Monday, February 21, 2011

Bad dietary advice generates fatalities

Using Open Innovation to Reinvent Primary Care white paper - Final 120710.pdf

"For average health outcomes, Americans spend extraordinary amounts of money on health care and do not receive full value for their expenditure. Current estimates suggest that medical costs consume 17 percent of our Gross Domestic Product (GDP). By 2025, these costs are anticipated to account for 25 percent of the nation’s total economic output. The rising cost of care is one of the biggest factors suppressing the take-home pay of American workers, particularly for moderate-income families. And currently, 10 percent of the population accounts for the majority of health care costs, further reducing the value derived from health care for most Americans. Not only is this high level of personal expenditure a poor value to the average American, a high level of spending on medical care creates unsustainable cost pressures on U.S. businesses that inhibit their ability to bring competitive products and services to market and jeopardizes our country’s global competitiveness."

The above paragraph neatly sums up America's current dilemma. Spending "extraordinary amounts of money on health care...jeopardizes our country's global competitiveness."

What can America do to reduce health care costs? I'd say, reduce the demand for medical services by improving the quality of the food supply and by correcting the mistakes in the Dietary Guidelines for Americans (DGA).

The big hindrance to correcting the government's dietary advice is certain dogmas that have gained widespread acceptance due to corporate influence. For example, the International Food Information Council Foundation (IFICF) is a sort of vortex of corporate educational influence shaping the content of textbooks, public health messages, advertising, media articles, and news stories. Here's what the IFICF says about itself:

The International Food Information Council Foundation (IFICF) is the educational arm of IFIC. IFIC's mission is to communicate science-based information on food safety and nutrition to health and nutrition professionals, educators, journalists, government officials and others providing information to consumers.

IFIC's purpose is to bridge the gap between science and communications by collecting and disseminating scientific information on food safety, nutrition and health and by working with an extensive roster of scientific experts and through partnerships to help translate research into understandable and useful information for opinion leaders and ultimately, consumers.

Note that the IFICF collects and disseminates information and translates research into useful information for opinion leaders. Of course, I would have no problem with these sorts of activities were it not for the fact that bad dietary advice generates fatalities.

I did not become aware of the IFICF until after the 2010 DGA document was released on January 31, 2011. An article by Elizabeth Rahavi, RD entitled "New Dietary Guidelines Released by USDA and HHS" attracted me to the IFICF website and, for several days, I explored the site, fascinated by what I was learning. As is my custom when I notice mistakes, I wrote a letter to the CEO of the IFICF.

February 18, 2011

David B. Schmidt - President and CEO
International Food Information Council
1100 Connecticut Avenue NW Suite 430
Washington, DC 20036

Dear Mr. Schmidt,

I am a layman who studies nutritional controversies. I've been doing this for more than three decades. For almost that long I've been concerned about certain aspects of the American Dietetic Association's dietary advice.

In 2004 I read an article about the Center for Nutrition Policy and Promotion (CNPP). Since the CNPP appeared to be the vortex of nutritional authority that dictates consensus of opinion as to what constitutes acceptable dietary advice, I wrote to the Director and pointed out some erroneous doctrines in the Dietary Guidelines for Americans (DGA). After several more letters and a phone call to his office he responded, suggesting I submit comment to the 2005 Dietary Guidelines Advisory Committee, which I did. I also wrote letters to each of the Committee members. However, when the 2005 (DGA) document was released, the mistakes remained.

It's six years later, the 2010 DGA have been released, and still, the mistakes persist. Thanks to an article entitled "New Dietary Guidelines Released by USDA and HHS" written by Elizabeth Rahavi, RD, I think I now know why.

Evidently, for many years, the International Food Information Council (IFIC) and similar corporation-funded nonprofits have influenced the content of dietetics education. And since dietitians have long been regarded by government and conventional medicine as the only legitimate dispensers of dietary advice, dietitians were chosen to update the DGA. Question is: are they qualified to do so? It seems not. Why? I suspect their education. Quoting Dr. Samuel Johnson, "The Supreme end of education is expert discernment in all things -- the power to tell the good from the bad, the genuine from the counterfeit, and to prefer the good and the genuine to the bad and the counterfeit."

For several generations, Dietetics education has produced dietitians uniformly indoctrinated with a belief set that favors the interests of the industrial food system. The IFICF website makes clear the origins of this belief set. Now, while I affirm the right of corporations to protect their interests, occasional use of obfuscation and propaganda is not in the best interests of the public health or the corporations that engage in that sort of behavior. To be sure, IFIC educational content is largely correct. But where dietary advice is concerned, it takes only one mistake to generate fatalities.

