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Wednesday, 10 September 2014

Dietary Guidelines for Americans: We don’t need no stinkin’ science

by Adele Hite, MPH RD

I know, I know. I never post. I never call. I don’t bring you flowers. It’s a wonder we’re still together. I have the usual list of excuses:

1) GRADUATE SCHOOL

But before I disappear off the face of the interwebz once again, I thought I share with you a quickie post on the science behind our current Dietary Guidelines. Even as we speak, the USDA and DHHS are busy working on the creation of the new 2015 Dietary Guidelines for Americans, which are shaping up to be the radically conservative documents we count on them to be.

For just this purpose, the USDA has set up a very large and impressive database called the Nutrition Evidence Libbary (NEL), where it conducts “systematic reviews to inform Federal nutrition policy and programs.” NEL staff collaborate with stakeholders and leading scientists using state-of-the-art methodology to objectively review, evaluate, and synthesize research to answer important diet-related questions in a manner that allows them to reach a conclusion that they’ve previous determined is the one they want.

It’s a handy skill to master. Here’s how it’s done.

The NEL question:

What is the effect of saturated fat intake on increased risk of cardiovascular disease or type 2 diabetes?

In the NEL, they break the evidence up into “cardiovascular” and “diabetes” so I’ll do the same, which means we are really asking: What is the effect of saturated fat (SFA) intake on increased risk of cardiovascular disease?

Spoiler alert–here’s the answer: “Strong evidence” indicates that we should reduce our intake of saturated fat (from whole foods like eggs, meat, whole milk, and butter) in order to reduce risk of heart disease. As Gomer Pyle would say, “SUR-PRIZE, SUR-PRIZE.”

Aaaaaaaand . . . here’s the evidence:



The 8 studies rated “positive quality” are in blue; the 4 “neutral quality” studies are in gray. The NEL ranks the studies as positive and neutral (less than positive?), but treats them all the same in the review. Fine. Whateverz.


According the exclusion criteria for this question, any study with a dropout rate of more than 20% should be eliminated from the review. These 4 studies have dropout rates of more than 20%. They should have been excluded. They weren't, so we’ll exclude them now.


Also, according to NEL exclusion criteria for this question, any studies that substituted fat with carbohydrate or protein, instead of comparing types of fat, should be excluded. Furtado et al 2008 does not address the question of varying levels of saturated fat in the diet. In fact, saturated fat levels were held constant–at 6% of calories–for each experimental diet group. So, let’s just exclude this study too.

See more exclusions here: http://eathropology.com/

Graham

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