Nutrition: Major government fail?

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By CHRIS EDWARDS | CATO INSTITUTE

Americans are getting used to failures by government experts. Government economists have a dismal forecasting record. Government actions and advice during the pandemic were often misguided. And dozens of former government intelligence experts got the Hunter Biden laptop story wrong.

A less recognized but also important failure may be in nutrition. Federal experts appear to have issued faulty advice for decades, even as American obesity exploded from 15 percent in the 1970s to 42 percent today. Federal guidance on nutrition has a large influence on health practice across society. Some researchers argue that Americans have generally responded to the guidance, yet obesity has nonetheless soared.

A clue to shortcomings in federal nutrition guidance comes from calorie data. A new U.S. Department of Agriculture (USDA) study shows that average daily calorie intake increased 21 percent from 1977–78 to 2003-04, and then started trending down. By 2017–18, calories were up 15 percent from the 1970s, but as the study notes, “the rise in obesity rate outpaced the increase in calorie intake.”

In a 2022 article, Professor of Nutrition Dariush Mozaffarian noted that “over the last 20 [years] we are not eating more calories, nor exercising less, but are still becoming more obese.” As average calories have dipped, the obesity rate rose from 31 percent in 2001–2002 to 42 percent today.

How can that be? Obesity is caused not just by the amount we eat but also what we eat. Generally, the government advised us to emphasize carbohydrates and deemphasize protein and fat, as shown in the food pyramid. But some nutritionists are now saying that was backwards. As a libertarian, I don’t want the government telling us what to eat, and our diets may have been better if that had been the case.

Like government experts, private‐​sector experts get things wrong. But the government uses mandates and subsidies to impose its will, and its strong positions often displace other views. In a presentation at Cato, author and science journalist Nina Teicholz discussed the government’s flawed nutrition standards and the harm she believes they caused.

She observed, “the level of certainty you need to have for public policy of an entire population ought to be very high,” and federal directives on nutrition fell far short of that level.

The chart shows average daily calorie intakes of Americans, based on the new USDA data. Carbohydrates are up 22 percent since the late 1970s, fat is up 12 percent, and protein is unchanged. It appears that we mainly want to look at carbs to explain the rise in obesity.

Below I excerpt from two studies that sync with Nina Teicholz’s views about the record of faulty government advice on protein, fats, and carbohydrates. I understand that other experts have conflicting views. Nutrition is a complex field and scientists have not figured it all out yet.

However, the costs of bad diets to individuals, the medical system, and society are huge, so we should pay close attention to government interventions. This is particularly true this year because Congress is set to consider another large farm and food subsidy bill, which may adversely influence American diets.

First, an excerpt from a 2015 study by Evan Cohen and colleagues in Nutrition. Note that the latest USDA data show fat calories up somewhat since this study was published.

Americans in general have been following the nutrition advice that the American Heart Association and the US Departments of Agriculture and Health and Human Services have been issuing for more than 40 [years]: Consumption of fats has dropped from 45% to 34% with a corresponding increase in carbohydrate consumption from 39% to 51% of total caloric intake. In addition, from 1971 to 2011, average weight and body mass index have increased dramatically, with the percentage of overweight or obese Americans increasing from 42% in 1971 to 66% in 2011.

… Since 1971, the shift in macronutrient share from fat to carbohydrate is primarily due to an increase in absolute consumption of carbohydrate as opposed to a change in total fat consumption. General adherence to recommendations to reduce fat consumption has coincided with a substantial increase in obesity.

… Since the late 1970s, the US government, following the American Heart Association (AHA) and much of academia, has consistently recommended lowering the dietary percentage of fat and saturated fat, as well as the absolute levels of dietary cholesterol, based on a theoretical link between those food components and higher risk for coronary heart disease. This government guidance suggested that the reduction of dietary fat would be accompanied by a concurrent increase in the dietary share of carbohydrate. Taken together, these recommendations were also considered to be beneficial for the prevention of overweight and obesity, along with diabetes, cancer, and other chronic diseases.

… In 1961, spurred by emerging medical and epidemiologic research, the AHA issued dietary recommendations to ‘reduce the intake of total fat, saturated fat, and cholesterol. In 1977, the US Senate Select Committee on Nutrition and Human Needs issued Dietary Goals for the United States, which recommended that fat consumption be reduced to 30% of energy intake, and that carbohydrate consumption be increased to account for 55% to 60% of energy intake.

Following this report, Dietary Guidelines for Americans, issued by the USDA and the US Department of Health, Education and Welfare (now the Department of Health and Human Services; DHHS) in 1980, recommended a reduction in the consumption of the share of total macronutrients attributable to fat and saturated fat, and a reduction in the absolute consumption of cholesterol. To compensate, the guidelines recommended increasing consumption of carbohydrate as a share of total calories because “carbohydrates contain less than half the number of calories per ounce than fats.”

