U.S. Dietary Guidelines Fail to Change Course

https://www.wsj.com/articles/new-u-s-dietary-guidelines-reject-recommendation-to-cut-sugar-alcohol-intake-11609254000?reflink=share_mobilewebshare

In 1977, the first edition of the U.S. Dietary Guidelines was published with an intent to reduce heart disease and diabetes through a diet high in carbohydrates, low in fat, and paying attention to measurements like blood cholesterol. Since that seminal moment, the health of Americans has spiraled downward with obesity, diabetes, heart disease and other metabolic conditions driving up health costs while driving down the quality of life. From the Dietary Guidelines, to the Food Pyramid, to the most recent version, My Plate (see picture), these dietary guidelines have been based on flawed science since their inception and have served to make our population sicker, unhealthier, and as evidenced by COVID-19, more susceptible to serious viruses and infections.

In the 2020 update to the Dietary Guidelines, a panel of academics and scientists recommended reducing the limit for added sugars from 10% to 6% of calories, as well as cutting the limit on alcoholic beverages for men from 2 drinks to 1 per day. Those recommendations were rejected. At least the recommendation for eliminating added sugars for children under 2 years old was accepted, but not reducing the recommended consumption of added sugars for the broad population is just another example of how flawed the Dietary Guidelines have been since their inception.

How Did We Get Here?

Post World War II America saw a booming economy. Soldiers were returning home, industry was expanding, the population was euphoric to finally have the most destructive conflict in human history in the rear view mirror. It was a time of extraordinary change. Consider:

  • Want replaced need. After years of sacrifice, hardship and resource constraints to support the enormous war effort, people were ready to splurge. Buying only what was needed transformed to buying what was wanted.
  • Boom of the suburbs. People were moving out of the cities into suburban homes. Commutes to work began to lengthen, no longer was walking to the local market relevant, and life at home took on a whole new look.
  • Smoking became en vogue. Restaurants, bars, offices & homes were only too eager to allow people the glamour of smoking, especially cigarettes. (Side note: It was noted that during World War II, Supreme Allied Commander Eisenhower would smoke 4 – 5 packs of cigarettes per day).
  • Automobile. Vehicles were being purchased at record levels, and driving became an enjoyable and convenient way of life. Automobiles also reduced the need for walking, and enabled the boom of the suburbs and “bulk” shopping, which coincided with more processing of foods to produce higher volumes at lower cost while ensuring shelf stability.
  • Food processing accelerated. Canned goods, boxed foods and additives were being used to make foods taste sweeter and last longer on grocery store shelves. America shifted from an agrarian to industrial economy, and even the food became industrialized, as evidenced by the extensive shift to soybean oils. Cheap, convenient, shelf stable, processed and sweet became the rule and both American companies & the population were “all-in.”
  • Television. The American consumer began to live life around the magic of TV, even experiencing a whole new category of processed foods called “TV dinners.” People were eating in front of the TV, and advertisers had a field day with selling all kinds of snacks and treats.
  • Fast food restaurants exploded. Quick, easy dining experiences were viewed as “treats”, as less cooking from scratch was done at home, and the signature American meal became a hamburger with french fries.

There was also an important moment in leadership. Dwight D. Eisenhower, one of the allied heroes from World War II who was subsequently elected President of the U.S., had a massive heart attack in 1955. This was an enormous shock to a nation that was feeling bullish about the future. It was around this same time scientists began performing “studies” to understand heart disease, cholesterol and what was contributing to these health issues. Smaller studies were performed, but the pivotal one was led by Dr. Ancel Keys, who with his Seven Counties Study in 1958, led a chorus of medical hypotheses that linked fat to heart disease, and demonized fat as the single macronutrient to avoid. Further studies through the 1960’s continued to suggest saturated fats were the single cause of a myriad of heart-related issues, and advised Americans to significantly reduce their consumption of saturated fats. Replacing these fats with substitutes like margarine, shortenings and vegetable oils were recommended as better choices for health and wellness.

