What's your opinion of the recommended dietary guidelines?

[Watchkeys]

I wonder how people who are trying to lose weight feel about 'the healthy diet' that's recommended to us, and whether they generally feel that it is, actually, a healthy diet, in terms of ensuring that we get the right nutrients.

I'm a PT, and have my own views on this, but I'm curious about how people feel about it generally, and what knowledge people base their opinions on, re nutrition.

But some people are 'too poor' to prepare proper food. It's not a judgement, it's just what it is (and it's shit). Studies show that the lowest 10% income households will need to spend 75% of their income on food to follow the eat well guidelines. That's just not sustainable. And the risk of, say, changing the guidelines so there's less emphasis on (relatively) cheap grains to higher cost fat/protein sources (which also often require additional resources for cooking) is that it just makes it even more unachievable.

The food pyramid was replaced in 2007 by the Eatwell Plate, and more recently the Eatwell Guide.

So, what is the guide?

Around a third starchy carbohydrates - choose whole grain or higher fibre

Around a third fruit and vegetables - at least 5 per day, try to choose a variety

Around 20% protein - pulses, legumes,beans, fish, eggs, meat

Around 10% dairy or alternatives - choose low fat/low sugar options

Small amount of unsaturated fat

So, contrary to popular belief, it doesn’t advise eating processed carbs or sugary treats at all.

It’s not that far from the Mediterranean diet, which has been consistently shown to be the healthiest diet.

I don’t agree that government guidelines are responsible for the obesity epidemic when firstly, most people have no idea what they are and secondly, the population as a whole does not follow them. Stephan Guyenet has done a lot of research in this area, showing that “low fat” never actually happened and indeed fat provides a larger proportion of our calories now than it did in the 1980s.

I would also ask about the evidence you have to support the Carbohydrate Insulin Model? Studies in this area have failed to show a clear advantage of a low carb approach to weight loss after adjusting for calories - see, for example, the DIETFITS study. Weight loss patterns are similar for a low fat approach and a low carb approach, with some people doing well and others less well on each diet. This remains true even when insulin resistant people go low carb - I.e. it makes no difference.

Could you link to one of these studies, please? (About the cost, I mean).

Even if more protein is necessary (which I would question - how many protein- deficient people are there in the UK?), it doesn’t have to come in the form of meat or fish. Beans, legumes and pulses are protein sources which are very cheap. They’re very good for the micro biome, too. (95% of UK population are thought to be fibre deficient).

Let's face it-if everyone was sticking to the guidelines no-one would be obese

How do you know? Why do you believe that to be true? Are we really suffering from obesity because we're too stupid to follow a simple set of guidelines, or might there be something else going on?

5 a day is based on nothing. No reliable science at all. 8 glasses of water a day, same. 2000kcal per day is a wild generalisation. There is no biological need for humans to eat any carbohydrate at all, and it is low in nutrient density, yet we are told that 1/3 of our kcal should come from this. Fibre is a subset of carbohydrate, so there's no need for that either.

The guidelines are based on weak studies, often funded, at least partially, by food corporations.

Whatever your opinion, all of those things are true. I think it's worth questioning the guidelines, at least, rather than assuming (based on what?) that they'd work if only individuals could stick to them.

@coronabeer https://foodfoundation.org.uk/sites/default/files/2021-10/Affordability-of-the-Eatwell-GuideFinall_Web-Version.pdf

I agree with you re protein totally both in terms of most diets providing enough and that there are cheap sources (but, to be honest, cooking beans etc requires equipment, energy and time/skills that people may not have).

@mynameiscalypso

i think that link says 42% of after housing costs income, not 75% of income for the bottom two deciles? A large proportion, admittedly. I’m in that income group - very lowest decile, post divorce. Trying to work out how much of my income goes on food for me and dd (plus greedy dog) - could be around that. Maybe slightly less.

@coronabeer The 75% figure is on the bottom of page 7 I think. I admit that I haven't read the whole paper but it's quoted in the new book on UPFs

Oh sorry, yes, it's income after housing costs.

