From prior posts you likely know how I feel about nutrition guidelines, especially those issued by the government. We've witnessed the fall of the food pyramid, the rise of the healthy eating plate, and the continued escalation in obesity and chronic diseases attributed largely to unhealthy eating habits. I personally followed the US Dietary Guidelines (DG) for years and became insulin resistant and watched the same thing happen to countless patients.
Are the updated guidelines any better than years past? I’ve called upon our nutrition expert, Prerna Uppal, to do an analysis and to provide some of her own recommendations at the end.
The first US Dietary Guidelines (DG) were released in 1980. Since then they have been updated every 5 years and last month (Jan 2016) the federal government released its latest recommendations for healthy eating with the 2015-2020 dietary guidelines.
The guidelines are a joint report by the United States Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) outlining nutrition and dietary guidelines for the general public.
The information influences the advice dietitians and doctors give to their patients, and informs the food industry on how they label foods and which foods are served in school cafeterias and community health programs.
As healthcare professionals, one expects the recommendations in the report to be steeped in scientific evidence and that the most current and unbiased data is reflected in the government’s recommendations. However, while the guidelines do contain nuggets of useful information, they have often been criticized for lacking a sound scientific basis.
For the most part the recommendations are the same…eat fat-free/low-fat foods, less saturated fat, less meat, mostly whole grains. However, we do have some first-timers (sugar, coffee) which deserve an explanation.
REVIEWING THE GUIDELINES
So let’s take a deeper dive at the 2015-2020 Dietary Guidelines to see if we can walk away with some practical nuggets. I’ll start off each guideline with a “Yeh” or “Neh” and then provide my thoughts based on more updated science and our clinical experience.
1. DG’s continue to recommend we consume < 10% of our total calories from saturated fats
Verdict: Neh! Recent evidence points to not needing to stay within these limits for most individuals.
There are many types of saturated fats and not all of them behave the same way and raise blood cholesterol levels. Although some people may be sensitive to dietary cholesterol, our blood cholesterol is influenced primarily by the liver’s natural production of cholesterol (aka “endogenous cholesterol production”) which is independent of the cholesterol we get through foods.
Clearly healthier saturated fats have not been addressed in the dietary guidelines in spite of extensive scientific evidence indicating we don’t need to balk at butter, cringe at coconut or grimace at ghee (read The Big Fat Surprise by Nina Teicholz).
Butter from organic, grass-fed, pasture-raised cows is a healthy saturated fat. We have touted the health benefits of grass-fed animal products on our radio shows as well as in prior posts like this and continue to advise our patients to include natural saturated fats as they don’t adversely affect blood lipids or increase heart disease risk in most of our patients.
It is the hydrogenated fats that are the culprits! This distinction is key to better understand which fats need to be vilified. Hydrogenated fats, better known as trans fats, sneak into our diets thanks to the government regulations that permit foods with a trans fat content of 0.5 grams or less per serving, to be rounded down to 0!
This can be misleading when you read food labels as unbeknownst to you, a little here and there can can very quickly add up to unhealthy levels and put you way above the FDA’s, GRAS (Generally Recognized As Safe) zone of 2 grams/day.
2. Advised to consume fat-free or low-fat dairy
Verdict: Neh! Not again!
The low fat craze of the past four decades has proved harmful both to our waistlines and our health. As we ate less fat, ironically we saw an increase in obesity and chronic diseases such as diabetes and heart disease. Ever wondered why? When food manufacturers removed fat from their products, they had to replace it with something- it turned out to be sugar and processed carbohydrates. We saw a surge in our added sugar intake as the food industry went berserk churning out “fat-free” but carb laden cookies, cakes and chips.
I highly recommend including full-fat dairy products such as whole milk, yogurt and paneer (Indian cheese) that come from organic, grass-fed, pasture-raised cows. The fat will add satiety to your meal, reduce inflammation, and can help curb overeating and trim that waistline. Read this post on dairy for more evidence. Fat also helps your body absorb fat soluble vitamins such as Vitamin A, D, E and K.
3. Consume < 10% of your total calories from added sugars
Verdict: Yeh! This is the first time that the DGs have set limits for added sugar!
In March 2014, the WHO report proposed this exact recommendation for added sugars (which amounts to 12 tsp/day), however they went on to say that for additional benefits we should further reduce our intake to < 5% of total calories (which equals 6 tsp/day).
