US Gov't Might Be Wrong/Low Fat Diets

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Low-Fat Diet Recommended By Federal Government May Have Unintended Consequenceshttp://www.medicalnewstoday.com/articles/96459.php

It is common knowledge that obesity levels in America have been

recorded at record levels, almost reaching the point of an epidemic.

However, in the wake of numerous federal guidelines that promote a low

fat diet, one must beg the question -- is it possible that the

government direction of dietary guidelines has somehow caused these

unintended consequences, or is it just a coincidence?

In the March 2008 issue of the American Journal of

Preventative Medicine, published by Elsevier,

authors R Marantz, MD,

MPH, Bird, AB, and H Alderman, MD, from the Albert

Einstein College of Medicine explore just this question. In it, they

suggest that the recommendations made by the government were based on

limited scientific data and the implied assumption that it could do no

harm. However, as evidence now may suggest otherwise, they warn that

these guidelines may actually be harmful pending further study.

" When dietary guidelines were initially introduced in the late 1970s,

their population-based approach was especially attractive since it was

presumed to carry little risk, " states Dr. Marantz. " However, the

message

delivered by these guidelines might actually have had a negative impact

on health, including our current obesity epidemic. The possibility that

these dietary guidelines might actually be endangering health is at the

core of our concern about the way guidelines are currently developed

and issued. "

If the guidelines can alter the behavior of the public, it is possible

that such alteration might have either positive or negative effects.

According to the authors, in 2000, the Dietary Guideline Advisory

Committee actually suggested that the lower fat diet recommendation

advised in 1995 may have been ill-advised, and might in fact be

harmful. This committee was concerned that " the previous

priority given to a

'lowfat intake' may lead people to believe that, as long as fat intake

is low, the diet will be entirely healthful. This belief could engender

an overconsumption of total calories in the form of carbohydrates,

resulting in the adverse metabolic consequences of high carbohydrate

diets. " The committee also noted that " an increasing

prevalence of obesity in the United States has corresponded roughly

with an absolute increase in carbohydrate consumption. "

Multiple data sets presented by Dr. Marantz and his colleagues support

these trends -- but the authors are carefully to specify that this

correlation does not necessarily imply causation. Instead, according to

Dr. Marantz: " it raises the

possibility of a net harmful effect of seemingly innocuous dietary

advice. These dietary recommendations did not necessarily cause harm,

but there is a realistic possibility that they may have. "

In the same issue of the American Journal of

Preventive Medicine, H. Woolf, MD, MPH, from Virginia

Commonwealth University and n Nestle, PhD, MPH, of New York

University assert that the federal guidelines are actually supported by

decades of research. While they are united in the opinion that people

often compensate for a low-fat intake level by consuming more calories

in total, they disagree with the authors of the original article that

the guidelines were inappropriate in promoting low fat diets. " The

guidelines were not the culprit, " according to Dr. Woolf, who believes

that sharing the dietary causes of disease was the correct course of

action.

Woolf and Nestle never call into question that guidelines can have

unintended consequences. But, they write: " When the prevailing

message fails

to achieve its intended aims or achieves the wrong ends, the solution

is not to abandon the enterprise but to reshape the message to achieve

desired outcomes. "

In a continuation of this parley, Marantz, Bird and Alderman gave

further commentary. " When trying to mitigate potential harm from past

guidelines based on inadequate science, issuing 'reshaped' guidelines

with similarly inadequate science merely perpetuates past mistakes. It

might sometimes be best to avoid translating flaccid arguments into

rigid guidelines. Ultimately, this boils down to a difference in world

view, much like the distinction between clinicians guided by the

therapeutic imperative and those guided by the maxim 'first do no

harm.' Of course, when the evidence is clear, beneficial interventions

are always favored, and harmful interventions always shunned. It is

when the data are unclear that challenges arise. "

Marantz concluded, " As doctors, our first call is to do no harm. That's

why we recommend that guidelines be generous in providing information,

but more cautious in giving direction. Any directions should be based

on the very highest standards of scientific evidence. After all, we

expect that much from pharmaceutical companies before they bring a new

drug to market. "

A Call for Higher Standards of Evidence for Dietary Guidelines

R. Marantz, MD, MPH, D. Bird, AB, and H.

Alderman, MD

American Journal of Preventive Medicine, Volume 34,

Issue 3 (March 2008)

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Do Dietary Guidelines Explain the Obesity Epidemic?

H. Woolf, MD, MPH, and n Nestle, PhD, MPH

American Journal of Preventive Medicine, Volume 34,

Issue 3 (March 2008)

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The Authors Respond

R. Marantz, MD, MPH, D. Bird, AB, and H.

Alderman, MD

American Journal of Preventive Medicine, Volume 34,

Issue 3 (March 2008)

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Here For Full Length Article