The early 70’s brought legislation that placed fat and cholesterol content on food labels, but it was determined American consumers needed clear, “expert” governmental advice of what they should eat. A committee in 1976 was created to make such recommendations, and after much debate & consternation, the 1977 Dietary Guidelines were published in January. They were as follows:

  1. Increase carbohydrates to 55% – 60% of caloric intake
  2. Reduce fat to approximately 30% of caloric intake
  3. Reduce saturated fats to approximately 10% of caloric intake. The remaining fat should come from poly and mono-unsaturated fats.
  4. Reduce cholesterol consumption to 300mg/day
  5. Reduce sugar consumption to approximately 15% of total daily caloric intake
  6. Reduce salt intake to 3 grams/day, which was seen as a 50% – 80% reduction

Additionally, the committee recommended the following

  1. Increase consumption of fruits, vegetables & whole grains
  2. Decrease consumption of meat
  3. Increase consumption of poultry and fish (primarily due to the lower-fat content)
  4. Decrease consumption of foods high in fat and partially substitute poly-unsaturated fat for saturated fat
  5. Substitute non-fat for whole milk, and decrease consumption of butterfat, eggs and other “high cholesterol” sources
  6. Decrease consumption of sugar and foods high in sugar content
  7. Decrease consumption of salt and foods high in salt content

The Results Are In…And We’re In Trouble

Since the late 1950’s, diagnosed diabetes was on an upswing, but still relatively small as a percentage of the population. However, since the 1980’s, the incidence of obesity & diabetes (primarily Type 2), has increased exponentially and continues to climb.

Through my consulting, advisory and strategic work, I created the following graphics to reinforce how dire of a chronic disease state we are in within the U.S.

Property of James F. Stone

What is so critical to understand is diet – what we eat, how we eat, how often we eat – is a direct contributor or driver of EVERY one of these conditions.

Obesity and diabetes go hand-in-hand. It is shocking to think that 42% of American adults are considered obese, with a BMI of 30+, while almost 90M Americans are considered “pre-diabetic.” Categorizing people as pre-diabetic is another way of saying they are insulin-resistant, and if dietary changes are not made immediately, they will almost certainly become Type 2 diabetic.

Diabetes is not just a problem in the U.S. Globally, it is estimated that over 420M adults are diabetic, which is 1 out of every 11 adults on earth. In China, the incidence of diabetes within the adult population in 1980 was 1%; today it is almost 12%.

The Problem With MyPlate

The decisions in 1977 were made based on poor science, ignoring research from almost 100 years earlier, broad & flawed assumptions and a general lack of hormonal behavior knowledge, and those decisions have cost us dearly. There are fundamental flaws with the MyPlate recommendation that need to change immediately if we are to reverse this disastrous diabetes and obesity trend.

