U.S. 2010 Dietary Guidelines: conflicts of interest

The New England Journal of Medicine recently published a review of the U.S. 2010 Dietary Guidelines,  which were published earlier this year. These guidelines are evidently written with conflicting interests in mind, giving almost equal weight to the welfare of the U.S. public and the welfare of businesses. The guidelines are significant to both parties.

Although the guidelines’ direct educational influence is modest, they have major impact on Americans’ diets, because federal food policies, including standards for schools, and many federal food-assistance programs must comply with them. The guidelines’ development was carefully watched by agro-industrial interests that stand to gain or lose from their implementation.

Even with conflicting interests in mind, the guidelines have some improvements.

The original Food Guide Pyramid, which encouraged substituting grain products for dietary fat (irrespective of their nutritional quality), may have inadvertently contributed to epidemics of metabolic syndrome and related chronic diseases by increasing refined-starch consumption. The 2005 version, MyPyramid, conveyed little interpretable guidance about healthful food choices. The current administration, motivated by First Lady Michelle Obama’s campaign against childhood obesity, has replaced MyPyramid with MyPlate. This image improves on its immediate predecessors, especially with advice to cover half the plate with vegetables and fruits.

Some of the “lost opportunities” (the review critiques) include the lack of attention given to explaining important nutritional information like distinguishing between carbohydrates.

the quality of carbohydrates, as characterized by their glycemic index, is dismissed as unimportant, whereas we believe the evidence strongly suggests the opposite.

The guidelines seem to be tip-toeing around obvious dietary issues and recommendations that are scientific facts. It also appears that the report avoids requesting the elimination of harmful products from the American diet in an attempt to remain sensitive to specific industries.

A clearer message would have been that Americans must reduce consumption of red meat, cheese, butter, and sugar, but that message would have offended powerful industries. Deep in the guidelines, diligent readers can find a recommendation to limit sugar-sweetened beverages, but these products deserve front-page attention as the single-greatest source of calories in the U.S. diet and an important contributor to obesity, diabetes, heart disease, gout, and dental caries.

There was a disheartening post I wrote a while back on how the government promoted an increased use of cheese. Cutting cheese out of my diet (I loved cheese!) was a significant factor to my weight loss.

The guidelines require you to “read between the lines” and figure out what specific products you need to cut out of your diet.


Dr John Ellis MD

Board-certified anesthesiologist, with expertise in cardiovascular anesthesia and the implications of obesity and sleep apnea in anesthesia. See vascularanesthesia.com for professional information. Dr. Ellis has used the strategies in here to: (1) lose 120 lbs over 18 months, (2) stop all antihypertensive medicines, and (3) no longer need CPAP treatment for sleep apnea.

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