Whatever your opinion of Robert F. Kennedy, Jr., he’s the first national candidate to platform the issue of chronic disease in America. To address this crisis, for children and adults alike, our response should be bipartisan.
As former members of the expert committee that oversees the science for the U.S. Dietary Guidelines, we can tell you that these chronic diseases are primarily driven by poor diet, and our guidelines are part of the problem.
At 7:30 a.m. tomorrow, millions of schoolchildren will be filling their cafeteria trays with orange juice, sugary cereals and donuts. Administrators encourage the kids to fill up, contending the meal will fuel their day.
This isn’t dystopian fiction — it’s breakfast in 2024 America, brought to you by the guidelines published every five years by the departments of Health and Human Services (HHS) and Agriculture.
The guidelines represent more than just suggestions. They’re the nation’s nutritional North Star, guiding everything from school lunches to military and hospital food and dietary advice by doctors and nutritionists.
But they’ve led us astray. Today, over 70 percent of American adults and one-fifth of the children are overweight or obese, with rates even higher in low-income families. This isn’t just a health crisis; it’s a national security crisis, too. One in three young adults is too overweight for military service.
As members (and one of us as a former chair) of the Dietary Guidelines Advisory Committee, we aimed for the highest quality reviews. Sadly, those standards have deteriorated, leading to a national nutrition policy that no longer reflects the best or most current science.
The guidelines were controversial at the start. In 1980, the National Academy of Sciences derided the diet’s foundational studies as “generally unimpressive.” The academy’s president went further, warning of potential unintended consequences from implementing recommendations with such scant evidence. Long-term clinical trials may be expensive and difficult to conduct, but they’re still an essential step before issuing population-wide recommendations.
Despite these concerns, the guidelines were embraced by government officials for most of the next four decades — even as the concerns of skeptics grew louder.
In 2017, two landmark studies from the National Academies of Sciences, Engineering, and Medicine delivered a critical verdict: The development process lacks scientific rigor and transparency, leading to guidelines that were not “trustworthy.” The reports made 11 concrete recommendations to improve rigor and transparency in the guidelines process. Yet, shockingly, follow-up evaluations in 2022 and 2023 revealed that the USDA had fully implemented none of them.
The result? Untrustworthy guidelines that continue to drive obesity and poor metabolic health.
Since the first guidelines were published in 1980, we’ve been told to fear fat and instead consume about half of all calories as carbohydrates. The current guidelines recommend up to 10 percent of calories as added sugar and six servings of grains daily, including three as refined grains.
This advice fundamentally misunderstands metabolism. Chronic high carbohydrate consumption — especially of refined grains and added sugars — drives obesity, diabetes, heart disease and other metabolic disorders.
The guidelines also maintain an unfounded hostility towards saturated fats, ignoring the last decade’s worth of evidence challenging their link to heart disease. Failure to update this science has meant the continued unjustified demonization of nutrient-dense foods such as eggs, meat and full-fat dairy, which together play a crucial role in a healthy diet.
Following the guidelines, Americans have increased grain calories by 28 percent since 1970, while reducing red meat intake equally. Butter and egg consumption dropped as vegetable oil use surged 87 percent. We’ve engineered a dietary disaster, swapping wholesome, satiating foods for processed carbohydrates that leave us hungry and sick. These are the “unintended consequences” we were warned about.
Fortunately, hope is on the horizon, thanks to this year’s farm bill. This massive legislative package, revisited every five years, could be key to unlocking a healthier future for America.
The bill proposes crucial reforms to the guideline-development process, demanding “standardized, generally accepted evidence-based review methods” and requiring full disclosure of potential conflicts of interest among committee members. These changes represent a vital step towards restoring scientific integrity to our national nutrition policy.
Transparency is an especially crucial fix, as conflicts run rampant. In the 2020 committee, almost all members had at least one conflict of interest with the food and drug industry; half had 30 or more.
The current lack of rigorous methodology is akin to playing a sports game with no referees, no rules and no sidelines — an open invitation to cherry-picking and bias. We’ve seen this play out in real time. In 2020, the expert committee ignored over 20 review papers from independent teams of scientists from around the world, which concluded that strong evidence is lacking for the continued caps on saturated fats. This selective use of evidence undermines the credibility of the entire process.
The farm bill’s proposed changes offer a chance to break this cycle. By mandating greater transparency and adherence to rigorous scientific standards, we can begin to rebuild trust in these crucial recommendations. Every meal served in our schools, every nutrition label on our grocery store shelves, and every physician pamphlet could finally be based on sound science rather than outdated hypotheses and industry influence.
The farm bill offers us a chance to choose science over ideology. It’s an opportunity to reclaim our health, one meal at a time.
Janet C. King, PhD, is Professor Emeritus of Nutritional Sciences at the University of California, Berkeley, and chair of the 2005 Dietary Guidelines Advisory Committee. Cheryl Achterberg is a former Dean at The Ohio State University and was a member of the 2010 Dietary Guidelines Advisory Committee.