From Medscape Medical News
March 10, 2011 — A nonprofit physicians organization came out hard against updated dietary guidelines recently issued by the US Department of Agriculture (UDSA), suing the government to force the USDA to change its recommendations.
The Physicians Committee for Responsible Medicine (PCRM) alleges that the USDA knowingly hides harmful foods behind obscure language in the report.
The guidelines are published jointly every 5 years by the USDA and the US Department of Health and Human Services and are supposed to represent the most current and sound scientific information available. The dietary guidelines are the blueprint for all federal nutrition programs, including school meals.
However, PCRM says in its lawsuit, rather than giving Americans nutritional advice that would help them fight obesity, the government instead bowed to conflicts of interest with agribusiness and blurred the message about foods Americans should eat less of.
PCRM President Neal Barnard, MD, was clear in his criticism of the USDA. “The dietary guidelines are the best they’ve ever been, but we’re pushing to make them better,” he said in an interview with Medscape Medical News.
“It’s critically important yet fundamentally dishonest when they have an explicit message of what foods to eat more of, but when it comes to foods to eat less of, they hide behind biochemical codes,” he said. “It’s intentional. And it doesn’t help the school nutritionist designing school lunch menus or a food planner in a rural town.”
The physicians’ committee, which says it represents more than 10,000 physicians and 100,000 other healthcare professionals, is a nonprofit public health organization advocating preventive medicine through proper nutrition. It took particular aim at the familiar food pyramid diagram.
The USDA’s MyPyramid diagram is ineffective and confusing to the general public, says the PCRM lawsuit. The physicians say it conveys abstract messages that must be translated into concrete food choices with a computer program that is not available to Americans who do not have access to a computer.
Dr. Barnard explained his organization’s opposition: “Last March we petitioned them to scrap the food pyramid. In 2005 they took away food groupings and just made it colored stripes, which is completely useless to the population the food pyramid is designed to teach: disadvantaged Americans who have no way of decoding the pyramid. It became totally useless.”
The PCRM argues that “there is no scientific basis for including meat or dairy groups in dietary guidance material” because people who avoid those foods have lower rates of diabetes, cancer, and cardiovascular disease.
Foods to Avoid Not Named
The dietary guidelines specify foods to eat more often such as fruits and vegetables, but when it comes to foods to eat less often, such as meat and cheese, the guidelines use “biochemical terms unfamiliar to the general public,” says the lawsuit. The PCRM finds it nonsensical that the guidelines call for limiting cholesterol, saturated fats, and solid fats “without clearly explaining that meat, dairy products and eggs are the only sources of cholesterol in the diet.”
Within the lawsuit petition, the PCRM reports that at the press conference for the release of the guidelines, Marian Burros, a journalist with Politico, asked defendant Secretary of Agriculture Tom Vilsack, “Why do you call it solid fat, instead of porterhouse steak? Or why do you call it solid fat, and then…the guidelines on dairy include cheese?”
Vilsack’s answer was vague, alleges the lawsuit: “Vilsack admitted that the dietary guidelines ‘essentially’ have a ‘way’ of listing foods that one should avoid, by ‘suggesting other foods.’ ”
PCRM Nutrition Education Director Susan Levin, MS, RD, addressed what the organization feels is Vilsack’s doublespeak: “Americans need straightforward health advice, not bureaucratic mumbo jumbo designed to protect agribusiness.”
Arthur Caplan, PhD, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia, agrees with the intent of the lawsuit, saying he does not know whether the USDA’s confusing language is purposeful, “but informed consent for consumers demands easy to understand, simple, straightforward language — that is not what it should be in this set of guidelines. The lawsuit seems to me,” he continued, “to be correct in demanding clearer language and less technical and food insider talk.”
The USDA did not respond to the PCRM’s written comments to the proposed dietary guidelines, so when the final recommendations were published at the end of January, Dr. Barnard felt his group had no choice but to file their lawsuit.
“We filed the lawsuit as our way of saying, ‘You will listen to us; the court will make you listen,’ ” said Dr. Barnard. “Our lawsuit guarantees that we will have their attention. We’re finally saying, enough is enough.”
The PCRM’s lawsuit also notches up its war against the USDA by alleging conflicts of interest. The lawsuit argues that the dietary guidelines are meant to be read by the general public, not scientists, yet it uses “inconsistent language, ambiguous phrases and biochemical terminology to avoid providing clear dietary information due to Defendants’ conflicts of interest.”
Those conflicts of interest include the Secretary of Agriculture’s statutory duty to foster “new or expanded markets” and to move “larger quantities of agricultural products through the private marketing system to consumers.” In addition, the lawsuit points to the fact that advisory committee members for the dietary guidelines have ties to meat and dairy food product industries, such as Dannon, Kraft Foods, and MacDonald’s Corp, which creates direct conflicts of interest.
“The Secretary of Agriculture has an impossible job when it comes to health,” said Dr. Barnard, “because his job is simply to make agribusiness richer.”
Dr. Caplan believes the USDA has a broader mandate, but that they are focused on a narrow part of their statutory authority. “The mandate to promote agriculture is the one that has dominated American government food policy forever, and that mandate often trumps health worries,” he told Medscape Medical News.
The PCRM wants a trial court to send its lawsuit to a full jury trial to declare that the defendants have violated the Administrative Procedure section of the US Code by issuing dietary guidelines not based on the preponderance of the medical knowledge, and to order defendants to withdraw portions of the dietary guidelines. The group also wants the USDA to rewrite and reissue the official dietary guidelines based on proper medical knowledge. That medical knowledge, according the PCRM, would specifically mention meat and dairy products as a major source of saturated fat in Americans’ diets.
It particularly galls the PCRM that although dairy products account for more than 30% of the saturated fat in the American diet, the guidelines disguise this fact by splitting dairy products into many categories, including cheese (8.5%), butter (2.9%), whole milk (3.4%), reduced-fat milk (3.9%), dairy desserts (5.6%), and pizza (5.9%), so that dairy products’ contribution to the diet is harder to see.
“Look, in 5 years, when the next dietary guidelines are written,” said Dr. Barnard, “diabetes will be the worst it’s ever been, obesity will be worse, if that’s even possible, and the government treats all this as if it doesn’t matter. In 2010, $128 billion was spent on diabetes treatment alone. Every state is having budget troubles. Is that because they spent too much on school buses? No, it’s healthcare. As a doctor, I can’t fathom why it isn’t taken seriously.”
When contacted by Medscape Medical News, a spokesman for the USDA, John Webster, replied: “Since this is now in litigation, we have no comment.”
Dr. Caplan thinks the USDA is ignoring its responsibility to the public by refusing to comment. “I think the criticisms merit a serious response,” he said.