Physician perspective: Keep politics out of dietary guidelines

The process by which the federal government provides the best available dietary advice to millions of Americans is under attack on Capitol Hill. As physicians and leaders of professional medical organizations, we are compelled to speak out. 

Physicians routinely provide patients with guidance on how to stay healthy. We rely on the best available scientific evidence to make these recommendations, and fortunately, we have had the Dietary Guidelines for Americans to turn to. Unfortunately, that could all change; there are unprecedented attacks taking place in Congress right now that threaten the scientific integrity of the guidelines.  

{mosads}Every five years, the guidelines are updated and published as America’s authority for nutrition advice. Important legislation, the Healthy, Hunger-Free Kids Act of 2010, called for school meals to conform to these guidelines, which makes sense: since children typically consume up to half of their daily calories in school, we have an obligation to ensure those meals are healthy and nutritious.  

At a time when nearly 1 in 3 school-age children and adolescents is overweight or has obesity and more than 1 in 3 American adults suffer from cardiovascular disease and diabetes, science, not politics, should drive the federal government’s efforts to revise the guidelines. And indeed, the guidelines themselves are informed by an expert committee made up of scientists, doctors and nutritionists who are nominated by their peers and selected by the federal government after a rigorous vetting process. They evaluate the evidence and provide independent advice to the U.S. government in the form of dietary guidelines. 

This process takes years, and is intentionally removed from the political process. And yet, it is currently under threat on Capitol Hill: Language pending in multiple spending bills would hinder the federal government’s ability to provide the best available advice to millions of children and adults on healthy diets and lifestyles. If enacted, efforts to reduce consumption of added sugars in order to lower the risk of cardiovascular disease, type 2 diabetes and dental caries would be stymied. Interventions to reduce screen time and increase physical activity in children and adults would be disrupted.  

What’s more, the language would limit dietary information or guidelines that can be included in the 2015 Dietary Guidelines for Americans only to those with a “strong” evidence rating, which means it is completely free from study design concerns or disagreements between findings. As any nutrition scientist or dietician will tell you, nutrition research is exceptionally difficult to perform. Meals are so complex and varied that establishing an individual’s true pattern requires meticulous diet tracking; population-level data is easier to obtain but less specific. In addition, there is an unlimited amount of factors that influence health, including physical activity, chemical exposure, and co-morbid health issues. A “strong” rating is only given if virtually every study on a topic agrees. As this rarely happens in science, the Dietary Guidelines for Americans have historically relied on both strong and moderate evidence to make key recommendations.  

Our patients deserve nutrition guidance that is free of political interference. The 2015 Dietary Guidelines for Americans will play a crucial role in the lives of millions of children and adults. Nutrition and physical activity are integral to a healthy population, and it’s essential that doctors are able to continue to advise our patients based on what the evidence recommends. Congress should support, not derail, what the science shows and keep the politics out of the guidelines.

Hassink, is president of the American Academy of Pediatrics. Stack is president of the American Medical Association.


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