2015 is going to bring great things. Among others, HBO’s Veep season 4, the AppleWatch, but most importantly, the USDA is going to publish their new Dietary Guidelines for Americans. Every 5 years, the institution graces us with a data-filled report, and a simple take-home message, usually in the form of a pyramid (or more recently, a plate) to tell us what diet to adopt in order to “maintain a healthy weight, reduce the risk of chronic disease, and promote overall health” (sic).
While we wait with bated breath, please allow me to take you on a trip down memory lane and look at the evolution of this dear Food Pyramid.
Let’s take a look at this beautiful ferris wheel: pretty straightforward and sensible recommendations. No vegetable oils, or refined sugar, lots of fresh produce. Basically (for the exception of Group 6), whole, real, unprocessed foods. The presence of the milk group is likely due to the influence of the National Dairy Council (they have always been successful at aggressively marketing their product. See: the ‘got milk?’ campaign).
Special mention to Group 7: BUTTER! (Let’s go right ahead and cross out that horrendous fortified margarine). Ah, these were the days when the American population was encouraged to eat saturated fat. This very quickly changed.
In the 1943 ferris wheel above, the bread/flour/cereals group accounted for only a 6th of the daily recommendations. Now in 1956, it is a third of the total servings! (4 out of a total 12-14 servings).
How did this happen?
In the 50’s, the processed food industry exploded. Fast food was everywhere. TV dinners, the remote control, and all the reagents needed to make stabilised starch products (breakfast cereal, WonderBread…) were invented. People loved it! And as for the inventors, this meant huge profits. (Remember Marion Nestle’s quote: “the more processed a food is, the more profit for the manufacturer”). By encouraging Americans to eat more grains, the USDA helped the processed food industry become the goliath it is today, and made its population sick. And it doesn’t stop here…
Okay, so now carbs (Bread, Cereal, Rice & Pasta) are the big grand daddy solid base of american nutrition. They aren’t even at equal weight with fruit and vegetables anymore. They are, the USDA would say, a solid foundation to a healthy diet, more so than fresh produce and un-processed foods.
Quick! Everybody buy Corn Flakes!
Carbohydrates are very low in nutritional value, spike blood sugar -leading to more hunger, weight gain, insulin resistance, and diabetes. Nevertheless, the USDA recommended that Americans consume 6-11 servings of these per day(!), to stay as full as possible while lacking fats which were unrightfully demonised.
The idea of putting all fats in the same boat, and more so, amalgamating them with sweets (a.k.a. the cause of diabetes, obesity, and chronic illnesses), is totally crazy.
The researchers wanted to see whether following the 1992 USDA Egyptian Pyramid recommendations would prevent chronic disease. To do so, they assessed how closely 67,000 women and 38,000 men followed them (in terms of servings per food group per day). The people were divided into 5 groups, or ‘quantiles’, from 1 to 5. 1 being a poor adherence to the dietary guidelines, and 5 being the group closest to the recommended USDA food habits. They then looked at the incidence of ‘Major Chronic Disease’ (cancer, stroke, diabetes…) in these individuals, over 12 and 8 years, respectively.
What did they find? Barely anything.
The women who followed the Food Pyramid the most accurately had only a 3% decrease in incidence of disease compared to the women who were the furthest from the recommendations (but honestly, it’s pretty much a flat line). For men, it was 11%. This means that men in group 5 only had an 11% reduction in MCD risk compared to those in group 1. And, funny note: it looks like if you are a man, being in Quintile 4 will make you the healthiest. This means following the guidelines juuuuuust almost well enough (but not too well, otherwise you will be in quantile 5 and get sicker!). A ‘convincing’ result would be a steadily decreasing curve for both groups. Clearly, there are other things going on, and following the US nutritional guidelines is not the key to preventing disease.
Again, this is an observational study, liable to recall-bias (subjects not accurately reporting their diet), and the data is pushed and pulled and adjusted in every way possible. But this remains, as of today, our best shot at observing wether or not the USDA guidelines are any good at helping with disease prevention. I will let you be the judge, but I do not think we can say that they are.
Kudos for making the grains group a little less prevalent this time, and not including a ‘dessert’ section.
Let’s consider the omnipresence of dairy since the first recommendations in 1943. Should we all be drinking milk instead of water? If it were all fair and square, the dairy group should just be inside the protein/animal products group, right? That would make the most sense. Difficult not to blame the National Dairy Council for this pan-century presence.
And finally, the fruit group. According to ChooseMyPlate.gov, “Any fruit or 100% fruit juice counts as part of the Fruit Group”
But maybe we can’t put anything past them. They do consider french fries as vegetables.
Time for the recap.
The guidelines are based on questionable data, and highlight the inherent conflict of interest in the USDA’s dual mandate: to promote US agricultural products (and the processed foods industry) as well as to advise the public about healthy food choices.
What can we hope to see in the 2015 report?
The evidence in meta-analyses is growing strongly and showing that saturated fat intake is not related to heart disease. I hope the USDA will drop their recommendation to eat processed, hydrogenated, and inflammation-causing vegetable oils instead of whole animal fats.
The USDA claims that dietary cholesterol increases the risk of heart disease, even though a joint meeting between the AHA and the American College of Cardiology decided to drop the restriction on dietary cholesterol. I know this sounds crazy, but cholesterol you eat has zero influence on blood cholesterol (I will write an article on this topic in the near future).
But perhaps most importantly, evidence has shown that low-carb diets are the greatest for fat loss, reversing Type 2 Diabetes, and reducing blood cholesterol (ratio of total cholesterol to HDL), as well as improving disease blood markers. Hopefully, the equalisation of grains and vegetables in the Food Pyramids between 1992 and 2005 indicates a future trend- let’s hope grains will be even less prevalent this year.
“Fat is not the problem. If Americans could eliminate sugary beverages, potatoes, white bread, pasta, white rice and sugary snacks, we would wipe out almost all the problems we have with weight and diabetes and other metabolic diseases.” – Dr. Willett, chairman of the department of nutrition at the Harvard School of Public Health
I’m looking forward to dissecting this year’s USDA guidelines and sharing my insights with you all.
In the meantime, please refer to this pyramid I made (great graphical design skills, I know, thank you). And if you want to read more of all this, feel free to subscribe to receive new posts by email! (at the top right corner of the blog)