We need a do-over. Why are the "Dietary Guidelines for Americans" housed at the USDA? Dumb question: Doesn't the United States Department of Agriculture advocate for, well...agriculture? Let's ditch 'em and give it to a scientific body that supposedly advocates for human health like the NIH? CDC?
Anecdote: agriculture people have noted that the MyPlate guidelines are similar to the guidelines for fattening up pigs for ... going to the place that pigs go before we eat them 😀😮
Plenty of corn, wheat, soy, skim milk ... foods that aren't satiating so you keep on eating and eating and adding body fat.
I hope RFK jr somehow gets these recommendations out of our institutions. I’ve eaten mostly eggs and red meats for the last three years and it turned my chronological clock back 20 years and dropped 40 lbs. Thanks for continuing the focus on these dangerous and conflicted “guidelines “.
The recommendation for "replacing poultry, meat, and eggs with peas, beans, and lentils as sources of protein" is the only thing I need to read to KNOW this report is a huge pile of bat guano. The vegans have usurped the process! WTAF?
Weak sources of low-density, less bioavailable protein. And they deliver many grams of carbs along with that protein. Lentils don't hold a candle to beef as a protein source.
Thanks, Nina, for continuing to highlight the lack of evidence—even in the teeth of evidence—that is the sorry state of our USDA Guidelines. One comment on the lack of ultra processed food (UPF) data: when I took my obesity medicine training we interacted with Carlos Monteiro MD the creator of the NOVA classification of UPF. It was pretty compelling (as nutritional research goes). There are now 7 reviews/meta-analyses that I am aware of. As with virtually all nutritional literature, RCT's are basically non-existent. Still, at what point do we invoke George McGovern's infamous "Politicians don't have to luxury of waiting until every last shred of evidence is in..." before we act on this?
1. “Food consumption by degree of processing and cardiometabolic risk: a systematic review” Int J Food Sci Nutrition (September 2020) 71(6):678-692. doi: 10.1080/09637486.2020.1725961. Epub 2020 Feb 13. Rev Saude Publica
2. “Food processing and cardiometabolic risk factors: a systematic review.,” (2020);54:70. doi: 10.11606/s1518-8787.2020054001704. Epub 2020 Jul 24. J Obes
3. “Ultra-processed food and the risk of overweight and obesity: a systematic review and meta- analysis of observational studies,” (Lond). 2020 Oct;44(10):2080-2091.
4. “Ultra-Processed Foods and Health Outcomes: A Narrative Review,” nts. (Jun 30 2020);12(7):1955. doi: 10.3390/nu12071955.
5. “Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies,” Nutr J 19, 86 (2020). https://doi.org/10.1186/s12937-020-00604-1.
6. “Consumption of ultra-processed foods and health status: a systematic review and meta-analysis,” Nutr. (2021 Feb 14);125(3):308-318. doi: 10.1017/S0007114520002688.
7. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ 2024;384:e077310 | doi: 10.1136/bmj-2023-077310.
Well, let's remember that the statement by George McGovern, which launched the US dietary guide guidelines based on insufficient evidence, is what got us into this mess in the first place. I believe that population wide recommendations based on week evidence should not be made, although you could have "soft" recommendations that suggest guidance where evidence is not yet sufficient. As for clinical trials, there is a large body of clinical trials on various topics, but they have been ignored
Seems to me that unless the committee is rid of its zombies (defined by Dictionary.com as “a person whose behavior or responses are wooden, listless, or seemingly rote; automaton”), we’ll not become rational & evidence based on our guidelines. Fingers crossed that between JFK Jr., Makary and Bhattacharya the committee recommendations can be thrown out & rewritten under the leadership of you, Nina!
Excellent article, as always. It’s unbelievable how bad the dietary guidelines are, and how much they contribute to our nation’s chronic disease issues. I’m hoping against hope that significant changes are made under RFK and that he doesn’t crumble under the weight of the current bureaucracy and status quo. And that he appoint you to lead the effort to institute new dietary guidelines for America, and possibly the world!
