U.S. Dietary Guidelines: An Evidence-Free Zone
Authors: Steven E. Nissen
Journal: Annals of Internal Medicine (2016)

Ideas and Opinions19 April 2016U.S. Dietary Guidelines: An Evidence-Free ZoneSteven E. Nissen, MDSteven E. Nissen, MDFrom The Cleveland Clinic, Cleveland, Ohio.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-0035 Annals Author Insight Video - Steven E. Nissen, MD In this video, Steven E. Nissen, MD, offers additional insight into his article, "U.S. Dietary Guidelines: An Evidence-Free Zone." SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail On 7 January 2016, the U.S. Department of Health and Human Services and Department of Agriculture released the Dietary Guidelines for Americans 2015–2020 (1). The preliminary report (released in February 2015) had generated considerable media attention by reversing decades of dogma with the statement that "cholesterol is not a nutrient of concern for overconsumption." Incredibly, in the final 2015 report, this statement has been removed, instead suggesting that "individuals should eat as little dietary cholesterol as possible." Which version should we believe? How can the same committee arrive at diametrically opposite conclusions? Now that the final report is available, it ...References1. U.S. Department of Health and Human Services, U.S. Department of Agriculture. Dietary Guidelines for Americans 2015–2020. 8th Edition. December 2015. Accessed at http://health.gov/dietaryguidelines/2015/guidelines on 8 January 2016. Google Scholar2. Bao Y, Hu FB, Giovannucci EL, Wolpin BM, Stampfer MJ, Willett WC, et al. Nut consumption and risk of pancreatic cancer in women. Br J Cancer. 2013;109:2911-6. [PMID: 24149179] doi:10.1038/bjc.2013.665 CrossrefMedlineGoogle Scholar3. Varraso R, Chiuve SE, Fung TT, Barr RG, Hu FB, Willett WC, et al. Alternate Healthy Eating Index 2010 and risk of chronic obstructive pulmonary disease among US women and men: prospective study. BMJ. 2015;350:h286. [PMID: 25649042] doi:10.1136/bmj.h286 CrossrefMedlineGoogle Scholar4. Lin J, Curhan GC. Associations of sugar and artificially sweetened soda with albuminuria and kidney function decline in women. Clin J Am Soc Nephrol. 2011;6:160-6. [PMID: 20884773] doi:10.2215/CJN.03260410 CrossrefMedlineGoogle Scholar5. Schernhammer ES, Bertrand KA, Birmann BM, Sampson L, Willett WC, Feskanich D. Consumption of artificial sweetener- and sugar-containing soda and risk of lymphoma and leukemia in men and women. Am J Clin Nutr. 2012;96:1419-28. [PMID: 23097267] doi:10.3945/ajcn.111.030833 CrossrefMedlineGoogle Scholar6. Teicholz N. The Big Fat Surprise: Why Butter, Meat & Cheese Belong in a Healthy Diet. New York: Simon & Schuster; 2014. Google Scholar7. Coronary heart disease in seven countries. Summary. Circulation. 1970;41:I186-95. [PMID: 5442782] MedlineGoogle Scholar8. The American Heart Association's Diet and Lifestyle Recommendations. Accessed at www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/The-American-Heart-Associations-Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp#on 7 January 2016. Google Scholar9. Chowdhury R, Warnakula S, Kunutsor S, Crowe F, Ward HA, Johnson L, et al. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med. 2014;160:398-406. [PMID: 24723079]. doi:10.7326/M13-1788 LinkGoogle Scholar10. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, et al; PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368:1279-90. [PMID: 23432189] doi:10.1056/NEJMoa1200303 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The Cleveland Clinic, Cleveland, Ohio.Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0035.Corresponding Author: Steven E. Nissen, MD, Department of Cardiovascular Medicine, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; e-mail, [email protected]org.Author Contributions: Conception and design: S.E. Nissen.Drafting of the article: S.E. Nissen.Critical revision for important intellectual content: S.E. Nissen.Final approval of the article: S.E. Nissen.This article was published at www.annals.org on 19 January 2016. PreviousarticleNextarticle Advertisement Annals Author Insight Video - Steven E. Nissen, MD In this video, Steven E. Nissen, MD, offers additional insight into his article, "U.S. Dietary Guidelines: An Evidence-Free Zone." FiguresReferencesRelatedDetailsSee AlsoU.S. Dietary Guidelines Frank B. Hu , Marian L. Neuhouser , Rafael Perez-Escamilla , Miguel A. Martinez-Gonzalez , and Walter C. Willett U.S. Dietary Guidelines Steven E. Nissen U.S. Dietary Guidelines Miguel A. Martinez-Gonzalez and Antonia Trichopoulou Metrics Cited byFood for Thought or Feeding a Dogma? Diet and Coronary Artery Disease: a Clinician's PerspectiveFood-Based Dietary Guidelines for Seafood Do Not Translate into Increased Long-Chain Omega-3 Levels in the Diet for U.S. Consumers"Lipid Nutrition Guidelines: A Comprehensive Analysis" by Harumi Okuyama, Sheriff Sultan, Naoki Ohara, Tomohito Hamazaki, Peter H. 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