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A Brief History of U.S. Dietary Guidelines

Prior to 1980, how in the world did anyone know how to eat? When you think of all the centuries, the millennia of human existence, how did the species manage to survive bumbling their way through day after day of undirected eating patterns? I’m guessing those of you who know me expected a few irreverent remarks when you read the title of today’s post. Still, I’ll try to keep myself on a short leash today. It’s a legitimate and even, in some regards, culturally (and probably politically) significant question: why were government dietary guidelines [1] ever put in place—and what was the backstory of their uses and modifications over time? Finally, what perspective can it bring to our understanding of embracing a “niche” dietary model [2] like the Primal Blueprint [3]?

While the first official set of nutritional guidelines were published in 1980 as a joint effort of the USDA (U.S. Department of Agriculture) and HHS (Department of Health and Human Services), earlier government issued reports had initiated the series and stoked federal involvement in nutritional “policy.” You could trace a long history of discussion and publication leading up to these developments, but I’ll stick with the more recent events for my purpose today.

The Origins of Government Recommendations

In the late 1960s, a public push for addressing hunger in poorer pockets of the country spurred the creation of a bipartisan “Select Committee on Nutrition and Human Needs” that existed from 1968-1977. Chaired by Senator George McGovern, the committee’s initial proposed aim would eradicate hunger and malnutrition in the United States. Committee members in the early years examined the reality of severe health conditions stemming from malnutrition considered to be third-world problems like marasmus [4] and kwashiorkor [5].

While the early years of the committee’s work focused on federal assistance to combat hunger, the string of hearing reports and wide-ranging research eventually sent them by the mid-1970s in the direction of nutrition policy with the goal of examining the link between diet and chronic disease. At this point, questions of both deficiency and overconsumption were on the table.

By 1977, the committee had compiled its research, including the testimony of American scientist Ancel Keys and others who promoted the still prevalent but unsubstantiated link between fat (and cholesterol) and heart disease [6]. (Some of you might recall Keys’ famous/infamous “Seven Countries Study,” highlighting conveniently cherry-picked nations in which both fat consumption and heart disease rates were high—and ignoring countries which contradicted the hypothesized link).

The committee finished out its work in 1977 with the resulting publication (largely influenced by Keys and his cohorts), “Dietary Goals for the United States,” the central recommendations of which were generally as follows:

(Sounds familiar, no?)

The guidelines’ publication was met with significant controversy. The American Medical Association for its part argued that nutritional guidance should come in the form of personalized recommendations from doctors to their individual patients [7]. The meat, dairy and sugar industries naturally battled the reports’ suggestions to decrease consumption of their products. Additionally, individual scientists within and outside of the U.S. rightly critiqued the research behind the recommendations and demanded additional review and revision.

While recommendations against meat consumption were eventually softened in an addendum version later that year, the basic recommendations remained the same for reports to come, including for the first official (aforementioned) brochure issued through the collaboration of the USDA and HHS, “Nutrition and Your Health: Dietary Guidelines for Americans.” This brochure would be the first of the ongoing series of federally issued dietary guidelines we’ve seen over the last few decades. (The newest version is being created now for 2015. More on that in a moment.)

What have these recommendations looked like through the years? While the longer narrative reports are too cumbersome to detail here, the very basic guidelines between 1980-2010 have been as follows.

1980 Guidelines (PDF [8])

1. Eat a Variety of Foods
2. Maintain Ideal Weight
3. Avoid Too Much Fat, Saturated Fat and Cholesterol
4. Eat Food with Adequate Starch and Fiber
5. Avoid Too Much Sugar
6. Avoid Too Much Sodium

If You Drink Alcohol, Do So in Moderation

1985 Guidelines (PDF [8])

Basically the same, except a terminology change to second recommendation:

2. Maintain desirable weight

1990 Guidelines (PDF [8])

Much the same with these changes:

2. Maintain healthy weight
3. Choose a diet low in fat, saturated fat and cholesterol
4. Choose a diet with plenty of vegetables, fruits and grain projects
5. Use sugars only in moderation
6. Use salt and sodium in moderation

1995 Guidelines [9]

The 1995 set of guidelines generally followed the previous concepts, revising the second of the seven recommendations and moving the suggestion about a low fat diet to the third rather than second placement. It also altered wording for the fifth and sixth guidelines.

Among other new resources, the 1995 guidelines introduced the “food pyramid [10]” we know and love (kidding).

2. Balance the food you eat with physical activity—maintain or improve your weight
5. Choose a diet moderate in sugars
6. Choose a diet moderate in salt and sodium

2000 Guidelines (PDF [11])

Guidelines increased from 7 to 10 and were clustered into 3 thematic groups, reflecting more substantive changes than previous years.

