Last week I wrote about the new vaccine schedule under RFK, which reveals his process. He doesn’t appear to have one. Our HHS secretary is shooting from the hip, ignoring expert advice, and trusting only his own conspiracy-addled instinct. He quickly followed with his take on the food pyramid, echoing unscientific nonsense he has been spouting for years. This also reflects another aspect of his lack of process – he does not respond to criticism. There does not appear to be any self-correcting mechanism in place, so he persists in error.
Like most dubious or alternative medicine-derived nutrition advice, it’s a mixed bag. There is often some common-sense advice mixed in, and some parts are reasonable, but the details and emphasis are often framed unscientifically. So let’s take a look.
RFK’s emphasis is on eating “real food” and avoiding processed food. I have written about the processed food gambit previously. The problem with this framing is that there is no operational definition of which foods are “real” or how much and what kind of processing poses a health risk. Yes – too much salt, fat, and sugar are a health risk, and processed foods often contain too much of these ingredients. But using “processed” as a short-cut is highly problematic.
First, not all processed foods are bad, and many are fine (like most things) in moderation. Also, this is a highly elitist recommendation. Not everyone has access to adequate produce, or the time to cook every meal. Many people rely on ready-made food for cost and convenience. RFK probably does not understand the intention-to-treat paradigm. What matters more than whether advice is precisely optimal is how people respond to that advice. Telling people to do something highly inconvenient or too expensive may be counterproductive.
A far better approach would be to regulate the processed food industry more effectively, so that the options people have are more healthful. Much of this could likely be accomplished with thoughtfully regulated labeling, requiring accessible transparency. Clearly visible warning labels about being high in salt or sugar would motivate manufacturers to avoid them, for example.
RFK also goes after non-nutritive sweeteners. This is a complex area of research, but there is no clear evidence that the net health effect of these sweeteners is negative. In fact, it is highly likely that they are superior to consuming sugar (yes, even “natural” cane sugar).
Perhaps the most controversial aspect of the new pyramid is that RFK puts meat and dairy near the top, recommending diets with higher levels of protein than the previous recommendation – up from 0.36 grams per pound of body weight to between 0.54 and 0.73 grams per pound of body weight. As a general recommendation, this is also likely counterproductive. Older adults and people on a weight-loss diet may benefit from a higher protein diet, but most people would not. In fact, most Americans already eat too much protein if anything, and further pushing high protein foods would likely come at the expense of fiber and other important constituents. He also underemphasized plant-based proteins like beans and legumes.
He also suggests full-fat dairy products. Again, this is highly likely to be counterproductive. The evidence suggests that people already consume too much dairy if anything, and increasing amounts are likely to result in consuming excess fat and sodium.
Nutrition experts are not impressed. Dalia Perelman, a research dietitian at Stanford University, pointed out internal contradictions in the recommendations:
“The guidelines contain internal contradictions,” she said. “They retain a numeric recommendation to limit saturated fat to 10% of calories, while simultaneously emphasizing meat and full-fat dairy and allowing portion sizes that make it very difficult to stay within that limit in real-world diets.”
Kennedy also recommends cooking with olive oil, which is fine, but also butter or beef tallow. This reflects his pseudoscientific fears of seed oils, not science or evidence.
In short – the recommendations are a mess. They are not evidence-based, not well-thought out from a public health perspective, and not even internally consistent. They are unlikely to make Americans more healthy, and in fact are likely to do the opposite. Given this is how RFK operates, we should expert more of this.
