Wednesday, February 16, 2011

New Dietary Guidelines: Hailed, Hackneyed and--a Cause of Obesity?

Big praise everywhere for the brand-new Dietary Guidelines for Americans, just released by the US Departments of Agriculture and Health. But why?

Apparently, previous guidelines had tip-toed on eggshells so as not to offend well-subsidized farmers and interest groups.  Fast food corporations pay good money in taxes, so the Feds didn't want to suggest that Supersized Fries should feed three, or that the Colonel quit serving chick wings you have to blot with paper towels to eat.

The Guidelines come out every five years by law, and the last one, in 2005, had very similar recommendations, just in less directive language. We've all been hammered with this same nutritional info since the first report in 1980. Every kid who's ever taken Health in junior high school has been tested on it.  Anyone who walks down a supermarket aisle gets a refresher course: "Now, with more fiber!" reads a label.  "And here's a great way to get those five servings of fruits and veggies!" chirps some food guru on a flat-screen TV in the produce section or over the check-out stand.

Let's see, do we want the margarine with the trans-fats or without??  The boastful red ZERO on the tub assures us no grams of that nasty heart-clogger lurk inside.

The problem is that despite redundant emphasis on less sweet and processed food, more fruits and veggies, more fiber and whole grains, less soda and salt--you know the drill--Americans have just gotten fatter.  Frankly, the statistics on obesity are a bit different from what we're led to believe, and I'll discuss them momentarily, but the result of the Feds' urging us to watch our dietary consumption is the opposite of their aim.  Knowledge and ubiquitous publicity about "shoulds" of nutrition have only brought a chunkier population. At the conclusion of this post, I'll tell you why.

In any case, with Michelle Obama adopting obesity-remediation as her personal campaign, we're sure to hear more...and more about it. Let's move!

Obesity stats: First off, a major caveat that the Centers for Disease Control uses the measure of BMI, "body mass index," which is notoriously crude, but all we've got. Every few years, statisticians of the NHANES program of the National Center for Health Statistics go out and take measurements on a sample using consistent methods, and classify subjects into three categories of heft, "overweight," "obese," and "extremely obese."

Now, here's the interesting thing: For adults over age 20, the "overweight," (BMI between 25 and 30) percentage of the population has stayed consistent for 50 years.  It was 31.5% in 1960-62, and 32.3 at the next measurement, 1971-4, compared to the latest figures from 2007-8 when 33.6% were overweight.  In 2005-6, "overweight" subjects were 32.2%, a tenth of a percentage LOWER than the figure for 1971-74.

The situation for the category called "obese," (BMI between 30 and 40) expanded from 13.4% at the 1960-62 first measurement to 15% in 1980. But then--at the next measurement (1988-94), there was a jump to 23.2%. And by the following measure, 1999-2000, the "obese" category swelled to 30.9%. That's a one-hundred-percent increase in just ten years! If people continued ballooning at the same pace, we'd expect to see 60% of the population "obese" by 2010--what a thought!

But there's a different outcome. Let me quote Katherine M. Flegal, et. al, a foremost researcher on obesity trends, in the Journal of the American Medical Association, (January 20, 2010—Vol 303, No. 3, page 235):

"In 2007-2008, the prevalence of obesity was 32.2% among adult men and 35.5% among adult women. The increases in the prevalence of obesity previously observed do not appear to be continuing at the same rate over the past 10 years, particularly for women and possibly for men."

Finally, stats regarding the "extremely obese" (BMI more than 40) are downright scary. In 1962, just .9% of the population--less than one percent--fell into that category. By 1976-80, the percentage was up to 1.4%. At the next measurement, 1988-94, the percentage doubled, to 3.0; by 2000 it was 5.0, and by 2005-6, it was 6.2%. The latest (2008) numbers show a slight drop, to 6.0%. The percentage of "extremely obese" mushroomed five hundred percent from 1962.

Why do I go through all these figures? Because they show that in the 20 years between 1980 and 2000, the rate of obesity skyrocketed. But it varied little before and after that period. Curious.

Do we blame those twenty years of thickening on McDonald's (which already had 1,000 restaurants by 1968) and fast food? On companies that added thousands of products to store shelves to answer working women's demand for convenience? On sloth encouraged by TV and the new lure of computer games? Or...could it be due to a virus (adenovirus 36)?  Hard to tell.

