As go diets, so go federal dietary guidelines?

By Elizabeth Cohen CNN Medical Correspondent June 1, 2000 Web posted at: 3:04 p.m. EDT (1904 GMT) This news analysis was written for CNN Interactive.

In this story: You-know-who and those darn details Hold the pickle, hold the pyramid Charting charts and diets RELATED STORIES, SITES

(CNN) -- Every five years, the federal government issues its official prescription for how to eat right and exercise.

And every year, Americans get fatter.

What is going on here?

New U.S. guidelines for good health Aim for a healthy weight Exercise at least 30 minutes each day Make food choices based on the U.S.Department of Agriculture "food pyramid" diagram Eat a variety of grains daily, especially whole grains Eat a variety of fruits and vegetables daily Keep food safe to eat Choose a diet that is low in saturated fat and cholesterol and moderate in total fat Choose beverages and foods to moderate your intake of sugars Choose and prepare foods with less salt Drink alcoholic beverages in moderation Source: U.S. Department of Agriculture

MESSAGE BOARD Health Talk

The latest guidelines from the U.S. Department of Agriculture are chock-full of mother-always-told-you advice such as "choose sensible portion sizes," "check product labels" and "choose a variety of fruits and vegetables daily."

The section on weight loss tells people to "choose a healthful assortment of foods that includes vegetables, fruits, grains (especially whole grains), skim milk, and fish, lean meat, poultry, or beans."

It is hard to argue with the basics -- these are instantly recognizable as some of the fundamentals of sound dietary advice. Among those applauding the new guidelines were the American Heart Association, the American Cancer Society, the American Diabetes Association, the American Dietetic Association, the American Institute of Cancer Research, and the North American Association for the Study of Obesity.

But, according to several doctors, nutritionists and consumer advocates interviewed by CNN, the guidelines are so broad that they are not as useful as they could be.

These experts say that since weight problems are now classified as an epidemic by the U.S. Centers for Disease Control, we need solutions proportionate to the epidemic.

"I'm afraid they [the guidelines] have minimal effect," said Dr. Andrew Weil, an alternative medicine advocate and author of "Eating for Optimal Health."

"It's stuff that everybody has heard a thousand times and it doesn't really register, and it doesn't have much impact on behavior when people go into restaurants or fast food restaurants or supermarkets."

Weil believes the guidelines should be more specific and direct: Tell people, for example, that to lose weight and be healthy they need to stop drinking soda and stop eating high-fat, high-calorie fast foods.

Why aren't the guidelines more specific? Some consumer advocates, including the Center for Science and the Public Interest, point out that the USDA is under tremendous pressure from every sector of the food industry to make its food look good -- or at least not make the food look bad.

The sugar industry and several food trade associations with interest in sugar, for example, wanted the USDA to stick to the 1995 guidelines, which told Americans to eat "moderate" amounts of sugar, according to Michael Jacobson with the Center for Science in the Public Interest.

The USDA wanted to get tougher this year by telling consumers to "limit" their intake of sugar, Jacobson said. The debate dragged on; the final guidelines contain both words.

But do Americans really care? The distinction between "limit" and "moderate" might make a difference to the sugar industry and to academicians, but it is less clear whether many overweight Americans would substantively change their eating habits simply from reading one word instead of the other.

Another challenge for the USDA is getting its message out. It is probably safe to say the guidelines are not a common topic of conversation among a vast majority of consumers.

"The government is not necessarily the best equipped to put the message out there -- after all, they have to compete against large corporations like McDonald's and Burger King who have tremendous advertising war chests," said Dr. Barbara Moore, a nutritionist with Shape Up America! a weight-loss advocacy group.

But, said Eileen Kennedy, USDA deputy undersecretary for research, education and economics, even if Americans do not know the guidelines, per se, studies show that 75 percent are aware of the Food Guide Pyramid that is based on the guidelines.

The pyramid, on the other hand, is dwarfed by the multitude of advertisements Americans see every day that encourages them to eat fattening foods.

Just think -- When was the last time you saw an ad for a fast food restaurant? Now think -- When was the last time you saw an ad for 5 A Day, a government program to encourage Americans to eat more fruits and vegetables?

Two other obesity-related announcements by the federal government this week drew praise in the nutritional world, even from some of those who criticized the new dietary guidelines.

The Centers for Disease Control released new pediatric growth charts that will make it easier for a pediatrician to determine a child's risk for obesity.

Using the new charts, a pediatrician will be able figure a child's Body Mass Index -- a specially calculated ratio of weight to height -- and then determine where that child ranks compared to his or her peers.

A child who ranks above the 95th percentile will be considered overweight, and a child who ranks between the 85th and the 95th will be considered at risk for becoming overweight.

And for the first time, the USDA plans on studying the comparative effectiveness of several popular diets, including high-protein diets and low-fat diets.

That is exciting to many people professionally concerned about obesity, because though some popular diets may not be nutritionally balanced in the mother-told-you sense, they are something everyday Americans try, every day.

Getting Americans to change their everyday eating habits -- with guidelines or pyramids or charts or diets -- is the overriding goal of the folks who keep tabs on our health.

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United States Department of Agriculture
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Health Statistics
Shape Up America!

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