  1. Obesity is not a result of “Calories in / Calories out”. The narrative for the last 40+ years has been to just eat less to lose weight. Millions of Americans have tried this, and failed, often multiple times. It doesn’t work, and the reason is not a lack of will, or a lack of discipline, or even a lack of exercise, but a lack of understanding of homeostasis and the role hormones play in weight management.
  2. Homeostasis is a state of equilibrium the body constantly seeks, and to find it, the body retains an incredible agility to adjust to changing conditions. For example, if you decide to embark on a weight loss program based on the failed calories in / calories out method, and you cut 500 calories from your daily diet, here’s what will happen. In the very near term (1 – 3 weeks), you will likely lose a few pounds, largely water weight. But as the body adapts to the new caloric intake, it will slow down your metabolism so you burn fewer calories during the day. It will balance your metabolism with your caloric intake. Your weight-loss stops, and to keep it going, you need to again reduce your caloric intake. This cycle continues until you’re basically not eating anything, and at this point, most people feel horrible & starved, give up, binge on foods they’ve been missing because this dietary experience has been so unfulfilling, and put on more weight than they had when they started.
  3. Obesity (& Type 2 Diabetes) is directly related to insulin and insulin resistance. Eating too many of the wrong foods, too often, and not balancing nutrients causes a consistently high level of the hormone insulin, which not only shuts down fat metabolism, but eventually encourages the body (including the liver) to store the excess calories as fat. Being in an insulin resistant state also continually triggers your brain (hypothalamus) to receive messages of hunger, which means your brain never processes the signal of being full. Hence, you always feel hungry and constantly eat. Guess which macronutrient generates the highest insulinogenic response? Carbohydrates…
  4. Carbohydrates have been known to cause weight gain for well over 100 years. I laugh at people who talk about ketogenic as a “fad diet.” Looking back to the late 1800’s, nutrition thought leaders knew that, to lose weight (fat), a low carbohydrate, higher fat diet was required. And it was proven again and again to be successful. Our current diet is overloaded with carbohydrates and that causes a multitude of problems such as inflammation; insulin resistance, which is the precursor to Type 2 diabetes; fat accumulation around organs (ie, fatty liver) as well as subcutaneous; heart disease; eyesight problems; gastrointestinal disorders like leaky gut and so on. But, the MyPlate dietary guidelines want us to consume 60% of our calories from carbohydrates?
  5. Eating fat does not make you fat. Fats are not created equal. A natural saturated fat from an avocado is very different than a processed saturated fat from a box of cookies, or a trans-fat from a partially-hydrogenated vegetable oil. Our bodies are well-built to manage natural fats, as they are essential to health and longevity (hence the name essential fatty acids). Fat is also the macronutrient that has the lowest impact on insulin, but because of its caloric density (9 calories vs. 4 in a protein or carb), it also provides satiation. High quality saturated fats come in foods with a balance of vitamins, minerals and amino acids that are critical to feed and sustain your body. Eggs, avocados, olive oil, macadamia nuts, grass fed/finished beef, butter, full-fat yogurt or dairy, and cold-water fish (ie, salmon) are just a few examples of outstanding foods that fuel your body.

So What Do We Do

The definition of business insanity is “keep doing what you’ve always done and expect different results.” Continuing to follow MyPlate and the archaic, flawed dietary recommendations is a recipe for insanity, not to mention poor health. We have forty years of history to show us this dietary direction not only is a failure, but it is contributing to an increase in disease, a decreased quality of life, and placing an enormous strain on our economy. It’s time to stop the insanity.

Here are three things you can do immediately to change the trajectory and take back your life through good dietary choices:

  1. Eliminate snacking. Every time you eat, you raise insulin, and the more your snacks are filled with sugars and carbohydrates, the more insulin you are stimulating. This is the path to insulin resistance, and ultimately, to Type 2 diabetes. Many products today market themselves as “healthy snacks” but they are far from it, both based on the ingredients used AND the constant eating and insulin stimulation as a result. Instead, aim for no more than three (3) meals per day, ensure you have at least 12 hours/day of no eating, and as you get more comfortable with this intermittent fasting approach you can increase your eating/fasting schedule to an 8/16 ratio (8 hours of an eating window / 16 hours of fasting).
  2. Stop counting calories. Calories in / calories out does not work, so stop worrying about it. Focus on the mix of macronutrients and change the percentage of your diet from 60% carbs to 60% high quality fats. Bring carbs down to 10% of your calories (or, to make it easier, 10% of your plate), with a focus on vegetables as your main source, and keep your protein levels in the 20% – 30% range of your diet. Eat a quality, sustaining meal with this macronutrient mix, and you’ll find yourself to be more satiated, less desirous to snack, and more mentally alert. You will begin to change your insulin resistant state, encourage your body to use your stored fat as fuel, and shed weight while improving your overall health.
  3. Favor quality & natural. If you’re eating food from a box, in a plastic wrapper or drinking a cola, stop those immediately. Eliminate sugar, added sugar and sugars from your drinks as a critical first step. Change your focus toward natural, unprocessed foods, take some additional time and spend some additional money on better ingredients to give yourself better health, and focus on fewer, better meals. Let me ask you this: why would you not be willing to spend more on quality foods, but accept spending money on medical treatments and pharmaceuticals necessary to manage chronic conditions due to your poor diet?

Health & Wellness is an investment, and it’s time to change course to reverse this obesity and diabetes trend through sound nutritional & dietary choices.

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