by Joshua J. Stone, MA, ATC, NASM-CPT, CES, PES, FNS

This blog entry originally posted @ http://athleticmedicine.wordpress.com/. Entry courtesy of author.

Chronic medical conditions is the leading cause of death in the United States. Nearly half of all adults have at least one chronic medical condition. Over the past 20 years there has been a significant rise in chronic disease. Over the past 15 years childhood obesity and diabetes is growing at an astronomical rate. Who is to blame? Nobody can really state exactly who, but  is it possible that the US government, specifically the United States Department of Agriculture (USDA) is responsible?

1992 Food Guide Pyramid

In 1992, the USDA released the first Food Guide Pyramid. The USDA obviously had good intentions, through heavy research the pyramid was developed to prevent, chronic disease, obesity, and dental carries. Over the years the Food Guide Pyramid evolved to in to more user-friendly versions, MyPyramid (2005) and MyPlate (2011). Despite making the guides more user-friendly, the USDA did little to evaluate data and change the science supporting the pyramid.  Unfortunately, the USDA got it completely wrong. Since the ’92 Food Guide Pyramid was released there has been a dramatic increase in chronic disease and obesity. Has the Food Guides failed the American people?

Let us evaluate the guides. The ’92 version has grains, fruits, and vegetables filling the bottom two rows of the pyramid, accounting for 20 of 26 possible servings. The 2005 version is much of the same, with a large portion dedicated to carbohydrates, but like the ’92 version, the largest portion is dedicated to grains. The 2011, MyPlate is simplified for the consumer, but again indicates most of your plate be comprised of carbohydrates. In fact, when you breakdown the percentages the guides recommend the consumer eat approximately 75% of calories from carbohydrate sources. What is wrong with this you ask? Well, below I have outlined 5 reasons why the USDA might be responsible for the rise in chronic disease and obesity.

Five Reasons Why the USDA Might Be Responsible for the American Obesity and Chronic Disease Epidemic

Reason #1: Misleading information

The guides suggest grains (bread, pasta, rice) account for the largest portion of carbohydrate consumption. The guides do not state 100% whole-grain. To the average consumer, this gives the impression that refined breads and pasta is a fantastic option.  So, the lay person, goes to a restaurant orders a plate of spaghetti and a side of garlic bread, and thinks -’this is a healthy low-fat meal’. After all, according to the guides this meal is well within the guidelines set forth by the USDA.

Additionally, the original guide said 6-11 servings of breads, grains, and pasta / day. Servings is key, because most individuals, myself included, grossly overestimate what constitutes a serving. Another note on servings: it gives a range of servings; 6-11 servings. This tells the consumer that you must have a minimum of 6 servings of grains. This misleading information has led to over-eating and over-eating of the wrong foods.

Reason #2: Satiety

Countless studies have correlated carbohydrate intake to increased hunger, specifically foods with high glycemic index (1, 2, 3). Primarily because of the insulin and blood glucose spike caused following the ingestion of carbohydrates. Newer research indicates that a higher than normal protein diet may actually be the reason for their partial success in inducing weight loss (4). Weigle, et al, found that the subjects felt more satiated with high-protein diet (5). In addition, Weigle’s team found total caloric intake decreased with when consuming more protein (5). There are two theories behind protein’s ability to increase satiety: 1 – High protein foods take longer to digest and leave the gut. 2 – Protein may impact our the hunger and satiety hormones of ghrelin and leptin. So the USDA is telling us to eat foods, that physiologically trigger us to eat more.

Reason #3: Insulin

When we eat carbohydrates insulin is released by the pancreas to begin glucose uptake from the blood. Insulin’s job is to take blood glucose and facilitate storage of glycogen  – our primary energy source. Insulin is also an indirect gate-keeper to fat metabolism, by inhibiting the release of glucagon. Glucagon is a hormone that has the opposite role of insulin. Glucagon is designed to take glycogen and convert it to glucose. Glucagon also creates glucose through lipolysis (the breakdown of fat). If we eat carbohydrates, the insulin response inhibits glucagon – thus prevents us from burning fat.

Reason #4: Elevated Inflammatory Markers

Chronic inflammation is a primary cause of most chronic diseases (6). Excessive consumption of refined carbohydrates, low dietary fiber intake, and a high omega-6 to omega-3 ratios are strongly associated with the production of proinflammatory molecules (7). One large study compared a Western diet and high protein diet. In this study, the western diet group had greater levels of inflammatory markers, including CRP and E-selectin, whereas those on the high protein diet had a significant decrease of inflammatory markers (8).

Reason #5: Importance Fat

In the original food guide pyramid it is stated that fats should be used sparingly. In both the 2005 version and 2011 version, the USDA’s guide says nothing about fat. This gives the impression that fat should be avoided. This is a huge mistake. Fat, specifically, Omega-3 fats – found in nuts, fish, and seeds – is very important. Clinical studies in adults with high cholesterol have shown that nuts lower LDL-cholesterol and improve the overall blood lipid profile (9). Additionally, frequent nut and seed consumption is associated with lower levels of inflammatory markers such as C-reactive protein (CRP), IL-6 and fibrinogen(10).

Does this indicate the USDA got it wrong and led the American people down the wrong path? I believe the aforementioned reasons have led to an increase in obesity and chronic disease in America. Is it really a coincidence that following the release of the guides there has been a dramatic rise in obesity and chronic disease? That being said, I believe in personal responsibility – I think it is up to the individual to make wise decisions. The USDA is not telling people to stop exercising. So, although I believe the USDA may have been a contributor – some blame should be put on the people.

What do you think? Can we blame the USDA’s Food Guides for steering the American people in the wrong direction?

References:

1. Wien M A, et al. Almonds vs complex carbohydrates in a weight reduction program. Int J Obes 2003. 27:1365-1372
2. Roberts SB. High-glycemic index foods, hunger, and obesity: is there a connection? Nutrition Review 2000. 58:163-169
3. Arumugam V, et al. A high-glycemic meal pattern elicited increased subjective appetite sensations in overweight and obese women. Appetite. July, 2007.
4. Astrup A, Meinert Larsen T, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet 2004;364:897
5. Weigle DS, Breen PA, Matthys CC, et al. A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin andghrelin concentrations. Am J Clin Nutr 2005;82:41–8.
6. Stehouwer CDA, Gall M-A. Twisk JWR, Knudsen E. Emeis JJ. Parving H-H. Increased urinary albumin excretion, endothelial dysfunction and chronic low-grade inflammation in type 2 diabetes: progressive, interrelated, and independently associated with risk of death. Diabetes.2002;51(4): 1157-1165.
7. Neustadt J. Western Diet and Inflammation. IMCJ. Vol. 10: 2  Apr/May 2011.
8. Lopez-Garcia E, Schulze MB, Fung TT, et al. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am JClin Nutr.2004;80(4):1029-1035.
9. Mukuddem-Petersen J, Oosthuizen W & Jerling J. A systematic review of the effects of nuts on blood lipid profiles in humans. J Nutr. 135: 2005. 2082–2089.
10. Rajaram, S, Connell, KM, and Sabate´ J. Effect of almond-enriched high-monounsaturated fat diet on selected markers of inflammation: a randomised, controlled, crossover study. BR J of Nut.  2010: 103, 907–912.