Racial Bias in the US Dietary Guidelines

The US Dietary Guidelines are released every five years by the United States Department of Agriculture (USDA). The new 2020 – 2025 US Dietary Guidelines were released 12/29/2020.

According to the Executive Summary, “The aim of the Dietary Guidelines is to promote health and prevent disease.” The US Dietary Guidelines are recommendations for what Americans should eat, are the policy upon which USDA feeding programs and nutrition education in schools and other institutions are based, and are also the basis for nutrition education materials for use in schools and other institutions.

The USDA feeding programs include the school meal programs, among many others. The school meal programs include school breakfasts, lunches, after school snacks, and more.

Beginning more than 15 years ago, the Coalition for Healthy School Food has provided in-person oral testimony, in Washington, for the guidelines for 2010, 2015, and 2020. Each of those years, we’ve seen significant testimony before the Dietary Guidelines Committee about the disproportionate impact of the standard American diet on people of color, as well as the power of a plant-based diet to prevent and reverse chronic diet-related diseases. As a result, the US Dietary Guidelines Committee, which writes the proposed guidelines, is fully aware of this information provided by the many organizations and health professionals which focus on healthy plant-based nutrition. They provide a report with recommended guidelines, but in what is a highly political process, they don’t have the final say. The final say highly influenced by the food industry and politics. 

One of the USDA’s missions is to promote American agricultural products, including meat, dairy, and eggs – foods that are strongly associated with diet-related diseases and which also crowd out the healthier whole plant foods. And, as noted before, another mission of the USDA is to develop and promote the US Dietary Guidelines for the purpose of helping Americans achieve good health and avoid chronic diet-related diseases. These are two conflicting missions. 

We are not the first organization to recommend that the US Dietary Guidelines efforts be moved to a different national agency, for example, the Department of Health and Human Services, or even a new agency, so that they are not dealing with a conflict of interest. Our federal government needs to prioritize evidence-based research over promoting unhealthy American agricultural products. The USDA should also be helping farmers who produce food that is not healthy transition to growing healthy plant food crops. But moving agencies alone will not be enough to change how Americans are advised to eat until “big food” stops calling the shots.

Key Takeaways from the 2020 – 2025 US Dietary Guidelines:

In the Guidelines, food recommendations are still influenced by the food industry, and the strongest evidence-based science for reversing heart disease and type 2 diabetes, and preventing other diseases, is still not mentioned.

Three main points that the new guidelines are emphasizing are the following:

  1. Chronic diet-related diseases are prevalent, including heart disease, type 2 diabetes, obesity, and some types of cancer, and 50% of American adults have at least one of these. Their premise here is that everyone can benefit by shifting to healthier eating patterns.
  2. The second has to do with dietary patterns, that nutrients and foods are not consumed in isolation.
  3. The third is the different needs of individuals at different stages of life.

Let’s unpack each of these a little bit more.

  1. Given the prevalence of diet-related diseases, in more than 50% of the adult population, why don’t the guidelines cite the diets that research has shown time and again to reverse heart disease, the biggest killer of Americans, and type 2 diabetes, another disease taking a huge toll on Americans? Furthermore, these diseases disproportionately impact persons of color, yet there is no mention of that.
  2. An aspect they get right: “Researchers and public health experts, including registered dietitians, understand that nutrients and foods are not consumed in isolation. Rather, people consume them in various combinations over time—a dietary pattern—and these foods and beverages act synergistically to affect health. The Dietary Guidelines for Americans, 2015-2020 puts this understanding into action by focusing its recommendations on consuming a healthy dietary pattern. The 2020-2025 Dietary Guidelines carries forward this emphasis on the importance of a healthy dietary pattern as a whole— rather than on individual nutrients, foods, or food groups in isolation.”  This is important and something that has been at the forefront of the messaging by T. Colin Campbell, PhD. We are proud to have Dr. Campbell on our advisory board. However, the Guidelines then fail to mention the healthy dietary pattern, a whole food plant-based diet, which has been proven to reverse heart disease and type 2 diabetes and results in lower rates of the diet-related diseases, including heart disease, type 2 diabetes, certain cancers, and some autoimmune illnesses among those who follow such an eating pattern. People who follow a whole-food, low-fat, plant-based diet are the only dietary pattern as a group where people on average are not overweight. People who follow this diet rarely have high cholesterol or high blood pressure. Normally after switching to such an eating pattern, these high numbers: weight, blood pressure, and cholesterol plummet to a healthy level.

