More on Diet and Carbohydrates

I tried to respond to your request for examples by pointing out that no claim had been made regarding what you were requesting examples for. The specific exchange: In other words, you evidently thought we were claiming that McDonald's had added low-fat/high-carb items to their menu in response to customer requests, and so you asked for examples. But that was not a claim that was being made, so it would make no sense to seek out examples. I do believe instances exist where companies have responded to explicit customer requests, but I don't think it's a primary avenue of change. I think the primary avenue is via marketing research, which takes a wide variety of forms, including canvasing customers.What I tried to do was describe what I think really happens, namely that members of the highly competitive food industry attempt to remain sensitive and responsive to public perceptions of dietary health lest it become a competitive issue that negatively affects them. If you want an example of this happening, I think Coyote's example of McDonald's eventually adding salads to its menus is a good example, but if what you require for evidence is internal marketing memos then clearly we cannot provide them. But obviously it was a competitive issue, because if I recall correctly, McDonald's, Burger King and Wendy's all added salads to their menus within a year or two of each other, at least in our area. I agree that the fast food industry was one of the last to jump on the low-fat bandwagon. Given the industry it doesn't surprise me.--Percy

Yes, I know, I'm well aware.You seem to think I'm being inconsistent and sending conflicting messages, so let me see if I can clarify.It only became necessary to clarify that the blame is actually distributed when you focused on my references to the government as knee-jerk "blame the government" complaining. Since you've raised that complaint I've been much more clear that the blame should be distributed, but I do believe the blame begins with the government because the guidelines they issued lent legitimacy to the science and to the advice from health organizations and the diet advice community. I explained this back in Message 61. My link to the 1980 guidelines was incorrect. It turned out to be a link to the 1990 guidelines. I apologized for the error. I don't know what more you want.But the 1980 guidelines were even more damning because they contained this gem: Yes, that's true, but the message about whole grains isn't the message that got across. The message that was much more effectively communicated was "fats bad, carbohydrates good". Remember, the advice we're talking about isn't a government brochure that most people didn't read. It's the advice from a multiplicity of sources as it was perceived by the public. What most people remember from the government is the food pyramid, it's base filled with high carbohydrate foods: Well, who am I to stand in the way of such determination. I'll close with a quote from Nina Teicholz's introduction to her book:

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Now, in 2014, a growing number of experts has begun to acknowledge the reality that making the low-fat diet the centerpiece of nutritional advice for six decades has very likely been a bad idea.

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--Percy

You're talking about the 1990 guidelines. Yes, I missed the reference to whole grained breads. Well, don't forget that the guidelines also advised reducing fat intake. Let me put the advice to reduce fat intake from page 9 together with the advice I quoted earlier from page 10 about increasing carbohydrate intake: And that in a nutshell is the government advice to reduce fat intake and increase carbohydrate intake. I think if you explain how what you think Teicholz is saying differs from what I'm saying it will help me understand where you're coming from a great deal. Why do you think she calls the nutritional advice a bad idea? Don't you understand that it's because it was bad for health? Here's Teicholz's previous paragraph, again from The Big Fat Surprise: Back to you: That's not a point of contention because it's not something anyone claimed. It's just something you're making up. The actual claim is that the bad nutrition advice played a significant role in the increases in obesity, diabetes and heart disease. Well, yes it is getting crazier as you make up more and more stuff. I still don't understand why you can't see how different what you claim I'm saying is from what I'm actually saying.--Percy

Well, first when you say "no one" followed the guidelines, even your own citation disagrees with you. And it's been explained that your criteria for "following the guidelines" are absurd. You classify anything short of 100% compliance as not following the guidelines. By your criteria, since most people roll through stop signs when they can, no one's following the traffic laws in America.Your own source reinforces what I've been saying about America's drive to decrease fat consumption, and about the increase in low fat options in grocery stores:

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"Profiling Food Consumption in America" (PDF) from USDA Factbook:

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Americans’ mid-1990s push to cut dietary fat is apparent in the recent per capita food supply data, which show a modest (8 percent) decline in the use of added fats and oils between 1993 and 1997, from 69 pounds (fat-content basis) per person to just under 64 pounds. As a result of consumer concerns about fat and mandatory nutrition labeling beginning in July 1994, food processors introduced over 5,400 lower fat versions of foods in U.S. supermarkets in 1995—97, according to New Product News, a trade magazine based in Albuquerque, NM.

