By Gary C. Smith, Colorado State University
The Historic Shift in Nutritional Guidelines
It’s hard to overstate what a radical departure from the government’s stand on nutrition the Dietary Guidelines For Americans (DGFA) represented when it came out in 1980; since 1956, USDA had been advising people to eat a well-balanced diet of four groups:
- Milk
- Meat
- Fruits & vegetables
- Cereals & grains1
Having dietary guidelines represented the first time the public had been advised to eat less of something rather than enough of everything.1 Prescribed to the public by the American Heart Association (AHA) since 1961 to fight heart disease, then adopted by USDA in 1980 as the official dietary plan for all men, women, and children, DGFA has been terrible for health in every way as evidenced by skyrocketing rates of obesity and failure to conquer heart disease.1
What Did the American Heart Association Recommend?
American Heart Association’s 1961 guidance recommended that the diet consist of…
- 30% of calories from overall fat.
- No more than 10% of calories from saturated fat.
- 55 to 60% of calories from carbohydrates2 (sugar is a “refined carbohydrate”).
It was revised in 1970 to add the statement, “To control fat intake, increase refined-carbohydrate consumption by choosing snacks from other food groups such as low-fat cookies, low-fat crackers, unsalted pretzels, hard candy, gum drops, sugar, syrup, honey, jam, jelly and marmalade”.3 In short, to avoid fat, people should eat sugar, the AHA advised.1
By 2020, Americans were getting 70% of their calories from plant-based foods and 30% from animal-based foods; 81% of their calories came from ultra-processed foods (i.e., those containing added sugars, fat, hydrogenated vegetable oils, and refined carbohydrates.)4
Did Dietary Guidelines Really Promote Health?
For a quarter-century (1970 until 1995), people seeking to be health-conscious by reducing fat consumption plowed their way through mega-tons of industry-generated bags of “Non-Fat” or “Low-Fat” salty, sugary, or crunchy products full of refined carbohydrates instead.5 AHA and DGFA clearly steered Americans – and the food industry – toward exactly that solution, and AHA rode the profit wave by charging a hefty fee for putting the AHA’s “Heart Healthy” check mark on dubious candidates such as Kellogg’s Frosted Flakes®.6
Contesting Theories: Keys vs. Yudkin
The premise and concept of having national dietary guidelines was predicated on the “Diet-Heart Hypothesis” in Ancel Keys’ “6-Countries Study”, which indicted the fat content of food as the cause of heart disease.7 Two scientists (believing that Keys had cherry-picked the six counties) added data from 16 more countries and conducted a “22-Countries Study” of the hypothesis.8 Their study revealed that other factors (e.g., the number of cars sold per capita, number of cigarettes sold, consumption of protein, consumption of sugar – all of which were measures of personal wealth) could equally explain the trends in heart disease in all these countries – but showed no correlation with heart disease when countries beyond Key’s original six were added.8
Keys Counters with a “7-Countries Study”
Keys, incensed by the results of the “22-Countries Study”, then initiated the now famous “7-Countries Study” to prove that fat consumption was the culprit and sugar consumption was not. From 1957 to 1970, Keys jousted with John Yudkin; Yudkin thought excess sugar consumption was the most likely cause of obesity and heart disease.9 Keys spent most of his time from the late 1950s to the early 1970s defaming Yudkin and making sure the “7-Countries Study” supported his Diet-Heart Hypothesis.1,10 As the research leaders from the seven countries met to discuss the conclusion of that study, Keys was aggressively disparaging of any hypothesis other than his own, and never allowed them to properly discuss sugar as a cause of heart disease.1
Italian Researcher Finds Correlation Between Sweets & Coronary Mortality
The results of the “7-Countries Study” were released in 1970 and claimed to demonstrate a strong correlation between the consumption of saturated fat and deaths from heart disease when the seven countries were compared to each other; but, within countries, the correlation between saturated fat and heart disease was not different from zero.11
Fourteen years later (in 1984), Keys followed up with these populations in all seven countries; by then, the consumption of saturated fat could no longer explain differences in heart disease rate at all – among or within countries.12
Twenty-nine years later (1994), an Italian researcher re-analyzed the raw data from the “7-Countries Study” and found that the category of foods that best correlated (r=0.821, or 82%) with coronary morality was “sweets” (i.e., sugar products and pastries).13
How Has Sugar’s Role Been Downplayed?
