Saturday, March 14, 2015

The Nutrition Debate #296: Another Nail in the Coffin of the Dietary Guidelines

Zoe Harcombe, popular author and obesity researcher, got her first piece in the British Medical Journal’s Open Heart recently. The BMJ is perhaps the world’s most discriminating arbiter of medical science. Its Open Heart organ is an “open access, peer reviewed, online-only journal dedicated to publishing research in all areas of cardiovascular medicine.” This piece fit the requirements, and the conclusion was earthshaking. The title tells it all: “Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systemic review and meta-analysis.”

Harcombe conceived of this original research article and collaborated with several other credentialed authors in the data extraction, meta analysis and writing of the manuscript. All the authors were involved in the critical evaluation of content and reported no competing interests. The article has 32 linked references and was externally peer reviewed by the BMJ.

The full-text article came to my attention from a piece in Diabetes in Control: “Government Dietary Fat Guidelines Did Not Have Sufficient Supporting Evidence.” The subtitle restates the CONCLUSION of the Abstract of the paper: “Dietary recommendations introduced for 220 million U.S. and 56 million UK citizens by 1983 did not have sufficient supporting evidence from randomized controlled trials.” To be clear, the RCT studies evaluated were all published before 1983.

For the uninitiated, 1977 was the year where in the U.S a Senate Select Committee called the McGovern Commission held a few hearings and subsequently published the Dietary Goals for the United States. That document, prepared by Senate staffers, was the precursor to the 1980 Dietary Guidelines for Americans, which was revised and republished every five years thereafter. The Brits followed with their own dietary standards in 1983. These events have been chronicled in many places including briefly in The Nutrition Debate #4, “Big Government, Big Pharma and Poor Little Dr. Atkins.”

The dietary recommendations introduced in the U.S (1977) and in the UK (1983) were to reduce overall fat consumption to 30% of total energy intake and reduce saturated fat consumption to 10% of total energy intake. The protein recommendation was set at a meager 10% and the carbohydrates at a whopping 60%. That’s why starting around 1980 we (as a population) started to get fatter. That’s why diabesity skyrocketed and heart disease and many other diseases of “malnutrition” (for lack of fat-soluble vitamins from animal based foods) have plagued our nations.

In recent years, we have come to realize that the American public are participants in the largest uncontrolled experiment in history. This experiment hasn’t turned out very well, and we are still suffering the consequences. So, now the Titanic is slowly changing course. The limitation on the total percentage of fat in the diet has been omitted (#294), and now, hopefully (#295), in the 2015 Dietary Guidelines, cholesterol will “no longer be considered a nutrient of concern for overconsumption.” Think about it: All the shrimp, egg yolks, butter, etc. you have given up over the years, needlessly.

 I suspect the BMJ piece is but one of several initiatives in the non-conflicted medical and nutrition community to influence the members of the 2015 Dietary Guidelines Advisory Committee (DGAC). This group has had to endure a barrage of testimony from powerful Agribusiness. This list of oral presenters from 1 day of the 2nd of 7 public hearings of the DGAC is just the tip of the iceberg and illustrates the immense pressure they are under. I’ve got my fingers crossed for their integrity.

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