Time to Stop Following the Guidelines?

Changes are coming. You can definitely tell that from the new administration in Washington.

One potential change I would love to see is a drastic update of the US Department of Agriculture’s (USDA) dietary guidelines.

From my time with manufacturing companies, I learned that the way to solve a problem is to drill down to the root cause and fix that. Then the problem doesn’t come back again. That’s something modern medicine is not a big fan of doing.

I certainly believe the root cause of most of our chronic disease is the diet Americans eat. The current USDA ‘food pyramid’ or guidelines for Americans have been in place since the 1970’s.

Coincidentally, the rates of obesity and chronic disease have been on an upward trajectory since the 1970’s.

These rates continue to increase despite people exercising more than ever and adopting healthier lifestyles such as reducing the rates of smoking cigarettes.

It’s not just in America. An ER physician in India collected data on 7,000 diabetic patients. The results showed 66% of them were vegetarian. All of the rest only ate meat a couple of times a month.

Indians eat very close to the USDA dietary guidelines.

Yet nutritionists still defend the guidelines and keep pushing them. What’s the definition of insanity again?

A new paper has just come out in the American Journal of Clinical Nutrition that says the studies supporting the USDA guidelines cannot be replicated.

Say what? Cannot be replicated? Isn’t that the basis for any scientific conclusion or theory? It says the systematic reviews (SRs) are “suboptimal” and are “critically low quality”.

The researchers documented other discrepancies in the systematic reviews:

  • The USDA did not conduct quantitative meta-analyses, having decided a priori to do “narrative” reviews, which are considered less rigorous and far less reliable.

  • The protocols were not pre-registered with an independent group (e.g., Open Science Framework), a “best practice” that “is associated with significantly higher SR methodological quality and reporting transparency.”

  • The SR process lacked transparency; the USDA team did “not appear to use…open materials, open data, open code, or open peer review.”

  • The USDA team neglected to use or complete the standard checklists (“PRISMA,” “AMSTAR,” and “SWiM”) required of all high-quality SRs to ensure rigor and transparency.

The authors of the paper did note that the SRs met 12 other methodological criteria, including no evidence of “spin bias”.

That last link came from Nina Teicholz’s substack. Nina is a nutritionist who very much believes that the low carb lifestyle should be the basis of the USDA ‘food pyramid’. I met her when I attended the MAHA event in Washington DC. She has a very good chance of changing the food pyramid if she is hired by Robert F Kennedy Jr.

It won’t be easy. Every time I have an obese resident come to us, the hospital or rehab center sends us paperwork telling us to feed them what the USDA current guidelines state. I have a feeling many medical establishments won’t want to change.

Yet the results speak for themselves. When I put these residents on a low carb diet, their weight loss is dramatic. They come to us because in many cases they were following the current food pyramid - even if it is somewhat loosely. And they were not seeing any significant results.

I think we have discovered the root cause of a lot of Americans ill health. Will we have the dedication to fix it at the root cause level?