July 5

Girth of a Nation

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Despite his snappy title, which I shamelessly stole for this post, Paul Krugman gets it wrong as to the cause of the obesity epidemic in this country. He points the finger at greedy corporate profiteers who are pied pipering the youth of the nation into the depths of reckless dietary abandon and consequent obesity.

The first step is to recognize the industry-financed campaign against doing anything for the cynical exercise it is. Remember, nobody is proposing that adult Americans be prevented from eating whatever they want. The question is whether big companies will have a free hand in their efforts to get children into the habit of eating food that’s bad for them.

I beg to differ.
I believe a big part of the problem can be laid at the doorstep of the US Government, specifically the USDA and their Dietary Guidelines for Americans (Dietary Guidelines).
The Dietary Guidelines are promulgated every five years, with the most recent being the 2005 version. The response of most people when informed that the new Dietary Guidelines have been published is: So what? In fact, that’s in so many words what Bill O’Reilly’s comment was when I was a guest on his show in early 2000 after the most recent version of the Dietary Guidelines had been released.
I pointed out that what makes these guidelines more important than the typical government directives is that federal law mandates that any company or institution providing food being paid for with US Government money must hew to the most recent Dietary Guidelines. Since somewhere in the neighborhood of 52 million people are fed daily courtesy of the government (these include the military, other government institutions, prisons, federally funded school lunch programs, etc.) most food manufacturers ignore the guidelines at their financial peril. After all, who wants to disregard a customer base of 52 million?
The USDA would have us believe that the Dietary Guidelines are a consensus of all the nutritional wisdom of a group of highly esteemed nutritional experts. Unfortunately, such is not the case. The guidelines are more a consensus of lobbyists for various political groups and manufacturers and commodity associations. The scientists come up with their regulations, then the lobbyists start to work on them to mold them into a form that pleases, or is at least acceptable, to their constituents. In the 2000 version, the scientific board recommended that sugar be limited, an idea that was totally unacceptable to the sugar lobby. Imagine how much sugar is consumed by 52 million people per day, then imagine that market evaporating thanks to a change in the nutritional guidelines. Needless to say, it got big sugar’s attention. Despite ferocious lobbying, the scientific board held firm. The matter was resolved when 30 or so senators from sugar-producing states wrote a letter to Dan Glickman, then Secretary of Agriculture, asking him to intervene. He did, and the limit sugar consumption recommendation was scrapped.
The main problem I see with the Dietary Guidelines, aside from the fact that they are absurd, is that it is almost impossible to get them changed in any meaningful way, lobbying issues aside. The guidelines were first put in place as a best guess as to what is the optimal diet (such best guess made by people with a vegetarian activist bent), then the law was constructed so that it takes an inordinately high level of proof to change them. The problem with this is that it is expensive to do nutritional studies—it’s expensive to do any studies, but drug companies pony up the bucks as they will recoup their costs in drug sales—and there is no one to pay for them other than the occasional grant here and there. Given the lack of funding it’s difficult to come up with the mass of studies required to meet the level of proof required to substantially change the recommendations. And, if the level of proof is met—as it certainly has been in my estimate by the large number of studies showing the superiority of the low-carbohydrate, higher-protein diet—there is still the obstacle of the many lobbyists for the forces who are best served by keeping the nutritional guidelines as they are.
You can find an interesting history of the development process for the Dietary Guidelines in the March 31, 2001 issue of Science written by Gary Taubes. Yes, this is the same Gary Taubes who wrote the article in the New York Times Magazine a couple of years ago that launched the latest low-carb diet revolution. The article is a long one and, unfortunately, not available unless you’re a subscriber to Science. Here is an excerpt so you can get the flavor:

Science by committee
Like the flourishing American affinity for alternative medicine, an antifat movement evolved independently of science in the 1960s. It was fed by distrust of the establishment–in this case, both the medical establishment and the food industry–and by counterculture attacks on excessive consumption, whether manifested in gas-guzzling cars or the classic American cuisine of bacon and eggs and marbled steaks. And while the data on fat and health remained ambiguous and the scientific community polarized, the deadlock was broken not by any new science, but by politicians. It was Senator George McGovern’s bipartisan, nonlegislative Select Committee on Nutrition and Human Needs–and, to be precise, a handful of McGovern’s staff members–that almost single-handedly changed nutritional policy in this country and initiated the process of turning the dietary fat hypothesis into dogma.
McGovern’s committee was founded in 1968 with a mandate to eradicate malnutrition in America, and it instituted a series of landmark federal food assistance programs. As the malnutrition work began to peter out in the mid-1970s, however, the committee didn’t disband. Rather, its general counsel, Marshall Matz, and staff director, Alan Stone, both young lawyers, decided that the committee would address “overnutrition,” the dietary excesses of Americans. It was a “casual endeavor,” says Matz. “We really were totally naïve, a bunch of kids, who just thought, ‘Hell, we should say something on this subject before we go out of business.’ ” McGovern and his fellow senators–all middle-aged men worried about their girth and their health–signed on; McGovern and his wife had both gone through diet-guru Nathan Pritikin’s very low fat diet and exercise program. McGovern quit the program early, but Pritikin remained a major influence on his thinking.
McGovern’s committee listened to 2 days of testimony on diet and disease in July 1976. Then resident wordsmith Nick Mottern, a former labor reporter for The Providence Journal, was assigned the task of researching and writing the first “Dietary Goals for the United States.” Mottern, who had no scientific background and no experience writing about science, nutrition, or health, believed his Dietary Goals would launch a “revolution in diet and agriculture in this country.” He avoided the scientific and medical controversy by relying almost exclusively on Harvard School of Public Health nutritionist Mark Hegsted for input on dietary fat. Hegsted had studied fat and cholesterol metabolism in the early 1960s, and he believed unconditionally in the benefits of restricting fat intake, although he says he was aware that his was an extreme opinion. With Hegsted as his muse, Mottern saw dietary fat as the nutritional equivalent of cigarettes, and the food industry as akin to the tobacco industry in its willingness to suppress scientific truth in the interests of profits. To Mottern, those scientists who spoke out against fat were those willing to take on the industry. “It took a certain amount of guts,” he says, “to speak about this because of the financial interests involved.”
Mottern’s report suggested that Americans cut their total fat intake to 30% of the calories they consume and saturated fat intake to 10%, in accord with AHA recommendations for men at high risk of heart disease. The report acknowledged the existence of controversy but insisted Americans had nothing to lose by following its advice. “The question to be asked is not why should we change our diet but why not?” wrote Hegsted in the introduction. “There are [no risks] that can be identified and important benefits can be expected.” This was an optimistic but still debatable position, and when Dietary Goals was released in January 1977, “all hell broke loose,” recalls Hegsted. “Practically nobody was in favor of the McGovern recommendations. Damn few people.”
McGovern responded with three follow-up hearings, which aptly foreshadowed the next 7 years of controversy. Among those testifying, for instance, was NHLBI director Robert Levy, who explained that no one knew if eating less fat or lowering blood cholesterol levels would prevent heart attacks, which was why NHLBI was spending $300 million to study the question. Levy’s position was awkward, he recalls, because “the good senators came out with the guidelines and then called us in to get advice.” He was joined by prominent scientists, including Ahrens, who testified that advising Americans to eat less fat on the strength of such marginal evidence was equivalent to conducting a nutritional experiment with the American public as subjects. Even the American Medical Association protested, suggesting that the diet proposed by the guidelines raised the “potential for harmful effects.” But as these scientists testified, so did representatives from the dairy, egg, and cattle industries, who also vigorously opposed the guidelines for obvious reasons. This juxtaposition served to taint the scientific criticisms: Any scientists arguing against the committee’s guidelines appeared to be either hopelessly behind the paradigm, which was Hegsted’s view, or industry apologists, which was Mottern’s, if not both.

So, we’ve ended up with a situation where the government sets the guidelines, manufacturers try to comply with the guidelines (and influence them, if possible), then the government and Paul Krugman blame the manufacturers when everyone gets fat.


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