It's so frustrating to see so many guidelines being supported by low quality science. I have looked through quite a few systematic reviews and with several quality assessment tools, like GRADE and the JBI critical appraisal tools, most research does not pass muster. A sslystematic review of systematic reviews from the cochrane library found that I think it was 6 % of the research assessed was of good quality research and was deemed as effective. This is not something to be proud of.
We all know what's going on. The system is dominated by vegetarians, vegans, climate change hysterics, and others who simply think eating meat is gross or is unethically cruel to animals. All of these people have fanatical pre-existing belief systems against more meat and eggs. Any scientific arguments they produce are simply contortions to force the science to align with the beliefs they already have and will continue to have no matter how many more RTCs are done.
Hi. When discussing my research proposal for patient diabetes education with my nurse educator, I shared that all the million dollar donors to the American Diabetes Association were companies that profit from people with diabetes, she adamantly stated, "That's your opinion." She is incorrect--this is a fact. I tried to correct her numerous times but she simply talked over me with her mantra, "That's your opinion." Any rights on how to go public with this or what to do in any other respect?
Provide them with well researched articles that contain hard facts. For instance, on the American nutrition, diabetics association the US Right to Know has done excellent work, documenting their conflicts of interest, including owning stock in Coke or Pepsi, I can't remember which. Let them read that and decide for themselves.
Reading your proof that there is no proof, concluding the government has been subjecting the world to woefully untested nutrition guidelines, it seems just as sensible that we upend the food pyramid and try a few years of low-carbohydrate guidelines. Let's see what happens! Those of us who get what you're saying would like to have more company, Nina. Thank you for this disturbing criticism of the footnotes from hell!
Hi Nina. Excerpt from the 'Misinformation' article you mentioned. "The DGA is developed using a rigorous and transparent scientific process, and with the advice of an independent, external committee of leading scientists. Career federal nutrition scientists who manage the process ensure that the methods used to develop the DGA remain state of the art."
By state of the art they must mean that career federal nutrition scientists have complete control of the process; they select the library of evidence to be evaluated, they select the external committee members who evaluate the science, and then they write the guidelines as suits their fancy. According to them, misinformation is any sort of analysis they disapprove of.
On the flip side, those critical of the Dietary Guidelines argue their case using the same sort of uncertain, associative science they disagree with; randomized, controlled studies involving numerous subjects. Is there rock-solid (experimental) evidence that replacing saturated fats with linoleic acid in the diets of insulin resistant subjects improves metabolic markers of health? Is there evidence that swapping animal proteins for plant proteins also improves metabolic markers of health? Yes to both these questions.
Is anyone curious as to why? Here is a clue. "The Mediterranean diet is low in arachidonic acid and rich in healthy fats such as monounsaturated fats found in extra-virgin olive oil (EVOO), nuts and omega-3 fatty acids from fish, which has been shown to lower the risk of inflammation, heart disease, cancer, diabetes and obesity, and other degenerative diseases." https://advancedmolecularlabs.com/blogs/news/new-red-meat-study-controversy
In my view, the obesity/diabetes epidemic stems from changes in the fatty acid profile of the food supply resulting in increased arachidonic acid intake.
Unfortunately, even scientists, familiar with the biochemical mechanisms that derange appetite, get confused as to which molecules are responsible for causing insulin resistance. For example, I challenge anyone who reads the below narrative to identify the two errors.
"Endocannabinoids and their G-protein coupled receptors (GPCR) are a current research focus in the area of obesity due to the system's role in food intake and glucose and lipid metabolism. Importantly, overweight and obese individuals often have higher circulating levels of the arachidonic acid-derived endocannabinoids anandamide (AEA) and 2-arachidonoyl glycerol (2-AG) and an altered pattern of receptor expression. Consequently, this leads to an increase in orexigenic stimuli, changes in fatty acid synthesis, insulin sensitivity, and glucose utilisation, with preferential energy storage in adipose tissue. As endocannabinoids are products of dietary fats, modification of dietary intake may modulate their levels, with eicosapentaenoic and docosahexaenoic acid based endocannabinoids being able to displace arachidonic acid from cell membranes, reducing AEA and 2-AG production. Similarly, oleoyl ethanolamide, a product of oleic acid, induces satiety, decreases circulating fatty acid concentrations, increases the capacity for β-oxidation, and is capable of inhibiting the action of AEA and 2-AG in adipose tissue. Thus, understanding how dietary fats alter endocannabinoid system activity is a pertinent area of research due to public health messages promoting a shift towards plant-derived fats, which are rich sources of AEA and 2-AG precursor fatty acids, possibly encouraging excessive energy intake and weight gain."