During the 1980s, the federal government continued to issue reports and recommendations encouraging Americans to limit fat consumption. In 1982, the Committee on Diet, Nutrition, and Cancer of the National Research Council issued Interim Dietary guidelines that recommended fat intake be lowered from 40% to 30% of total calories in the diet, officially endorsing the AHA’s recommendations from 1961 and the Senate committee’s recommendations from 1977. The USDA and DHHS recommendations have remained largely unchanged since 1980. In 1992, the Food Guide Pyramid was released, urging Americans to use fats, oils and sweets “sparingly,” and to consume between 6 and 11 servings of bread, cereal, rice, and pasta.

… There is a strong relationship between the increase in carbohydrate share of total intake and obesity.

… this study demonstrated that general adherence to government dietary recommendations to decrease fat share of total dietary intake has been accompanied by a rapid increase in obesity rates.

Second, an excerpt from a 2022 study by Joyce Lee and colleagues in Frontiers of Nutrition:

[From 1800 to 2019] processed and ultra‐​processed foods increased from <5 to >60% of foods. Large increases occurred for sugar, white and whole wheat flour, rice, poultry, eggs, vegetable oils, dairy products, and fresh vegetables. Saturated fats from animal sources declined while polyunsaturated fats from vegetable oils rose. Non‐​communicable diseases (NCDs) rose over the twentieth century in parallel with increased consumption of processed foods, including sugar, refined flour and rice, and vegetable oils. Saturated fats from animal sources were inversely correlated with the prevalence of NCDs.

… Ancel Keys’ Diet‐​Heart Hypothesis posited that the mid‐​nineteenth century heart disease epidemic resulted from “a changing American diet”: increased consumption of fats, especially saturated fatty acids (SFAs), and decreased grain consumption.

… The unprocessed elements of our nineteenth century diet–animal fats, whole fat dairy, fresh vegetables, and fresh fruits—were progressively replaced with more processed elements, including industrial seed oils, HFCS, and ready‐​to‐​eat snacks and meals. The data do not support the widely publicized [Ancel Keys’] “changing American diet” of increasing animal‐​derived SFAs over the first 60 years of the twentieth century.

Rather, polyunsaturated fats and partially hydrogenated fats from vegetable oils progressively replaced lard, butter, and other animal‐​derived fats. Across the twentieth century, rising rates of obesity, diabetes, heart disease, and cancer were associated with stable SFA consumption. Yet, large increases in sugar and refined carbohydrate consumption and more modest increases in total calories make refined carbohydrates and total calories more likely factors than SFA in NCD pathogenesis.

… The increased consumption of red meat and SFAs as the cause of the heart disease epidemic was one foundation for Keys’ Diet‐​Heart Hypothesis, strengthened by authoritative repetition, including McGovern’s Senate Select Committee’s Dietary Goals for America (1977), Science in the Public Interest’s (1978) monograph The Changing American Diet, the New York Times columnist Jane Brody’s (1985) Good Food Book, Surgeon General Koop’s Report on Nutrition and Health (1988), and the World Health Organization’s Diet, Nutrition, and the Prevention of Chronic Diseases (1990). However, neither the USDA nor other data supported this narrative.

… The alleged increase in American SFA consumption in the twentieth century was considered the cause of the dramatic rise of non‐​communicable diseases (NCDs) … [But] our findings suggest that SFAs are unlikely to drive obesity, diabetes, or other NCDs.

… US and international agencies and medical associations strongly supported a low‐​fat/​low‐​SFA, high‐​carbohydrate diet for everyone over age 2 years, and through 2008, advocated sugar as healthy for diabetics and the general population.

… Evidence supports both the roles of energy balance and refined carbohydrates‐​insulin mechanisms in obesity, with their relative roles likely varying based on genetics and other factors.

… our findings suggest that increased sugar and refined carbohydrate consumptions during the twentieth century in America may have played a larger role than total calories or physical activity, although this remains a speculation without accurate data on all variables.

Data Notes: The chart shows average daily calories for all Americans over age two. USDA data on grams were converted to calories using 4 grams per calorie for protein and carbohydrates and 9 grams per calorie for fat. Using this approach, the sum of calories in the chart matches the USDA total for 1977–78 but understates the total for 2017–18 of 2,093 calories. More on nutrition and the farm bill here and here. The Nutrition Coalition explores these issues here.

This column first appeared at Cato.org.

32 COMMENTS

  1. Nutrition is definitely among the failures of the government. They should stay out of what they know nothing about. They talk to hear their head rattle and expect ALL of us to just say yes. Hopefully, the general public will begin to say no and heal themselves by eating the food they need, not what the government says you need.

  2. People have become too far removed from the land. Only a generation or two ago, everyone had a parent or grandparent who grew up on the farm. No more, now food comes from the store (just like gas comes from the gas station). Our civilization has become separated from its origins. Ideally, the human (just like any other animal) would go forth each day to grub out food from nature to prepare and eat. Our lives would be built around food, and food security govern us. Like too many things in our society, too many people defer this function to others, far too often to our governing bodies. This will not end well. Return to the land. Hunt and gather, and grow. Subsistence, self-sufficiency, should be the goal for everyone. And better heath will follow in the process.

