On September 23, 2013, the Swedish Council on Health Technology Assessment (SBU) published a two-year compilation of scientific literature entitled Dietary Treatment for Obesity.1 Based on SBU’s conclusions that diets with low (less than 20% of total energy) to moderate (less than 40% of total energy) carbohydrate intake and high fat intake are more effective for losing weight, improving cardiovascular health and stabilizing blood glucose levels when compared to a low-fat diet, Sweden became the first Western nation to recommend a low-carbohydrate, high-fat (LCHF) diet to its citizens.2
In contrast, the United States Department of Agriculture’s (USDA) MyPlate program promotes a relatively high-carbohydrate diet. For a 2000 calorie per day regimen, MyPlate recommends:
- 6 ounces grains, with at least 3 ounces whole grains
- 2.5 cups vegetables, with 1.5 cups dark green vegetables, 5.5 cups red and orange vegetables, 1.5 cups beans and peas, 5 cups starchy vegetables and 4 cups other vegetables per week
- 2 cups fruit
- 3 cups low-fat or fat-free dairy
- 5.5 ounces lean protein, with fish as the main protein source two days per week, and beans, peas, nuts and seeds consumed often
- 6 teaspoons oil
- 260 calories solid fats and added sugars3
Unlike SBU, MyPlate does not recommend certain percentages of macronutrients, but the following table provides a sample day based on a 2000 calorie, MyPlate diet, excluding the 260 discretionary calories from sugar and solid fat.
At 48% of total energy intake, the carbohydrates in this sample MyPlate diet exceed the SBU definition of a moderate-carbohydrate diet. Yet as evidenced by quotations from SBU and USDA’s Dietary Guidelines for Americans, USDA claims the high-carbohydrate MyPlate diet provides almost identical benefits to SBU’s LCHF diet.
Of course, the recommendations by both SBU and USDA are not mandates; no citizen is compelled to obey them. However, students whose school participates in the USDA-run National Student Lunch Program (NSLP), which provides low- or no-cost lunches to participating schools, do find their meals subject to certain dietary standards. For example, in Chicago Public Schools (CPS), skim milk is the only beverage provided to students at lunchtime, even for those who are lactose intolerant. Funded by taxpayers, CPS pays $20 million each year for milk. Since USDA does not reimburse a school for a lunch unless it contains certain food items, many students report feeling pressure from cafeteria workers to take milk even if it makes them sick. A 2013 waste audit from five CPS schools showed that up to one-half of all milk received by students was thrown away, along with the taxpayers’ dollars that paid for it.
USDA claims children need the calcium in dairy to build strong bones, but studies show little correlation between dairy consumption and bone health. Dr. Frank Greer, the former nutrition chairman for the American Academy of Pediatrics, notes African-Americans “show the biggest, strongest bones of all groups” despite their low rate of milk consumption, while Caucasians have some of the highest dairy consumption and poorest bone health. Lactose intolerance is especially common among African-Americans, Hispanics, Asians and Native Americans, the four ethnic groups that make up 91% of CPS students. Though the NSLP does allow non-lactose alternatives as a substitute for milk, CPS does not provide these more expensive beverages to its students.13 And while skim milk fulfills the MyPlate standard for fat-free dairy, a recent study published in Archives of Disease in Childhood, reported that “children who drank skim milk and 1% were heavier than those who drank 2% and whole.” Researchers hypothesized that people who drink low-fat or low-calorie beverages will end up eating more because their beverages are less filling.14
Still, students who attend schools with NSLP lunch programs have an alternative. They can bring their own lunch. That’s not the case in the Canadian province of Manitoba, where the government’s Early Learning and Child Care lunch regulations require parents to send children to school with a “balanced” lunch, as defined by Canada’s USDA-like Food Guide.15 Under these rules, schools must supplement an unbalanced lunch with the absent food group(s) and the offending parent receives a fine. Manitoban parent Kristen Bartkiw sent her children to school with lunches containing leftover homemade roast beef and potatoes, carrots, an orange and some milk. Deciding their lunches lacked grains, the school gave her children Ritz crackers and fined Bartkiw $10. As Bartkiw writes, the school would have accepted a lunch of “microwave Kraft Dinner and a hot dog, a package of fruit twists, a Cheestring, and a juice box” over her homemade lunch.16
While it’s hard to debate the inanity of a policy that leads to force-feeding children Ritz crackers and fining their parents in the name of healthy eating, the real issue at hand is the efficacy of governments making any dietary recommendations to its citizens, enforceable or not. SBU recommends an LCHF diet, while USDA promotes a diet rich in whole grains and higher in carbohydrates and low in saturated fats, yet both organizations maintain their diet best promotes weight loss, improves cholesterol biomarkers and reduces the risk of type 2 diabetes.
