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For four decades, the US government and other health organizations such as the American Heart Association have told us to limit dietary intake of cholesterol and to adopt a low fat diet. Cholesterol and fat, we were told, are dangerous to our heart health and must be minimized to prevent heart disease. Both of these positions are being overturned, in what can only be described as a stunning reversal. The Dietary Guidelines and Advisory Committee (DGAC), an independent advisory group, is dumping its low fat diet demands and is rescinding what was once considered dietary dogma, the low cholesterol diet.

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What Has Brought About This Change?

The Dietary Guidelines Advisory Committee (DGAC), meets every five years to make dietary recommendations to the US Department of Agriculture (USDA) and the Department of Health and Services (HHS). The committee is tasked with reviewing current nutritional research and making recommendations to the USDA. The final guidelines will be published later this year. Normally, the USDA follows the DGAC guidelines closely. If so, there are some sweeping changes being made to what we will be told to eat or not eat.

So What’s Changing?

Previously, the DGAC recommended that cholesterol intake be limited to no more than 300 mg/day and dietary fat be less than 30% of calories. Both of these recommendations are gone.

The report states that it will not bring forward the low cholesterol guideline “…because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol…”

And: “Cholesterol is not a nutrient of concern for over consumption.”

Regarding fat intake, the recommendation in past reports has gone from low fat (less than 30%), to moderate fat to the current position:

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“…dietary advice should put the emphasis on optimizing types of dietary fat and not reducing total fat.”

And: “reducing total fat (replacing total fat with overall carbohydrates) does not lower CVD risk.”

And: “The consumption of “low-fat” or “nonfat” products with high amounts of refined grains and added sugars should be discouraged.”

After 40 plus years, we now can eat eggs and shrimp again, don’t need to watch our dietary cholesterol, and needn’t worry about the total amount of fat we consume. Many scientists and nutritionists have been saying this for decades but were ignored or outright attacked. The anti-cholesterol, anti-fat advice was never based on sound, scientific principles.  The recommendations directly contributed to the increase in chronic diseases, such as diabetes, obesity, and even some cancers.

The charts below says it clearly:

low fat guidelines

On the upside, the 2015 DGAC dietary recommendations are generally (with some exceptions) more in line with current scientific thinking and very comprehensive in scope. The report itself is 500 pages.

What The DGAC Got Right

Besides the cholesterol and fat recommendations, there are other positive aspects to the DGAC report worth mentioning:

  • Nutrients of Concern – the report specifies nutrients that are being either over-consumed or under consumed by the American population and its subgroups. Vitamin A, vitamin D, vitamin E, folate, vitamin C, calcium, and magnesium are under consumed along with fiber and potassium. Saturated fat and sodium are considered to be over consumed (more about this below).
  • Added Sugars – previous reports warned of added sugars in the American diet (Americans consume up to 30 teaspoons full of sugar every day!) but for the first time the DGAC recommended that added sugars be reduced to 10% of the daily diet, or 12 teaspoons. The report cited strong scientific evidence for the destructive effect of dietary sugar on the American population. It endorsed removing sugary drinks from schools, among other actions.
  • Sustainability – for the first time the committee has included concerns about “the impact of food production, processing, and consumption on environmental sustainability” in its recommendations. This is an important step towards opening up a nationwide dialogue on what constitutes a sustainable diet. The call to limit meat consumption is, however, problematic. Is it meat or industrial agriculture and other factors that are the problem? There is a great need for debate on this topic to reach a viable answer.
  • Acculturationas new ethnic groups enter the American mainstream, their adherence to traditional diets wanes and their health deteriorates. Efforts need to be made to support traditional diets and preservation of health. This was a welcome addition to the report.
  • Psychological and Neurological Health the role of diet in both neurological and psychological health in areas such as childhood development, depression. and cognitive impairment received important but limited endorsement. Research is expanding rapidly in this area.

What The DGAC Got Wrong

Unfortunately, the DGAC got some things wrong.

  • Saturated Fat – the DGAC report warns against the dangers of saturated fat. This is a controversial recommendation given the numerous studies (both epidemiological and RCTs) indicating that intake of saturated fat is not linked to heart disease. It’s unfortunate that the DGAC has chosen to ignore compelling scientific evidence that saturated fat is not the culprit. The recommendation to replace saturated fat with vegetable oils is especially worrisome.
  • Sodium – there is a great deal of controversy over the necessity to drastically lower sodium intake as a means of lowering blood pressure and preventing cardiovascular disease. Scientific evidence is contradictory as to the extent sodium reduction is necessary and for whom it would be an effective strategy. More research is needed to clarify who would benefit from sodium reduction, what that reduction might be, and what the dangers are of a very low sodium diet.
  • Red Meat – the new DGAC recommendations include limiting even lean red meat. The science behind this is weak and certainly not robust enough to warrant a universal recommendation. Although the committee does not call for the elimination of red meat entirely, it goes too far in proposing a limit to red meat consumption. Rigorous clinical trials are needed to establish the role of lean red meat in the American diet.

Conclusion

Overall, the DGAC recommendations are an improvement over past reports. Eliminating cholesterol and healthy fat intake as concerns clearly addresses the distorted, unscientific recommendations dating back to 1977. The areas of saturated fat, sodium intake, and red meat consumption all need further scientific study and are misleading as they now stand.  Fortunately, the report is helpful and accurate in focusing on the dangers of added sugars, sustainable food practices and security, issues of acculturation, the effect of poor diet on neurological and cognitive health, and targeting nutrients of concern and dietary patterns.

The DGAC recommendations will not be finalized until later in 2015. A comment period will allow interested individuals to make their opinions heard before the final report is published. You can go to health.gov to comment.


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