Food For Thought: Healthy Planet Left Behind In U.S. Dietary Guidelines

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Every five years the US it apartment of agriculture issues new dietary guidelines for Americans. It usually demonstrated as a food pyramid indicating which foods we should eat a lot of and which foods to cut back on. The food guidelines are often controversial and this year and another controversy was added to the discussions. The question was raised should the recommendations be extended from a healthy diet to include a healthy planet. The 20 15th dietary guidelines advisory panel suggested that food system sustainability become part of the government dietary advice. And ultimately the Obama administration rejected the suggestion but the fact that the recommendation was made may indicate a new view on the connection between food and health. Joining me as Dr. Cheryl Anderson and is this assistive professor at of medicine in the UC school of medicine she was on the 2015 dietary guidelines advisory committee. Welcome Cheryl. Inc. you it's good to be here. And Katie for our as a dietitian and it should lecture at Sandy State University and welcome Katie. I think you. Show can you explain to us how the issue of sustainability was introduced into the panel discussion about dietary guidelines? Certainly. In the beginning of our process we outlined a framework which we were going to think about the various questions that we wanted to answer for the 2015 dietary guidelines advisory report. And we use the social ecological jewel model as a framework cannot model given its very definition really helps us think about what in addition to the individuals behaviors are important in the person being able to accomplish their health goals as well as their nutrition goals. And that includes things like their family environment, their social and cultural environments, as well as policies and other factors that affect health. And sustainability came into the discussion because of our use of that framework. I see recorded the discussion on sustainability focus on meat production? Is actually focused on whether or not the evidence base that we used to determine what the relationships are between foods, nutrients, dietary patterns, and health could be made in a way that would emphasize land, water, energy use, and greenhouse gas emissions so that we might be able to help -- have recommendations that are consistent with where we are trying to go overall in terms of health for the planet. And what did you look at in terms of land and water use in the health of the atmosphere when it comes to specifically meet production? We had experts come in, they were vetted just like every committee member in terms of conflict of interest in things of that sort to consult with us on how we might address the issues of sustainability. And through modeling approaches we were able to use the literature base that exists to conclude that there was a moderate graded mount of evidence to support that plant-based diets more so than animal-based diets because of methane production for example, were indeed more sustainable than meat diets. I'm interested Cheryl and what that discussion sounded like. Were there dissenting voices? We were a consensus panel. So every time we met we had a public meeting in Washington DC at the national Institute of health offices in Bethesda and we were very clear and recorded and everyone joined in to see what was happening but while we were deliberating certainly scientists brought their points of views and their interpretations of the literature as we met in the committees to vet everything through but at the end of the day the actual recommendation that is made in the report is a consensus on the part of the committee. I understand. What kind of link did the panel make between consumption and production? In other words was the panel thing people should eat less meat because it was better for their health or because it was better for the planet? The Mac fantastic question. It's actually primarily, the question is what are the results of the various patterns on health outcomes better nutrition related? And in that realm we found nothing that surprising that diets that were lower in red and processed meats, lower and refined grains, lower in sugar sweetened foods and Beth beverages, and higher fruits and vegetables and high-grade -- whole grains were actually better and had health advantages. Those very characteristics are consistent as we found in literature with a more sustainable diet. I see. So they were basically compatible purpose The conversations are happening in tandem. Did you expect your recommendations would be accepted by the Department of Agriculture? That's a great question because the advisory report is just that. It's an advisory report. And there has been precedents for some things not being included in the final guidelines that come from the secretaries of Health and Human Services and the secretary of US Department of Agriculture. We were disappointed to hear that the sustainability aspect of the report would not be brought into consideration. However I have to say Maureen that this was a wonderful opportunity for the nation and many sectors of the nation to have this conversation around sustainability of our food supply. This denial of this particular recommendation is a little bit different than the ones that they have done before. Basically they said sustainability has no place in these dietary guidelines. That a surprise to you? That is a surprise because first of all our meetings were transparent in these conversations have been happening for two years. However we are probably on the cutting edge of something here. The 2010 could dietary guidelines mentioned sustainable agriculture however this is the first time that it's being what that in such a prominent way. I can say that prominent scientists who have convenes as an Institute of medicine committee recently produced a beautiful report that looks at or food systems and thinking about how our recommended patterns of eating either challenging RFID systems were working in concert with the food systems whether it's beneficial or likely to confer some hazard down the road so it's an emerging conversation and I'm happy to be part of the guidelines advisory committee that brought that to the forefront. Katie Ferrera let me get you into the conversation. The Final Cut dietary guidelines won't be released until later this year so we won't know exactly what's on it but during congressional testimony we got a good hint that these guidelines are not going to be a radically different from the last ones. Heavy on fruit and vegetables lay on sugar and processed foods. My question to you is what kind of impacts do these dietary guidelines actually have? The dietary guidelines are put forth every five years to help shave nutrition policy and every nutrition program out there if you think about 30 million children in the United States who received the national school lunch program these guidelines help drive determine issues about which foods can and cannot be served. As a practitioner we see it tripled -- trickle down to that level about what are the nutrients people are not getting enough of and how can I as an educator and practitioner help people when they go to the store people don't go to buy calcium and fiber and they go to buy foods. And how do we translate those important messages that Dr. Anderson's committee worked on to real food-based recommendations for clients in population in general. To see these guidelines and the recommendations that the federal government makes being translated into the kinds of foods that kids get in school lunch programs and things of that nature? Yes certainly and having the support and evidence of the committee we need to make recommendations based on evidence. And these are evidence-based guidelines that we should be eating more plant-based foods. We note that those are better for us. More fruits and vegetables, whole grains, legumes. But how do people go about doing that? And that's