These opposing claims leave only two possibilities: 1) that one government has made gross, life-threatening errors in its experimental design and data collection or 2) that both sets of recommendations are relatively true since the content of a person’s diet has little effect on her health anyway. In the first possibility, the errant government is disseminating advice that is deleterious to the health of its citizens. The two claims are akin to one side maintaining that women should avoid alcohol when pregnant, while the other encourages expectant mothers to increase their alcohol consumption to improve the health of their fetus. And given that each government’s claims dismiss those made by the diet promoted by the competing government, the first possibility seems far more likely than the second. Yet if the latter possibility turns out to be true and both diets are equally healthful, then the recommendations are useless and the whole exercise has been a colossal waste of taxpayers’ money. The basic conclusion to be drawn from SBU’s recent reversal of Western dietary advice is that governments who fund research to provide nutritional counsel to their citizens are conducting a program that is either incompetent or unnecessary. The role of nutritionist does not belong in government hands.
- “Swedish Expert Committee: A Low-Carb Diet Most Effective for Weight Loss.” Diet Doctor. 23 Sept. 2013. Online. 4 Jan. 2014. http://www.dietdoctor.com/swedish-expert-committee-low-carb-diet-effective-weight-loss.
- Swedish Council on Health Technology Assessment. Food Obesity. Trans. Google Translate. 2013. Online. 4 Jan. 2014. http://translate.google.com/translate?hl=en&sl=sv&tl=en&prev=_dd&u=http://www.sbu.se/sv/Publicerat/Gul/Mat-vid-fetma-/.
- “My Daily Food Plan.” United States Department of Agriculture. Online. 4 Jan. 2014. http://www.choosemyplate.gov/food-groups/downloads/results/MyDailyFoodPlan_2000_18plusyr.pdf.
- Calorie totals from Calorie King. Online. 4 Jan. 2014. http://www.calorieking.com.
- Swedish Council on Health Technology Assessment, 2013.
- U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition. Washington, DC: U.S. Government Printing Office, Dec. 2010. Online. 4 Jan. 2014. http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. p. 36.
- Swedish Council on Health Technology Assessment, 2013.
- U.S. Department of Agriculture and U.S. Department of Health and Human Services, 2010, p. 24.
- Swedish Council on Health Technology Assessment. Dietary Treatment for Obesity. Cited in “Swedish Expert Committee: A Low-Carb Diet Most Effective for Weight Loss,” 2013.
- U.S. Department of Agriculture and U.S. Department of Health and Human Services, 2010, p. 36.
- Eng, Monica. “Lactose intolerance: When drinking school milk makes students feel sick.” Chicago Tribune. 26 Nov. 2012. Online. 5 Jan. 2014. http://articles.chicagotribune.com/2012-11-26/health/ct-met-school-milk-lactose-intolerance-20121126_1_lactose-intolerance-soy-milk-school-milk.
- Rodell, Besha “Skim Milk is Making You Fat.” LA Weekly. 9 Jul. 2013. Online. 5 Jan. 2014. http://blogs.laweekly.com/squidink/2013/07/skim_milk_obesity_fat.php.
- Minister of Health Canada. “Eating Well with Canada’s Food Guide.” 2011. Online. 5 Jan. 2014. http://www.hc-sc.gc.ca/fn-an/alt_formats/hpfb-dgpsa/pdf/food-guide-aliment/view_eatwell_vue_bienmang-eng.pdf.
- Freedhoff, Yoni. “Parents Fined For Not Sending Ritz Crackers In Kids’ Lunches.” Weighty Matters. 18 Nov. 2013. Online. 5 Jan. 2014. http://www.weightymatters.ca/2013/11/parents-fined-for-not-sending-ritz.html.
- “Ritz Original.” Mondeléz International, 2013. Online. 6 Jan. 2014. http://www.ritzcrackers.com/en/Varieties/Originals/Original.aspx.