Welcome to the controversial world of dietary recommendations. Seriously, what do you do when you hear opposing stories about fat, cholesterol, carbs, supplements, etc.? Probably the same thing the experts do – expound on your own opinions and go get a snack!
Debate from All Sides
Criticism ignited over recent U.S. Dietary Guidelines (USDG), which diluted evidence that disagrees with long-held dogma from the nutrition establishment. A really good CardioBrief article from Larry Husten (reprinted in MedPage Today) explains. Bottomline – it’s time for nutrition research to set and use standards. Hopefully, they will implement them more effectively than some fields (but that’s another story).
“…it is time to transition from the current evidence-free zone to an era where dietary recommendations are based on the same quality evidence that we demand in other fields of medicine.”
– Steve Nissen, Cleveland Clinic in Annals of Internal Medicine
One crucial point to consider is the difference between a true cause vs. a related factor (correlation) to a health problem. By the way, this Los Angeles Times article explains “correlation is not causation.” Unfortunately, the USDG did not take this into account, according to this criticism:
“…in the 2015 DGAC [Dietary Guidelines Advisory Committee] report, the distinction between correlation and causation is either ignored or dismissed.”
– Edward Archer, Gregory Pavela, and Carl J. Lavie in Mayo Clinical Proceedings
If this was an esoteric debate between scholars, no one else would care. But we have to care. Guidelines impact millions of people whose health may get worse, as evidenced with increasing levels of obesity and diabetes when people replace fat and cholesterol-laden foods with sugar and carbs. Experts are also worried about trends in coronary heart disease, some cancers, and other diseases.
Why Diet is Hard to Study
Another excellent article in Vox from Julia Belluz outlines 6 major reasons why it’s hard to study nutrition, according to 8 health researchers. Please read the article for details – here are the reasons:
- It’s not practical to run randomized trials for most big nutrition questions.
- Instead, nutrition researchers have to rely on observational studies — which are rife with uncertainty.
- Another difficulty: Many nutrition studies rely on (wildly imprecise) food surveys.
- More complications: People and food are diverse.
- Conflict of interest is a huge problem in nutrition research.
- Even with all those faults, nutrition science isn’t futile.
Where Does This Leave Us?
Today’s “precision medicine” promise (notice I didn’t say reality?) shows that bodies handle food, drugs, and other things differently. All of our guidelines need to reflect this. Research standards can also account for observational challenges and research bias. Conflicts of interest should also have major repercussions for abuse, such as losing research and/or medical privileges. These are just a few of the changes needed in this important field of research. Please voice your opinions whenever and wherever possible.
All content © 2016 by Deborah Collyar unless otherwise specified. All rights reserved. Permission is granted to use short quotes provided a link back to this page and proper attribution is given to me as the original author.
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