    • 80% of the US population is urban, w/ many living in apts & condos.
      How are they going to hunt, gather & grow?

      • The gov will allow them to subsist through EBT cards and social credits. Eventually there a standard minimum income will be codified. Pick up trash or report a hate crime and you will earn yourself bonus points.
        war is peace and peace is war,,,,out

    • Destroying Western civilization, for one.
      .
      Instilling maniacal and wildly exaggerated fear over a bad flu, for another.
      .
      Whipping up warmongering hysteria in support of an endless series of neocon-inspired foreign wars, for another.
      .
      Yes, our governments are very successful.

    • Our kids school in Juneau has a program where kids can be fed breakfast and lunch for free. Year round. Because lots of the kids come to school without eating. So yeah I guess the government stepping in and feeding these kids is pretty awesome they are doing that since the parents are so irresponsible

      • It is not the schools’, nor the government’s, responsibility or right to play surrogate parent and nanny to anyone’s children. If kids’ parents are not feeding them at home (and honestly, how often does such a thing really happen?), then that is on them, not the taxpayers.

        • Agreed. But when a handful of students show up malnourished.. guess what happens? The whole class is held up as a teacher deals with a student that’s having a temper tantrum or is behind on their studies because they haven’t slept, haven’t ate.. who knows where the parents are. It’s better that the school at least fills that gap of kids being hungry. Thank you for that. Volunteer at your local elementary school and witness the problems the faculty face with kids that have less than perfect parenting at home. It’s quite pathetic the time they have to contribute to problem kids. Several kids have a full time faculty member that just shadows the kid to every class all day to only deal with the kid’s problems. Volunteer for a few weeks the. See if you can provide an answer to the problem they face. Just saying “it’s not our problem” is probably the same answer you would get from one of those children.

  4. We the people, need to STOP relying on a government that does NOT have our backs!!! Why would we trust our government to teach us about nutrition????

  5. Americans are addicted to highly processed carbs and processed meats. They’re also lazy and lack discipline. When you eat crap and don’t exercise, this is what happens. Even the military has had to lower their admission standards and has spent millions of dollars to treat the fat people they’re letting in. China/Russia, etc. are not our real enemies, its our laziness and lack of movement. We’ll kill ourselves long before some external threat does us in.

    • C- Man,
      I agree with your premise.

      I believe that Richard Nixon’s Secretary of Agricultural started the obese ball rolling with the introduction of a Corn that produces High Fructose Corn Syrup. This stuff is the primary ingredient in Soda Pop and appears in almost every processed food on grocery shelves. .

      Another problem is that carb loaded foods that cause obesity and a myriad of other health problems are the grab bag of choice by folks who use Food Stamps. In Alaska via By- Pass the Government further underwrites the cheap delivery of these unhealthy food to Rural Areas. The result is rotten teeth. obesity, diabetes and poor nutrition.

      The answer is simple, get back to the Garden, Tundra, Fishing Hole, eat fresh unprocessed Meat and Fish and pick more berries!

      Thanks for your comment.

      • Yes and not only that, high fructose corn syrup is illegal in many countries and for good reason. It causes diabetes. How about all the human growth hormones pumped into our meat supply. They also call those sex hormones buy the way. Could have something to do with all the gender confusion. Just sayin. FYI the FDA does not give a damn about your health. This is a for profit health care system. Another fact for you,,,,,of ALL the industrialized nations we are dead last in health care and #1 for profitability.

  7. Once Again(!!!) … Emblematic of of Complete Failure & Destruction … “Government” is the Common Denominator to current problems.

  9. I guess if you want to be a chubby unicorn you can. However! Everyone lives more comfortably at a proper weight for their body size. We don’t need to give up a comfort food, we have some fine resturants with kind staff serving food and portions that would be criticized here. Take Everything in moderation- the Word of God says(you know don’t be greedy).

  10. People should stop looking to government for the answer to everything, that’s not what government is for.

  11. The lo carb / hi fat approach was the clinical approach to obesity through the early 1960s, when a charismatic group captured the discussion, leading to publication of the hi carb / lo fat food pyramid by the FDA. Like the approach to COVID, this was a top-down position completely disconnected from any data, yet adopted by both the government and the medical community for half a century.

    Walt Kelly observed that we have met the enemy, and he am us. Note that fat in diet turns off the appetite. Cheers –

  12. Wasn’t nutrition one of “horse-face” obama’s gigs? No wonder it’s been a total failure.

  13. Two of my heroes- Adelle Davis and Jack LaLanne. I used to do jumping jacks with Jack as a kid. Made it easier to get involved with sports. Baseball. basketball, tennis, skiing, motocross, and hiking.
    And to this day I still like wheat germ and take vitamins. Vitamins and supplements saved my rear end during covid.

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