A History of Nutrition Guidelines

 The history of Government recommended
nutrition guidelines in the United States now
spans over 100 years.  During this time, the
United State Department of Agriculture’s
(USDA) nutrition guides promoted at various
times from 4 to 11 food groups.  For most,
these guidelines became the basis of what they
were taught about nutrition and quite likely many
of their food preference.
 
 In recent years, the Government’s nutrition
guides have been criticized for not accurately
representing the best scientific information and
for being overly influenced by agribusiness
interest.  With the Department of Agriculture
having conflicting mandates for providing
nutrition guidelines and for promoting
agribusiness it’s not difficult to see why nutrition
policy might have run off the tracks.

 The Government’s first nutrition guidelines
were published in 1894 as a farmers' bulletin.  
These guidelines advocated measuring
calories, variety, proportionality, and
moderation.  An efficient and affordable diet
was described as one that focused on nutrient-
rich foods, less fat, less sugar and less starch.  
While well intended, this early guide advised
against vegetables.  At that time the science of
nutrition was in its infancy with the discovery of
the first vitamin still sixteen years away.

 In 1916, a new recommendation was issued
that categorized foods into five food groups:  
milk and meat, cereals, vegetables and fruits,
fats and fatty foods, and sugary foods. These
guidelines remained through the Great
Depression years with several variations based
on affordability.  By 1941 the guidelines were
updated to include a few vitamins and minerals.

 In 1943, a graphic nutrition guide called the
‘Basic 7’ food groups was issued as part of
helping maintain nutritional standards under
WWII food rationing.  The Basic 7 food groups
included:

 1. Green and yellow vegetables
 2. Oranges, tomatoes, grapefruit, cabbage
and salad greens
 3. Potatoes, vegetables, and fruits
 4. Milk, cheese, and other milk products
 5. Meat, poultry, fish, eggs, dried beans, peas,
nuts, and peanuts
 6. Bread, flour, and cereals
 7. Butter and fortified margarine

  In 1956 the Government began promoting a
new nutrition guideline called the "Basic Four"
food groups.  Until 1992, the ‘Basic Four’
remained the standard for nutrition education in
public schools.  Recommendations for minimum
servings from the ‘Basic Four’ food groups
included:

 • Vegetables and fruits (four or more servings
daily).

 • Milk and milk products (four servings for
teens and two for adults).

 • Meat, fish, or beans (two servings daily).

 • Cereals and bread (Four servings daily)

 Other foods were suggested to round out the
‘Basic Four’ meals and satisfy appetites. These
included additional servings from the ‘Basic
Four’ or foods like butter, margarine, oils, jellies,
syrups, etc.  To promote the ‘Basic Four’
nutrition recommendation, a food guide pyramid
was introduced.   Interestingly, the first ‘Basic
Four’ chart suggested by nutritional experts
featured fruits and vegetables as the biggest
group, not bread.  The original chart also
emphasized eating less meat, salt, sugary
foods, bad fat, and additive-rich factory foods.
Unfortunately, the proposed chart was
overturned at the hand of special interests in the
grain, meat, and dairy industries.  The final
guidance included more refined grains, meat,
commercial snacks and fast foods.
 
 Twelve years later the ‘Basic Four’ pyramid
was updated with a guide called MyPyramid.  
The somewhat abstract design depicted a
nutrition recommendation in which grains
narrowly edged out vegetables and milk in
equal proportions. Fruits were next in
proportional serving size, followed by a
narrower wedge for protein and a small sliver
for oils. An unmarked white tip represented
discretionary calories for items such as candy,
desserts, etc.  Stairs were added up the left
side of the pyramid with an image of a climber
to represent a push for exercise.

 In June 2011 after 19 years of the food
pyramid recommendations, the MyPlate
nutrition guide was issued.  In the MyPlate
scheme, a plate and glass depict five food
groups.

  While the MyPlate recommendation is an
improvement, it is still not the best
recommendation based on current research.
Numerous research findings demonstrate that
the US Dietary Guidelines still fall short of needs
for health.  For now, special interest groups
from agribusiness maintain a stronger influence
through the revolving door of agribusiness and
Government than do experts from the science of
nutrition. Of additional concern is the
Government’s reliance on advice from
professional bodies such as the American
Heart Association, the  American Diabetes
Association, and the American College of
Cardiology, which in the past have been
suspected of influence by agribusiness.  On a
positive note, the Government’s 2015 report
found that a healthy diet should comprise higher
quantities of plant-based foods and lower
quantities of animal-based foods.  It also
reported that a plant-based diet was better for
the environment than one based on meat and
dairy.  While these recommendations are
encouraging, progress in realizing the best
guidelines will remain a contest between the
need for public health information that provides
the best advice and defenders of agribusiness.
 