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And while consumers may be failing to meet some guidelines, they were apparently successfully meeting other guidelines, like the now defunct food pyramid I mentioned earlier, described here, again by your own source, ironically from the same page you've been quoting from:

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"Profiling Food Consumption in America" (PDF) from USDA Factbook:

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Many consumers’ diets now meet or exceed the Food Guide Pyramid serving recommendation for grain products. The Pyramid recommends 9 daily servings of grain products for a 2,200-calorie diet, 6 servings for a 1,600-calorie diet, and 11 servings for a 2,800-calorie diet. The food supply, adjusted for waste in the home and throughout the marketing system, provided an average of 10 daily servings of grain in 2000. This is an underestimate.

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This can be a complicated issue. You can't just pull out a few facts, make up your own rules, then leap to conclusions.--Percy

The key question before the nation more than a half century ago was the mystery of what was causing the dramatic increases in obesity, diabetes and heart disease. The answer was too much fat in the diet, and the advice was to reduce fat intake and increase carbohydrate intake. Both the answer and the advice turned out to be wrong, and as a result rates of obesity, diabetes and heart disease continued at high levels or even increased.The problem with the guidelines and dietary advice was that it made fat the bugaboo and pushed people toward higher consumption of carbohydrates. Had carbohydrates been made the bugaboo then the obesity/diabetes/heart-disease epidemic would have been averted. The point of the salad example was to show how the food industry responds to customer demand. The demand for more healthy offerings came from people who had been influenced by advice about diet, particularly fat. Without the scientific research and statistics distilled for public consumption by the government, health organizations and the diet advice community the public would never have become aware of either the problem or the proposed solution. The public concern about fat was coincident with the guidelines expressing concerns about fat because the public concern was a reaction to them. No, not way behind. I believe the fast food industry began offering salads in the 1990s, the period during which the food industry responded most strongly to demand for low fat foods. No one's making claims here that "people with proper caloric intakes got fat or sick," though that is certainly possible. The problem is that nutrition advice warned against fat instead of against carbohydrates, the real danger. The more carbohydrates consumed, particularly refined carbohydrates, the more one experiences glucose spikes (forces cells toward metabolic syndrome, strains pancreas, eventual result can be obesity and diabetes), the higher one's triglyceride levels and the worse one's LDL/HDL ratios (related to heart disease). But I do think it's important to show that people actually followed the advice. That's why I provided the charts showing increased carbohydrate consumption relative to fat, and described the history of the food industry responding to the public's demand for more low-fat offerings. More evidence than that would require actually getting into people's heads.--Percy

From the USDA Healthy Eating Index Webpage:

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The Healthy Eating Index (HEI) is a measure of diet quality that assesses conformance to federal dietary guidance. USDA’s primary use of the HEI is to monitor the diet quality of the U.S. population and the low-income subpopulation. For this purpose the Center for Nutrition Policy and Promotion (CNPP) uses the data collected via 24-hour recalls of dietary intake in national surveys. The HEI is also used to examine relationships between diet and health-related outcomes and between diet cost and diet quality, to determine the effectiveness of nutrition intervention programs, and to assess the quality of food assistance packages, menus, and the US food supply. The HEI is a scoring metric that can be applied to any defined set of foods, such as previously-collected dietary data, a defined menu, or a market basket.

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Here is a laymen friendly version of the index provided by Nielsen that I think is based upon their own polls or data gathering techniques rather than the actual HEI, but it gives a flavor for what can be learned (source): Their description:

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The chart below shows the seasonal nature of healthy eating habits across the U.S. You’ll notice that every year, consumers make unhealthy food choices over the holidays. Then in January, diets get back on track and healthy eating is a priority again. Another observation is that January seems to set the tone for healthy eating throughout the year. The month of September (back-to-school) is another time when Americans tend to make healthier food decisions.

