Dietary Guidelines: Who, What, Why, and WTH?

Perhaps you’ve hear the kerfuffle going on recently over the new dietary guidelines  released back in February. What’s going on, exactly? Is butter back?

The “Dietary Guidelines for Americans  is updated every five years, and it is billed as a joint effort of the Department of Agriculture and the Department of Health and Human Services. Does that smell like a conflict of interest? It definitely isn’t as politically neutral as it might wish. There are lots of competing interests, including financial pressure from segments of the food industry. The department of agriculture wears a lot of hats— and decisions about farm subsidies, for example,  are not based on health needs, but rather on economic considerations that are limited to the agricultural sector. But as you and I both know, food and health can’t be separated. To the credit of these government departments, though, they do rely on a panel of experts who review evidence that goes into the guidelines. So, at least science is in the room too!

SO, that said, what are we looking at in this updated version of the guidelines? It’s more than the much-touted removal of restrictions on total fat and cholesterol. It’s actually a pretty big shift in the way the government has always given dietary advice.

The major theme is a focus on whole foods rather than on individual nutrients, which is, believe it or not, “revolutionary”.

There’s general advice to eat vegetables, fruits, and whole grains, to include seafood and legumes, to moderate both dairy and alchohol consumption, and to lower meat, sugar, and refined grain consumption. That sounds pretty much like what I’ve always told my patients. All this will sound pretty familiar to fans of Michael Pollan: Eat food. Not too much. Mostly plants.


It’s sensible, flexible, and moderate. It looks good! But then it comes down to. . . . so what do I eat? The good part is, these guidelines can be met through lots of different patterns— you could be vegan, or eat Mediterranean style, or paleo, and still do it. The bad news, though, for some people, is that it’s not a clear protocol. So many people seem to want to know what the exact plan is that will make them thinner, stronger, faster, healthier, or smarter. And there is just no such thing as a detailed plan that will work for everyone. We’ve become so used to thinking about food reductively— carbs! fat! protein! cholesterol! — that it is hard to change the paradigm back of thinking about food as a whole. But that’s exactly where we need to go. But here’s the rub: whole foods are not profitable for food companies. You can’t tweak the formula of a walnut or a sweet potato. That’s WHY they’re whole and that’s part of why they’re healthy. But this isn’t good news for corporations that formulate and sell processed foods.

There’s more science to discuss— I’ve often noted that the science of nutrition is treacherous— and there’s certainly more politics to discuss (maybe even more treacherous?), and maybe some day I will— but for now, I’m glad to see a sensible, holistic approach to diet that I hope will start to trickle down into the popular press, too.

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