Thursday, June 18, 2015

Goodbye Dietary Guidelines?

There is an old saying that goes: if you don't like something, change it. 

While I am generally supportive of the basic tenant of this statement, I also like the saying: you can have your own opinions, but you can't have your own facts. 

During dinner with a friend in Washington, DC I learned of identical language found in both the House Agriculture (pg. 80; Sec. 734) and Labor an Human Services (pg. 98; Sec. 232) 2016 appropriation bills that will all but paralyze the release of the Dietary Guidelines for Americans. You heard right; the Dietary Guidelines for Americans have joined the Supplemental Nutrition Assistance Program (SNAP- also known as Food Stamps) and the Healthy, Hunger Free Kids Act (the school lunch program) as the new politicized hotbed.

The language bars funding to the Guidelines unless the agencies comply with patronizing requirements:
"None of the funds made available by this Act may be used to release or implement the final version of the eighth edition of the Dietary Guidelines for Americans, revised pursuant to section 301 of the National Nutrition Monitoring and Related Research Act of 1990, unless the Secretary of Agriculture and the Secretary of Health and Human Services comply with each of the following requirements:

1. Each revision to any nutritional or dietary information or guideline contained in the 2010 edition of the Dietary Guidelines for Americans and any new nutritional or dietary information or guideline to be included in the eight edition of the Dietary Guidelines for Americans-

A) shall be based on scientific evidence that have been rated "grade 1: Strong" by the grading rubric developed by the Nutrition Evidence Library of the Department of Agriculture; and 
B) shall be limited in scope to only matters of diet and nutrition intake.

2. The Secretaries shall release a preliminary draft of the eight edition of the Dietary Guidelines for Americans, including a list of the scientific studies and evidence supporting each revised or new nutritional or dietary information or guidelines, for a period of public comment of at least 90 days

3. Following the end of the public comment period, the Secretaries shall provide a period for agency review of public comment of at least 60 days."

But what is at the heart of this debate? According to Philip Brasher at Agripulse, it's all about "protecting meat." He states that the House appropriators are seeking to ensure the Obama administration doesn't use environmental factors in writing the federal dietary guidelines for meat consumption and that the 2015 recommendations are strictly limited to “matters of diet and nutrient intake”, an effort to thwart the inclusion of environmental considerations in the guidelines.

Those that work in food and nutrition know the complexity of nutritional science, food politics and healthy food environments. A bit of science training of legislators may do us all good. "Grade 1 strong" research would require the use of methods that should be barred by any respectable Institutional Review Board. It would also throw out the new language that supports dietary patterns (not Grade 1 strong) AND any recommendations about physical activity (not Grade 1 strong OR "in the scope of diet and nutrition"). See these examples of recommendations that don't make the "strong" grade. Since a tenant of the food industry's health messaging is centered around personal responsibility and physical activity, this may have some critics outside of the meat lobby.

Implications of the Language

§  USDA and HHS complete a revised DGA every five years. The public has already had approximately 24 months to weigh in on the development of the 2015 DGAs – in addition to 75 days to comment on the DGAC report. The list of scientific studies that will be used to inform the DGAs is completed. Any additional public comment would significantly delay the release of the 2015 DGA, which is set to be released by the end of the calendar year.

§  The language undercuts the whole development process for the Dietary Guidelines; the Advisory Committee conducts an exhaustive, systematic review of the evidence, including a bias assessment. The recommendations have to be based on the best evidence available, but unfortunately not all of that evidence can be “strong.” Studies of strong design with minor methodological concerns are included in Level II (Moderate) Evidence Grade. It is not just the quality of evidence that we need to take into account, but also the preponderance of evidence. There are very important studies that may have minor flaws, but contribute to the preponderance of evidence that we want to take into account for the DGACs.

§  The implication of the language would be that the 2015 Dietary Guidelines would be prohibited from taking into consideration the totality of the scientific evidence reviewed by the Dietary Guidelines Advisory Committee report, including the evidence linking diet and cancer risk.

