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  #1   ^
Old Sat, Sep-16-17, 04:09
JEY100's Avatar
JEY100 JEY100 is online now
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Default Redesigning the Process for Establishing the Dietary Guidelines for Americans

The National Academy of Sciences has published a report requesting that the US Dietary Guidelines be based on strong scientific evidence. Here is their own press release, and the Nutritional Coalition PR below summarizes how important this statement is. In The Big, Fat Surprise, interesting info that it was the Academy of Science under Phillip Handler that fought against the tide of issuing a DGA that cut fat without more solid scientific evidence, titled Toward Healthful Diets. Then there was a Consensus Conference in 1984 when the Academy and Pete Ahrens at Rockefeller were overwhelmed and silenced. 30+ years later they have the chance to turn around guidelines.

Quote:
The Dietary Guidelines for Americans (DGA) provides nutritional and dietary information with the intention of promoting health and preventing chronic disease, and serves as the basis for all federal nutrition policies and nutrition assistance programs, as well as nutrition education programs. This guidance is updated and released every 5 years by the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (HHS). The process of updating the DGA is informed by an assessment of relevant scientific data by a federal advisory committee of nationally recognized experts, called the Dietary Guidelines Advisory Committee (DGAC). Congress mandated that the National Academies of Sciences, Engineering, and Medicine (the National Academies) evaluate the process used to update the DGA. This mandate resulted in two reports. The first report,Optimizing the Process for Establishing the Dietary Guidelines for Americans: The Selection Process, highlighted opportunities to improve the DGAC selection process. This second report, Redesigning the Process for Establishing the Dietary Guidelines for Americans, offers a comprehensive review and recommendations for improving the rest of the process to update the DGA.

http://www.nationalacademies.org/hm...-americans.aspx

NUTRITION COALITION REACTS TO NATIONAL ACADEMIES OF MEDICINE REPORT ON BROKEN PROCESS BEHIND THE U.S. DIETARY GUIDELINES FOR AMERICANS

http://www.nutrition-coalition.org/...-for-americans/

Quote:
WASHINGTON – The Nutrition Coalition applauded a report, released today by the National Academies of Sciences, Engineering and Medicine (NASEM) on the process used to develop the Dietary Guidelines for Americans (DGA). A crucial finding of the report is that the current DGA process for reviewing the science falls short of meeting the “best practices for conducting systematic reviews,” and that “methodological approaches and scientific rigor for evaluating the scientific evidence” needs to “be strengthened.” The report states, “To develop a trustworthy DGA, the process needs to be redesigned.”

This lack of a firm scientific foundation for the DGA is emphasized throughout the report:

“The adoption and widespread translation of the DGA requires that they be universally viewed as valid, evidence-based, and free of bias and conflicts of interest to the extent possible. This has not routinely been the case.” [S-1]

“The methodological approaches to evaluating the scientific evidence require increased rigor to better meet current standards of practice.” [S-4]

The process to update the DGA should be comprehensively redesigned to allow it to adapt to changes in needs, evidence, and strategic priorities.” [S-4]

Members of The Nutrition Coalition responded to the report:

Jeff Volek, Scientific Advisory Council Member for the Nutrition Coalition, PhD RD Professor, Department of Human Sciences, The Ohio State University: “These guidelines don’t operate in a vacuum. Flaws in the DGA process are the major force shaping the U.S. food supply, and they drive dietary advice by all health-care practitioners as well as all federal nutrition policy – from school lunches to food stamps to even the meals served to our active duty military service members. For years, we’ve been told that the Dietary Guidelines are the gold standard and that if Americans are obese and diabetic, it must be their fault. This report confirms that this is not the case.”

Nina Teicholz, Nutrition Coalition co-founder, science journalist and author of The Big Fat Surprise, whose controversial critique of the DGA published in The BMJ, identified many of the problems cited in the NAM report. “The good news is that we now have indisputable evidence that the DGA lack a firm scientific foundation, and we finally can chart a path forward for ensuring that this important policy is evidence-based.

“This report confirms what top nutrition experts have been trying to tell Congress, USDA, and HHS for years—our nation’s top nutrition policy is not based in sound science.