There are different dietary needs at different stages of life, and yet the overall messaging of healthy eating is much more the same than different for the various phases of life. By focusing so much on the different stages of life, they are missing the bigger picture of the benefits of a whole food plant-based diet for all. Instead of creating a framework for different life stages, they could have easily incorporated the different needs when discussing each food group.

Problems with the new Guidelines:

  • The Vegetarian Dietary pattern, listed in the appendix, does not mention a fully plant-based (vegan) diet – the dietary pattern most associated with an ideal weight and lower rates of chronic diseases.
  • The Guidelines incorporate fortified soy milk into the dairy category, but specifically eliminates other non-dairy milks from the dairy category: “Other products sold as “milks” but made from plants (e.g., almond, rice, coconut, oat, and hemp “milks”) may contain calcium and be consumed as a source of calcium, but they are not included as part of the dairy group because their overall nutritional content is not similar to dairy milk and fortified soy beverages. Therefore, consuming these beverages does not contribute to meeting the dairy group recommendation.”
  • Why is their nutrient composition different? Because many of them don’t contain as much protein. Yet, despite all the protein hype in this country, protein is not considered a “nutrient of concern” and most people get too much. Too much animal protein has many negative health consequences.
  • The failure to address the impact of dairy on persons of color is a huge omission, and to continue promoting dairy as a major part of the diet when it makes a huge percentage our population sick is unconscionable.
  • We see this racial bias on a regular basis because the US Dietary Guidelines are taught in school as the MyPlate Guide. This is the pictorial representation of the US Dietary Guidelines. Children who are experiencing tummy aches, constipation, and diarrhea daily are not learning that the cause could be dairy, which they are encouraged to have 3 – 4 times a day. Forty to fifty-three percent of African American and Latinx Americans will get type 2 diabetes at some point in their lives, compared to 33% of the population overall. Teens that have type 2 diabetes already are not learning that it could be reversed with a low-fat, whole food plant-based diet. We can not have equity until healthy foods, and evidence-based nutrition education is available to all.
  • Under “Protein Foods” meat, poultry, eggs, and seafood are listed before nuts/seeds/soy products. In the Executive Summary, beans, peas, and lentils are left completely out of the protein group even though where they are listed under vegetables it mentions that they can count as a vegetable or a protein. This is a huge omission, especially since the image of that category seems to include a bean. Beans, peas, and lentils should be the first grouping of food listed under “protein foods” never mind that they were directly omitted from this category. In the narrative that discusses protein, it does make reference to beans, peas and lentils, but most people don’t read the details, they look at the summaries and the images that illustrate those summaries.
  • Here again, the failure to address the impact of meat, dairy, and eggs on persons of color is a huge omission. While foods and beverages that come from animals are problematic for all people, they are far more so for people of color.
  • Aside from directly excluding beans, peas, and lentils from the protein group, the guidelines note that “Protein also is found in some foods from other food groups, such as dairy.” Actually, protein is found in all whole foods, including all whole plant foods. Fruit is really the only category where the amount of protein is on the lower end. As a percentage of calories, vegetables and grains, and to a lesser extent, fruits, are also sources of protein in the diet.
  • Five years ago, the Dietary Guidelines Committee, to their credit, tried to get environmental considerations mentioned as part of the US Dietary Guidelines. That’s because the single biggest thing any individual can do to work to reverse climate change is to eliminate or at least reduce the animal products in their diet. Politics prevailed and this recommendation was discarded and not included in the final 2015 Guidelines, with the reasoning that the Dietary Guidelines are about nutrition only and don’t take into consideration other factors. Really? They have, for a long time now, included exercise, and they still do. They also include cost of food. The problem is that climate change creates huge climate events that harm and kill people, and the warming environment brings diseases from warmer climates to places they were never before seen. In addition, the warming climate and climate events have a huge and negative impact on food crops. The continued omission of the impact of diet on the environment is a real shame.
  • Clicking over the MyPlate page, I took a quiz. For each group it asked me how often I ate foods from each of the categories. It also asked if I was vegetarian (vegan was not an option). Even though I clicked yes for vegetarian, and even though I said I ate foods from the plant-based proteins, and fortified soy milk more than 6 times a week each (the highest number of servings you could choose in each category), the results were that I needed help in the protein and dairy category, and it sent me to a list of recipe’s that could help: most of which contain chicken, none of which were vegetarian (never mind vegan) but also angel food cake (5 grams of protein per slice)… It’s obviously a major problem to tell vegetarians (or vegans) to each chicken, and why would they be recommending angel food cake???