Why (and how) has Yudkin’s “Sugar-Obesity-Heart Hypothesis”9 been so cleverly covered-up?:
- Yudkin’s evidence was excoriated by Ancel Keys, Key’s followers, and the World Sugar Research Organization.14
- A reduction in sugar consumption was advised in the first draft of the 1977 Senate Select Committee on Nutrition and Human Needs national diet policy but it mysteriously disappeared after lobbyists from the Nutrition Foundation (funded by “Big Food” manufacturers like General Foods™, Quaker Oats™, Heinz™, National Biscuit Company™, etc.) intervened.15
- It re-appeared – as “Americans should reduce total fat, saturated fat, dietary cholesterol, sugar, and salt” – when the U.S. Congress published “Dietary Goals for the United States”.16
- The phrase “Americans should reduce sugar consumption” remained in “Dietary Goals For Americans” when it was released by USDA in 1980 because the U.S. Congress had approved it as a part of “Dietary Goals for the United States”.16,17
The Evolution of the USDA’s Dietary Recommendations
Eventually, the DGFA became the basis for the USDA Food Pyramid, which has morphed into the USDA MyPlate in recent years.1 In 1992, using the Egyptian Great Pyramid’s triangulation, USDA subdivided one face of their “Food Pyramid” according to the proportions of each of six “food groups” that DGFA says people should eat.18 At the tip of the triangle (i.e., at its pinnacle), with the warning “Use Sparingly”, is the “Fats, Oils, & Sweets” food group; nearby, in a side panel, it calls out “added sugars” as being problematic.18
The 2020-2025 DGFA did not contain the USDA Food Pyramid and replaced it with a diagrammatic called MyPlate.gov. That infographic consists of a dinner fork, a large circle, and a small circle. The large circle represents a dinner plate and is divided into four parts (Fruits, Grains, Vegetables, and Protein); the small circle represents a coaster and says “Dairy”.19
Sugar Consumption Over the Years: A Brief Overview
For 40 years, the Food Pyramid was taught to students in public schools and universities as well as those in the healthcare community with emphasis on a four-tiered “consumer advice” categorization: Eat Less, Eat Moderately, Eat More, Eat Most.20 “Sweets” were in the “Eat Less” tier. That didn’t work. By the end of the 20th century, the American food industry was providing more that 150 pounds of sugar per capita.21
Where Did the 2020-2025 DGFA Land on Sugar?
Between 1980 and 2020, DGFA tinkered with phraseology, changing its admonition to consumers from “should reduce sugar consumption”17, to “should limit calories from added sugars”22, to “should be encouraged to consume less than 10% of calories per day from added sugars”23. When the 2020-2025 DGFA Advisory Committee made its recommendations to the USDA and USDHHS on July 15, 2020, it included a key change: “We recommend 6% (down from 10%) of a person’s calories should come from added sugars”; but when DGFA 2020-2025 was released it said “less than 10%” (not 6%).24 That’s evidence of meddling by the Deep State and/or lobbyists (by Big Sugar, Big Food, NIH, or AHA).25,26
John Staunton says, “It’s amazing that people still pay attention to all the news about foods, given that nutritionists have changed their opinions on virtually every bit of eating advice they have given us over the years – look at what’s happened to advice about cholesterol, and fats, and sodium.”27 Nina Teicholz blames food companies that corrupted nutrition recommendations toward their profit-driven ends, and blames nutrition scientists who over-interpreted weak science to become dietary dogma.1 And, that is undoubtedly the reason that DGFA has relentlessly refused to consider any evidence that contradicts the last 35 years of nutritional advice.28
To be fair, though, DGFA – from the beginning – has warned against consuming too many sweets and too much sugar. DGFA 2020-2025 states, “A healthy dietary pattern doesn’t have much room for extra added sugars…foods and beverages high in this component should be limited.17 Limits are:
- Less than 10% of calories per day starting at age 2.