Although I've read that Abstract numerous times over the past few years, I didn't notice the errors until it was pointed out that AEA and 2-AG molecules are not prostanoids. The below comment by Norwegian animal science researchers illustrates my point.
"Because arachidonic acid (AA) competes with EPA and DHA as well as with LA, ALA and oleic acid for incorporation in membrane lipids at the same positions, all these fatty acids are important for controlling the AA concentration in membrane lipids, which in turn determines how much AA can be liberated and become available for prostaglandin biosynthesis following phospholipase activation. Thus, the best strategy for dampening prostanoid overproduction in disease situations would be to reduce the intake of AA, or reduce the intake of AA at the same time as the total intake of competing fatty acids (including oleic acid) is enhanced, rather than enhancing intakes of EPA and DHA only." https://pmc.ncbi.nlm.nih.gov/articles/PMC2875212/
Another aspect of fatty acid metabolism that is not well understood has to do with fasting and exercise. Again, it was an animal science researcher that explained these aspects of energy allocation.
"The increased proportional intake of dietary fat, decrease in feeding frequency and increased physical activity in free-ranging compared to captive cheetahs are all predicted to result in enhanced mitochondrial FA oxidation through the lowering of circulating glucose concentrations and insulin:glucagon ratios. During fasting/refeeding cycles and increased levels of exercise, tissue PUFA concentrations have been shown to deplete rapidly in both humans and rats. These studies show that most PUFAs, including α-linolenic acid (ALA) and linoleic acid (LA), are preferentially oxidized in periods of exercise or fasting. During refeeding, SFAs and monounsaturated fatty acids (MUFAs), such as palmitic acid and oleic acid, are also more rapidly replaced than any of the PUFAs. Similarly, the concentrations of most plasma PUFAs and MUFAs have been shown to be significantly lower in rats fed a high fat ketogenic diet than in controls. The predicted increase in FA oxidation in free-ranging cheetahs is therefore likely to also skew their serum FA profiles toward lower proportional serum concentrations of PUFAs and MUFAs relative to SFA." https://pmc.ncbi.nlm.nih.gov/articles/PMC5167222/
In the final analysis, excessive arachidonic acid in cell membranes translates into appetite derangement and inflammation. When linoleic acid molecules displace arachidonic acid molecules in cell membranes, circulating levels of AEA and 2-AG diminish (restoring appetite control) and prostanoid levels drop, which decreases inflammation.
Good Lawd; don't mean to be perverse, well actually I do, but the word that jumps into my head is Clusterf*. Conflicts of interest; evidence lacking or non existent or worse intimated as existing and not existing. Anybody who has paid attention, knows, I mean KNOWS that we are in crisis mode here. We are overfed, undernourished, under exercised, over stimulated, sucking down anti anxiety and depression meds at all time highs, under rested (sleep). What is a poor boy to do; too old to sing in a rock and roll band. So I'll continue to give Nina as much support as I can and pray, hope, somehow believe that the jokers writing the rules, i.e. Guidelines resolve their cognitive dissonance in favor of evidence, i.e. truth as we know it at a point in time. I mean come on, the security of the nation is at risk. Seriously, more than 50% of those wishing to join the military can't pass a physical fitness test, too fat and weak.
Thanks Nina. Hope that you don't burnout with the frustration!
