New U.S. Dietary Recommendations to Correct Misunderstanding about Cholesterol, Not Fat

Thomas Jefferson once said, “If people let the government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny.” On this issue, TJ seems to have hit the nail on the head.

Since Uncle Sam started telling us what to eat, Americans have steadily grown less healthy in many ways. In the 1970s, we were told to eat less meat and more grains. We listened, but it did little to curtail the oncoming obesity “epidemic” (some claim government recommendations may have actually caused this epidemic). And for decades, we have been told to restrict our consumption of cholesterol in order to reduce our risk of cardiovascular disease. That is, until now. The new dietary guidelines will no longer recommend restrictions on cholesterol consumption. This is a great first step, but the best advice is to stop listening to government nutritional advice.

For many people, this will seem like an abrupt about-face after 50 years of lectures about cholesterol. But for those in the medical research field, the shift is long overdue. During the last decade, it has become increasingly clear that there is no real evidence linking dietary cholesterol and blood serum cholesterol (which is used as a stand-in for CVD risk). While many physicians are still wedded to the idea that their patients at risk for cardiovascular disease should limit their egg consumption, it sounds like the Dietary Guidelines Advisory Committee—a joint effort of HHS and USDA—has finally come to grips with the evidence. Unfortunately, the real lesson remains unlearned: the U.S. government shouldn’t be the authority on what is or isn’t a healthy diet.

The DGAC, which consists of “nationally recognized experts,” meets every five years to review medical literature and hash out recommendations for what a healthy diet should look like. Their report to the secretaries ultimately becomes the official Dietary Guidelines for Americans, which is used by policy makers as a guideline in federally administered nutritional programs and assistance. Unfortunately, it sounds like they will still cling to their increasingly suspect beliefs about saturated fat.

Like cholesterol before it, the last decade of research on saturated fat has cast doubt on its link to cardiovascular disease. In a British Medical Journal article published last May, Aseem Malhotra, an interventional cardiology specialist, said that government obsession with reducing total cholesterol has led to millions of people being overmedicated with statins, a class of drugs that do reduce blood serum cholesterol, but don’t seem to reduce mortality and can have severe side effects. Several meta-analyses on the effect saturated fat may have on coronary disease risk found no significant link. 

Yet, physicians and public health advocates are gun-shy about giving people the freedom to eat as much or little of the so-called “bad” fat. At Harvard’s School of Public Health, researchers still classify saturated fats as “bad,” but do note the growing body of research demonstrates that “[c]utting back on saturated fat will likely have no benefit, however, if people replace saturated fat with refined carbohydrates—white bread, white rice, mashed potatoes, sugary drinks, and the like. Eating refined carbs in place of saturated fat does lower ‘bad’ LDL cholesterol—but it also lowers the ‘good’ HDL cholesterol and increases triglycerides.”

 Of course, this is exactly what people do when they try to reduce their consumption of fat; they generally end up consuming more sugar and carbohydrates (but they’re fat free!). According to Harvard, “[c]utting back on saturated fat can be good for health if people replace saturated fat with good fats, especially, polyunsaturated fats.” Throwing another wrench in this debate is the fact that, one of the meta-analyses that found no link between saturated fat and cardiovascular risk, also found no link between consuming polyunsaturated fats—the so-called “good fats”—and a cardioprotective effect.

What does all this tell us? Simply, human nutrition is an extraordinarily complex field of research and that a committee of bureaucrats isn’t great at determining the best dietary composition. Certainly, government working with research scientists can help disseminate new information about nutrition and health as it is discovered, but its current policy of creating one-size-fits-all diet based on popular beliefs about nutrition is clearly not working. Perhaps it’s time we take responsibility for our own health instead of letting the government tell us what we should or shouldn’t eat.