Sarah Hallberg, Executive Director of the Nutrition Coalition, DO, MS: “I sincerely hope that as a country this report will put us on a path towards science-based and effective guidelines that help, not hurt, our overall well-being. “I find my patients get healthier—lose weight and even reverse their diabetes—by doing what the current science says, which is the complete opposite of what the Guidelines tell them. It’s obvious to me, as a practitioner, that these Guidelines do not reflect the best and most current science. “Whether they realize it or not, virtually all Americans are impacted by the DGA, which is our nation’s top nutrition policy. It is imperative that we get this process right before as we head into the cycle for the next set of guidelines, which are due in 2020.”

Key recommendations from the report, titled Redesigning the Process for Establishing the Dietary Guidelines for Americans, include:

Strengthen the Evidence Base: Methodological approaches and scientific rigor for evaluating the evidence should be strengthened by using validated, standardized processes and methods with the most up-to-date data. It is critical that, for example, the Nutrition Evidence Library is aligned with best practices for conducting systematic reviews and uses appropriate methods. [4-9]

Crafting recommendations that address all Americans, not just those who are healthy: Given the prevalence of chronic disease and risk for chronic disease in the population, this National Academies committee believes it will also be essential for the DGA Policy Report to include all Americans whose health can benefit by improving their diet based on the scientific evidence. Without these changes, present and future dietary guidance will not be applicable to a large majority of the general population. [2-14]

Reducing sources of bias and conflicts of interest: The adoption and widespread translation of the DGA requires that they be universally viewed as valid, evidence-based, and free of bias and conflicts of interest to the extent possible. This has not routinely been the case. [S-1]

Redesigning the DGA process to be more transparent: To develop a trustworthy DGA, the process needs to be redesigned. […] It will be imperative for the process to enhance transparency, manage biases and conflicts of interest to promote independent decision making, promote diversity of expertise and experience, support a deliberative process, and adopt state-of-the-art processes and methods to maximize scientific rigor. [2-15]

The view that the DGA are not fully evidence based has been echoed by numerous scientific experts, such as:
Dr. Fiona Godlee, The BMJ editor-in-chief, editorialized: “Given the ever increasing toll of obesity, diabetes, and heart disease, and the failure of existing strategies to make inroads in fighting these diseases, there is an urgent need to provide nutritional advice based on sound science.’

Statements by other experts concerned with the evidence-base of the DGA can be found here.
In 2015, Congress appropriated $1 million for a review of the DGA process after concerns were raised by both researchers and nutrition experts alike during the last development cycle. That review is now complete, and the findings confirm the Nutrition Coalition’s view that the Guidelines are not fully evidence-based and do not adhere to basic methodological standards for reviewing the science.


Edit add: DietDoctor article titled: The Process Behind the Dietary Guidelines Is Broken, Says National Academies of Medicine

https://www.dietdoctor.com/process-...demies-medicine

Last edited by JEY100 : Sat, Sep-16-17 at 15:39.
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  #2   ^
Old Sat, Sep-16-17, 06:22
teaser's Avatar
teaser teaser is offline
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Maybe offering options would be better. I don't want guidelines against a low fat diet any more than I want guidelines again a low carb diet. If you're going to go with option A, here are the advantages and possible drawbacks, here's the best way to go about it, etc.

Diet by committee needs to stop, anyways. We've got a situation where if the population eats something like 35 percent fat and 10 percent of it saturated, they're told to eat 30 percent fat and 7 percent saturated. Even if I though low fat was the way to go, I can't imagine believing that such a weak intervention would do me any good.
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  #3   ^
Old Sat, Sep-16-17, 07:07
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GRB5111 GRB5111 is offline
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I agree with teaser's point and I would add that due to the fact that no one person responds to a designed diet in the same way, we need to understand the health implications of consuming types of fats, proteins, and carbohydrates against a backdrop of metabolic tendencies. There are those who can do very well with a low fat approach, however, those that do well also are inclined to have a well-designed WOE based on eliminating nutritional gaps to maintain health. It's the same issue for LCHF as well.