 In 2020, the Government will publish a new set
of nutrition guidelines based on a review of
current scientific findings, inputs from industry
and public comment. Once again, the battle for
influence over the national diet will begin in
earnest with agribusiness having the financial
upper hand, science having an essentially
unfunded seat at the table, and the public
generally unaware of plans for their future.
 
 Given that a significant percentage of all
chronic diseases in this country are attributable
to lifestyle choices with poor dietary habits
being the major culprit, healthful eating must be
promoted as a public health priority.  Without
this national priority, the cost of healthcare will
continue to rise and will in time exceed the limits
of affordability causing significant reductions in
availability and quality of service.
 
 The progression of preventable chronic
conditions like type 2 diabetes and Alzheimer’s
clearly points to the failure of existing national
policies.  Fifty years ago, there were about two
million Americans with type 2 diabetes.  Today
diabetes is estimated to impact 160 million
Americans diagnosed with diabetes or pre-
diabetes.  In both cases, lifestyle is the most
common cause of a national epidemic that is
preventable, treatable and for type 2 diabetes
often, reversible through dietary and other
lifestyle modifications.
 
 If the future cost of healthcare is a concern to
you then let your elected representatives know
that you favor having the Government promote
nutrition guidelines that reflect the most healthful
choices.
 
 To the extent that my voice can be heard, I will
continue to argue that the best diet for disease
prevention and optimal health for most people is
one that consists predominantly of plant-based
whole foods.
 
 You can also play an important role in the 2020-
2025 Dietary Guidelines development process
by expressing concern to your elected officials.  
Below you will find a statement that supports
needed objectives for the 2020-2025 nutrition
guidelines.  You can be sure the voice of
agribusiness will be heard.  By 2020 we will
know if the best evidence for health has
become national policy that can help influence
what children are taught in school.  With over
two generation taught poor dietary habits,
getting back on track could take some time.
 
 About getting back on track, do you have daily
walks in your plan?  If not, set the clock for a
morning walk.  The cool Spring mornings are
near perfect for a walking meditation.  A
morning walk along one of our greenways
before 7:00 am is good medicine for the body
and soul.
 
     
Nancy Neighbors, MD
      Huntsville, Alabama


        Statement of Objective for
the 2020-2025 Dietary Guidelines

 Feel free to use the statement below in
advising your elected representatives about
your preferences for meaningful national dietary
guidelines.  National guidelines are important
because they flow into a wide range of
educational materials including public school
instruction.  Without a positive influence early in
life, dietary habits can be quite difficult to
change.

 “The 2020-2025 Dietary Guidelines must be
updated to reflect the evidence and speak to
the power that individuals have to prevent, treat
and reverse chronic disease through whole
food, plant-based nutrition. Plant-based nutrition
has the power to mitigate obesity, hypertension,
high cholesterol and dyslipidemia, insulin
resistance in diabetes and much more.  
Considering that the number one prescribed
medication in the US is statins (to treat high
cholesterol and inflammation), Americans
should be made aware that cholesterol is found
ONLY in animal foods (meat, poultry, fish,
dairy).  By replacing cholesterol-containing
foods with whole plant foods, they are able to
dramatically reduce their cholesterol, reduce
inflammation, and reduce their need for
medications.  Whole food plant-based nutrition
is also typically very low in sodium, high in fiber,
nutrients, and phytochemicals and provides
more than sufficient amounts of protein - a
macronutrient that is typically correlated with
meat.  The US public on average consumes
nearly twice as much protein as needed.
Minimally processed, whole food plant-based
nutrition diets, high in vegetables, fruits, whole
grains, beans and other legumes, nuts and
seeds with minimal (or no) animal products,
added oil, and refined sugar defines the
concept of "food as medicine" and must be
both addressed and included in the 2020-2025
Dietary Guidelines.”
 

               Nutrition Tip

 Beans are an amazing food that typically has
about 7 grams of fiber per serving.  Enjoy them
all including big beans, small beans, lentils,
black-eyed peas, pintos, kidney beans, etc.  If
new to using dry beans as a regular part of your
diet then soak overnight, cook thoroughly and
begin by eating smaller portions.  As your
digestive system adapts to increased fiber all
will work out naturally.  Beans served with
cooked greens and whole grains make an
amazingly nutritious combination.  Don’t be
surprised when you begin to lose excess
weight, notice skin looking healthier and find
you have more energy.