After 35 years, isn’t it time we had better Dietary Guidelines?
A vision for better dietary guidelines that actually work
In the above photo, you can see the 2015 Dietary Guidelines Advisory Committee (DGAC) meeting in September 2014. They have been finalizing their draft recommendations to go into their final report. Their charge has been to review the last guidelines, from 2010, to see what, if any, changes are needed for the 2015 guidelines, based on any new evidence they deem important.
I’ve watched many of their meetings, which are available online, and come away unimpressed. Is this the best we can do in the 21st Century?
A little personal history might be in order here. I never wanted to learn about nutrition or food. I wanted it to all just work. I wanted the Dietary Guidelines to work, to make me healthy so I could go on with everything else in life I wanted to do, like ride bikes, work, play, watch TV, and travel.
What I found, however, in the early to mid 1990s, was that following the USDA Dietary Guidelines didn’t actually work that well for me. I had large energy swings, and was hungry and thirsty all the time. Following the Dietary Guidelines turned me into a prediabetic, with unstable blood sugars and raging thirst.
After a couple of years of this, I thought: “this can’t be right!” How can I feel so terrible if eating this low-fat, high fruit and vegetable, food pyramid diet is supposed to be making me healthy?
That’s when I started looking for alternative advice on how food was supposed to make me feel, and how it was supposed to work to make me feel good and healthy.
The landscape for alternative nutrition advice was pretty slim in the mid 90s, but eventually I found the key to unlock my current passion about nutrition. I read the book Protein Power, by Drs. Eades. Finally, it started making sense.
I realized that nutrition is less about what you eat than all the spaces in-between, how your body operates and functions on what you feed it. Nutrition is less about eating than how you feel. Learning to connect what you eat to how you feel is the key.
To make a long story short, ever since, I’ve been keenly interested in nutrition for my own personal self-interest. I feel that I’ve had to learn so much about nutrition, not because I wanted to, but because much of the official dietary advice just didn’t seem to work for me or give me the promised and expected results.
On this journey, I’ve read so much and thought so much about what’s wrong with our current Dietary Guidelines and what could make them better. It’s time to share these thoughts.
10 Ways to Improve our current Dietary Guidelines
Here are ways we could radically improve our Dietary Guidelines.
1. Faster, constant updates and revisions
Why in the world does it take the DGAC two years to review the evidence—just to see if anything has changed since the last guidelines?
An update every 5 years is just too long and too slow. We live in the internet age of constant updates. Five years might as well be a century as far as all the new things we have to learn to deal with in that time.
We need constant updates and revisions since our food environment changes every day with new products, new scientific results, and even more choices about what exactly to eat every day. We can’t wait five years for an update.
2. Feedback Mechanism needed
What do you do when the Guidelines don’t work? What do you do then? What’s Plan B? And how can you let the USDA know their advice isn’t working? (Besides waiting another three years for them to open up the public comment window and give selected persons just under three minutes to give oral testimony?)
Dietary Guidelines are rules, similar to software, in that they are programming inputs to your body, what to eat, to produce health. When your software or apps don’t work, you can submit bug reports and enhancement requests. We need similar ways to report problems and issues such as side effects and adverse events.
Something like the UK Yellow Card scheme would be a nice way to provide feedback: https://yellowcard.mhra.gov.uk/
The Yellow Card Scheme now supports the reporting of all suspected problems or incidents to all healthcare products, not just suspected side effects to medicines
3. Personalized Guidelines instead of one-size-fits-all
Why can’t the Dietary Guidelines be customized for each person and perhaps different situations? Each of us is different, unique, unlike everyone else.
You are not like everyone else. You live in your own environment with your own special history. Why should you eat the same as everyone else? Why should that even work?
We need to move beyond the one-size-fits-all mentality and customize dietary patterns for each person, that are suited to each person’s specific needs, characteristics, history, and circumstances.
4. Teach me how to tell if what I’m eating is working
We need testable Guidelines. Teach me how to tell if what I’m eating is working and making me healthier.
Teach me what eating right and wrong feels like, so I can tell on my own—what to look for and notice and be aware of, and how to fix it. Don’t just tell me what to eat and assume it’ll work! All too often your past advice hasn’t worked, leaving us stuck not knowing what to do.
Teach me the process of using diet and nutritional knowledge to improve and promote and restore health, in a holistic (and not so reductionist please), round-trip way so I understand it is not just about eating but also digestion, absorption, metabolism, and excretion—and overall how my diet makes me feel.
How can I tell if my diet is making me healthier, every day, every meal? I’m not interested in risk factors and medical tests, but in measures of well-being and everyday performance and functioning: real health you can feel and use and makes life better today, not some vague promise of a longer life or diseases prevented.
Wellbeing is functional health – that you feel good and can perform all the ways you need to and want to. Optimal wellbeing and health is something you should have now and all the time.