To attempt to achieve a universal dietary guideline for everyone is folly. To understand this fact and implement a varied approach with choices would be the first indication that the DGA recommendations could be of value in the future. In the past, members of the DGA advisory board have had agendas or are named to that role for the purpose of implementing a specific food agenda. This must stop if we are to make any progress in making the DGA process valuable for all.
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Old Sat, Sep-23-17, 12:00
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Benay Benay is offline
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Thank for this update, Jey. I just posted a blog post about the fallacies in the DGA system and wish I had seen this report before I posted it. I go along with Volek and Phinney that one diet does not fit all- especially when you factor in insulin sensitive versus the insulin resistant as in the Gardiner follow-up study. Also, if the DGA insists on making recommendations on exercise, remember V&P demonstrated that exercise improves fitness but is not universally useful in weight reduction.

Just in case anyone wants to read what I have said, here is my blog: /https://pamelajbrink.wordpress.com/2017/09/20/reading-and-interpreting-research-reports/

Last edited by Benay : Sat, Sep-23-17 at 14:21. Reason: Add information
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  #5   ^
Old Wed, Oct-04-17, 03:43
JEY100's Avatar
JEY100 JEY100 is online now
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Mandate is clear: Flawed dietary guidelines process must be reformed
BY REP. ANDY HARRIS, M.D. (R-MD.

Quote:
The nation’s senior scientific body recently released a new report raising serious questions about the “scientific rigor” of the Dietary Guidelines for Americans. This report confirms what many in government have suspected for years and is the reason why Congress mandated this report in the first place: our nation's top nutrition policy is not based on sound science.

In order to “develop a trustworthy DGA [guidelines],” states the report by the National Academies of Science, Engineering and Medicine (NASEM), “the process needs to be redesigned.” Among other things, the report finds that the guidelines process for reviewing the scientific evidence falls short of meeting the "best practices for conducting systematic reviews," and advises that "methodological approaches and scientific rigor for evaluating the scientific evidence" need to "be strengthened.” In other words, the Dietary Guidelines for Americans are far from the “gold standard” of science and dietary advice they need to be. In fact, they may be doing little to improve our health at all.

A crucial point, according to the report, is the need to upgrade the U.S. Department of Agriculture’s Nutrition Evidence Library (NEL), which conducts the scientific literature reviews. The NEL needs more “up-to-date” methods, outside technical expertise and external peer review of its work. A review of the NEL process in 2015 published in The BMJ (British Medical Journal), for instance, found that several of the evidence reviews had not been conducted systematically, allowing for cherry picking or outside industry influence, and that some 33 percent of the scientific questions requiring systematic reviews did not receive a review. Other recommendations by the National Academies report include improving transparency of the guidelines process and the need for the Guidelines to address not just healthy Americans but also those—now a majority—who are suffering from nutrition-related diseases.

For instance, rates of type 2 diabetes have quadrupled and obesity has nearly doubled since 1980, the very year that the guidelines were launched. For all of us in government, this is a matter of urgent concern. It seems clear that the lack of sound science has led to a number of dietary tenets that are not just mistaken, but even harmful - as a number of recent studies suggest.

For instance, the guidelines’ recommendation to eat “healthy whole grains” turns out not to be supported by any strong science, according to a recent study by the Cochrane Collaboration, a group specializing in scientific literature reviews. Looking at all the data from clinical trials, which is the most rigorous data available, the study concluded that there is “insufficient evidence” to show that whole grains reduced blood pressure or had any cardiovascular benefit. Another recent study, called the Prospective Urban Rural Epidemiology (PURE), followed 135,335 people worldwide, and found that there was no effect on cardiovascular mortality with higher saturated fat consumption. This same finding has been echoed over the past decade in thirteen other review papers on saturated fats, on all the clinical trials and all the observational data to date. Even more worrying, PURE found a link between the low levels of saturated fat currently recommended by the Dietary Guidelines and an increased risk of stroke. The paper, which was published in The Lancet, concluded that “global dietary guidelines should be reconsidered in light of these findings.” The study leader, Yusuf Salim, chair of cardiovascular medicine at McMaster’s University and immediate past president of the World Heart Federation, added that “saturated fat in moderation actually appears good for you.”

