Opinion & Contributed Articles

2010 Dietary Guidelines, Deconstructed

by Marion Nestle | Feb 02, 2011
Opinion

I have now had time to look at the full report of the 2010 Dietary Guidelines-all 95 pages of what they are calling "the policy document."

dietaryguidelinescover-featured.jpg
Oh no!  What happened to the Selected Messages for Consumers that I posted yesterday?  "Enjoy your food" is not in it and neither are any of the other clear, straightforward messages. This is a big disappointment.

Nevertheless, the document is well worth reading.

It addresses my complaints about the executive summary.  It explains the meaning of the annoying SOFAS (solid fats and added sugars).  It discusses the need to improve the food environment.

Let me share a few thoughts about selected issues.

SOFAS

The report translates its advice (pages 62-68).   It translates  "Cut back on foods and drinks with added sugars," a nutrition euphemism, as:

Drink few or no regular sodas, sports drinks, energy drinks, and fruit drinks.  Eat less cake, cookies, ice cream, other desserts, and candy.  If you do have these foods and drinks, have a small portion.

But it translates "Cut back on solid fats" in yet another euphemism:  "Select lean meats and poultry, and fat-free or low-fat milk and milk products."  This, no doubt, is to avoid the politically impossible "eat less meat."

Added sugars

The report lists synonyms for added sugars that you might find on a food label (page 75).  The 2005 Dietary Guidelines included "fruit juice concentrates" on that list.  The 2010 guidelines do not.  The Table lists "nectars" but not fruit juice concentrates.  How come?  It doesn't say.

Food group patterns

The report describes healthy patterns for diets ranging from 1,000 to 3,200 calories a day.  For a diet containing 2,000 calories, you are only allowed 258 calories a day from SOFAS.  That's all? One 20-ounce soft drink contains more than that and so does  one tablespoon of butter and a 12-ounce soft drink.  No wonder the guidelines don't want to be specific about foods when they mean "eat less."

Sodium

The recommendation to reduce sodium intake to 2,300 or 1,500 mg per day is addressed to the wrong people.  Individuals cannot do this on their own since most salt is already added in restaurant and processed foods.  The report recognizes this:

Consume more fresh foods and fewer processed foods that are high in sodium.
Eat more home-prepared foods, where you have more control....
When eating in restaurants, ask that salt not be added....

Vegetarian and vegan diets

The report includes diet plans for lacto-ovo vegetarians and vegans (pages 81 and 82).  Applause, please.  When I was on the dietary guidelines advisory committee in 1995, we tried to say something useful about vegetarian diets but were forced to add something about the nutritional hazards of such diets, minimal as they are.  Not having to do this is a big improvement.  But you too only get 258 calories for SOFAS.

How about changing the food environment?

The report makes it clear that the food environment strongly influences the food choices of individuals, and it urges efforts to:

-- Improve access to healthy foods
-- Empower people with improved nutrition literacy, gardening and cooking skills
-- Develop policies to prevent and reduce obesity
-- And for kids, fix school meals, encourage physical activity, and reduce screen time

 In short, there is plenty to work with here. You just have to look hard and dig deep to find it.

What is the food industry's reaction?

Just for fun, I've been tracking some of the industry reactions. The soy people love it. The report mentions soy along with nuts and seeds in the USDA's meal patterns (page 79), and soy has its own category in the vegetarian and vegan diets (page 81 and 82).

The meat people don't love it so much. They are a little worried that seafood is pushed more than meat, but the American Meat Institute is giving it a nice spin, pointing out that the overall meat recommendation has not changed since 2005.

And the Salt Institute? "Dietary Guidelines on Salt Drastic, Simplistic, Unrealistic."

I rest my case.

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This first appeared in Marion Nestle's Food Politics on Feb. 1, 2011.  Reprinted with permission.