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HEI is an area of ongoing research, and other measures have been proposed.--Percy

The information was mostly for Jon, but I thought it might be of interest to everyone so I didn't address that message to anyone in particular. The information about the Healthy Eating Index Webpage was meant to rebut his claim that one either adheres to nutrition guidelines or one doesn't, that there is no in between. But the Healthy Eating Index measures precisely what Jon claims can't be measured beyond a "yes or no" assessment, and I presented an example with the Healthy Eating Index from Nielsen: This shows that compliance with nutritional goals varies over time and is not an all or nothing proposition. But very little in this world *is* an all or nothing proposition, and I'm a bit amazed this has to be explained.But it looks like you clicked on links that eventually took you to the 2010 USDA Dietary Guidelines, so let's discuss that. Here I collect the various points with specific advice about dietary fat:

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• Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids.
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• Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats.
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• Reduce the intake of calories from solid fats and added sugars.
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• Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages.
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• Replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oils.
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• Use oils to replace solid fats where possible.

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Some of this advice is absurdly detailed. While some number of consumers must exist who track their calories so closely and who know how many calories in each food derive from saturated fats versus monounsaturated and polyunsaturated fats that they can follow that first guideline, it can't be many.The advice against solid fat makes sense because early in the brochure they make clear its a dense source of calories, but what are the sources of solid fat? My guess was foods like cheese and yogurt, but not until page 24 do you find the first definition of solid fats: "Solid fats are found in most animal foods but also can be made from vegetable oils through the process of hydrogenation, as described below."Reading forward we see that butter and lard are examples of solid fats, but footnote "a" of Figure 3-3 tells us that coconut oil, palm kernel oil and palm oil are also solid fats. Solid fats are not actually defined until page 27, and now we find that even the fat in milk is considered a solid fat.So enough of the analysis about the fat advice. What we have here in the USDA guidelines for 2010 about fat is a complexity of information that few can remember let alone follow. I'm sure most people never read the brochure and get their nutritional information from other sources, mainly the media on shows like the nightly news and talk shows like Opra. There's also email and Internet websites. The message heard by most Americans regarding fat is a simple oen: fat is bad. That there are some who have been oblivious to this message that has dominated and persisted for over half a century bewilders me.But we are now learning that the true dangers come from carbohydrates, not fats, so now let's look at what the brochure's guidelines say about carbohydrates.Which is nothing.The word "carbohydrate" appears 27 times in the brochure, but not in a single guideline. By contrast the word "fat" appears 601 times. To be fair the brochure often uses the word "grains" when it really means "carbohydrates", but the word "grain" only appears 324 times. So adding it all up, grains and carbohydrates are referenced 351 times, fats 601 times. The emphasis on fat is clear.Here are the guidelines that reference grains:

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• Limit the consumption of foods that contain refined grains, especially refined grain foods that contain solid fats, added sugars, and sodium.
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• Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains.
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• Choose foods that provide more potassium, dietary fiber, calcium, and vitamin D, which are nutrients of concern in American diets. These foods include vegetables, fruits, whole grains, and milk and milk products.

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These guidelines have the advantage of being very simple as long as one understands the difference between refined grains and whole grains. Unfortunately today (and I think you mentioned this earlier) it can be very difficult to find real whole-grained foods because the food industry has successfully lobbied for weaker labeling standards, and now you can, for example, find the whole-grained label on breads that are little different in carbohydrate and fiber content from white bread.The guidelines also contain some truly dangerous misinformation:

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Glycemic index and glycemic load have been developed as measures of the effects of carbohydrate-containing foods and beverages on blood sugar levels. Strong evidence shows that glycemic index and/or glycemic load are not associated with body weight; thus, it is not necessary to consider these measures when selecting carbohydrate foods and beverages for weight management.