PURE additionally found that the lowest risk for cardiovascular or total mortality was for those consuming the most fat, up to the 45 percent of calories as measured in the study. Mortality was disturbingly higher among those consuming only 32-34 percent fat, as the Dietary Guidelines are currently modeled. This PURE data is also supported by a large amount of more rigorous trial evidence, including long-term data, showing that higher fat diets lead to more weight loss and better outcomes for blood glucose control, an important factor in type 2 diabetes. How could the Dietary Guidelines have missed the mark on so much important evidence? The National Academies report provides not just an explanation, but also a roadmap into the future for how to put the guidelines on a firm scientific foundation.

It is imperative that the advice championed by our national nutrition policy be unimpeachable. With the process for the 2020 guidelines soon to be underway, now is the time for the Congress to take action to reform the Dietary Guidelines development process so that proposed guidelines work as intended – as a tool to restore and protect our nation’s health. Harris represents the 1st District of Maryland.


http://thehill.com/blogs/congress-b...process-must-be
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  #6   ^
Old Tue, Oct-10-17, 04:21
JEY100's Avatar
JEY100 JEY100 is online now
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Tom Naughton has his praise and then own libertarian take on Rep. Harris's letter in The Hill.

The USDA dietary guidelines gets the spanking it deserves.

http://www.fathead-movie.com/index....ng-it-deserves/
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  #7   ^
Old Tue, Oct-10-17, 12:49
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Dodger Dodger is offline
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With the science that has been done on human nutrition, I believe that there is no recommendation for a guideline that could be made. We don't understand the biochemistry of humans enough to sort the wheat from the chaff, so to speak.
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  #8   ^
Old Mon, Oct-16-17, 06:02
JEY100's Avatar
JEY100 JEY100 is online now
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Dr Zoe Harcombe investigates the new dietary guidelines for the Flemish speaking part of Belgium, but her conclusions as to why diet guidelines are so hard to change could apply to most any country. http://www.zoeharcombe.com/2017/10/...ary-guidelines/
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Old Mon, Oct-16-17, 06:24
M Levac M Levac is offline
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The process is wrong a priori, can't be fixed by more of the same. In this post http://forum.lowcarber.org/showpost...883&postcount=7 I explain a bit what the idea is. Solution is simple because problem is simple. The problem is that what's called the "Official Dietary Guidelines" is nothing but a menu designed by producers of the foodstuff that make up this menu, basically the same as every other diet book we can buy, except it's a giant industry behind this one. Solution begins by acknowledging that fact. Then, depending on your position, either do some serious science to figure out what's really good (and what's really bad) for us and make guidelines based on that, or allow all diet makers to get their piece of the pie by integrating them all into the official guidelines with corresponding support.

For example consider the Dieticians' profession. It's monolithic, doesn't advise any other diet but the official guidelines, even for diabetics - more carbs cuz that's all the producers make, ya? It's not a genuine profession, it's more of a sales rep job. The instant we let in all other diet makers, suddenly these same "professionals" have to read tons of books, just like we did on this forum. They can no longer advocate a single diet from a professional point of view - the guidelines don't allow this behavior. Or, they can no longer favor the current food industry cuz the science is sure to contradict everything about the current guidelines.

Let me put it this way. It doesn't matter how many brilliant scientists we put on a panel - there's no science to back anything they recommend.
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Old Wed, Oct-18-17, 03:42
JEY100's Avatar
JEY100 JEY100 is online now
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Here's a way to figure out what is good or bad for us. Start with whatever we have been doing since 1970 that resulted in an epidemic of obesity and diabetes (result very bad). Then look at the newly released food availability data and reverse the two that stand out...large increases in processed oils and HFCS.

https://ninateicholz.com/new-us-food-availability-data/ (First time food availability data has been released in a decade)
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Old Wed, Oct-18-17, 04:12
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cotonpal cotonpal is online now
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Nina Teicholz's website is worth visiting. She is able to clearly and rationally discuss issues pertaining to nutrition, science, and government policy while providing her critics with clear responses to the often personal and nasty attacks directed towards her. She is a brave person.

Jean
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