the challenge is translating the hundred page document into bullet points. They want to hear how do I actually put that into practice? And tell me -- don't tell me what to eat less about what I need Timor. Not with the challenge of public health. And use fun people remain confused by what they are eating? There a lot of conflicting messages out there and sometimes they have a bad diet and can elicit with the supplement or they hear things on the news and people spend more and more money every year on the weight loss industry and the dietary guidelines are in for population were two thirds are overweight or obese and over half the people are in the country have a preventable chronic disease that's tied to die. The messages are out there and there's a disconnect where there's a lot of work for health practitioners and nutritionist to help get these guidelines into practice at the consumer level. Cheryl besides the controversy over the inclusion of sustainability there's been criticism that the guidelines continue to cling to the idea of low-fat. When more dietitians are racing -- embracing the idea that fat in our diet is not a particular health risk. Did you discuss that? Yes we did in the advisory report from the 2015 committee has a total fat recommendation that is slightly higher than we have seen in past years. One of the novel things about the report is we outline numerous paths. So instead think this is the diet you should follow as Katie mentioned people would like options. We outline for different dietary patterns for which there is evidence that they confer health benefit and we show the nutrient composition of those diets, the total fat and percentage ranges from 83 to 38 -- 33 to 38 and we model food patterns with complete menus that people can select from if they are trying to accomplish dietary patterns. I think it's very comprehensive and translated should it be adopted by the secretary at the end of their. I want to bring about something about sustainability and argued that you probably have heard during all of your discussions when the panel was deciding whether or not to recommend a sustainable option, the critics say that the focus on meat production in terms of sustainability is not correct because they say it may take less water unless land to grow 10 pounds of apples than it does to raise 10 pounds of beef, but the need -- meets nutrition is more lasting and nourishes more people. How did you take into consideration? So Maureen as I mentioned earlier have multiple aspects to look at. We were doing this under the framework that was more inclusive than might have been done in the past and dietary guidelines advisory committee's. None of our primary recommendations suggest to the American public that they should illuminate meat from their diets. And you also reiterated recently that this is about the correct balance in the whole package of how people should be eating. So as I mentioned we have four different types of diet and helpful dietary patterns people can engage in them and once vegetarian and the others include meets in ranges that we think is acceptable for good health outcomes. Another perhaps criticism about sustainability Pacific league as an issue that should be included on the food guidelines, why not include the price of food and availability of fresh fruits and touch walls and low income neighborhoods? What makes the issue of sustainability distinct from those other important concerns? They are not distinct in our report is 600 pages and a lot of things get missed and having everyone digest and consume the report so to speak. Unfortunately the sustainability aspect that focused on heavily but there are five different sections of the first being on as Katie mentioned earlier the landscape in terms of health and nutrition related concerns for these chronic conditions in our countries experiencing and the second being on food nutrients and dietary patterns and health outcomes. The third looking at physical act to be an diet and behavior change. The other one looking at physical diet and food environments and then sustainability. So your question lands in the food environment in the end activity environment realm where we do cover stuff like pricing, accessibility, health equity. These are important issues where every single person in this country regardless of where they live, work, play, or pride should have access to the kinds of diets we are recommending. Do think that aspect of your report is going to be accepted by the agriculture department? At this point we're not sure what the secretaries will do but the only thing that we have heard is that the sustainability peace will not be brought forward. It would be my wish and my hope that all of the other pieces get very serious consideration and make their way into the guidelines we get by the end of your. Katie do you see more people becoming concerned not only about what they are eating but were comes from? Yes certainly. I think it is important from a practitioner -- unfortunate from a nutritionist and point because the that the state sustainability won't be part of it because when you talk to someone about fish and omega threes and inevitable lead they ask which once better for me farmed or wild salmon? And it's challenging not to have evidence-based guidelines that you can turn to and say this is what we recommend because of XY and Z and especially in the San Diego environment that people are increasingly aware of and interested in where their food comes from not just what it does to our bodies. That certainly important but again we make food decisions based on what's good for ourselves but also increasingly and as we should be what's good for a planet. Is that the kind of advice you give to people? Even though it doesn't have the backing of the US government? It depends who you are speaking to. If you're speaking to a population were purchasing organic foods is not an normal possibility it's certainly appropriate. But there are other environments my focus is on the nutrient content. I would rather have you eat conventionally produced fruits and vegetables then organic junk food. So depends on who you are talking to but across all spectrums of life I think you are increasingly seeing people interested in where does my food come from and what is the better option. I get the fat and calories etc. but is organic better? Or is this form is better than wild? And I've been speaking with Cheryl a great deal of course about the committee that she was on but I'm wondering if you could make a suggestion about the 2015 dietary guidelines what would you like to see changed or included? One think I'm very happy is a lot of eat more messaging and sometimes as a practitioner we get tired of the eat less because they tune out of that. And intends the government guidelines get the criticizing for you not having eat less messages and people want to know what they can eat more of. So being able to speak to the evidence base that Dr. Anderson was talking about the benefits of a plant based diet. If you can switch any more legumes, black beans, lentils, fruits, vegetables, whole grains. And give people practical suggestions on how to put them in your diet you're more likely to have success at lease from the print -- practitioner level than a list of foods you should eat. And people to not shut down when you start talking like that. You tell people they can't do something and that's all they hear. What you want to tell them is what they can do. Certainly in the dietary guidelines will still retain some of that language of the benefits of a plant based diet and it may not be in regards to sustainability but certainly from a nutritional aspect we know the benefits of using less to read and processed meat and hopefully the guidelines will retain that language from the advisory committee and that recommendation report. I want to thank you both been speaking with Cheryl Anderson assistant print professor at UC schools medicine and Katie for a dietitian and lecturer at Diego State University. Into both very much. Think is getting her.