Public health advocates worry that dietary advice will get lost in translation
Saturday, October 2, 2010; 5:09 PM
Every five years the federal government updates its dietary guidelines for Americans. This year, with most Americans overweight or obese and at risk of high blood pressure, policymakers are working to reinvent the familiar food pyramid and develop advice that is simple and blunt enough to help turn the tide.
Although most people do not read them, the guidelines have broad impact on Americans' lives. They dictate what is served in school breakfast and lunch, in education materials used by SNAP - formerly called food stamps - and in the development of information on the nutrition labels of food packages.They also underpin education materials that are available in community centers, doctors' offices and hospitals.
What the guidelines will say when they are unveiled in December is still under wraps. But the interagency committee is searching for new ways to communicate lessons about healthful eating and is working to make the food pyramid "more meaningful and engaging," said Dr. Robert Post, deputy director of the U.S. Department of Agriculture's Center for Nutrition and Policy Promotion that is leading the development of the guidelines.
Healthy eating has gained a high profile through Michelle Obama's "Let's Move" initiative to fight childhood obesity. But historically, the government has shied away from offering controversial advice. And with food, everything is controversial: A boost for one type of food in the guidelines can be viewed as a threat by providers of competing products. The result, critics say, is a nutritional education system so politically influenced that it is ineffective.
This year's process appears to be no exception. In public comments, the meat lobby has opposed strict warnings on sodium that could cast a negative light on lunch meats. The milk lobby has expressed concerns about warnings to cut back on added sugars, lest chocolate- and strawberry-flavored milks fall from favor. Several members of the Massachusetts congressional delegation also weighed in against added-sugar restrictions in defense of the cranberry.
"This is the real test of whether this administration is serious about helping people to change their diets," said Margo Wootan, director of nutrition at the Washington-based public health watchdog Center for Science in the Public Interest.
Even if the political will is there, developing useful advice remains a challenge. It has to be broad enough to apply to myriad ethnic and other taste preferences. It must be prescriptive enough to provide guidance to shoppers who have to choose between tens of thousands of products on grocery store shelves and are befuddled by ever-changing nutrition information.
According to a study conducted by the International Food Information Council, an industry trade group, 46 percent of consumers agree that food and health information is often confusing and conflicting. And no wonder: Eggs, once shunned because of cholesterol, are now praised for their protein content. Carbohydrates, once exiled from fashionable plates, are back in vogue, provided they come from whole grains. This year, 88 percent of Americans were unable to accurately estimate the number of calories they should consume, up from 85 percent in 2009.
"We can't load people down with different messages," said the USDA's Post. "We have to focus on practical, simple, easily applied messages that show action that consumers can take."
The food industry has lobbied hard to ensure that the government emphasizes carrots, not sticks, in nutrition messages. Consumers want control over their diet, lobbyists say, and they resent messages that dictate what should and should not be eaten.
Policymakers have long seen the wisdom of this strategy. And when they have strayed from it, the political heat has been intense. In 1977, a Senate select committee led by Sen. George McGovern (D-S.D.) was forced to beat a hasty retreat after it initially recommended that Americans could cut their intake of saturated fat by reducing their consumption of red meat and dairy products. Its revised guidelines suggested choosing "meat, poultry and fish that will reduce saturated-fat intake."
McGovern, whose constituents included many cattle ranchers, lost his seat in 1980. Since then, in case after case, the guidelines have refrained from suggesting that Americans eat less of just about anything.