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Glycemic index is a measure of a carbohydrate-containing food's ability to produce glucose spikes in the blood stream, and glucose spikes are strongly suspected of being a primary contributor to metabolic syndrome and diabetes. Fat does not produce glucose spikes.The brochure is long, 95 pages, I've only touched the surface, I could analyze it for hours, but I've got things to do today, so that's enough for now. I don't hold out much hope for the 2015 guidelines. The growing acceptance of the dangers of carbohydrates by both the scientific and nutrition communities is a relatively recent phenomenon, and the "fat is the real bad boy" community still has a large stake in things.--PercyEdited by Percy, : Grammar.

Nobody said that it was. The claim is that with government guidelines as a basis the nutrition advice community drove the public's avoidance of fat and pushed them toward carbohydrates, causing increased rates of obesity, diabetes and heart disease. I can see that you're examining this claim and asking yourself, "What should we see if this claim is true?" One of the answers you evidently arrived at is that if the claim is true then the percentage of people following the guidelines should be approximately the same as the number of people who are obese, diabetic and heart diseased. But that's not a valid extrapolation from the original claim I made, and in any case you deny that there can even be a "percentage of people following the guidelines". You claim it's an all or nothing affair. While I wouldn't put it in these terms, there is some solid truth in your characterization of what I'm saying. The real world isn't black and white, and we all live in the real world. You seem to be trying to impose black and white interpretations on the messiness of the real world where there are many shades of gray. In the real world people follow poorly understood guidelines to varying degrees.I do agree with you that if Americans had followed the guidelines to the letter that the obesity/diabetes/heart-disease epidemic would have been largely avoided. They'd still have been wrong about fat and carbohydrates, and as a result disease rates would have been higher than necessary, but it would have been modest and not epidemic. Uh, because it's wrong? People stop at red lights somewhere north of 99% of time, but by your criteria no one is following the traffic laws. Your binary measurement criteria would tell us that no country in the world is following their traffic laws, leaving no way to compare, say, Naples where people roll through red lights at will to New York where they generally don't.This shouldn't have to be explained.The rest of your message focuses on more details from the guidelines. My intention in quoting a couple excerpts from the guidelines was just to show how some parts reinforce what I've been saying. I understand that other parts of the guidelines reinforce what you've been saying about people not following the specific details of the guidelines, and I readily concede that point, but it was never mine or anyone's claim that they did.The claim is that the nutrition advice community, most importantly the government, focused the public's attention on avoiding fat when the real danger was carbohydrates.--PercyEdited by Percy, : Grammar.Edited by Percy, : Clarify first sentence.

I've been discussing this issue for years beginning with the Good Calories, Bad Calories, by Gary Taubes thread back in 2008, and at no time have I ever claimed that increasing rates of obesity, diabetes and heart disease were caused by strictly following the government's USDA dietary guidelines that are updated every five years. I'm sorry if I gave you the impression that that was my position, but if I did then hopefully I can be forgiven for assuming people were already familiar with my position after having discussed it here for so long.I don't believe any diverse population could adhere in any significantly thorough way to such detailed guidelines, and I would never make such a claim. My claim remains the same as it was way back in 2008, that Americans have been duped by government guidelines into thinking it was important to avoid fat if they wanted to reduce their chances of obesity, diabetes and heart disease, when it turns out the actual danger is carbohydrates.--Percy

As I've explained several times, I don't want to blame the government. I want responsibility for the problem assigned where it properly belongs, because responsibility for the solution likely lies in the same place. The government bestowed legitimacy upon the inadequate science that blamed fat for the increasing rates of obesity, diabetes and heart disease, and it can take it away.There is one interesting irony to note, however. The government's decades long role in convincing the public that fat was responsible for America's worsening health was very significant, but its role in correcting that impression may be much less. Back when Atkins was first pushing the low-carb diet the science wasn't conclusive and he was hammered, but there's been a lot of research since then, and the science is more and more clearly implicating the true cause: carbohydrates. With the science now painting so clear a picture the government's position may be less relevant. Even though, as Faith has noted, the current guidelines still demonize fat, low-carb offerings are surging in grocery stores. I'm not expecting much change in the 2015 guidelines, but maybe we'll be pleasantly surprised.--PercyEdited by Percy, : Grammar.Edited by Percy, : Grammar.

