The United States' official dietary guidelines received a much-anticipated update Thursday — but also received criticism for bowing too much to the pressures of the food industry and offering mixed messages to the American public, in the midst of an obesity epidemic.
The guidelines, which influence public health policy, including decisions like how school lunch menus are created, will be in effect until the next set of guidelines is created in 2020. They are updated every five years based on recommendations from an advisory panel of scientists, doctors, and public health policy experts, and are supposed to include the latest evidence-based recommendations for food consumption for the public. This year, for instance, the government came down hard on sugar and lifted its warnings on cholesterol, but refrained from making any bold statements on red meat just months after the World Health Organization announced new warnings on the link between red meat and cancer.
The disparity between the US guidelines and those of other groups, as well as the frequent changes to the guidelines, have led to a sense of distrust among Americans, according to some experts and critics, who say that the influence of the food industry and politicians in determining what guidelines actually get passed along to the public undercut their authority. And the American public, they say, desperately needs clarity: more than one-third of Americans are obese, according to the Centers for Disease Control.
"Some parts of it I think you can trust and other parts I question the intentions," said Vasenti Malik, a researcher in the nutrition department at Harvard's T.H. Chan School of Public Health.
"Our national food policy is highly inconsistent, especially when it comes to telling people what not to eat," Marion Nestle, professor of Nutrition, Food Studies, and Public Health at New York University, said. "That's where politics comes in, big time."
Valenti said that the panel's recommendations on sugar, sodium, and saturated fat were all well-established and based on strong evidence.
"But the other stuff, there are wishy-washy recommendations," she said. "Like it's good to include fruits and vegetables, but they included starch, and that's surprising because potatoes are not helpful in terms of chronic disease risk. We know they're a risk for diabetes."
More glaringly, she said, was the decision to continue to include a recommended low-fat dairy intake, despite a lack of clear evidence that dairy has health benefits, and the decision not to include a warning on red and processed meat.
"This version is not up to par and it's not really based completely on the evidence," she said.
The new guidelines were praised by Heather Mangieri, a registered dietitian and spokesperson for the Academy of Nutrition and Dietetics, who saw them as a step forward in urging Americans to consider "eating patterns" rather than specific nutrients as good or bad.
"The overall message is watch your eating pattern, and I think that's a huge, huge take-home message and I love that they're emphasizing it. In the past people were very focused on one food or one nutrient rather than the pattern," she said. "Teaching consumers in the public what foods to go after as far as single nutrients doesn't always work. Sometimes it's confusing to think about specific foods."
Malik praised the scientists on the panel for their initial draft of the new guidelines, which included a warning on red meat consumption that tied in sustainability as a concern. But that draft, published in early 2015, generated such serious blowback from the beef industry it led to a Congressional hearing over how the dietary guidelines are established, according to the Washington Post. Congress then approved a measure in the budget that will compel the National Academy of Medicine to conduct a review over how the dietary guidelines are written going forward.
"I hope this will make sure that the Dietary Guidelines are science-based," said Rep. Collin C. Peterson, s Democrat of Minnesota and ranking member of the House Agriculture Committee, said at the time, according to the Post report. "They keep changing so much I'm not sure how many of the American people pay attention to it anymore."
(Peterson's lobbying record shows that among his top donors are the dairy, turkey, and farming industries.)
Ultimately, the warning to reduce red meat intake was nixed from the final guidelines.
"It does seem that beef farmers and the dairy industry are powerful groups and it does seem that they have some influence," Malik said. "The original recommendations that were put forth in the advisory committee were evidence based and very thoughtful, but now what's come out is sort of a combination of that intention and whatever the government and industry has distilled it down into."
Nestle said that politics always plays a major role int he drafting of the dietary guidelines because corporations play such a strong role in America's politics.
"The guidelines are subject to politics every inch of the way. Every food company has a vested interest in what they do and do not say. And the meat industry is especially powerful," Nestle said in an email. "Government guidelines are critically important but they often focus on corporate rather than public health. Corporations have a bigger role in government in the US than in many other countries. That's why the WHO's recommendations are so important."
The consequences of having the nation's food policy influenced by politicians and corporations are that many Americans still don't know exactly what to eat, observers said. Mangieri said that many Americans turn to seemingly-simple and straightforward diets they find online and elsewhere rather than the government's food guidelines because they seem like they will provide quick results just by following a few simple clear rules.
"There's almost too much information, too many diet plans," she said. "The internet has given us access to so much information, anybody can put out information as an expert and it's very confusing to consumers."
Valenti said that a clearer set of evidence-based guidelines might help, particularly with Americans' carbohydrate intake, which she said is one of the leading contributors to the obesity epidemic.
"There should a very clear message that refined grains are not good for health and should be replaced by whole grains and plant-based proteins, and that's not coming through," she said. "And it's been part of the problem in years past and clearly will be going forward, too."