And do you believe it's education that suddenly stopped that steep climb in obesity a decade ago?

The authors of the 112 pages of the current "Dietary Guidelines"  (really only 59 pages of written content before all the appendices) would have us think so. Their recommendations are written in such lofty, vague, sweeping, academic and sometimes, hysterically funny prose as to render them flaccid.  And of course, the document recommends lots more government studies and commissions and interventions and regulations and education efforts as the way to shrink the citizenry. And inflate the budget.

Then, in a final chapter, the Guidelines acknowledge:
Although more consumer education is needed on achieving calorie balance, meeting nutrient needs, and staying physically active, information alone does not lead to behavior change.

Yes, that's right. You can lead a kid to water, but you can't make him drink (if there's soda handy), as the barage of healthy-eating information over the last thirty years has demonstrated.  Additional commissions and partnerships and studies likely won't work to reduce us either, if propping fan mags featuring skinny movie stars right where you buy your food can't inspire purchasers to slim down.  Shoppers ingest the magazine's cheesecake photos as they're loading their Haagen Dazs onto the conveyor belt.

Every market contains vegetables, a far wider variety of them than when I was growing up, including microwave-ready pouches you just nuke for five minutes and fork into.  Just about everyone has access to healthy food as well as the simply satisfying kind, the neck-up tranquilizers that offer rewarding crunches to salve frustration, or creamy smoothness to comfort.  Anybody can put on tennis shoes and go for a jog, or a walk, or climb the stairs in the building--they just don't.  The Guidelines are likely useless, but okay, if they mean there will be less junk in junk food, great.

I believe, however, that the Guidelines and experts telling Americans what they should eat and do are actually causing obesity, because they teach us to not trust our own instincts, to detach from our natural signals of hunger and satiation, and to override the internal mechanism that tells us what it is our bodies need right then.

If we could stop saying that sugar and ice cream are "bad" and celery and apples are "good," we just might clear the way to understand what our naturally thin grandparents did:  you eat when you're hungry, eat what pleases you, and move on to other activities when comfortably sated.  If it were possible to respect our individual likes and dislikes and toss out pyramids that once were squares, perhaps we could be at peace enough to relax about food and get on with actually developing our talents and minds and accomplishments.

One of the most humorous parts of the Dietary Guidelines is a silly diagram (6:1) of all the influences on people's eating and exercise habits.  Using colored ovals and arcs, we get a list of everything a bunch of people could brainstorm, including religion, community design and safety, food service and retail establishments, body image.  The one influence on what we eat that was completely absent from the 24 items packed into 4 sub categories was--body cues.  Hunger.

In other words, the authors of the august Dietary Guidelines for Americans 2010 believe eating choices are completely determined by factors external to the body consuming the food.

Certainly, the choice of particular foods that might satisfy one's body needs is shaped by factors like the cuisine of his family, or what's available.  But what's behind the idea of, say, "I feel like having a hamburger" versus "feeling like" having any other item on the menu?  The Dietary Guidelines would have us disregard the natural messages that tell us what we need nutritionally in favor of chewing some tasteless whole-grain lump, or even a tasty whole-grain lump that wasn't what our bodies needed at that moment.

I realize I'm going against the grain, but the Guidelines' emphasis on distinguishing bad from good foods turns attention from the primary source of food choices, which should be the body's communication of its needs, rather than a Federal Department or even the First Lady.


  1. Going against the grain? It's not only the height of absurdity to suggest that Americans eat what they do because the Gubmint tells them what to do, but it's entirely unsupported in evidence or argument.


  2. Clay, you didn't get my point. It's not that the government's edicts are the reason why people eat what they do. People eat what they do in spite of what the government is trying to get them to eat.

    The public, which has overall gotten much fatter in the last 30 years since all the healthy-talk, tunes out all this advice in favor of using food for immediate psychological reasons. Ask obese people what they know of the "right" way to eat. They know.

    What contributes to people eating bad stuff and way too much is experts' incessant message that what you're feeling physiologically isn't to be trusted; that what you internally want to eat is not what you SHOULD eat.

    I think the obesity problem is complex, but for the majority of cases, stifling the Big Brother advice (eg. the Guidelines) might help people trust their own body cues, so they could turn attention to addressing the stressors that drive over-eating.

    (BTW, I've led workshops on this issue for 29 years.)

