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Why everyone wants you to eat more…the problems confronting our forthcoming dietary guidelines

As reported in a recent Croakey post, an NHMRC committee is in the process of drafting new dietary guidelines. This is inevitably an incredibly fraught and contested process.

There are so many powerful players with an interest in encouraging us to eat more of whatever it is they sell.

Often these marketing campaigns are dressed up as health campaigns – you only have to visit your local butcher to see how clever the meat industry has been in this regard (or look at the advertising in the medical magazines). Their extensive PR and marketing campaigns indicate how seriously the industry is taking the health and environmental sustainability concerns that are increasingly being raised about meat-rich diets.

Researchers, too, often have an interest in encouraging a focus on their favourite nutrients, sometimes at the expense of the bigger picture.

There are very few powerful voices with an interest in telling us to eat less.

Yet clearly, for the sake of our ever-expanding waistlines, this is a message that most of us need to hear, loud and clear. Nor is over-consumption of food and drink, particularly the highly processed and packaged varieties, a recipe for planetary health.

The implications for public health and dietary guidelines of this power imbalance — between the eat more versus the eat less brigade — are spelt out by the US public health nutritionist, Professor Marion Nestle in her 2003 book Food Politics. If you are interested in food and health more broadly, it’s essential reading.

I asked Marion Nestle if she’d write for Croakey about the role of environmental sustainability as a criteria for dietary guideline development in the light of this recent editorial from The Australian.

She said she was too busy but suggested I quote from relevant posts on her blog.

Here are a few snippets:

On the 28 June, she blogged about the new Dietary Guidelines Advisory Committee report released earlier this year in the US (the US guidelines can be downloaded in full here if you have access to Google documents)

She notes that the US committee’s report is advisory. From 1980 through 2000, dietary guidelines advisory committees actually wrote the final US Dietary Guidelines. No more. Since 2005, the sponsoring agencies decide what the Dietary Guidelines will say.

She notes:

“Only once does the report say the clear and simple: “Avoid sugar-sweetened beverages” (p. 65).  Nowhere does it explicitly say to eat less steak, hamburger, French fries, pizza, cookies, or ice cream.

Like previous editions of the Dietary Guidelines, this one talks about foods in the context of eat more (fruits and vegetables).  For eat less advice, it switches to nutrients.  I’d call this obfuscation (and politics).

But the report—for the first time—emphasizes environmental influences on obesity:

The 2010 DGAC recognizes that the current food environment does not adequately facilitate the ability of Americans to follow the evidence-based recommendations outlined in the 2010 DGAC Report. Population growth, availability of fresh water, arable land constraints, climate change, current policies, and business practices are among some of the major challenges that need to be addressed in order to ensure that these recommendations can be implemented nationally.

What business practices?  It doesn’t say.  It does, however, recommend:

  • Improve foods sold and served in schools, including school breakfast, lunch, and afterschool meals and competitive foods so that they meet the recommendations of the IOM report on school meals….
  • Increase comprehensive health, nutrition, and physical education programs and curricula in US schools and preschools, including food preparation, food safety, cooking, and physical education classes and improved quality of recess….
  • Remove sugar-sweetened beverages and high-calorie snacks from schools, recreation facilities, and other places where children gather.
  • Develop and enforce responsible zoning policies for the location of fast food restaurants near schools and places where children play….

This is excellent advice.  But how about some suggestions about what individuals might do about it?

The report says little about food marketing.  Beyond “Develop and enforce effective policies regarding marketing of food and beverage products to children…,” the report says virtually nothing about the well documented impact of food marketing on children’s food choices, dietary intake, and health.  Unless I missed it someplace, the research review does not cite the Institute of Medicine’s 2006 landmark report, Food Marketing to Children and Youth: Threat or Opportunity.

It buries the need for policy changes in long wordy lists.  It states the needs for low-income Americans to have access to and afford healthier foods; to produce fruits, vegetables, and grains sustainably; to ensure household food security; to promote sustainable aquaculture; and to encourage the food service industry to serve healthier foods and smaller portions.  It does not—and perhaps cannot—recommend policy changes to achieve these important goals.

Overall, the report contains plenty of material for food, nutrition, and health advocates to work with, but you have to read between the lines to find it.”

***

Just last week, on the 21 July, Nestle wrote that the committee’s report and its advice about health and sustainability must “come as a serious challenge” to the meat industry.

The report recommends:

Shift food intake patterns to a more plant-based diet that emphasizes vegetables, cooked dry beans and peas, fruits, whole grains, nuts, and seeds. In addition, increase the intake of seafood and fat-free and low-fat milk and milk products and consume only moderate amounts of lean meats, poultry, and eggs.

Nestle advised: Keep an eye on the “eat less meat” theme.  She said: “My guess is that we will be hearing a lot more about it.”

****

Meanwhile, as the NHMRC committee continues its work, expect to hear plenty more from the various groups with an interest in telling us to eat more – for the sake of our health, of course.

It’s one dish that I’d suggest washing down with a large bucket of salt.

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Population Health Congress 2015
2016 conferences
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#ANROWS2016
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2017 conferences
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#OTCC2017
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Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
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