On September 30, the Senate Commerce, Science, and Transportation Subcommittee on Consumer Affairs and Product Safety held a hearing to examine the rise in obesity in Americans and whether U.S. dietary guidelines are to blame. Noting that close to one-third of all Americans are now clinically obese and that since 1980 twice as many children and three times as many adolescents are overweight, subcommittee Chair Peter Fitzgerald (R-IL) said, “We are losing the battle of the bulge.”
Criticizing the current “food pyramid,” which is based on the Dietary Guidelines for Americans promulgated by the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS), Sen. Fitzgerald said, “We have an obligation to ask a painful but obvious question: is there a link between our expanding waistlines and the USDA food pyramid?” Additionally, Sen. Fitzgerald announced his intent to introduce legislation to grant HHS sole oversight of the guidelines, saying, “I think it is a mistake to make the USDA the general in the war on obesity. The primary mission of the USDA is, after all, to promote agricultural products.”
According to Dr. Eric Hentges of USDA, the Secretaries of Agriculture and Health and Human Services are required to jointly publish the Dietary Guidelines for Americans at least every five years. He said, “The Guidelines must: (1) contain nutritional and dietary information for the general public; (2) be based on the preponderance of current scientific and medical knowledge; and (3) be promoted by each federal agency in carrying out any federal food, nutrition, or health program.” As such, the current guidelines, issued in 2000, are being reviewed, and an updated version will be released in 2005.
Noting that Dietary Guidelines “serve as a framework for many federal initiatives,” Dr. Arthur Lawrence of HHS added that they “provide a vehicle for the government to speak with one clear voice.” He stated that the guidelines serve as the basis for a number of HHS physical and nutritional campaigns, including: the National Institutes of Health’s (NIH) National Heart, Lung, and Blood Institute’s Red Dress Project, which is designed to raise awareness that heart disease is the number one killer of women; the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases’ Take Charge of Your Health: A Teenager’s Guide to Better Health; and the Centers for Disease Control and Prevention’s National Bone Health Campaign, Powerful Bones, Powerful Girls, which is designed to promote optimal bone health among girls aged 9-12.
Also criticizing the current guidelines, Dr. Walter Willett of the Harvard School of Public Health called for “a major redrawing” of the food pyramid. According to this testimony, some of the flaws in the current guidelines include: · A failure to distinguish types of fat, some of which are undesirable, such as trans and saturated fats, and some of which are healthier, such as unsaturated fats; · The promotion of a high intake of starches, whether refined or whole grain, which contribute to excessive calories; · A failure to distinguish among protein sources; and · The promotion of high dairy consumption, which contains large amounts of saturated fat.
Dr. Michael Jacobson of the Center for Science in the Public Interest concurred, saying, “The basic problem with the Food Guide Pyramid is its failure to distinguish between better and worse foods within a food group. Thus, the dairy group mixes fat-free milk with high-fat cheese content. The protein group mixes fatty meat with wholesome beans and fish. The grains group mixes white bread with whole wheat bread.” Adding that the pyramid should be changed to “encourage people to eat more of the most healthful foods and less of the least healthful,” Dr. Jacobson said that the Dietary Guidelines for Americans also should “use clearer, stronger language and highlight specific foods to avoid.”
While agreeing that the guidelines and the food pyramid need to be restructured, two witnesses presented conflicting testimony as to the optimal diet: a diet low in fat and simple carbohydrates or a diet high in protein and low in carbohydrates.
Dr. Dean Ornish of the Preventive Medicine Research Institute at the University of California, San Francisco discussed his low-fat diet, saying it is a “better approach” because it reduces “the intake of simple carbohydrates and increases the consumption of complex carbohydrates (also called whole foods). These include fruits, vegetables, legumes, and whole grains such as brown rice and whole wheat flour in their natural forms.” He continued, “These foods are naturally high in fiber, which slows their absorption, preventing a rapid rise in blood sugar…In summary, whole foods are more dense in nutrients, less dense in calories, and high in fiber.”
Additionally, Dr. Ornish cited studies showing that complex carbohydrates are associated with decreased risk of coronary heart disease and diabetes. “Complex carbohydrates are low in disease-promoting substances such as cholesterol, saturated fat, and oxidants and have at least a thousand substances that are protective,” he said. However, Dr. Stuart Trager of Atkins Nutritionals, Inc. disagreed, “The message of caloric control and fat reduction has not produced the anticipated reduction in the rising rate of obesity that was expected.” He stated that the Atkins approach, named for the late Dr. Robert Atkins, focuses on “educating individuals to make intelligent food choices favoring nutrient dense whole foods in a way that includes adequate protein and fat which provides satiety and satisfaction and improves compliance.” Additionally, “by shifting attention away from calorie counting, portion control, and fat reduction, Atkins teaches individuals how to make better selections while at the same time addressing other significant health risks through exercise.”
Dr. Trager also said that recent studies have shown that “by limiting carbohydrates, individuals demonstrate equal or greater weigh loss…than that seen with traditional recommendations, without any clinical evidence of increased cardiovascular or metabolic risk identified.”
