Dietary guidelines and the obesity epidemic

In a recent issue of the American Journal of Preventive Medicine (2008;34:234-240; http://www.ncbi.nlm.nih.gov/pubmed/18312812?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum) Paul Marantz, Elisabeth Bird and Michael Alderman from the Department of Epidemiology and Population Health of the Einstein College of Medicine, New York, published a paper in which they call for higher standards for dietary guidelines. Their paper argues that dietary guidelines are often based on indirect and sometimes weak evidence, that resulting guidelines may cause harm instead of health benefits, and that dietary guidelines may better be avoided if not based on adequate evidence. They use the fat reduction guideline as an example. In the 1980s and 90s dietary recommendations in most countries included recommendations to reduce dietary fat intake to less than 30 or 35 percent of total energy intake. The authors argue that this recommendation was not based on firm evidence (i.e. total fat is not an issue, type of fat is more important) and that the recommendation has issued changes in peoples diets and in food production and innovation towards less fat, but also towards more sugar and other carbohydrates, leading to higher calorie intakes, and thus possibly contributing to the obesity epidemic. A comment on their paper by Steven Woolf and Marion Nestle was published in the same issue (http://www.ncbi.nlm.nih.gov/pubmed/18312816?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).