Dietary guidance fiascos – two sets of federal nutrition guidelines contradict each other

Dietary guidance fiascos – two sets of federal nutrition guidelines contradict each other – editorial

Helen A. Guthrie

During the month of April, the topic of dietary guidance received an unprecedented level of coverage in the public press. First, on April 8, a group identifying itself as The Physicians Committee for Responsible Medicine, a Washington-based nonprofit organization active in health and research policy, asked that the Department of Agriculture abandon its support of the traditional food groups and substitute instead their four food groups-whole grains, vegetables, fruits and legumes. They proposed that foods of animal origin in the dairy and meat, fish and poultry group at most assume a minor role in the American diet. They maintained that the American public’s continued use of such foods is responsible for deaths from cancer, heart attacks and stroke and that drastic recommendations were necessary. Publicity at the time indicated that the group numbered about 2000 concerned physicians. What it failed to reveal was that this was the same group that had been actively opposed to the use of animals in biological research and that they were part of the anti-vivisectionist movement in the country.

At no point in their press conference did they acknowledge what every nutritionist knows: that such a dietary prescription most certainly leads to severe nutritional inadequacies. To illustrate the point we provide in Figure 1 a comparison of the nutrient profiles of the average of two menus following the Basic Four recommendations that the group feel should be discarded and the average of two following the recommendations that the group proposes. In both cases the diets were composed of the foods from the recommended groups that were reported most frequently in both the Nationwide Food Consumption Survey (NFCS) and the NHANES II, both conducted beginning in 1976. It is obvious that the former provides a foundation diet with at least 80% of the Recommended Dietary Allowances for most of the nutrients for which RDAs exist. The diet proposed by the physicians’ group is lacking in calcium, iron, zinc and vitamin B12. In addition, the quality of the protein in the diet could be severely compromised unless great skill is used in combining the vegetable protein sources to assure the appropriate amino acid mix. The bioavailability of iron in the “new” diets will suffer because of the lack of heme iron. This can be partially compensated for by the high intake of vitamin C if it is evenly distributed throughout all meals. The high fiber content of the proposed diet could well interfere with the absorption of several of the trace elements and make it difficult to ingest enough calories to support growth or maintain body weight. Acceptance of this proposed scheme could only result in nutritional inadequacies and an unbalanced intake associated with no less severe problems than those it is purported to relieve.

The second fiasco for dietary guidance was the result of a precipitous decision on the part of the Secretary of Agriculture to withdraw the release of a new graphical representation of the Food Wheel used since 1984 to provide guidance to the public in selecting a “total diet.” Both the recommendations for intake of essential nutrients and the advice given in the Dietary Guidelines for Americans, which were concerned not only with preventing nutrient deficiencies but also reflecting the current thinking on the role of diet in health promotion and the prevention of chronic diseases were considered. The controversial graphic was in the form of a pyramid which had, for the last 3 years, been under study by USDA’s Human Nutrition Information Service (HNIS), the lead group within USDA responsible for its nutrition education activities. While the pyramid contained exactly the same information as the Food Wheel which it was designed to replace, it was unacceptable to the Cattleman’s Association because it placed the meat, fish and poultry group in parallel with the dairy group, both of which were above the cereal, fruit and vegetable groups, creating the impression that they were less important than the groups on the foundation on the base of the pyramid. In fact they were placed in that position because there were fewer servings recommended each day-a recommendation that has existed for years without giving rise to any comparable criticism. (It should be noted that the four servings from meat and dairy groups together provide about the same number of calories as do the six servings of the cereal group at the base of the triangle.) Equally offensive to its critics was the location of this food group directly under the “fats, oils and sugars” group (to be used with caution), a location that both the meat and dairy groups felt Stigmatized’ their products. This close position on the diagram was construed as casting food groups with important nutritional merit in a bad light. In canceling the authority to release the “pyramid,” which had already gone to press, the Secretary of Agriculture justified this action on the basis that it had not been adequately tested with children in addition to adults.

With this much publicity and obvious contradictory advice within a very short period, it is understandable that the public is expressing confusion about what professionals feel is appropriate advice. Obviously the challenge to nutrition professionals and nutrition educators in particular to straighten out the misconceptions is great.

Helen A. Guthrie, Ph.D.

Editor, Nutrition Today

Healthier Choices: Eating Less Fat is a 13-minute videotape that shows viewers how to make low-fat choices at restaurants and grocery stores and how to prepare low-fat meals at home. Its use is intended for clients of health care providers, extension groups, worksite education, introductory college classes and health club clientele. Print materials include Leader’s Guide with activities, lesson plans, bulletins and camera-ready activity sheets. Production date: 1990. Purchase price: $67.95. Contact: UW-Madison Nutrition Education Program, 1415 Linden Drive, Madison, WI 53706; phone: 608-262-4044.

Carbo Choices is a 16-minute videotape that addresses typical questions and concerns about fiber, starch and sugar in relation to health concerns and common myths associated with carbohydrates. Print materials include a manual with promotional materials, follow-up activities, evaluation forms, camera-ready handouts and a fiber poster. The target audience includes worksite health promotion, community education, introductory college classes and clinical settings. Production date: 1990. Purchase price: $125.00. Rental fee: $13.50. Contact: Thomas McKenna, Penn State Audio-visual Services, University Park, PA 16802. Phone: 1-800-826-0132. Warning: Dieting May Be Hazardous to Your Health is a 27-minute videotape produced by Consumers Union that helps the viewer sort through misinformation and claims to achieve weight loss without risking health. Topics include unsafe diets, diet pills, liquid diets and diets that work. Production date: 1990. Purchase price: $79.00. Contact: Films Incorporated, 5700 North Ashland Avenue, Chicago, IL. Phone: 1-800-323-4222; fax: 312-878-0416.

The Winning Wager: Managing Cholesterol Through Diet and Exercise is a 9-minute videotape that motivates adults to lower their cholesterol through diet and exercise. This production identifies specific ways to choose foods that are low in fat from the four food groups. Production date: 1990. Purchase price: $295.00. Rental: $40.00. Contact: Altschul Group Corporation, 930 Pitner Avenue, Evanston, IL 60202. Phone: 1-800-421-2363; fax: 708-328-6706.

COPYRIGHT 1991 Lippincott/Williams & Wilkins

COPYRIGHT 2004 Gale Group