CNPP staff controls all aspects of the Dietary Guidelines revision process from the selection of the DGA Advisory Committee to the writing of the final draft. Here's what the CNPP says about itself. "In formulating these Guidelines every five years, CNPP works to ensure that Americans hear 'one nutrition voice,' with a focus on consistent, factual messages supported by the science." Sadly, CNPP dietitians, food scientists, and nutritionists, appear to be immune to outside influence from scientists seeking to correct mistakes.[1]

Thus far I haven't enumerated the mistakes which affect both the quality of the food supply and nutrition messages Americans are exposed to via advertising, media articles, dietetics counseling, and dietetics literature. I'll have another do that. Here's what prominent heart surgeon Dr. Dwight Lundell was saying in early 2009:

We have done a disservice to the American people and it is time to right the wrong. Let me begin by saying quite emphatically based on scientific fact cholesterol does not cause heart disease...Over 25% of the population takes statin medications. Now there’s a feverish rush to prescribe statin medication preventatively to otherwise healthy people.[2] If statins prevented heart disease, why has heart disease soared year after year and is the number one taker of human life? Just that fact alone should have everyone questioning the validity of the cholesterol theory and taking statin medications.

Cholesterol does not cause heart disease–inflammation in the arteries does. What is inflammation and where is it coming from? The answer to that question is both tragic and sad. The very dietary recommendations born of the cholesterol theory of no-fat and low fat foods cause inflammation. Polyunsaturated Omega-6 oils; packaged and processed foods created for shelf life and not long life; sugars and simple carbohydrates create inflammation. This is the cause of an epidemic of heart disease, obesity and other chronic illnesses.[3]

More recently, cardiothoractic surgeon Dr. Mehmet Oz discussed inflammation on his nationally syndicated TV show in a segment entitled Know Your Omega Fatty Acids.[4]

Mr Schmidt, I urge you to look into this. As Dr. Oz noted, the American food supply is drenched in omega-6s and anyone who doesn't take steps to reduce omega-6 intake to a safe level is at risk for chronic inflammatory disease. One can try to balance omega-3s and 6s by increasing omega-3 intake but, as Dr. William Lands observed, that doesn't provide protection from heart attack - it simply improves ones chances of surviving one.[5]

I appeal to your sense of obligation to do what's best for this country. Please begin to educate yourself, your staff, and your corporate donors about the omega-6 hazard. The introduction of omega-6 seed oils into the food supply about a hundred years ago amounts to an uncontrolled experiment resulting in an ongoing public health disaster of unimaginable proportions.[6]

Finally, although my principle focus has been omega-6, I'm also concerned about excessive fructose intake, the recommendation to restrict total fat intake, and the incessant anti-saturated fat messages.[7] It's dubious practice to use observational studies to justify dietary advice to substitute foods rich in omega-6s for foods containing healthy saturated fats.

David Brown
1925 Belmar Dr
Kalispell, MT 59901
Nutrition Education Project

1. “In The Face Of Contradictory Evidence: Report Of The Dietary Guidelines For Americans Committee” by Adele H Hite, MAT; Richard D Feinman, PhD; Gabriel E Guzman, PhD; Morton Satin, MSc; Pamela Schoenfeld, RD; Richard J Wood, PhD, Nutrition, Volume 26, Issue 10 (October 2010) published by Elsevier. DOI: 10.1016/j.nut.2010.08.012.
2. Note: An ounce of secondary prevention can cost a ton of money.
3. The Cholesterol Theory– A Tragedy To Health


Joy Twesigye said...

I think you are describing the competing interests of "health care partners" getting in the way of population health very accurately. It is evidenced in the lack of a cohesive national food policy and reports of some pharmacists trying to curtail access to mail-away pharmacies. Thank you for highlighting our work on Primary Care. We at Hope Street Group believe that breaking down the calcified structures and patterns of our health care system is imperative in order to achieve better health. This means that people have to change habits but maybe most importantly, perspective. Doing the same thing is just giving us the same results-- that we don't want. Good for you for holding health as the primary goal that we need to achieve together!

ellowen deeowen said...

You're concerned with excess fructose consumption? As Americans we consume over 100 pounds of sugar annually. The majority of this is not the fructose found in vegetables and fruits but more complex, processed sugars that are not as easily metabolized. Assuming you are correct with cholesterol vs inflammation, most fruits and vegetables have anti-inflammatory properties. I was directed here from another site where you were commenting on whole vs skim milk. Skim milk has a higher sugar content than whole milk. I agree in that some of the nutrition is lost by removing the fat globules, as you stated, however it is my understanding that any modifications to food reduce their nutritional value. Americans are being fed processed garbage fortified with synthetic vitamins. The problem with the statements that are being made by the government is that they are trying to say that a processed alternative is better than the natural source. Too much fat is not good regardless of the source and the same goes for sugars. However, the natural, least processed route is always the better route.

David Brown said...

ellowen, thanks for sharing your views. Regarding your comment about consuming too much fat, saturated fats are generally benign at any percentage of total dietary intake as long as they are consumed in the context of adequate supportive nutrition. Since added sugars and refined grains do not supply adequate quantities of nutrients required to properly metabolize fat, for those who are not carbohydrate resistant, it makes sense to restrict fats of all sorts when consuming a high carbohydrate diet.

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