- Avoid foods and beverages with added sugars for those younger than age 2.
- Avoid feeding sugars to infants so they might not crave it as they grow older.17, 18
Is the Food Industry Sending Mixed Messages?
On the other hand, there is evidence of ambivalence, mixed-messaging, end-runs, and work-arounds to placate manufacturers of sweets and sugary foods/beverages. FDA, USDA, and AHA send mixed messages to consumers inasmuch as they have policies that warn against consuming too many sweets, too much sugar, and/or too much refined carbohydrates, yet will allow front-of-package marketing claims of “Healthy” or “Heart-Healthy®” on products that clearly do not meet the nutritional standards of their policies.29,30,31,32
Even that may not be enough as the food industry appears to be rallying around government approval of the Nutrient Profiling System (i.e., Food Compass Scores), which creates a new “Healthfulness” scale and a new Food Pyramid.33,34,35,36,37
Evidence Against High-Carbohydrate Diets
For 60 years, there has been ample evidence that high-carbohydrate diets and sugary foods/beverages were the most plausible explanations for all or some of obesity, stroke, heart disease, and cancer.1,2 Between 1961 and 2001, four scientific reports concluded that high-carbohydrate diets were more plausible explanations for heart disease than were total fat, saturated fat, or cholesterol.9,14,38,39 Sugar (natural and/or added), white flour, and other refined carbohydrates are almost certainly the main drivers of obesity, cancer, heart disease, and diabetes.1,40
Population-specific data from 175 countries/territories were used to explore correlations between life expectancy and intakes of meat vs. carbohydrate crops; meat intake was positively associated with life expectancy while carbohydrate-crop intake was negatively related to life expectancy.41 Promotion of near-vegetarianism, via low-fat/high-carb dietary guidance, will most likely result in shortened life expectancy because people will likely be more susceptible to chronic illnesses.42 The EAT-Lancet Committee on Food, Planet, Health report concluded that the world must move to a daily dietary target, which will require consumption of sugars to decrease by 50%.43
What Does Modern Research Indicate About Sugar?
Harvard University studied 75,000 women and 44,000 men and reported in JAMA Internal Medicine that people could reduce their risk of early death nearly 20% by sticking to the tenets of their dietary plan and only if the plan complies with the mandates (including “less than 10% of calories from added sugars”) of the DGFA.44
A National Institutes of Health study published in Circulation demonstrated that cutting 20% of sugar from packaged foods and 40% from beverages could prevent…
- 2.48 million cardiovascular disease events such as strokes, heart attacks, and cardiac events.
- 490,000 cardiovascular deaths.
- 750,000 diabetes cases in the United States over the lifetime of the current adult population.45
A research study conducted in the United Kingdom followed more than 110,000 people’s health for nine years and have reported that the more “added sugar” a person ate, the higher was their risk of heart disease and stroke.46 Called “free sugar” or “added sugar”, the culprit is found most often in sugared soda drinks, pastries, sweet snacks, breakfast cereals, honey, fruit juices, and candy.46
A review of 73 meta-analyses, which included 8,601 research studies, revealed that high consumption of “added sugar” was associated with significantly higher risks of 45 negative health outcomes, including diabetes, gout, obesity, high blood pressure, heart attack, stroke, cancer, asthma, tooth decay, depression, and early death.47, 48
The Big Picture: Metabolic Syndrome & Sugar’s Impact
History tells us that obesity, diabetes, heart disease, and other chronic ailments are interconnected. Known today as the “metabolic syndrome”, this constellation of chronic medical problems used to be called the “obesity sextette”, the “Western diseases”, the “disease of civilization” or – in the early 1900s as sugar swept across the English colonies – the “saccharine diseases”.1
Food Safety Net Services offers nutritional analysis for foods and beverages to measure the content of sugar and other compounds.