I think a previous poster has linked to how the guidelines were developed. Similar guidelines exist in virtually all countries, as far as I can tell. (I would be genuinely interested to hear of any countries whose dietary guidelines are substantially different from our own - please link, if possible).

Lots of the criticism of the guidelines comes from “mavericks” with books (or diet programmes) to sell. Yet you don’t see any conflict of interest there? For example, try looking on Google Scholar to see how many scientists agree with your assertion that dietary fibre doesn’t benefit health. Are they all funded by “Big broccoli?”

I don’t think any scientist claims that specific calorie requirements apply to every human, in every situation - some will need more, some less. That’s why they’re called guidelines. Also , the available calories from different foods will vary - some calories are indigestible (starches), whilst others require energy to be extracted (proteins). So the availability of calories to the body will differ according to the source of those calories - high availability from fats and highly-processing carbs, lower availability from proteins and complex carbohydrates. (Complex carbohydrates are a source of B vitamins, healthy fats, protein, fibre and minerals).

Beans and other pulses can be cooked in a slow cooker, or you can use canned versions. It seems to be a uniquely UK (and possibly US) thing that a diet based on beans and basic fruit, veg, plus grains, eggs etc is unattainable to the very people who would probably benefit from it the most.

Many much poorer countries base their diet mostly on such foods, eg dhal bhat in Nepal, which is lentils, rice, spices and whatever vegetables are available. Cheap, healthy and tasty. Likewise in many other places.

As for the OPs question - 'How do you know? Why do you believe that to be true? Are we really suffering from obesity because we're too stupid to follow a simple set of guidelines, or might there be something else going on'

No-one won't know what a healthy diet looks like, or is unable to find out. After all, nearly everyone has all the information in the world at their fingertips. It's just that it's easier and more tasty to some, to eat a different diet. But not necessarily cheaper, so that's not usually the reason. After all, a lot of processed food, snacks, drinks etc, are expensive in comparison.

@BarbaraofSeville Poverty is an absolutely huge factor in health (including) food inequality. Cheap supermarket value white bread is always going to be cheaper than a loaf of sourdough from a baker (especially if you can't afford the ingredients to make your own upfront)

Who said anything about buying artisan baked sourdough bread?

It's a valid point that what is basic cheap food in many countries is considered to be aspirational and inaccessible in the UK. This is something that we need to try and solve.

I was being slightly facetious. But if you look at the bread we're 'supposed' to buy (sourdough, free from UPFs etc), it's always going to be more expensive than the cheap options which is all that a lot people can afford. It's an issue with the western food system and industry for sure but, back to the OP's original question, in a system which is rigged and unfair and drives inequality, the guidelines themselves are a good starting point for many people.

Thought a bit more about some of this whilst I was out walking the dog.

A couple of thoughts: shame schools insist on teaching food tech, rather than food and nutrition. Perhaps that would be an opportunity to teach people how to cook healthy, cheap and nutritious food? (My daughters both spent food tech lessons doing things like drawing up a 3d cross/section of a sandwich before they made one on the next lesson, or creating a “mood board” before they could bake a fruit crumble.)

Absolutely agree about pulses - that’s what many if the poorest people in the world live on. We eat lots of them, but I agree that lots of people don’t really know what to do with them due to unfamiliarity.

Also thought this thread is a great example of the Dunning-Kruger effect: people who have maybe read a couple of books or watched some videos assuming they know more than scientists who have studied this for years.

Have to include myself here - I have read a lot of nutrition books, articles and scientific journals and listened to lots of podcasts for the last 3-4 years, but that’s it. I have changed my mind about some things - no longer convinced about the carbohydrate-insulin model, for example whereas it really “made sense” to me at one point. I’m no expert and am still learning, but at least I think I’m getting better at spotting the quacks. I’ve forgotten which nutrition scientist said something like “There’s always money to be made in telling people they can eat the foods they like to eat” and you see it a lot. People don’t want to hear they should be eating whole grains, fruit vegetables, fish, pulses - they want to hear they can have steak and cheese - or, alternatively, lots of refined carbs, as long as they watch the fat content.