We need a do-over. Why are the "Dietary Guidelines for Americans" housed at the USDA? Dumb question: Doesn't the United States Department of Agriculture advocate for, well...agriculture? Let's ditch 'em and give it to a scientific body that supposedly advocates for human health like the NIH? CDC?
Excellent point! Never thought of that!
Anecdote: agriculture people have noted that the MyPlate guidelines are similar to the guidelines for fattening up pigs for ... going to the place that pigs go before we eat them 😀😮
Plenty of corn, wheat, soy, skim milk ... foods that aren't satiating so you keep on eating and eating and adding body fat.
I hope RFK jr somehow gets these recommendations out of our institutions. I’ve eaten mostly eggs and red meats for the last three years and it turned my chronological clock back 20 years and dropped 40 lbs. Thanks for continuing the focus on these dangerous and conflicted “guidelines “.
Food $cience
It sounds like RFK Jr. will be able to make some desperately needed changes. Yay!!
The recommendation for "replacing poultry, meat, and eggs with peas, beans, and lentils as sources of protein" is the only thing I need to read to KNOW this report is a huge pile of bat guano. The vegans have usurped the process! WTAF?
Weak sources of low-density, less bioavailable protein. And they deliver many grams of carbs along with that protein. Lentils don't hold a candle to beef as a protein source.
Thanks, Nina, for continuing to highlight the lack of evidence—even in the teeth of evidence—that is the sorry state of our USDA Guidelines. One comment on the lack of ultra processed food (UPF) data: when I took my obesity medicine training we interacted with Carlos Monteiro MD the creator of the NOVA classification of UPF. It was pretty compelling (as nutritional research goes). There are now 7 reviews/meta-analyses that I am aware of. As with virtually all nutritional literature, RCT's are basically non-existent. Still, at what point do we invoke George McGovern's infamous "Politicians don't have to luxury of waiting until every last shred of evidence is in..." before we act on this?
1. “Food consumption by degree of processing and cardiometabolic risk: a systematic review” Int J Food Sci Nutrition (September 2020) 71(6):678-692. doi: 10.1080/09637486.2020.1725961. Epub 2020 Feb 13. Rev Saude Publica
2. “Food processing and cardiometabolic risk factors: a systematic review.,” (2020);54:70. doi: 10.11606/s1518-8787.2020054001704. Epub 2020 Jul 24. J Obes
3. “Ultra-processed food and the risk of overweight and obesity: a systematic review and meta- analysis of observational studies,” (Lond). 2020 Oct;44(10):2080-2091.
4. “Ultra-Processed Foods and Health Outcomes: A Narrative Review,” nts. (Jun 30 2020);12(7):1955. doi: 10.3390/nu12071955.
5. “Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies,” Nutr J 19, 86 (2020). https://doi.org/10.1186/s12937-020-00604-1.
6. “Consumption of ultra-processed foods and health status: a systematic review and meta-analysis,” Nutr. (2021 Feb 14);125(3):308-318. doi: 10.1017/S0007114520002688.
7. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ 2024;384:e077310 | doi: 10.1136/bmj-2023-077310.
Well, let's remember that the statement by George McGovern, which launched the US dietary guide guidelines based on insufficient evidence, is what got us into this mess in the first place. I believe that population wide recommendations based on week evidence should not be made, although you could have "soft" recommendations that suggest guidance where evidence is not yet sufficient. As for clinical trials, there is a large body of clinical trials on various topics, but they have been ignored
Seems to me that unless the committee is rid of its zombies (defined by Dictionary.com as “a person whose behavior or responses are wooden, listless, or seemingly rote; automaton”), we’ll not become rational & evidence based on our guidelines. Fingers crossed that between JFK Jr., Makary and Bhattacharya the committee recommendations can be thrown out & rewritten under the leadership of you, Nina!
Excellent article, as always. It’s unbelievable how bad the dietary guidelines are, and how much they contribute to our nation’s chronic disease issues. I’m hoping against hope that significant changes are made under RFK and that he doesn’t crumble under the weight of the current bureaucracy and status quo. And that he appoint you to lead the effort to institute new dietary guidelines for America, and possibly the world!
