Shantanu Nundy, MD  
Chicago, IL

Specialties: Preventive Health, general medicine

The University of Chicago Primary Care Group
Department of Internal Medicine
Chicago, IL
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Dietary Guidelines 2010: A Worthwhile Read

Feb 15, 2011 - 0 comments



dietary guidelines americans




Healthy Eating




Weight Loss



In case you missed it, Dietary Guidelines for Americans, 2010 was published this month.(1) Commissioned by law, the Dietary Guidelines are revised and published every 5 years as a joint effort between the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) based on an expert panel review of the most recent data on health and nutrition. For a nation obsessed with dieting and weight loss, and in the midst of an epidemic of obesity, diabetes, and chronic diseases, the release of the latest national nutrition guidelines has come with limited fanfare and media attention.(2,3)

A large part of the problem is that over the years we have been conditioned to pay little attention to these reports. Although the effort put forth by scientists in generating the report is impressive, many of their key conclusions are either obvious or old news. A key finding of this year’s report is to eat less and maintain calorie balance (shocker!). Other recommendations are outdated or more controversial than the authors suggest. While the dangers of saturated fats are accepted as dogma, the body of evidence supporting this assertion is surprisingly weak, leading some experts to dismiss or even reverse the recommendation to reduce the consumption of saturated fats.4 Finally, those recommendations that are evidence based are difficult to act on, such as the report’s plea to consume “less than 300mg per day of dietary cholesterol” (calorie counting is notorious difficult, let alone milligrams of cholesterol). As a result, we have come to believe that we are more likely to get up to date, factual, and easy to follow advice from a celebrity magazine at the checkout counter than we are from our own government and leading scientists.

Underpinning the above is the simple fact that the Dietary Guidelines is not only a scientific document, it is also a political one. Given its primary role in protecting U.S. agricultural interests, including the powerful food industry lobby, the USDA is hardly an impartial source. Thus this year’s report marks the first time specific food items are named such as “pizza” or “fried white potatoes” despite the well-established deleterious effects of these foods. And we still are waiting to be formally admonished against eating processed and packaged foods and instead are simply told to eat foods lower in salt, added sugars, and saturated fats (all of which food industry products are exorbitantly high in).

Despite all the caveats above, I highly recommend reading Dietary Guidelines 2010 in its entirety. Regardless of where you fall on the low-fat versus low-carb debate, or whether you are an ardent supporter of Michael Pollan and local farmers, the report provides a critical summary of where we stand as nation on our most pressing public health problem. If we are to have any hope of reversing the tide of the obesity and chronic disease epidemic, we as a nation must educate ourselves about the nature of the epidemic and the choices we make that fuel it.

Consider the data table below showing the top 25 sources of calories among Americans (taken directly from the report):(3)

The table shows that the number 1 source of calories for Americans across multiple age groups is grain-based desserts (e.g., cake, cookies, pie, donuts, pastries). Pause on this for a moment. More of our calories are coming from desserts than any other food? And yet how often it is that we hear people ask, “Why do I keep gaining weight?” Though the answer for specific individuals may vary, as a nation the answer is clear. Among children ages 2 to 18 pizza and soda/energy/sports drinks are ranked 2 and 3, respectively. Regardless of your nutrition beliefs I suspect you are appalled by the notion that we are raising our children on a diet of dessert, pizza, and sodas.

Dietary Guidelines 2010 is filled with illuminating figures and text like the table above that help create a portrait of what Americans are eating and what the health consequences are. Sometimes the most powerful behavioral motivation is simply holding up a mirror to ourselves, and this report can serve as that mirror.

America, Dietary Guidelines was written for you with your tax dollars, so you might as well read it. But just this once, don’t forget to sprinkle a few grains of salt on it first.

- Shantanu Nundy, M.D.

1 http://www.health.gov/dietaryguidelines/

2 article in NY Times, http://www.nytimes.com/2011/02/01/business/01food.html

3 good editorial from NY Times, http://opinionator.blogs.nytimes.com/2011/02/08/is-eat-real-food-unthinkable/

4 http://beyondapples.org/2009/08/20/are-we-getting-nutrition-all-wrong/

5 page 3, http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf

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