The DG’s “added” sugar restriction excludes naturally occurring sugars such as those found in dairy and fruits. But then, what about fruit juice? Fruit juice may be a source of natural sugars but contributes a hefty dose of carbohydrate to spike anyone’s blood sugar, especially if they are mostly sedentary
Bottom line, pay attention to both. Thankfully, the new food label will be listing added sugars separately from natural sugars and this should help us stay on track. Last year, for the first time ever, the FDA proposed that food companies need to list “added” sugars on the food labels. The proposal is still under review.
In the meantime, read the ingredients on those food labels carefully for those hidden sources of sugar. This is no easy task, given manufacturers have come up with a growing list of “code names” for sugar. Read about the 61 common sugar nicknames here at Sugar Science, an excellent resource.
4. Role of Dietary Cholesterol
Verdict: Yeh! Remember “Cholesterol is no longer a nutrient of concern?”
The DGs have downplayed cholesterol to support this statement from Feb 2015. Glad they got this one right. I would like to reiterate that free-range, pastured eggs are a good source of high quality dietary cholesterol. Cholesterol as I explained is mostly endogenously produced by our bodies and dietary cholesterol has little to no effect on blood cholesterol, so don’t shy away from some healthy cholesterol containing foods and check your cholesterol levels regularly to make sure you are not one of the few people who has elevated levels from dietary cholesterol. This is uncommon in our clinical experience.
Also, keep in mind that cholesterol does serve some essential roles in the body like optimizing the health of our neurons (nerve cells) and contributing to the production of steroid hormones.
5. Oils have been specifically recommended
Verdict: Neh! A serving of inflammatory foods anyone?
The DGs advise vegetable oils such as canola, sunflower, safflower, corn and soy. These oils are high in omega-6 fats and have thrown off our omega-6:omega-3 ratio. This ratio needs to be balanced for optimal health and disease prevention.
Have you ever seen how these vegetable oils are made? They are heavily processed with chemical solvents (how does hexane sound?), bleach and deodorizers used in their extraction. The resultant product is extremely unhealthy and promotes inflammation in our body.
Healthier plant oils include coconut oil (discussed here), avocado oil, extra virgin olive oil (EVOO), and my personal favorite, ghee (discussed here). Ghee and coconut oil don’t fit the DG bill since they are saturated fats!
Again, they seem to have overlooked evidence of the healthy fats that abound in nature which have the opposite effect of these industrialized seed oils. When used in moderation, they actually lower inflammation, the root cause of most chronic health conditions like heart disease and cancer!
6. What About Coffee?
Verdict: Yeh! Another first-timer! Great news for coffee lovers…
Moderate consumption of both coffee (and alcohol) can be a part of a healthy eating plan. Coffee made it to the DG list and scientific studies are indicating its health benefits.
But, don’t be drinking it ad lib…a limit of 2 drinks per day is advised. Keep in mind that although coffee may not increase the risk of chronic health conditions like heart disease, it may compromise sleep or may make anxiety worse.
Bottom Line: 3 Neh, 3 Yeh. Surely the govt. can do better than that!
CLOSING THOUGHTS AND PRERNA'S RECOMMENDATIONS
So why would the well-funded government not get this totally right ? Speculation is that political pressures from the billion-dollar food industry lobbying groups, influence our antiquated national guidelines more than cutting edge nutritional science based on scientific evidence. Supposedly even within the food industry, it all depends on who carries more clout.
Does sugar get to stay on for another 5 years on the Dietary Guidelines (DG) report or does red meat? Perhaps it depends on who has deeper pockets and therefore more staying power. So, it pays to be vigilant and not accept the guidelines verbatim.
In conclusion, take the government recommendations with a grain of salt (and by the way, do be sure to read up on their take on sodium. I decided to pass up the salt shaker!) Use time-tested wisdom as you try to make sense of all the conflicting nutrition information out there and follow my simple, six-step rule:
- Eat a mostly plant-based diet with copious amounts of fresh vegetables, regardless of whether you are a vegetarian or a meat-eater.
- Include a couple servings of fresh fruits daily (avoid juices, dried and canned fruit), especially antioxidant-rich ones like berries
- Limit processed and packaged foods
- Avoid soda and sugary beverages. Water is your best choice.
- Limit red meats and luncheon meats that contain nitrates/nitrites and aren’t of the grass-fed variety. Choose organic, grass-fed meats instead to maximize nutrients like omega-3s and minimize toxins. This study supports the nutrient density of organic meats and dairy
- Eat foods rich in omega-3 fats like fish (wild salmon), grass-fed meats and dairy, and leafy greens
Prerna Uppal, MS, RD, CDE