It's so frustrating to see so many guidelines being supported by low quality science. I have looked through quite a few systematic reviews and with several quality assessment tools, like GRADE and the JBI critical appraisal tools, most research does not pass muster. A sslystematic review of systematic reviews from the cochrane library found that I think it was 6 % of the research assessed was of good quality research and was deemed as effective. This is not something to be proud of.
We all know what's going on. The system is dominated by vegetarians, vegans, climate change hysterics, and others who simply think eating meat is gross or is unethically cruel to animals. All of these people have fanatical pre-existing belief systems against more meat and eggs. Any scientific arguments they produce are simply contortions to force the science to align with the beliefs they already have and will continue to have no matter how many more RTCs are done.
Insanity.
Hi. When discussing my research proposal for patient diabetes education with my nurse educator, I shared that all the million dollar donors to the American Diabetes Association were companies that profit from people with diabetes, she adamantly stated, "That's your opinion." She is incorrect--this is a fact. I tried to correct her numerous times but she simply talked over me with her mantra, "That's your opinion." Any rights on how to go public with this or what to do in any other respect?
Provide them with well researched articles that contain hard facts. For instance, on the American nutrition, diabetics association the US Right to Know has done excellent work, documenting their conflicts of interest, including owning stock in Coke or Pepsi, I can't remember which. Let them read that and decide for themselves.
Sorry, I misread that. For the American diabetes Association see the work in the Guardian by Neil Barsky.
Reading your proof that there is no proof, concluding the government has been subjecting the world to woefully untested nutrition guidelines, it seems just as sensible that we upend the food pyramid and try a few years of low-carbohydrate guidelines. Let's see what happens! Those of us who get what you're saying would like to have more company, Nina. Thank you for this disturbing criticism of the footnotes from hell!
Hi Nina. Excerpt from the 'Misinformation' article you mentioned. "The DGA is developed using a rigorous and transparent scientific process, and with the advice of an independent, external committee of leading scientists. Career federal nutrition scientists who manage the process ensure that the methods used to develop the DGA remain state of the art."
By state of the art they must mean that career federal nutrition scientists have complete control of the process; they select the library of evidence to be evaluated, they select the external committee members who evaluate the science, and then they write the guidelines as suits their fancy. According to them, misinformation is any sort of analysis they disapprove of.
On the flip side, those critical of the Dietary Guidelines argue their case using the same sort of uncertain, associative science they disagree with; randomized, controlled studies involving numerous subjects. Is there rock-solid (experimental) evidence that replacing saturated fats with linoleic acid in the diets of insulin resistant subjects improves metabolic markers of health? Is there evidence that swapping animal proteins for plant proteins also improves metabolic markers of health? Yes to both these questions.
Is anyone curious as to why? Here is a clue. "The Mediterranean diet is low in arachidonic acid and rich in healthy fats such as monounsaturated fats found in extra-virgin olive oil (EVOO), nuts and omega-3 fatty acids from fish, which has been shown to lower the risk of inflammation, heart disease, cancer, diabetes and obesity, and other degenerative diseases." https://advancedmolecularlabs.com/blogs/news/new-red-meat-study-controversy
In my view, the obesity/diabetes epidemic stems from changes in the fatty acid profile of the food supply resulting in increased arachidonic acid intake.
Unfortunately, even scientists, familiar with the biochemical mechanisms that derange appetite, get confused as to which molecules are responsible for causing insulin resistance. For example, I challenge anyone who reads the below narrative to identify the two errors.