§  Here are some examples of recommendations with a moderate grade that would be cut if we used only a Level I Strong Evidence Grade:
  • Recommended dietary patterns that are higher in vegetables, fruits, and whole grains; include seafood and legumes; are moderate in dairy products (particularly low and non-fat dairy) and alcohol; lower in meats, and low in sugar-sweetened foods and beverages, and refined grains are associated with favorable outcomes related to healthy body weight or risk of obesity. 
  • Higher intake of added sugars, especially in the form of sugar-sweetened beverages and the link with increased risk of hypertension, stroke, and coronary heart disease in adults.
  • The relationship between higher sodium intake and risk of cardiovascular disease and high blood pressure. 
  • Replacing sugar-containing sweeteners with low-calorie sweeteners to reduce calorie intake, body weight, and body fat.
  • The relationship between dietary patterns and colorectal cancer and post-menopausal breast cancer risk. 
  • Moderate evidence indicates that dietary patterns rich in vegetables, fruit, and whole grains, and lower in animal products and refined carbohydrate, are associated with reduced risk of post-menopausal breast cancer.

Some of the current 2010 DGA recommendations (including sodium) are based on “moderate” evidence. The way bill language is written, we would not be able to change those without “strong” evidence, but anything already in the 2010 DGA’s could remain, which is inconsistent.  The scientific evidence in support of lean meat is also not “strong”, so that might cause some concern.

This language will exclude the important recommendations in the DGAs on physical activity. It is very important for Americans to understand the holistic approach they should be taken to prevent chronic disease and maintain a healthy lifestyle including both diet and physical activity.

The Dietary Guidelines Advisory Committee report, which serves as the basis for the DGAs already went through a public review and comment period so requiring another comment period would be duplicative and wasteful of government resources. 

Taking Action (Updated)

You can take action, demand that the Committees let the Secretaries of Agriculture and Health do their jobs. If you are represented by one of these representatives (see below), call with or e-mail this message...
"I urge you to let the Secretaries of Agriculture and Health do their jobs and consider the recommendations of the expert committee on the Dietary Guidelines for Americans regarding the impact of diet on both human and environmental health."

If your Representative is not on one of the Committees, everyone can contact the Agriculture Appropriation Committee Chair, Robert Aderholt (Alabama) and Labor and Health Appropriations Chair Tom Cole (Oklahoma).

If you bave a representative on either committee, please contact them as well.

House Agriculture Appropriations Subcommittee
  • Robert Aderholt, Alabama, Chairman
  • Kevin Yoder, Kansas
  • Tom Rooney, Florida
  • David Valadao, California, Vice Chair
  • Andy Harris, Maryland
  • David Young, Iowa
  • Steven Palazzo, Mississippi

  • Sam Farr, California, Ranking Member
  • Rosa DeLauro, Connecticut
  • Sanford Bishop, Jr., Georgia
  • Chellie Pingree, Maine
House Labor & Human Services Appropriations Subcommittee

  • Tom Cole, Oklahoma, Chairman
  • Mike Simpson, Idaho
  • Steve Womack, Arkansas, Vice Chair
  • Chuck Fleischmann, Tennessee
  • Andy Harris, MD, Maryland
  • Martha Roby, Alabama
  • Charlie Dent, Pennsylvania
  • Scott Rigell, Virginia

  • Rosa DeLauro, Connecticut, Ranking Member
  • Lucille Roybal-Allard, California
  • Barbara Lee, California
  • Chaka Fattah, Pennsylvania

Dietary Guidelines Background

The Dietary Guidelines provide a crucial basis for federal nutrition policy, nutrition programs and education, and in identifying research needs. Currently the Guidelines provide science-based advice for persons aged two and over that will promote health and also prevent chronic disease. Guidelines that provide consistent messages help consumers make healthy choices for themselves and their families. These areas will impact Americans’ awareness of healthy eating for many years.
The Dietary Guidelines help direct the course of developing effective, quality nutrition policy and guiding the regulatory process. It is also important for consumers to understand the Dietary Guidelines to help make help healthy food choices for their families. Public health nutritionist found that the Dietary Guidelines:
1. Are grounded in strong and emerging science.