References:
1 Teicholz, Nina. 2014. The Big Fat Surprise. Simon & Schuster. New York NY.
2 Taubes, Gary. 2001. Science 291: 2536-2545.
3 American Heart Association. 1995. An Eating Plan For Healthy Americans. Dallas TX.
4 Layman, Don. 2020. Purdue University. July 15 Issue.
5 Baum et al. 2012. Journal of Clinical Lipidology 6: 216-234.
6 Rothstein et al. 2003. Rochester Studies In Medical History. University of Rochester Press.
7 Keys, Ancel. 1956. Journal of Chronic Disease 4: 364-380.
8 Yerushalmy, J. and H. Hilleboe. 1957. New York State Journal of Medicine 57: 2343-2354.
9 Yudkin, John. 1972. Pure, White, And Deadly. Penguin. New York NY.
10 Keys, Ancel. 1971. Atherosclerosis. 14: 193-202.
11 Keys, Ancel. 1970. Circulation 41 and 42, AHA Monograph 29: 1-211
12 Keys, et al. 1984. Preventive Medicine 13: 141-154.
13 Menotti et al. 1999. European Journal of Epidemiology 15: 507-515.
14 Leslie, Ian. 2016. The Guardian. April 7 Issue.
15 Mottern, Nick. 2009. Interview with Nina Teicholz. March 25 Issue.
16 Seiz, Keith. 1977. US Government Printing Office. Washington DC.
17 USDA-USDHHS. 1980. Dietary Guidelines For Americans. Washington DC.
18 Smith, Gary. 2023. Colorado State University. July 22 Issue.
19 USDA. 2023. MyPlate.gov. Accessed on May 13, 2023.
20 Eliason, Nat. 2019. Health. April 22 Issue.
21 USDA. 2003. Agricultural Fact Book 2001-2022. Washington DC.
22 McNeill, Shalene. 2016. The Beef Checkoff. February Edition.
23 Gabbett, Rita. 2016. Meatingplace. January 7 Issue.
24 Fusaro, Dave. 2020. Food Processing. August Edition.
25 Teicholz, Nina. 2022. Meatingplace. October 28 Issue.
26 Dittmer, Steve. 2020. AFF Sentinel. August 12 Issue.
27 Stanton, John. 2018. Food Processing. June Edition.
28 Teicholz, Nina. 2015. British Medical Journal. September 23 Issue.
29 Stevens, S. and E. Presnell. 2022. Food Quality & Safety. May Edition.
30 Food Processing. 2020. April Edition.
31 Scott, Chris. 2022. Meatingplace. September 7 Issue.
32 Front-of-package statement. 2023. Great Value® Extra-Raisin Bran. Accessed on June 15, 2023.
33 Carlson, Paige. 2022. Drovers. August 10 Issue.
34 Mozaffarian et al. 2021. Nature Food 2: 809-818.
35 Teicholz, Nina. 2021. Nutrition Coalition. November 29 Issue.
36 Mares, Justin. 2023. Fox News. January 4 Issue.
37 Karst, Tom. 2021. The Packer. November 28 Issue.
38 Ahrens et al. 1961. Transactions of the Association of American Physicians 74: 134-146.
39 Albrick, Margaret. 1962. Archives of Internal Medicine 109: 345-359.
40 Taubes, Gary. 2007. Good Calories, Bad Calories. Alfred A. Knopf. New York NY.
41 You et al. 2022. International Journal of General Medicine 15: 1833-1851.
42 de Lazaro, Enrico. 2002. Science News. February 22 Issue.
43 Muirhead, Sarah. 2019. Feedstuffs. January 16 Issue.
44 LaMotte, Sandee. 2023. CNN. January 9 Issue.
45 Shangguan et al. 2021. Circulation. September Edition.
46 Processed Foods. 2023. AG-WEB. February 15 Issue.
47 Rogers, Kristen. 2023. CNN. April 5 Issue.
48 Huang et al. 2023. British Medical Journal 381: e071609.