Government advice against cholesterol is responsible for products like this: But it's been known for some time that dietary cholesterol is broken down and digested and not absorbed into the bloodstream. Cholesterol in the body is produced by the body and doesn't come from dietary cholesterol.The possibility exists that the 2015 version of the Dietary Guidelines for Americans may finally drop the advice against dietary cholesterol: Panel suggests that dietary guidelines stop warning about cholesterol in foodAn excerpt:

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A summary of the committee’s December 2014 meeting says Cholesterol is not considered a nutrient of concern for overconsumption. Translation: You don’t need to worry about cholesterol in your food.

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Why not? There’s a growing consensus among nutrition scientists that cholesterol in food has little effect on the amount of cholesterol in the bloodstream. And that’s the cholesterol that matters.

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AbE:I like this excerpt even better:

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Dr. Steven Nissen, chair of cardiovascular medicine at the Cleveland Clinic, told USA Today It’s the right decision. We got the dietary guidelines wrong.

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Well, yes, you did, and not just about cholesterol.--PercyEdited by Percy, : AbE.

I'm not sure why you're asking. Is it because you think the government didn't give out diet advice before the first detailed USDA guidelines in 1980?If you're interested in more detail just let me know and I'll dig it out for, but for now just let me provide this short and insufficiently detailed excerpt from the Wikipedia article on Ancel Keys.

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After observing in southern Italy the highest concentration of centenarians in the world, Keys hypothesized that a Mediterranean-style diet low in animal fat protected against heart disease and that a diet high in animal fats led to heart disease. The results of what later became known as the Seven Countries Study appeared to show that serum cholesterol was strongly related to coronary heart disease mortality both at the population and at the individual level. As a result, in 1956 representatives of the American Heart Association appeared on television to inform people that a diet which included large amounts of butter, lard, eggs, and beef would lead to coronary heart disease. This resulted in the American government recommending that people adopt a low-fat diet in order to prevent heart disease.

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In case it isn't obvious after reading this, Keys' research marks the origin of the "fat is bad" dietary advice.I don't know how old you are, but back in the 1950's and 1960's, just like today, the results of research and government studies and advisory groups were occasionally reported in the media. By the time Egg Beaters was introduced there had already been more than a decade of warnings about dietary cholesterol from various groups, including the American Heart Association and the government. Naturally after all this time I remember nothing specific, but I do clearly remember how conscious everyone was of the warnings about cholesterol.Research from as far back as the 1930s showed that dietary cholesterol has little influence on blood cholesterol, and the government has had many opportunities over the decades to make things right, but they never did. There are some positive indications that this year the government might finally make things right with the upcoming 2015 Dietary Guidelines for Americans.--Percy

I have no specific low-carb diet to enter into the discussion. My own personal recommendations:

• Avoid refined carbohydrates. This includes anything containing sugar, but also white rice, pasta, white bread, potatoes, etc.
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• Don't trust labeling about whole grains. The American food industry successfully lobbied for a weakening of the labeling standards a number of years ago after they encountered consumer resistance to their whole-grained products. If you've found a tasty whole-grained bread then it very likely isn't really a whole-grained bread. Same with whole-grained pasta. Many whole-grained products today are not much different in terms of calories, carbohydrates and fiber from their refined grained counterparts, and they usually contain more sugar or syrup.
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• If you must consume refined carbohydrates, make sure they aren't combined with fat. Examples of refined carbohydrate/fat combinations to avoid are Chinese fried rice, and potatoes with butter or sour cream.
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• My own personal ad hoc rule: if it tastes good, it's fattening.

--Percy

Bacon is great - in fact, any meat is fine, as long as it's not processed.I guess when I said that I mostly had in mind my wife's many attempts to make good tasting healthy food, because I've found that low-carb eating can become a bit boring. Invariably, if it tasted good we gained weight. It's surprising how many supposed healthy or low-calorie recipes aren't.--PercyEdited by Percy, : Grammar.

If you're implying you never denied there was a pervasive "fat is bad" message out there, then it would be difficult to just forget it and move on. I'd feel there was no point replying to you as later you'd just claim you'd actually meant something different.--Percy