There is a lot more to unpack about why these guidelines are unlikely to help anyone get healthier, including lack of direct messaging about the benefits of a plant-based diet. It is our hope that the new incoming administration will prioritize the health of people over the profits of “big food” and make the US Dietary Guidelines truly fulfill the stated purpose… to promote health and prevent disease.

 

Getting Plant Based Entrees in Schools

Getting Plant Based Entrees in Schools

Getting Plant-Based Entrees in Schools

Schools are the place where children go to learn each day. Parents count on the school doing everything they can to protect their children. And yet there is one area where the school is usually out of step with what research shows will protect our children – food and nutrition. This is not unique to schools – it is a society wide problem. Despite updated meal and snack standards, schools are still full of unhealthy food. Candy at Halloween, bake sales, cupcakes for birthday parties, chocolate milk at breakfast and lunch, highly processed breakfasts, and lunch entrees that resemble fast food (though they are likely to have far less sodium and fat, in order to meet the regulations). Wellness policies, required by the federal government, are supposed to address nutrition guidelines, but often times the policy is largely ignored.

This article focuses on school lunches.

Schools in New York City, Ithaca, NY, and one small upstate district work in partnership with the Coalition for Healthy School Food. In Ithaca and the small school district, vegan entrees have been added to the menus. In New York City, the Coalition worked with the New York City Office of School Food to create a vegetarian menu and offer it to schools as an option. As a result, there are now at least five vegetarian schools in New York City (and likely more between the time this article was written and published!). Offering vegan entrees does not cost more – if it did, schools would not be able to offer them. Schools have about $1.10 to spend on the actual food costs for a lunch, out of the $3.23 reimbursement for a student receiving a free meal. The rest of the money goes to cover staff pay and benefits, equipment repair and replacement, and sometimes utilities. Expensive ingredients are not possible. So non-dairy cheese, tempeh, and avocados, and many of the faux-meats are not likely to be on school menus. Exciting ways to add vegan options to menus includes special days: Meatless Mondays, Try It Tuesdays, Wellness Wednesdays, or World Food Day Thursdays. They could add hummus or cold bean salads that count as a meat alternate to their salad bars. It’s important to have a basic understanding of the school meal program, before trying to work with a school to make changes. Working to change school food takes time and requires resources. Developing relationships is important, as is being able to determine your point of entry into the system. If the Food Service Director is not receptive, you may need to go to the school board or superintendent. But it would be best to go directly to the Food Service Director first, so that they feel respected. Work with them and be helpful – they don’t need more work to do, as they are overwhelmed, so getting extra feet on the ground to help implement changes is important. See the Food Service Director as your friend, because if you are serious about creating change, you will be spending a lot of time with them. The Coalition for Healthy School Food can help by providing advice, recipes, and resources. Schools may be “Self-Op” meaning the school district employs the food service personnel, or they may work with an outside company (Contract Management). Either way, the funding for school meals does not come from the school budget, the program operates separately. Funds come from federal and state reimbursements (most, but not all states provide an additional reimbursement), paid meals, a la carte sales, and catering. Some schools do a lot of scratch cooking, and some do none, using all frozen, canned, or otherwise packaged foods. Some schools cook/prepare food out of a central kitchen, distributing food to other schools in the district, while others do this in their own kitchens. For lunch, five categories of food must be offered: meat or meat alternate, grain, vegetable, fruit, and milk. Of these five components of food, only three components need to be taken in order for the meal to be reimbursable by the government, and at least one of the components needs to be either a fruit or a vegetable. For each child receiving a free meal, the federal government will reimburse a school in the $3.23 (rates are higher in high need schools, Alaska, and Hawaii). As a reminder, about $1.10 of this is for the food cost. The meal standards implemented in 2012 require more fruits and vegetables, subcategories of vegetables which must be served at least once a week (greens, red/orange, legumes, starchy, and other), whole grains, sodium limites, and calorie ranges. Schools were required to offer grains that were “100% whole grain rich”. But in a classic example of food industry spin, whole grain rich actually means 50% whole grain. Now, schools can receive an exemption for grains and can reduce their grains to 80% whole grain rich (40% whole grain).