2. Are focused on food patterns – how and what actual foods we eat – more than individual nutrients.

3. Look at food beyond just what's on your plate – from how it's produced to where itis sold and consumed and more.

The Dietary Guidelines Advisory Committee (DGAC) is a 14-member committee of independent experts, convened by the Departments of Agriculture and Health and Human Services. The DGAC spent 20 months reviewing the latest scientific evidence on nutrition and physical activity. Their advice is mostly unchanged from a report issued by the 2004 expert panel, prior to publication of the 2005 Dietary Guidelines. The recommendations include: Americans need to eat more fruit, vegetables, whole grains and fiber; Americans should consume more plant-based foods and eat less foods with solid fat and added sugars; and Americans should consume dairy products that are low-fat or non-fat.

The DGAC Scientific Report makes the following recommendations:

1. Reduce consumption of added sugars, by setting a maximum limit to 10 percent of calories (50 grams or 12 teaspoons) 
2. Reduce daily sodium intake to 2,300 milligrams per day for the general population.

3. Limit red meat and processed meats high in saturated fat and sodium to reduce the risk of cancer and other adverse health outcomes. 
4. Reduce foods high in saturated fats and replace saturated fats with monounsaturated or polyunsaturated fats. 
5. Include strong recommendations regarding measures to encourage consumption of fruits and vegetables.

6. Provide clear recommendations to help people identify and consume whole grains in place of refined grains.

7. Develop policies to promote water as the primary beverage of choice and reduce consumption of sugar sweetened beverages.

8. Recognize sustainability as an essential component of federal dietary guidance.

The report has already been sent to the Secretaries of Agriculture and Health and Human Services to be used as they and their staffs write the 2015 Dietary Guidelines. HHS and USDA accepted public comments on the scientific report until May 8, 2015.

The consensus from a large coalition within the public health community is that these guidelines will help consumers be able to choose healthy safe foods for their families which is an overarching goal of the Guidelines.

Monday, March 16, 2015

Repeal The Seal: No Kids Eat Right Logo on Food Products

I am participating in the #RepealTheSeal campaign to show my disagreement with the Academy’s recent decision to allow the Kids Eat Right logo onto food packaging. I invite my fellow colleagues and bloggers who share this opinion, or who support this campaign, to also post this Open Letter on their own blog, to sign the petition at, and/or to use #RepealTheSeal hashtag via social media. 

Below please find our petition letter as well as instructions for how other RDNs can sign the petition and post it to your own blog and social media platforms so that we can garner signatures from as many RDNs as possible. --Cheers, Ashley


March 16, 2015

To Mary Beth Whalan, President Sonja Connor, leadership at the Academy and the Kids Eat Right (KER) Foundation:

As long-time members and proud supporters of the Academy of Nutrition and Dietetics (AND), we are dismayed, shocked, and saddened by the blog post in last week’s New York Times. The piece ( – ) reports on the KER Foundation’s Nutrition seal— a seal that the Academy states was not an endorsement of the product, but is an indicator of the brands that support Kids Eat Right.

As dedicated Registered Dietitians/Nutritionists and food and nutrition experts, we are protesting the Academy’s position to allow the Kids Eat Right logo on Kraft Singles, as well as the possibility to allow any future implied endorsement of any product by AND for the following reasons:

Flawed Understanding of the Marketplace
We wholly reject the rationale that the Academy used in their formal press release to defend the nature of the relationship between Kraft and the Academy. A logo on a product label is an endorsement, an alignment, and recognition of a paid relationship. Simply stating otherwise in a press release, no matter how emphatically, doesn’t change this fact. Rather, AND’s actions illustrate how profoundly out of touch AND is with business principles, which has put our professional integrity and credibility at risk. It is also a decision that is out of touch with members’ values.

