Why the delay? Why the acceptance? These are key questions, and the simple answer is that what we believe determines what we see.
British diabetologist Edwin Gale, in “The Hedgehog and the Fox: Sir Harold Himsworth (1905– 93),” 2013
Finally, we get reasonable dietary guidelines from the U.S. government, or so I think, with the critical caveat, of course, being that “or so I think” business.
The new version of the DGAs moves much closer to what I think of as a healthy diet than previous versions. The inverted food guide pyramid speaks for itself.
Animal products at the top. Refined grains are at the bottom, in very minimal quantities, and sugar is absent entirely.
The guidelines, or so I think, are a return to common sense, a necessary rejection of the focus on plant-based eating that was a direct outcome of the cholesterol dogma of the 1980s—i.e., animal products are major sources of saturated fats; plant-based foods are not--and the pathological science embedded in the observational epidemiology (about which I’ve written here, here, and here).
The guidelines also represent a shift in nutritional paradigms: serum cholesterol is no longer the center of the health universe in this paradigm; blood sugar is, and so the insulin response to the foods we eat. The thinking is fundamentally different; the implications are as well.
In previous versions of the DGAs, all guidance had to be reconciled with a fundamental goal of keeping LDL cholesterol low. A healthy diet was, as much as any single factor, an LDL-lowering diet. That meant minimal meat and dairy products, both significant sources of saturated fat; processing (or ultra-processing, for those who like that terminology, which I don’t) was an acceptable evil so long as what’s processed are carbohydrates and plant-based foods.
With the new DGAs, the overriding message is to consume unprocessed whole foods, animal or not. These are the foods that require minimal insulin to control blood sugar. The acknowledgement toward the end of the 10-page document that “individuals with certain chronic diseases may experience improved health outcomes when following a lower carbohydrate diet,“ is itself an acknowledgement that for many of us, the fewer the carbohydrates we consume, the healthier we will be.
So what happened, and why now?
Or “why the delay? Why the acceptance?” as the British diabetologist Edwin Gale asked in the epigraph above, in the context of another paradigm shift that took decades to come to fruition. This was the realization that type 2 diabetes was not a disorder of insulin deficiency but of insulin resistance, a concept first proposed in the 1930s by Harold Himsworth (among others) and not widely accepted by Himsworth’s fellow diabetologists for another half a century.
Why, in this case, did it take so long to get back to what seems like common-sense guidance on healthy eating, and why do we get it now (and from Robert F. Kennedy Jr., of all people, leading the way)?1
