Monday, December 9, 2019

Retrospective #296: Another Nail in the Coffin of the Dietary Guidelines

Zoe Harcombe, popular UK author and obesity researcher, got her first piece in the British Medical Journal’s Open Heart in February 2015. The BMJ is one of the world’s most discriminating arbiters of medical science. Open Heart 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 RANDOMIZED 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 article and collaborated with several other credentialed authors in the data extraction, analysis and writing of the manuscript. All the authors were involved in the critical evaluation of content and reported no competing interests. The article was externally peer reviewed, has 32 linked references and has now been cited (December 2019) 169 times by other science articles.
The full-text article came to my attention from a 2015 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. [1N 1977] AND 56 MILLION UK CITIZENS BY 1983 DID NOT HAVE SUFFICIENT SUPPORTING EVIDENCE FROM RANDOMIZED CONTROLLED TRIALS.” To be clear, the randomized controlled trials (RCTs) 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 first “Dietary Guidelines for Americans” (1980), which was revised and republished every five years thereafter. The Brits followed suit 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” (12/31/2010).
Among many other things, the dietary recommendations introduced in the U.S in 1977 and in the UK in 1983 recommended that we limit dietary cholesterol, present only in animal foods, to 300mg a day. A single, large, hen’s egg yolk contains 187mg! As reported in Retrospective #295, that 300mg limitation was finally lifted in the 2015 iteration of the DGA. Did you know that? So was the recommendation that we limit total fat. That change too has been little reported by the mainstream media. Who, after all, in Agribusiness and Big Pharma would profit from these changes? No one. Only we, the consumer of food, by improved health and wellbeing.
The 1980 DGA recommended that we reduce overall fat consumption to 30% of total calories and reduce saturated fat consumption to 10%. The protein recommendation was set at a meager 10% and the carbohydrates (sugars and refined carbs from manufactured foods in boxes and bags) set at a whopping 60% of calories (300g or 1,200kcal).
AND THAT, MY FRIENDS, IS WHY WE, AS A POPULATION, STARTING AROUND 1980, STARTED TO GET FATTER. That’s why diabesity skyrocketed and heart disease and many other “diseases of civilization” (of malnutrition really, from lack of the fat-soluble vitamins A, D, E and K from animal-based foods) have plagued our nations.
In recent years, we have come to realize that the American and British public have been participants in the largest uncontrolled experiment in history. This experiment hasn’t turned out well. We are still suffering the consequences.
But now, if seems, 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), DIETARY CHOLESTEROL WILL “NO LONGER BE CONSIDERED A NUTRIENT OF CONCERN FOR OVERCONSUMPTION.” Are you thinking ruefully about all the shrimp, egg yolks, butter, full-fat dairy, (milk, cream, cheese, yogurt, etc.) you have needlessly given up over the years?
Harcombe’s BMJ piece was but one of several initiatives in the non-conflicted medical and nutrition community to appear in the scientific press. Richard Feinman’s et al., “12 points of evidence,” a very well documented piece in Nutrition (2014) was another that has been widely disseminated in the U. S. (now cited in 505 science journal articles).
And now, in 2019, Nina Teicholz, author of The Big Fat Surprise, a 2014 best seller which itself was a riff on Gary Taubes’s seminal 2002 NYT Sunday Magazine piece, “What If It’s All Been a Big Fat Surprise,” has ramped up her efforts at The Nutrition Coalition to influence the 2020 Dietary Guidelines for Americans now in preparation. I’ve got my fingers crossed, but my hopes…well, are not too high.

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