Failure to Provide Transparency to AND Members and Consumers
We work hard to provide full transparency in all of our own business relationships, and we expect the same from the Academy. Failure to be transparent about ANDs actions violates the Academy’s own Ethics Policy*, which calls for the highest standards of honesty and integrity, and for members to not engage in false or misleading practices of communications.

Actions Requested of the Academy: #RepealtheSeal
We ask that the Academy make available to its members, the media and the public the following:
  • We ask for full transparency regarding the process of approval to allow the KER logo on the Kraft product— including the names of those involved, the meeting minutes of the discussion, and Board’s vote on this issue.
  • We ask for full disclosure of the terms of the financial agreement between KER Foundation and Kraft. We also request full transparency regarding the status of future agreements under consideration for use of our Logo.
  • We ask the Academy to provide their plan for the discontinuation of this specific relationship with Kraft and removal of the KER logo off Kraft Singles product packaging.
Academy members deserve strong leaders who will protect the integrity of the Registered Dietitian/Nutritionist credential. This latest action is an embarrassing misstep that must be corrected swiftly in order to prevent further damage to the RD/RDN brand and to the Academy.

Rachel Begun MS, RDN
Kate Geagan MS, RDN
Regan Jones, RDN
Ashley Colpaart, MS RDN


PETITION – Sign the petition at (, which outlines the steps we are asking that The Academy and KER take to rectify this situation.

POST – Post the above Open Letter to the Academy and KER leadership on your blog and/or social media platform(s) to reach your peers and audience. Please use the #RepealTheSeal hashtag. While we kindly ask that you keep the Open Letter intact, if you have any additional thoughts or commentary that would be of interest to your readers, please feel free to include that in your own post.

PROMOTE – Please share this Open Letter and/or links to the petition on your social media platforms or your blog, and please feel free to invite others to repost on their blogs and social media networks. If you do share this on your blog, please include the following suggested language to help your audience understand how they can help support the campaign:
I am participating in the #RepealTheSeal campaign to show my disagreement with the Academy’s recent decision to allow the Kids Eat Right logo onto food packaging. I invite my fellow colleagues and bloggers who share this opinion, or who support this campaign, to also post this Open Letter on their own blog, to sign the petition at, and/or to use #RepealTheSeal hashtag via social media.

We thank you for your support!

*American Dietetic Association/Commission on Dietetic Registration Code of Ethics for the Profession of Dietetics and Process for the Consideration of Ethics Issues. J Acad Nutr Diet2009;109(8):1461-1467.

Friday, March 13, 2015

Corporate Relationships and Cheesy Facts

By now you have heard the news of the Academy of Nutrition and Dietetic's Partnership between Kraft Foods and Kid's Eat Right, which was recently criticized in a New York Times Article on March 12th 2015. 

To see Academy President Sonja L. Connor introduce the initiative in her March 2015 address click here (starts at minute 2:02) or visit the Kids Eat Right: CheesyFacts page for more information (coming soon!). 

Kraft Singles will be the first product to receive the Kid's Eat Right endorsement. But, while Kraft Foods dietitian Kari Ryan touts the nutrient benefits of Kraft Singles as a means of addressing calcium and Vitamin D deficiencies in children, The Foundation asserts that the label is not an endorsement of a product, but rather, an acknowledgement of financial support of Kids Eat Right. 