© Food Safety News

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Discuss

Morton Satin
02/02/2011
9:54AM

Marion,

Please don’t rest your case – in fact, you haven’t presented a case as far as I have seen. You seem to prefer stereotyping industry and promoting hearsay evidence rather than dealing with the actual evidence. I’m with the Salt Institute, so you can stereotype me as you wish. But I’m here just to pass on the evidence, so please don’t kill the messenger – just address the evidence.
I know, evidence may be very boring for most readers, but peer-reviewed publications do represent the actual clinical evidence that the zealots at the dietary guidelines have neglected to share with the public. For instance the peer-reviewed paper just published in 'Metabolism, Clinical and Experimental' by Garg et al, of the Harvard Medical School. It's entitled, "Low-salt diet increases insulin resistance in healthy subjects" and describes how otherwise healthy people develop insulin resistance (the precursor to diabetes) within 7 days of being placed on a low-salt regime, while those that were on a regular salt diet did not. You can see it at:
http://www.ncbi.nlm.nih.gov/pubmed/21036373
Or perhaps you may be interested in the impact of low salt diets on heart patients – if so, check out the papers by Paterna et al in 'Clinical Science' and the 'American Journal of Cardiology' - "Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure" which can be found at:
http://www.ncbi.nlm.nih.gov/pubmed/17688420 and http://www.ncbi.nlm.nih.gov/pubmed/19101237

In fact, I am pleased that the dietary guidelines have finally begun to focus on whole foods and eating patterns rather than isolated nutrients. It’s a pity that it took the dietary guidelines 30 years and a public announcement by the Secretaries of Agriculture and HHS to state what granny has always said.

I am also pleased that the Dietary Guidelines talk so highly about the Mediterranean eating pattern, which has been responsible for the excellent health statistics of that part of the world. What the dietary guidelines do not state and what ‘politically correct’ nutritionists omit, however, is that the levels of salt consumption in the Mediterranean diet are much higher than in the US diet. And, as far as increasing consumption of salads and vegetable is concerned, you can forget if you reduce salt - it is the salt that makes these food items more palatable – if not, they taste like grass. Ask the Italians – they eat 40% more salt than we do and have better cardiovascular figures (please ask me for the peer-reviewed reference).

I always find it a bit strange to see the looks of disbelief I get when I tell people that lowering the salt content of foods will greatly increase the obesity epidemic. How can that be?

Well, it’s quite simple really. People will eat more food and calories just to satisfy their innate appetite for salt. Most professional nutritionists at last year’s American Society of Nutrition meeting agreed.

For any skeptics out there, we have a great many similar examples. When ‘light’ beer was produced, people drank far more of it; when we cut the sugar out of soft drinks, people swilled tons more low-cal beverages; when we cut the fat out of foods, people gorged themselves on low-fat, no-fat foods to such an extent, they ushered in the current obesity epidemic.

What do you possibly think people will do when they face a big bag of low-salt chips?

These are not theoretical arguments – they are the facts of life – if you are interested in theories, please see the Dietary Guidelines.

Michael Bulger
02/02/2011
12:26PM

@Morton Satin:

For someone from the Salt Institute, you seem to be unfamiliar with the subject. First of all, you seem to over look the fact that the DGs were based on a multitude of peer-reviewed studies (not just three).

I glanced at the abstract of the first study you cite. What you describe as a low-sodium regime might more accurately be depicted as an extremely low-salt regime. The study found risks occurring at <20mmol/d. The new recommendations would be well above that at closer to 70mmol/d. You should reevaluate your use of the study as evidence.

As to your assumption that humans have an innate taste for salty snacks and would not possibly be satisfied by lower-salt options, you once again seem to be facing evidence to the contrary. From the DGAC report: "Taste preference for sodium is neither fixed nor innate. Rather, it is a malleable trait that is influenced by dietary exposure. At birth, there is no indication that salty substances are distinguishable or preferred (Beauchamp, 1986). "

"Studies have demonstrated that reducing dietary sodium intake over a time period of as little as 3 to 4 weeks can decrease preference for salty foods and increase acceptance of foods with reduced sodium content (Bertino, 1982;; Cooper and Sanger, 1984)."

To put it simply, the less salt we eat, the less we care for it. This, I am sure, does not seem good for your business. Think instead of the lives saved and the extended lives (and therefore ability to purchase products) that will result.

If you insist on heaping praise upon salt, please do not insult the public by trying to pass off studies of salt deprivation as evidence that current levels are beneficial.

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