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Low-Fat Diet Recommended By Federal Government May Have Unintended Consequences
It is common knowledge that obesity levels in America have been
recorded at record levels, almost reaching the point of an epidemic.
However, in the wake of numerous federal guidelines that promote a low
fat diet, one must beg the question -- is it possible that the
government direction of dietary guidelines has somehow caused these
unintended consequences, or is it just a coincidence?
In the March 2008 issue of the American Journal of
Preventative Medicine, published by Elsevier,
authors Paul R Marantz, MD,
MPH, Elizabeth Bird, AB, and Michael H Alderman, MD, from the Albert
Einstein College of Medicine explore just this question. In it, they
suggest that the recommendations made by the government were based on
limited scientific data and the implied assumption that it could do no
harm. However, as evidence now may suggest otherwise, they warn that
these guidelines may actually be harmful pending further study.
"When dietary guidelines were initially introduced in the late 1970s,
their population-based approach was especially attractive since it was
presumed to carry little risk," states Dr. Marantz. "However, the
message
delivered by these guidelines might actually have had a negative impact
on health, including our current obesity epidemic. The possibility that
these dietary guidelines might actually be endangering health is at the
core of our concern about the way guidelines are currently developed
and issued."
If the guidelines can alter the behavior of the public, it is possible
that such alteration might have either positive or negative effects.
According to the authors, in 2000, the Dietary Guideline Advisory
Committee actually suggested that the lower fat diet recommendation
advised in 1995 may have been ill-advised, and might in fact be
harmful. This committee was concerned that "the previous
priority given to a
'lowfat intake' may lead people to believe that, as long as fat intake
is low, the diet will be entirely healthful. This belief could engender
an overconsumption of total calories in the form of carbohydrates,
resulting in the adverse metabolic consequences of high carbohydrate
diets." The committee also noted that "an increasing
prevalence of obesity in the United States has corresponded roughly
with an absolute increase in carbohydrate consumption."
Multiple data sets presented by Dr. Marantz and his colleagues support
these trends -- but the authors are carefully to specify that this
correlation does not necessarily imply causation. Instead, according to
Dr. Marantz: "it raises the
possibility of a net harmful effect of seemingly innocuous dietary
advice. These dietary recommendations did not necessarily cause harm,
but there is a realistic possibility that they may have."
In the same issue of the American Journal of
Preventive Medicine, Steven H. Woolf, MD, MPH, from Virginia
Commonwealth University and Marion Nestle, PhD, MPH, of New York
University assert that the federal guidelines are actually supported by
decades of research. While they are united in the opinion that people
often compensate for a low-fat intake level by consuming more calories
in total, they disagree with the authors of the original article that
the guidelines were inappropriate in promoting low fat diets. "The
guidelines were not the culprit," according to Dr. Woolf, who believes
that sharing the dietary causes of disease was the correct course of
action.
Woolf and Nestle never call into question that guidelines can have
unintended consequences. But, they write:Â "When the prevailing
message fails
to achieve its intended aims or achieves the wrong ends, the solution
is not to abandon the enterprise but to reshape the message to achieve
desired outcomes."
In a continuation of this parley, Marantz, Bird and Alderman gave
further commentary. "When trying to mitigate potential harm from past
guidelines based on inadequate science, issuing 'reshaped' guidelines
with similarly inadequate science merely perpetuates past mistakes. It
might sometimes be best to avoid translating flaccid arguments into
rigid guidelines. Ultimately, this boils down to a difference in world
view, much like the distinction between clinicians guided by the
therapeutic imperative and those guided by the maxim 'first do no
harm.' Of course, when the evidence is clear, beneficial interventions
are always favored, and harmful interventions always shunned. It is
when the data are unclear that challenges arise."
Â
Marantz concluded, "As doctors, our first call is to do no harm. That's
why we recommend that guidelines be generous in providing information,
but more cautious in giving direction. Any directions should be based
on the very highest standards of scientific evidence. After all, we
expect that much from pharmaceutical companies before they bring a new
drug to market."
A Call for Higher Standards of Evidence for Dietary Guidelines
Paul R. Marantz, MD, MPH, Elizabeth D. Bird, AB, and Michael H.
Alderman, MD
American Journal of Preventive Medicine, Volume 34,
Issue 3 (March 2008)
Click
Here For Full Length Article
Do Dietary Guidelines Explain the Obesity Epidemic?
Steven H. Woolf, MD, MPH, and Marion Nestle, PhD, MPH
American Journal of Preventive Medicine, Volume 34,
Issue 3 (March 2008)
Click
Here For Full Length Article
The Authors Respond
Paul R. Marantz, MD, MPH, Elizabeth D. Bird, AB, and Michael H.
Alderman, MD
American Journal of Preventive Medicine, Volume 34,
Issue 3 (March 2008)
Click
Here For Full Length Article
Written by Anna Sophia McKenney
Copyright: Start Sanatate
Not to be reproduced without permission of Start Sanatate
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