According to the NY Times, The Academy: 
"emphatically denied that the label was an endorsement. “The Kids Eat Right logo on Kraft Singles packaging identifies the brand as a proud supporter of Kids Eat Right,” Mary Beth Whalen, the Academy’s executive director, said in an email statement. “It also serves to drive broader visibility to, a trusted educational resource for consumers."
Furthermore ABC News, pinpointing the "reversal of how most ads work", quoted Academy Spokesman Ryan O'Malley saying: 
"Kraft is putting the Kids Eat Right logo [on its packaging and] saying Kraft is a proud supporter of Kids Eat Right, not vice versa. The academy has never once endorsed any product, brand or service, and we never will."
It is really a stretch for me to understand how this "trusted educational resource for consumers" is justifying such a potentially confusing relationship, to dietitians and public alike. 

UPDATE: The Academy released this Statement


In my experience as a leader within the Academy for over a decade, no issue has been more divisive to the dietetics profession (Academy members and non-members alike), than the Academy's Corporate Sponsorship program. While the Academy staff has attempted to more clearly articulate the Academy's Sponsorship program, I remain perplexed about how the Academy Foundation, the philanthropic arm of the Academy of Nutrition and Dietetics and a 501(c)3 charity, and its two programs (Kids Eat Right and The Future of Food) is governed. 

This spring the governing body of the Academy (The House of Delegates) will conduct its 2015 meeting on May 2 and 3, 2015. On May 2, the delegates will discuss the mega issue "Engaging Members in the Need to Address Malnutrition Across Nutrition and Dietetics Practice Settings." On May 3, the delegates will discuss the Academy's corporate sponsorship program.

The Current  Question they are asking Membership is: 

"How do we evolve our existing sponsorship program to further the mission, vision and goals of the Academy while safeguarding the Academy's reputation and integrity?"
How timely. 

The Meeting Objectives are:
1. Understand the impact of the sponsorship program on the profession, Academy Foundation, and the Academy, 

including DPGs, MIGs and affiliates. 
2. Identify the Academy’s steps in evaluating alignment with a potential sponsor. 
3. Identify elements of the Academy’s corporate sponsorship program that need to be retained or modified. 

 Talk with your delegate(s) about this issue in advance of the Spring 2015 Virtual HOD Meeting (May 2-3, 2015). 
1. Have you, your students, or your affiliate or DPG been impacted by sponsorship? 
2. How do you view corporate sponsorship (identify pros and cons)? 
Your delegate will discuss your feedback during the table dialogue at the Spring 2015 Virtual HOD Meeting.

If there was ever a time for members share their concerns, suggestions or feedback, the time is now. 

If you are a member, please act before Friday March 20th -- (or before you go on Spring Break). 

Take a few minutes to:

1. Read the HOD Fact Sheet on the topic. 

2. Submit comments to BOTH your DPG Delegates and State Affiliate Delegate. Delegate contact information is available here

(For the Hunger and Environmental Nutrition DPG members, your delegate is Meg Bruening and she set up a survey to receive comments here.)

3. Publicly share your thoughts to empower other members to speak up. If you are on Twitter, please RETWEET:

As an RD, I'm appalled with the @eatrightkids label on @kraftsfoods Singles, endorsement or not. #RDchat #cheesyfacts

4. Share this call to action with your colleagues and networks. 

Friday, August 22, 2014

Registered Dietitian Challenge

Greetings colleagues and friends!

The Amyotrophic lateral sclerosis (ALS) Ice Bucket Challenge (#icebucketchallenge) has emerged as a game changer, raising funds and awareness for an amazing cause.  Valid criticism aside (the need to consider water conservation during a severe drought), the ALS challenge is encouraging folks to be active in a new way and is arguably creating a way for organizations to raise awareness and engage in our social media society. Most importantly, as of August 22, 2014 the challenge has raised $53.3 million dollars for ALS research.

In the spirit of the #icebucketchallenge, I am encouraging my profession of Registered Dietitian Nutritionists to participate in an #RDchallenge with the goals of:

a.) building rapport and appreciation within our profession, and 

b.) raising funds for our valued Academy of Nutrition and Dietetic Political Action Committee (ANDPAC)--- the only political action committee broadly focused on food, nutrition and health. (It ranks among the top health professional political action committees in the country!)

