Dietary Guidelines 2015: Why Lift Fat and Cholesterol Limits But Still Promote Low Fat Dairy?

When the 2015 Dietary Guidelines for Americans (DGA2015) are finally issued they will likely follow the recommendations of the DGA committee. The DGA report (available here) has made giant strides in reversing four decades of bad advice coming from the government and the American Heart Association (AHA.)

Namely, as I discussed in detail here they no longer consider cholesterol a nutrient of concern and recommend lifting any specific limit on dietary cholesterol.

In addition, as a recent article in JAMA suggested  they have finally lifted  any recommended limit on percent daily intake of fat and we should celebrate and encourage this.

As we have pointed out multiple times, higher fat intake is not associated with heart disease or obesity and it makes no sense, therefore to impose limits on its consumption.

In fact, replacement of fat with carbohydrates is the worst dietary change you can make (with the exception of exchanging butter for industrial processed oils containing trans-fats).

Arguably, thanks to four decades of government and  AHA advice to cut fat and cholesterol we have seen the rise of sugar consumption and obesity as food manufacturers have agreeably made products that fulfill requirements for low fat but still taste good.

The new analysis and report from the DGAC 2015 will hopefully reverse this as they seem to have gotten most of the science right.

Non fat or Low-Fat Dairy Still Recommended

However, they have, inexplicably, left in recommendations for non-fat or low fat dairy.

As I have written about here and here there is no scientific evidence that supports the concept that dairy processed to remove dairy fat is healthier than the original unadulterated product.

In fact, evidence suggests full fat dairy reduces central obesity, diabetes and atherosclerosis in general.

It is virtually impossible in most grocery stores to find full fat yogurt or milk. The vast majority of the dairy aisle is devoted to various low or non fat concoctions which have had loads of sugar and chemicals added and are arguably worse than a Snickers bar.

Flawed Reasons for Low Fat Dairy Recommendations

I believe there are three reasons for this failure of the DGA 2015 and nutritional experts to correct the flawed advice to eat non or low-fat dairy over full fat:

1. In  few randomized dietary studies showing benefits of a particular diet over another, non fat or low fat dairy was recommended along with a portfolio of other healthy dietary changes.

The overall benefit of the superior diet had nothing to do with lowering the dairy fat but was due to multiple other changes.

2. The dairy industry has no motivation to promote full fat dairy. In fact, they do better financially when they can take the fat out of milk and sell it for other purposes such as butter, cheese, and cream.

3. Saturated fat is still mistakenly being treated as a monolithic nutritional element.  Although dairy fat is mostly saturated, the individual saturated fats vary widely in their effects on atherogenic lipids and atherosclerosis. In addition, the nature of the saturated fat changes depending on the diet of the cow.

If the DGA 2015 doesn’t get this issue right we risk another decade of the public consuming high sugar, low fat yogurt in the mistaken belief that they are engaging in healthy behavior.

-ACP

 

 

 

8 thoughts on “Dietary Guidelines 2015: Why Lift Fat and Cholesterol Limits But Still Promote Low Fat Dairy?”

  1. Question – if you follow a VLCHF diet and your LDL-P is > 2000, your LDL-C is >200 and your ApoB is >200 should you be concerned?

    If your hsCRP is < .5 and you HA1C is < 5.2 are the lipids of no concern?

    1. The standard lipid risk factors in you are high and worrisomely high. Given LDL>190 you should consider statin therapy.
      If you had reservations about taking statins and especially if there was no family history of premature strokes or heart attacks I would keep a very close eye on any subclinical atherosclerosis that might be developing. (See my posts on coronary calcium and vascular screening)
      If evidence for subclinical atherosclerosis advanced beyond chronological age, a strong argument could be made to start treatment.

  2. Don’t you think energy/nutrient density could/should influence the recommendations, too? The studies showing neutral or beneficial effects of high-fat products usually adjust for energy intake.

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