Thursday, January 07, 2016

The new Dietary Guidelines are broad and respectful of diverse views

The federal government's Dietary Guidelines for Americans 2015 were released this morning. This official publication of the Departments of Agriculture and Health and Human Services will offend nobody. Certainly, any student of food policy can appreciate why its authors made the decisions they made. The departments are under intense pressure from Congress, and an official document of this type necessarily reflects a broad and inclusive area of common ground.

The Washington Post headline says the new guidelines mean, "go ahead and have some eggs." Marion Nestle observes that the guidelines use "protein" as a euphemism for "meat" and "added sugars" as a euphemism for soda. Although the guidelines do include a phrase about "decreasing intakes of meats, poultry, and eggs," especially for men and teen boys, they exclude all mention of environmental sustainability, thereby avoiding considerable controversy. The Washington Post article gives the final word not to a nutrition scientist but to Nina Teicholz, a journalist and low-carb author who is on the board of the Nutrition Coalition, which lobbies for changes to federal dietary guidance. The coalition will have little to complain about in the official 2015 guidelines.

If you place less value on political common ground and more value on sharpness, detail, and authority of scientific evidence review, breadth of topic coverage, and basic writing with vigor, don't be distressed that official departmental guidelines are not really the place to find such virtues. You may continue to read and cite the earlier unofficial external Dietary Guidelines Advisory Committee report for years to come.

The new official guidelines retain the outer shell of the Advisory Committee's interest in food policy and economics topics. Chapter Three sets up a framework for considering a wealth of approaches to improving diets in every possible setting: homes, schools, worksites, communities, and food retail settings. The official recommendations have a mild character, suggesting quite rightly that somebody should do something, but without assigning specific difficult tasks to particular actors. For example, this chapter's strategies include:
Expand access to healthy, safe, and affordable food choices that align with the Dietary Guidelines and provide opportunities for engaging in physical activity.
In addition to that sound recommendation in the official guidelines, I will continue to read a related passage from the unofficial Dietary Guidelines Advisory Committee report.
Moderate to strong evidence shows that targeted environmental and policy changes and standards are effective in changing diet and physical activity behaviors and achieving positive health impact in children, adolescents, and adults....

It will take concerted, bold action on the part of individuals, families, communities, industry, and government to achieve and maintain healthy dietary patterns and the levels of physical activity needed to promote a healthy U.S. population.This will entail dramatic paradigm shifts in which population health is a national priority and individuals, communities, and the public and private sectors seek together to achieve a population-wide “culture of health” through which healthy lifestyle choices are easy, accessible, affordable and normative—both at home and away from home.
In such a culture, preventing diet- and physical activity-related diseases and health problems would be much more highly valued, the resources and services needed to achieve and maintain health would become a realized human right across all population strata, the needs and preferences of the individual would be seriously considered, and individuals and their families/households would be actively engaged in promoting their personal health and managing their preventive health services and activities. Health care and public health professionals would embrace a new leadership role in prevention, convey the importance of lifestyle behavior change to their patients/clients, set model standards for prevention-oriented activities and client/employee services in their own facilities, and manage patient/client referrals to evidence-based nutrition and comprehensive lifestyle services and programs. Communities and relevant sectors of our economy, including food, agriculture, private business, health care (as well as insurance), public health and education, would seek common ground and collaborations in promoting population health. Initiatives would be incentivized to engage communities and health care systems to create integrated and comprehensive approaches to preventing chronic diseases and for weight management.
The new official guidelines are quite nice, but, in addition, the 2015 Dietary Guidelines Advisory Committee report will retain a place on my syllabus.

1 comment:

  1. Do you not apprehend why the rambling pie-in-the sky passage (among others) was omitted from the official guidelines? Seriously?

    A desperate wish for world peace and harmony and a spontaneous linking of arms around your unsubstantiated opinion (optimistically referred to as common ground) couldn't be further from a dietary recommendation. It is no recommendation at all. It is a doleful, oh woe is us cop out. The problem is laid at everyone's door and left at that. How is that helping? Hope is not a plan.

    Was the committee assigned the task of envisioning and reporting to us the imagined ideal world where all Americans would subsist on a diet of unicorn milk ice cream topped with just the right amount of rainbow sprinkles? If not, then it missed its mark altogether. What a dismal disappointment.

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