What should the Dietary Guidelines for America be?

Steve Kirsch Uncategorized

In a nutshell, here’s what I think the DGA should be:

  1. Limit the amount of sugar/refined carbs you eat as much as possible (foods with high glycemic index) These cause the most damage and is likely the leading cause of the diabetes epidemic.
  2. Eat real foods as much as possible. These are foods that aren’t processed.
  3. 1.5gm/kg of lean body mass protein, 0%-40% carb, 30%-80% fat is reasonable macro-nutrient mix for healthy people trying to stay healthy. Note: This is highly variable between individuals. Many people can be healthy on a low-fat, high-carb diet as long as it is based on real food.
  4. Avoid foods labeled “low fat” and “non fat” and choose the full fat alternative whenever possible
  5. Limit polyunsaturated vegetable oils including trans fats.
  6. Eating red meat is fine. There is no need to cut off the fat.
  7. A low-carb dietary pattern (20% to 30% from carbs or even as low as 5%)  is perfectly healthy.

For the last 35 years, the reports have completely failed to point out the most obvious and fundamental error of the dietary guidelines.

The guidance to eat less fat to lose weight and be healthier is completely opposite of what we should be doing and what the science says is healthy. There have been more than 23 large random controlled trials comparing low fat to low carb diets. In every single trial, on every single metric, low carb beat low fat.

If we really want to end obesity, heart disease, and diabetes in the US, the path is clear: avoid foods labelled “low fat” and “non fat”. Stick with real foods, avoid sugar and refined carbs, and shift your diet so you are eating about 20% protein and no more than 40% of your calories from carbohydrates. Most of your calories should come from fat.

You don’t have to give up any foods you like. Just shift your food preferences away from foods high in carbohydrates. It’s as simple as that.

Everyone has a different point of view on the proper dietary advice to give to people, even among the people I respect the most.

Certainly “no advice” worked up to 1977.

But the world is in a very different place now with all the carbs and low-fat and non-fat products bombarding people.

Most people need to be told eating fat will make you thin and can benefit from that advice.

Why are we promoting dietary patterns that have been shown to be less effective than a simple low carb diet? And why is the government not promoting low carb diet or the diet we had prior to 1977 when carb % = fat %?

And why not promote dietary patterns that, based on what we know today, are the healthiest? We could do a lot worse.

I have been most impressed with low-carb diet data. I haven’t seen any data for any other dietary pattern that produces superior results.

Most interesting to me is people who walk the talk long-term.

Dr. Richard Bernstein has eaten super low carb for 40 years and his bloodwork is unmatched in terms of health indicators. Why not tell people to move in that direction? If we all ate like Bernstein, we’d be a LOT healthier. That may not be the ideal, perfect diet, but it is a hell of a lot better than any other diet I’ve seen.

His results are NOT because he’s genetically blessed either. He used to eat a high carb diet and his numbers were awful. He switched the diet and magic happened.

I realize that one data point doesn’t make the case, but I don’t think you can find ANYONE IN THE WORLD who followed any other diet advice that can beat Bernstein’s numbers (the most interesting being his Triglyceride/HDL ratio of .36).

Lipid testLow fat dietLow carb dietNormal range
LDLwasn't available in 197053<100
HDLwasn't available in 1970123>39
Lipoprotein(a)wasn't available in 1970undetectable<10 is normal
Triglyceride/HDLwasn't available in 19700.36<2 is ideal. >4 is too high. This is a great indicator of CVD risk for both men and women.

Now I grant you that Bernstein doesn’t have a small book with the Bernstein Diet that prove that everyone can follow his diet.

But I think we should start with the healthiest diet, try to mass produce it, and then tweak the material and government guideline to support it. That’s where I would start. We won’t achieve perfection, but we will move things in a better direction than we are now. Also, we should make it clear that the diet may not work for everyone at all times. Individual tailoring is best.