We don’t know what to eat

(Daniel Acker/Bloomberg News)

The government wants to have it both ways.

On Thursday morning, federal officials released long-awaited dietary guidelines for the first time in five years. The recommendations are meant to inform Americans about what they should and shouldn't eat.

But the message is pretty confusing. When they tell you what to eat, they speak directly, naming foods that are easy to identify. When they tell you what to avoid, they speak opaquely, referring to nutrients that are hard to grasp. In some places, they remove older warnings about certain foods. In others, they add new ones about the same foods. In other words, they still say not to eat them.

All together, the guidelines risk leaving a public as unsure about what they should and shouldn't be eating as before.

Start with the recommendations of things you should eat more of. Vegetables are talked about at length—and in depth. Fruits, too, along with many other foods the government tells us are healthy. The clearest sign of this clarity comes early on, in the first chapter, where a bulleted list shows what "a healthy eating pattern includes."

Notice how many specific foods are mentioned: beans and peas, colored veggies, yogurt, nuts, etc.

Now, look at the things that "a healthy eating pattern limits" (pictured below):

Notice anything different?

In place of foods we know—things we understand well and can eat more of or try to avoid—are nutrients we've heard but likely misunderstand. Instead of sugary drinks, we're told to limit sugar; instead of red meat, we're told to limit saturated fat; instead of processed foods, we're told to limit sodium.

"The minute they start to talk about things to eat less of, they invoke nutrients instead of foods," said Marion Nestle, who is the Paulette Goddard Professor of Nutrition & Food Studies at New York University. "I dare someone to explain saturated fat to me, or to tell me where most sugar or salt comes from in their diet."

The problem is that people might understand that too much salt or sugar is bad, but not be equipped with the know-how to actually curb their intake. Salt, Nestle says, is particularly problematic in this regard, since so much of the sodium Americans eat comes from prepared and packaged foods.

"Most salt is in processed and restaurant foods, but they don't tell people in their concise recommendations to avoid them or eat less of them," she said. "This is where the switch from foods to nutrients really doesn't help anybody."

The same goes for red meat, which is virtually absent from the guidelines. In its place, the word protein appears frequently, often when bundling the various types of meat. Allison Aubrey and Maria Godoy, who cover food for NPR, this morning explained how the guidelines more or less punt addressing red meat directly:

The suggestion to limit meat intake comes in more subtle form. For instance, the guidelines point out that many teen boys and adult men consume more than the recommended 26 ounces a week of protein from animal sources, so they should "reduce overall intake of protein foods by decreasing intakes of meat, poultry, and eggs."

There's also an overall recommendation — unchanged from 2010 — to reduce saturated fat intake to less than 10 percent of daily diet, a shift that could, in practice, require limiting intake of red meat.

On her blog Food Politics, Nestle calls out what she believes is a harmful use of euphemisms in the guidelines. Saturated fat, she says, is merely a euphemism for meat; added sugars, a euphemism for sugary beverages; and sodium, a euphemism for processed and junk foods. She wishes they would say things more plainly, like "eat less meat" and "eat less processed and junk food."

Internal contradictions

But the confusion extends beyond semantics. At times, the guidelines even seem to contradict themselves on what to do.

Take eggs, for instance.

Americans pumped their fists when news broke earlier this year that an advisory committee that does the research the government uses to craft the final guidelines proposed lifting the 300 mg daily limit on dietary cholesterol (roughly one egg). That proposal made it into the guidelines—yes, there is no longer an official recommended limit on dietary cholesterol.

But here's the thing: the language in the section about dietary cholesterol doesn't exactly say that eggs are great either. In fact, it plainly warns that dietary cholesterol is bad and should be avoided. Here's the actual text:

The body uses cholesterol for physiological and structural functions but makes more than enough for these purposes. Therefore, people do not need to obtain cholesterol through foods.

The Key Recommendation from the 2010 Dietary Guidelines to limit consumption of dietary cholesterol to 300 mg per day is not included in the 2015 edition, but this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns. As recommended by the IOM,individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern.

So yes, there is no official recommended limit, but a close read of the language clearly shows the fewer omelettes you eat the better.

The confusing message is underscored by how both critics and supporters of a diet that includes a good portion of eggs cited the guidelines.

"While many Americans avoided eggs for years due to their cholesterol content, that thinking has evolved," the industry backed American Egg Board said in a statement.

At the same time, advocates for plant-based diets that believe we should eat fewer eggs also found themselves pleased with the new recommendations.

"We're happy with the new language," said Neal Barnard, who is the president of the Physicians Committee for Responsible Medicine, a non-profit organization which advocates for plant-based diets. "The new guidelines are actually stronger than previous guidelines, not weaker. Instead of limiting dietary cholesterol, they should say eat as little dietary cholesterol as possible."

The problem, Nestle laments, is largely an issue of communication. The seemingly opposite reactions to the very same passage about dietary cholesterol, she says, shows how a lack of a concrete example and easily understood advice can confuse.

People, she worries, end up with a good understanding of what they should be eating, but a much poorer understanding of what they shouldn't.