The categories that offer the greatest opportunity for improvement are the dairy and the meat categories.

Milk MUST be offered, but it does not have to be taken. It would take an act of Congress to change this. Given this reality, there are three things schools can do to reduce milk consumption:

  1. Eliminate chocolate milk as an option.
  2. Make sure the free water, which is required by federal law to be available in the cafeterias, is available, and that students are able to get up to get it, or that it is brought to their table.
  3. Offer non-dairy milks. When a student has a note from their parent or doctor that they need a non-dairy milk, a school may, but is not obligated to provide it. Non-dairy milks cost more, and reimbursements do not cover the added cost. The non-dairy milk must also meet certain nutrient requirements.

The meat/meat alternate category allows for serving beans, lentils, split peas, tofu, processed meats, and non-dairy yogurt (this would not be affordable for schools). Generally, the serving size for legumes is ½ cup of beans, lentils, or split peas. For tofu it’s 4.4 ounces. Manufactured vegan items would do well to apply for the Child Nutrition (CN) label. This allows food service directors to feel sure that the product will qualify as a meat/meat alternate. One frozen product that we love is falafel tots from American Bean Products. In all the schools we’ve tested them in, they’ve been a big hit. The Coalition for Healthy School Food has recipes which qualify as a meat alternate. These are plant-powered entrees from around the world and are bean, lentil, or tofu based. Some of the favorites are West African Beans and Greens, Ms. Patel’s Rajma, North African Red Lentils, Awesome Bean Burger, and Pasta Faggioli.

Sustainability: Look at Your Plate

Sustainability: Look at Your Plate

Sustainability: Look at Your Plate

Reduce, Reuse, Recycle, use a low-flow showerhead, turn down the heat, walk, bike, drive a hybrid, get energy efficient appliances, live in a smaller house.  These are all great ways to live more sustainably. Yet there’s one way you can help the environment and reduce global warming that still doesn’t get the attention it deserves. Look at Your Plate!

Two major reports emphasize the serious problems with raising animals for food (and drink). The United Nations, Food and Agriculture Organization, reported back in 2006 in their report Livestock’s Long Shadow 1 that animal agriculture accounts for more global warming than all transportation combined, at 18% and 14% respectively.

Then, in 2009, the lead environmental researchers from the World Bank published a report in Worldwatch Institute’s Journal: Livestock and Climate Change: What if the Key Actors in Climate Change Are…Cows, Pigs, and Chickens? 2 It stated that all previous figures were severely underestimated and that the production of animals and their products for food to a whopping 51% of global warming.