"Endocannabinoids and their G-protein coupled receptors (GPCR) are a current research focus in the area of obesity due to the system's role in food intake and glucose and lipid metabolism. Importantly, overweight and obese individuals often have higher circulating levels of the arachidonic acid-derived endocannabinoids anandamide (AEA) and 2-arachidonoyl glycerol (2-AG) and an altered pattern of receptor expression. Consequently, this leads to an increase in orexigenic stimuli, changes in fatty acid synthesis, insulin sensitivity, and glucose utilisation, with preferential energy storage in adipose tissue. As endocannabinoids are products of dietary fats, modification of dietary intake may modulate their levels, with eicosapentaenoic and docosahexaenoic acid based endocannabinoids being able to displace arachidonic acid from cell membranes, reducing AEA and 2-AG production. Similarly, oleoyl ethanolamide, a product of oleic acid, induces satiety, decreases circulating fatty acid concentrations, increases the capacity for β-oxidation, and is capable of inhibiting the action of AEA and 2-AG in adipose tissue. Thus, understanding how dietary fats alter endocannabinoid system activity is a pertinent area of research due to public health messages promoting a shift towards plant-derived fats, which are rich sources of AEA and 2-AG precursor fatty acids, possibly encouraging excessive energy intake and weight gain."
Although I've read that Abstract numerous times over the past few years, I didn't notice the errors until it was pointed out that AEA and 2-AG molecules are not prostanoids. The below comment by Norwegian animal science researchers illustrates my point.
"Because arachidonic acid (AA) competes with EPA and DHA as well as with LA, ALA and oleic acid for incorporation in membrane lipids at the same positions, all these fatty acids are important for controlling the AA concentration in membrane lipids, which in turn determines how much AA can be liberated and become available for prostaglandin biosynthesis following phospholipase activation. Thus, the best strategy for dampening prostanoid overproduction in disease situations would be to reduce the intake of AA, or reduce the intake of AA at the same time as the total intake of competing fatty acids (including oleic acid) is enhanced, rather than enhancing intakes of EPA and DHA only." https://pmc.ncbi.nlm.nih.gov/articles/PMC2875212/
Another aspect of fatty acid metabolism that is not well understood has to do with fasting and exercise. Again, it was an animal science researcher that explained these aspects of energy allocation.
"The increased proportional intake of dietary fat, decrease in feeding frequency and increased physical activity in free-ranging compared to captive cheetahs are all predicted to result in enhanced mitochondrial FA oxidation through the lowering of circulating glucose concentrations and insulin:glucagon ratios. During fasting/refeeding cycles and increased levels of exercise, tissue PUFA concentrations have been shown to deplete rapidly in both humans and rats. These studies show that most PUFAs, including α-linolenic acid (ALA) and linoleic acid (LA), are preferentially oxidized in periods of exercise or fasting. During refeeding, SFAs and monounsaturated fatty acids (MUFAs), such as palmitic acid and oleic acid, are also more rapidly replaced than any of the PUFAs. Similarly, the concentrations of most plasma PUFAs and MUFAs have been shown to be significantly lower in rats fed a high fat ketogenic diet than in controls. The predicted increase in FA oxidation in free-ranging cheetahs is therefore likely to also skew their serum FA profiles toward lower proportional serum concentrations of PUFAs and MUFAs relative to SFA." https://pmc.ncbi.nlm.nih.gov/articles/PMC5167222/
In the final analysis, excessive arachidonic acid in cell membranes translates into appetite derangement and inflammation. When linoleic acid molecules displace arachidonic acid molecules in cell membranes, circulating levels of AEA and 2-AG diminish (restoring appetite control) and prostanoid levels drop, which decreases inflammation.
Good Lawd; don't mean to be perverse, well actually I do, but the word that jumps into my head is Clusterf*. Conflicts of interest; evidence lacking or non existent or worse intimated as existing and not existing. Anybody who has paid attention, knows, I mean KNOWS that we are in crisis mode here. We are overfed, undernourished, under exercised, over stimulated, sucking down anti anxiety and depression meds at all time highs, under rested (sleep). What is a poor boy to do; too old to sing in a rock and roll band. So I'll continue to give Nina as much support as I can and pray, hope, somehow believe that the jokers writing the rules, i.e. Guidelines resolve their cognitive dissonance in favor of evidence, i.e. truth as we know it at a point in time. I mean come on, the security of the nation is at risk. Seriously, more than 50% of those wishing to join the military can't pass a physical fitness test, too fat and weak.
Thanks Nina. Hope that you don't burnout with the frustration!