5. Sharing Dietary Experiences – Crowdsourcing what works
Instead of all of our dietary experiences being scattered across myriad nutrition forums and blogs, why don’t we have a way to collect data on what works for people?
Haven’t we realized that the Dietary Guidelines are a giant observational experiment that we should be collecting data on? An experiment that unfortunately has probably caused the huge rise in obesity and an even bigger epidemic of what I call “unhealthiness” that includes metabolically damaged normal weight and under-weight people.
Why isn’t there a way to measure how well your diet is working and be able to share that with others that share similar characteristics, to develop patterns and allow analytics to find trends and related effects?
Why aren’t we using the power of the internet, mobile devices, big and small data, and social networking to crowdsource better dietary guidelines for the 21st Century? Dietary Guidelines that actually work, instead of what experts tell us every five years should work.
6. Focus on health first instead of diet
One of the 7 Habits of Highly Effective People is “Begin with the end in mind.”
Just what is the goal of the Dietary Guidelines? Health, right? So why don’t we start there and work backwards to see what gets us there, instead of listening to experts tell us to “eat this, not that” with the vague promise that it’ll lower our risk factors for chronic diseases and may contribute to a longer life.
Focusing on health means knowing what health is. How can you eat a healthy diet if you don’t know what health is? For a new way to look at health, see my Health Now page. Health is more than the absence of disease and low risk factors; it’s feeling good, everyday. It’s feeling good all day long, not falling asleep after lunch.
7. Make some Dietary Guidelines APPs already
Where are the Dietary Guidelines apps in the age of smartphones?
Dietary Guidelines should be app-ified by now. The USDA’s SuperTracker food tracking web site is not good enough in the smartphone age. We need apps. Isn’t this obvious?
The Dietary Guidelines are a relic of a pre-personal computer, pre-internet, pre-web, pre-mobile phone, pre-apps age. Isn’t it time they joined the future?
We need 21st Century Dietary Guidelines: open, fast, constantly updated, do-it-yourself, relevant, personalized, customized, individual, dynamic, responsive, evolving, tailored, and tested.
8. Grade yourself properly DGAC
The DGAC considers “what works” to mean what works to get people to follow their guidelines—not what actually works to make us feel better and healthier, because these two things are not necessarily the same.
Stop using adherence to your possibly fatally flawed guidelines as a measure of what works. We may not be following your advice because experience tells us it doesn’t work. If people are not adhering to your advice, take a deep look and ask why.
9. Stop blaming the victims when Guidelines don’t work
Perhaps it’s not us, it’s you (DGAC).
Most of us are not that stupid to keep trying a dietary plan that doesn’t deliver the promised and expected results. And some of us don’t have a choice: SNAP (food stamps), National School Lunch Program, VA Nutrition and Food Services, etc.
The DGAC seems to be composed of experts who believe that it’s all our fault (the public) for not listening to their “correct” advice, that we’re all just too lazy and gluttonous to follow their expert recommendations and guidelines. So they blame us instead of looking at what they might be doing wrong.
10. USDA should stop serving two masters
The Dietary Guidelines are officially a joint effort of the USDA (United States Department of Agriculture) and the DHHS (Department of Health and Human Services).
The USDA serves two constituencies. They are supposed to promote the US agriculture industry, and as half of the sponsoring organization for the Dietary Guidelines, they are supposed to promote public health. But what if these two goals come into conflict?
Perhaps we should just have HHS develop the Dietary Guidelines, but then who’s to say they wouldn’t be just as industry-influenced as they are now?
Let food be thy medicine . . .
When are the Dietary Guidelines supposed to work? If I follow the Dietary Guidelines—like taking medicine—when should I feel the effects? and what/how should I feel? what benefits should I notice/see? When? Today? Week? Months?
The entire Dietary Guidelines process and paradigm is old-fashioned. It tries to prescribe food as medicine (which is good), but it’s not customized to each person’s unique needs, with no feedback mechanism or process to tell if it’s working, with no measuring stick, and no alternative treatments (different diet plans) to try.
Dietary Guidelines seem to be built on the Doctor-Patient Prescription (Rx) model—but without individuals (us) knowing how to determine efficacy of treatment—and no feedback mechanism when things go awry. Instead of the prescription model, we need a feedback-driven process of what works and doesn’t.
Dietary Guidelines do not tell you what to look out for (signs and symptoms) to indicate whether your diet is working or not. It’s like saying, here, take this medicine forever, or at least the next 5 years, till we update our advice again—and if you have problems, side effects, adverse effects—tough, not our fault, you must be doing it wrong because we’re the experts, we have evidence, and we cannot be wrong!
After 35 years , we can do better than what we’re getting from the DGAC. We desperately need to.
What it takes is a new way of looking at health, of defining health, that moves us completely away from the past 40 years of prevention paradigm thinking, to what makes us optimally healthy today, not long into the future.
In my next post, I will start laying out how exactly we, together, can create the 21st Century Dietary Guidelines we need—by focusing on health first.