AFTER you have contributed to ALS, consider joining the #RDchallenge by: 
  1. Writing a hand written letter to a Registered Dietitian Nutritionist that has been influential to your career. Currently the United States Postal Service is offering beautiful Farmers' Market Stamps to adorn your envelope.
  2. Take a photo of your card (blacking out personal information) and post your photo on Facebook, Instagram, or Twitter. 
  3. Tag three (3) other Registered Dietitian Nutritionists to challenge them to participate and use the #RDchallenge hashtag. You may also want to tag #RDchat or post on a Dietetic Practice Group's Facebook page, Instagram site, or Electronic Mailing List to reach your colleagues. 
Once you are tagged you will have 24 hours to participate or you must donate funds to ANDPAC to help support their upcoming legislative efforts! But honestly, if you are given the honor of being tagged, I hope you will choose to contribute to ANDPAC regardless! 

To begin, I wrote my letter to the current Chair of the  Hunger and Environmental Nutrition Dietetic Practice Group Dianne Lollar. This year Dianne received the 2014 National Women, Infants and Children Leadership Award. She is a savvy, smart, and dedicated RD with years of service to the Academy of Nutrition and Dietetics. Dianne is also an amazing organic farmer and has been an inspiration to me. Enjoy your card Dianne!

To get things rolling I am tagging a few fellow RDs from Twitter. Good luck!







Monday, March 4, 2013

Practice Paper: Promoting Ecological Sustainability within the Food System

A new Practice Paper from the Academy of Nutrition and Dietetic is available and the topic is Promoting Ecological Sustainability within the Food System. I'm happy to see the final paper since I helped review it months ago as a member of the Hunger and Environmental Nutrition Dietetic Practice Group. The final paper was authored by my colleague Ramona Robinson-O’Brien and Bonnie L. Gerald.

I really like this call to action:
It is important to continually evaluate current food system practices and promote practices that support and sustain natural resources and the environment. Food system sustainability is dependent, in part, upon the protection and conservation of soil, water, energy, and the preservation of biodiversity. Promoting food system sustainability can be an admirable goal among RDs and DTRs. 
I was also intrigued by this address to decreased pesticide usage and possible suggestion to support organic agriculture:
The use of pesticides in agriculture may have a negative impact on wildlife and the wider environment (water, soil, air) if leaching, runoff, or spray drift occurs. In an effort to mitigate adverse environmental exposures, consideration should be given to alternative cropping systems less dependent on pesticides, the development of pesticides with improved safety profiles and formulations, and appropriate use of spraying equipment. 
There is also a fantastic section on consumer options, including growing interest is local food, “Know Your Farmer, Know Your Food,” farm to institution work, and innovations to address food access including SNAP benefits at farmers markets, community gardens, and utilization of cooperative extension. 

Finally, I was also super excited to see a shout out to some fantastic resources that some fellow HEN DPG members developed:

Included in the resource figure (Figure 1) is a link to the document “Healthy Land, Healthy People: Building a Better Understanding of Sustainable Food Systems for Food and Nutrition Professionals, which provides wide-ranging recommendations for RDs and DTRs to incorporate professional practices in support of ecological sustainability in the food system. RDs and DTRs are encouraged to utilize this valuable tool to identify practical examples within a variety of practice areas. Wilkins and colleagues contend that the economic, ecological, and social sustainability of the food system matter as much as the nutritional value of its products and encourage RDs and DTRs to practice “civic dietetics” by integrating food system awareness into their work.

Monday, January 30, 2012

Live in Austin- Breastfeeding

This mom is too hip for words. Way to feed that baby nature's perfect food.

Sunday, January 29, 2012

Shit Dietitians Say

I had to join the fun. Please comment. Did I leave anything out?