  3. I'd say public never really cared for any guidance from anyone, even though it may say it does (and actually believe it). What changed over that same period is the "improvements" in our daily lives that allowed people to become less physically active. Everyone tends to get lazy and "efficient" and only more aware take notice and don't allow for the "conveniences" to let them get out of shape. Conscious rejection of those handicaps (like elevators, driving around the corner for couple bags of groceries, etc), doing house cleaning on our own, walking to get stuff done, instead of driving, and on and on, is the key to be more like our grandparents' generation.

    And since, again naturally, only certain category of people is able to have that kind of discipline, we're bound to see those kinds of number increases, and little, if anything, can be done about it.

  4. Sergei, yes, people can now get away with less physical exertion due to "conveniences," but I find it interesting that simultaneously, gyms, jogging, triathalons and even soccer leagues gained popularity.

    I think the main thing causing obesity is that food is an easy response to stress and depression (and boredom and a host of other emotions) and people now have the time and disposible income to use that means of coping.

  5. You're right, there are more gyms etc., however, people making serious use of those are of the "aware" type to begin with. Or some of the "other" (larger) category just checking it out, really, and using it as an excuse to have a double dinner that same night, defeating the purpose entirely :)

    As far as food used to "cure" depression and anxiety -- that was probably always the case. The thing is, back in the day no one could get away with abandoning their necessary daily chores, whereas now...

    I guess, what I'm trying to say is that it's external factors that play the most significant role in this development (could it be true for everything else?), rather than any attempt at influencing people by trying to "educate" them.

  6. Northern Light, I can accept I may have missed your point, but to me the following your explanation sounds like a distinction without a difference.

    "What contributes to people eating bad stuff and way too much is experts' incessant message that what you're feeling physiologically isn't to be trusted; that what you internally want to eat is not what you SHOULD eat."

    If you are not eating what you feel like eating due to the messages of experts, are you not doing as someone else tells you to do? Add that to the fact that your first three paragraphs look at the USDA's dietary guidelines, and it's hard to escape the message that the Gubmint speaks and we obey.

    It may be unintentional, and I'll even give you that it's implicit rather than explicit, but it's implied strongly enough to be a clear message in your piece. However, your reply to me drives it home explicitly:

    "...but for the majority of cases, stifling the Big Brother advice (eg. the Guidelines) might help people trust their own body cues..."

    I don't question your credentials, but I do question the argument. You pose a number of interesting ideas -- that the messages of experts affect eating decisions, that internal cues are intrinsically healthy, that the health and nutrition culture of the last 30 years differs fundamentally from the previous 30, and that government publication of nutrition guidelines means the meddling Gubmint is "trying" to get us to eat in a particular way -- NONE of which are supported by evidence.

    Frankly, I think it's very likely that participants in an obesity workshop are desperate for any place to dump their responsibility. You've already admitted that the obese know how to eat. I agree that obesity is -- in some cases -- complex. In others it's quite simple: too many calories and sedentary lifestyle. We all make choices that define our lives. Someone who knows the "right" way to eat and chooses not to has no one to blame but himself.

    You also fail to address two issues of great importance to obesity: the steady decline in cost per calorie over the last 100 years, and the degree to which most people's life are entirely sedentary. And while I don't know your thinking well enough to accuse you of it, I suspect you omit these issues because they're harder to spin into partisan rhetoric.

  7. Clay, thank you for your thoughtful comment. The points you claim are not supported by evidence actually all have solid research backing them up, all cited in a book I'm working on related to this issue.

    Recently, research has found many factors that could cause the rise in obesity, not related to "too many calories and a sedentary lifestyle," though of course in many cases those are exactly the culprits.

    However, the way bodies USE calories varies; the amount of leptin, discovered relatively recently, plays a part, as well as, perhaps, the Adenovirus 36, and, likely, other factors that determine one's "setpoint" (which is resistant to change). Several studies have found that obese and normal people consume very similar amounts of calories--and even when activity is controlled for, some people are obese, and others not. Genetics are implicated, but other factors as well.

    It seems research disputes the generalization that the national obesity problem is something that can be controlled by will-power and more exercise--alas. And so, Dietary Guidelines that insist on it are not realistic.

    Btw, my workshops are mainly populated by normal-sized people, not the obese--distress over food and weight is endemic in our culture.