How do I know (or at least suspect they are “quacks”) if I have admitted I’m not an expert? I see if they are a scientist, and, if so, in which field they specialise. Have they carried out any studies of their own? Do they admit to nuance, or are they very black and white in their thinking? Do their references stack up? (I sometimes cross-check and find that the reference doesn’t say what it claims they say). Are they cited by other scientists? Have they got a financial interest in promoting their claim? Are they honest - will they admit to being mistaken, or change their minds in the face of new evidence? Do they address conflicting evidence fairly?

@coronabeer

no longer convinced about the carbohydrate-insulin model, for example whereas it really “made sense” to me at one point

Why are you no longer convinced, if you don't mind me asking?

How do I know (or at least suspect they are “quacks”) if I have admitted I’m not an expert? I see if they are a scientist, and, if so, in which field they specialise. Have they carried out any studies of their own? Do they admit to nuance, or are they very black and white in their thinking? Do their references stack up? (I sometimes cross-check and find that the reference doesn’t say what it claims they say). Are they cited by other scientists? Have they got a financial interest in promoting their claim? Are they honest - will they admit to being mistaken, or change their minds in the face of new evidence? Do they address conflicting evidence fairly

Randomised control trials, and meta-analyses of them particularly, will save you all this effort. It's not about the person. It's about the evidence.

Lots of the criticism of the guidelines comes from “mavericks” with books (or diet programmes) to sell

Yes, and sometimes, some of it is accurate, too. Mavericks thought smoking shouldn't be recommended by doctors. Mavericks suggested that Thalidomide might be what was causing the issues. Mavericks took against transfats.

You don't have to assess the person if they're basing what they're saying on evidence. You have to look at the evidence, and other evidence too.

How about a meta study about diabetes and dietary fibre, which you seem to think is unnecessary https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003053

Yes, and lots of the people I’m talking about don’t carry out or use evidence from RCTs. Basically, just because they’ve written a book, it doesn’t mean that what they say is accurate.

Apart from that, it’s difficult to use RCTs for nutritional research for a number of reasons: effects of nutrition may not show up for years or even decades; it’s difficult to track exactly what people eat and how well they conform to a set dietary pattern (people lie or make mistakes); eating proportionately less of one food or food group means eating proportionately more of something else, but the nature of the “swap” might affect outcome.

If you want to know about how the recommendations for 5 a day came about, try reading this
https://www.cambridge.org/core/journals/public-health-nutrition/article/joint-whofao-expert-consultation-on-diet-nutrition-and-the-prevention-of-chronic-diseases-process-product-and-policy-implications/9C5F92142766286FE744EA4412A53476
and all the references.

You want evidence, you have a lot of reading to do.

Another one about adherence to a diet. They even delivered the food and some people found it hard to follow.
https://www.mdpi.com/2072-6643/13/3/967

Is this thread just an excuse to be argumentative @Watchkeys? Seems entirely pointless because no matter what anyone has posted you have disagreed with it.
The NHS has to use evidence based research to create its guidelines.

'...addresses... the likely implications of nutrient recommendations and dietary guidelines for food supply and production and the need for developing integrated strategies'

So, food production companies and conglomerates are being borne in mind.

'Although a definition for dietary fiber has not yet been established... Current evidence indicates... potential health benefits...'

It's not exactly compelling evidence, is it.

So much this. What the world eats cheaply and healthily is considered wanky in the UK. It's really not.

It's perfectly clear what the thread is for from the OP, and it's ok for me to post my own opinions, even if they're at odds with others' views.

The NHS has not used evidence based research. Where is your proof for the statement that they have to? Or is that an assumption?

If you find the disagreement and debate on the thread uncomfortable, you don't need to keep reading it.