No need to argue over numbers. Whether it’s 18%, or 51%, or somewhere in between, this is an opportunity. Yes, we can recycle, use a low-flow showerhead, and all the rest, but by reducing our consumption of animal products, we have an opportunity to make a much bigger difference every time we sit down to eat. Choosing what we eat is also much easier (and more possible) than downsizing our home or buying a hybrid car, two other actions that can make a big difference, but which may not be possible for many.

And grass-fed, “humanely” raised animals are no exception.3 They contribute to these figures. They take up more space, live longer, and produce more methane and other greenhouse gases, and generally use more resources and cause more pollution than raising plants for food. And while local foods are appealing for many reasons, researchers from Carnegie Mellon University found that what you eat matters more than where it’s grown. Transportation is responsible for only 11% of greenhouse gasses related to food, while delivery from the producer to the retailer contributes only 4%.

The results of a major study by Gidon Eshel and Pamela Martin show that comparing meals that have the same number of calories, a meat-based meal produced 24 times as much C02 as a plant-based meal.

If one person exchanges eating animal products for a plant-based diet, they could reduce carbon dioxide emissions by at least 1.5 tons per year.4 If every American had one meat-free day per week, it would save the same amount of CO2 emissions as taking 19.2 million cars off the road! 5 Can you skip a hamburger once a week? Do that for a year and you’ve helped fight global warming the same amount as not driving a car 520 miles.6 The water savings are huge, too. You could go for six months without a shower to save as much water as you would by not eating four hamburgers.7

By reducing the number of meals that include animal products, we can make a pretty big difference! It has been said that if all people in the world ate the way we do in the United States, we would need 4 planet earths by the year 2050 to produce the food. Yet we have plenty of space on the planet for a plant-based diet for all inhabitants of planet earth.8

And what’s better for the environment is also better for our health. The 2010 US Dietary Guidelines now tell us (in the pictorial form called My Plate) to make healthy plant foods— vegetables, fruits, and whole grains—at least ¾ of what we eat. The meat category was renamed the “protein” category to deemphasize meat. And online, click on the protein category at the My Plate website, and you will see that 29 out of the 78 items listed are plant-based proteins.9 The Dietary Guidelines even devote a whole page to vegan diets.10

People who eat vegan diets are slimmer than their meat-eating counterparts—by an average of 40 pounds, according to a study of thousands of vegans, published in the journal of the American Diabetes Association.11 So the new decline in meat consumption in this country is good news not just for the environment, but in the battle against obesity as well.

So look at your plate. Because the most powerful step we can take to avert global warming is to stop – or at least reduce – consuming animal products.

Amie Hamlin is the Executive Director of Coalition for Healthy School Food, a non-profit that introduces plant-based foods and nutrition education in schools to educate the whole school community. 

 

  1. http://www.fao.org/3/a0701e/a0701e.pdf
  2. https://healthyschoolfood.org/wp/wp-content/uploads/2019/12/51-percent-of-global-warming-from-animals-Worldwatch-and-World-4.pdf
  3. http://awellfedworld.org/climate
  4. http://www.greenamerica.org/livinggreen/lessmeat.cfm
  5. http://www.meatthetruth.nl/download/20080518_US_carbon_savings_table.pdf
  6. http://www.scientificamerican.com/article.cfm?id=the-greenhouse-hamburger
  7. http://www.worldwatch.org/node/549
  8. http://www.scotsman.com/news/environment/the-world-is-not-enough-soon-we-ll-need-three-planet-earths-1-2294500 note: despite the name of the link, reading will reveal that it’s 4 planets if everyone in the world eats the way we do in the US.
  9. http://myplate.gov/food-groups/protein-foods.html
  10. http://health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf Note: pages 52-53 and 82.

  11. http://care.diabetesjournals.org/content/32/5/791.abstract