“Aim for Fitness”

1. Aim for a healthy weight.
2. Be physically active each day.

“Build a Healthy Base”

3. Let the Pyramid guide your food choices
4. Choose a variety of grains daily, especially whole grains
5. Choose a variety of fruits and vegetables daily
6. Keep food safe to eat [related to preventing foodborne illness]

“Choose Sensibly”

7.  Choose a diet that is low in saturated fat and cholesterol and moderate in total fat.
8. Choose beverages and foods to moderate your intake of sugars
9. Choose and prepare foods with less salt
10. If you drink alcoholic beverages, do so in moderation

2005 Guidelines [12]

The 2005 Dietary Guidelines offered a substantially more complex set of recommendations—41 suggestions total (23 for the general population, 18 for “special populations” such as pregnant women). You can read the full set of 41 recommendations here [13]. The USDA also released the MyFoodPyramid Food Guidance System shortly after the official 2005 guidelines.

The nine topics covered by these guidelines were as follows.

Nutritional messaging, while more detailed and made available in more consumer-friendly public-focused versions, remained roughly the same. Noteworthy modifications or additions include emphasizing fitness efforts that incorporate cardiovascular conditioning, flexibility exercises and strength-building exercise and the balancing of potassium-rich foods [14] with moderation of sodium intake.

The guidelines emphasized obtaining less than 10% of total calories from saturated fat sources, less than 300 mg of daily cholesterol intake and as low as possible trans fat consumption. Total fat intake should favor polyunsaturated [15] and monounsaturated sources and should fall between 20-35% of total caloric intake.

The 2005 guidelines also present the concept of “discretionary calorie allowance” for the “small amount of calories” that may be applied to “solid fat and added sugar” choices when other food selections have been appropriately nutrient dense.

2010 Guidelines (PDF [16])

The 2010 Dietary Guidelines for Americans (the most recent iteration) took a pivotal turn as they were written not for “healthy” Americans but for an overweight/obese population. Talk about a sad commentary on the state of our nation that our national guidelines were now addressed for a presumed unhealthy population.…

Two “new” concepts that were stressed in this iteration of the guidelines included:

1. Maintaining “calorie balance” (ye olde outdated “calories in, calories out” model [17]) throughout the full lifespan to manage weight, which had actually been an element of the 1977 report.

2. Emphasizing nutrient dense foods by scrutinizing how many of a food’s calories came from fat or added sugar versus its total caloric value (never mind that clean fats offer their own essential health benefits…).

Also within the guidelines report is the assertion [16] that “strong evidence” suggests “that there is no optimal proportion of macronutrients that can facilitate weight loss or assist with maintaining weight loss.” Simultaneous to this declaration, the report lists 4 of the top 5 sources of calories for Americans (over two years of age) as the following: grain-based desserts, yeast breads, soda/energy/sports drinks and pizza.

Given the recognized prevalence of obesity, what should this list suggest about the optimal balance of macronutrients [18]—specifically the recommended high carbohydrate proportion (2 cups of fruit, 3 cups of grains and 2 1/2 cups of vegetables each day)? As they say, “How’s that working for ya?”

The 2010 guidelines for the first time recommended a 1500 mg sodium limit for those over 50-years-old, those who are African-American or who have existing chronic conditions like hypertension or diabetes [19]. This new point is in addition to the traditional 2300 mg limit suggested for the general population. The 2010 version also took out the 2005 language about “discretionary calories” and recommended limiting refined grains (PDF [20]).

Why Do These Guidelines Matter?

When the initial focus of government efforts was expanding federal food assistance programming, a major interest was setting standards for these programs—what foods would be covered by food stamps and the WIC program or what standards would be used for subsidized school lunch programs.

Yet, their impact is broader than public funding or institutional benchmarks. Government issued guidelines establish a cultural norm [21], an anticipated standard. Whether they reflect the latest and most trustworthy scientific standards (they don’t), the majority of the public will view these guidelines as the most authoritative source for nutritional information. And this is where it gets tricky.

It’s clear industry forces (e.g. Big Ag) as well as institutional inertia (e.g. Can the rest of the country ever let go of the old fat fallacy, please?) have a seat at the table when it’s time to establish the latest round of nutrition recommendations, and I’ll go out on a limb and say this shouldn’t make anyone comfortable. The 2015 guidelines are in the works [1], and already the process is a loaded political subject. I’ll say it makes me feel that much better that my dietary choices are based on something a little more established [22] than the result of political and financial wrangling.

How much the government should be involved in the actual creation of food guidelines is probably a topic for another post if not another blog altogether…. Nonetheless, if this has you fired up (or you’ve been fired up on this issue for a while), there’s a petition [23] you might check out “demanding that quality science determine the 2015 U.S. dietary guidelines.” There’s an interesting thought at least….

I’d be remiss if I didn’t mention that if any of this interests you, there’s a fantastic book my company published called Death by Food Pyramid. In it author Denise Minger exposes how shoddy science, sketchy politics and shady special interests have shaped American dietary recommendations—and the impact this has had on the health of Americans. She does this with much more wit, humor and knowledge about this topic than I’ve showcased here in this short blog post. I highly recommend it. Lucky you, you can claim a free digital copy of Death by Food Pyramid for a limited-time. Learn all the details here [24].

Thanks for reading today, everyone. I’d love to hear your thoughts on these government issued guidelines and their shifts in some areas (and inertia in many others) over time. Have a great end to your week.

Prefer listening to reading? Get an audio recording of this blog post, and subscribe to the Primal Blueprint Podcast on iTunes for instant access to all past, present and future episodes here [25].