process that opens up vast possibilities for bias, despite the fact that nearly 100% of papers are now searchable online, and (4) a heavy reliance on government data that has been deemed by multiple experts to be “invalid” or “inadmissible.”
If the lack of scientific rigor and/or the narrow focus of the Guidelines is of concern to you, please submit a public comment to the USDA. See our post on how to do this (scroll down).
American Diabetes Association (ADA) Publishes Scientific Consensus Paper with New Focus on Carb Restriction
The recent “Consensus Report” on adult therapy for the first time strongly emphasizes carbohydrate restriction. Three out of the four recommendations for treating type 2 diabetes include some mention of reducing carbohydrates, including the need to "minimize grains and sugars" and that "[r]educing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia." The report also includes the keto diet as a viable option. Only the low-carb and Mediterranean diets were considered to be supported by “robust” evidence for the treatment of type 2 diabetes; evidence for the DASH or plant-based diets was considered less strong.
New Academies’ Salt Guidelines Return to “Lower is Better”
How much salt is optimal for good health? According to a report last month by the National Academies of Sciences, Engineering and Medicine (NASEM), lower is indeed better. This conclusion contradicts the organization’s own 2013 review of the data, however, and since that time, the evidence supporting moderate (not low) salt intake has only grown stronger. Thus, it is something of a mystery as to why this latest NASEM report reverted to a previous orthodoxy on salt. NASEM’s current report sets the adequate intake (AI) of sodium to 1,500 mg/day for anyone over age 19, far lower than the 2,300 mg/day previously set by the organization. Read more in our blog post on the Academies’ report, which includes an analysis of bias on the expert panel.
Can a Low-Fat Diet Reduce Deaths from Breast Cancer?
It’s surprising that journalists would report on this study as if it were a rigorous clinical trial or that they would report on it at all, since (1) it hasn’t been published yet, and (2) it’s not, actually, the Women’s Health Initiative (WHI) clinical trial. That large, NIH-funded, randomized controlled clinical trial ended more than a decade ago, with results showing that a low-fat diet does not prevent breast cancer. This recent study, by contrast, is an epidemiological follow-up on the WHI population. Quite a few reporters didn’t seem to understand this distinction. Epidemiology is not an intervention and is therefore a far weaker kind of evidence, with results, in nutrition, that have been shown to be correct only 0-20% of the time.[1] Our belief is that the media should not report on studies with such poor odds for accuracy.
SPOTLIGHT ON WAYWARD SCIENCE
“Decades of early research on the genetics of depression were built on nonexistent foundations. How did that happen?” This article in The Atlantic shows how a hypothesis about a gene came to be adopted as fact, spurring “a thousand research papers,” all of which turned out to be a waste. “We built whole imaginary edifices on top of this idea,” one scientist lamented, yet it was wrong. How do expert communities let this happen?
A new study found that 57% of studies overstate (“spin”) their heart-disease results, i.e., they portray non-significant findings as significant. This raises the question: If medical journals go along with publishing these results, who will protect good science?
To end on a less depressing note, we are reviving a 2015 story about an investment banker who’s trying to raise “The Kobe Beef of Pork.” It’s a passionate endeavor, and he’s still at it.
[1] 20%: Ioannidis JPA. The challenge of reforming nutritional epidemiologic research. JAMA. 2018;320:969-970; 0%: Young SS, Karr A. Deming, data and observational studies. Significance. 2011;8:116-120.
The Nutrition Coalition is a nonprofit educational organization working to strengthen national nutrition policy so that it is founded upon a comprehensive body of conclusive science, and where that science is absent, to encourage additional research. We accept no money from any interested industry.
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