Harvey Levenstein, professor of history at McMaster University in Hamilton Ontario has just written a book entitled “Fear of Food - a history of why we worry about what we eat.” (See: http://tinyurl.com/ckyldhd ). In fact there is a legitimate medical condition called cibophobia or sitophobia, which causes a person to fear food, usually when it is prepared by someone other than themselves or if it contains an unfamiliar ingredient.

The fear of food has been around since we have chosen to allow others to prepare our foods. (See: http://tinyurl.com/bpyu6h7 ). The 1589 English Bread Assize was issued to protect consumers from flour contamination. One of the more famous books of the 19th century on food adulteration was written by Fredrick Accum in 1820, and described the fraudulent practices used in making bread, beer, tea, condiments and dairy products. This naturally heightened the fear that many had of foods being prepared by others.

The first regulation to control such practices was the Pure Food and Drug Act of 1906, also called the Wiley Act. As a result, food adulteration dropped dramatically. Nevertheless, many people still have a great deal of fear and suspicion of foods. Most of these are now driven often by the fear tactics of ‘consumer’ activists, who appear to be very long on rhetoric, but rather short on scientific evidence. Unfortunately, a great many journalists have abandoned solid research for the hype and headlines that these activists generate.

As a result, we have a population that is continuously bombarded with exaggerated threats posed by the dangers of foods. The old line, “Even paranoids have enemies,” may be cute but doesn’t vindicate paranoia. It is the same with any irrational fear, including cibophobia.

The book “Fear of Food” is a worthwhile read, especially since it also describes the negative role of organizations such as the American Heart Association in generating exaggerated and unjustified food fears amongst consumers in order to promote its own parochial goals. In fact, a full investigation of the tactics of the AHA would make an interesting book in itself. Keep that in mind the next time you eat supposedly heart healthy foods.

The Dietary Guidelines are a joint product of USDA and HHS. These Dietary Guidelines are reviewed, fully updated, and published every five years. The 2010 Dietary Guidelines must contain nutritional and dietary information for the general public and be based on the very latest scientific and medical knowledge.

For the 2010 Dietary Guidelines, the Dietary Guidelines Advisory Committee (DGAC) was appointed to conduct an analysis of the latest scientific information on diet and health and to prepare a report summarizing its findings. As far as electrolytes are concerned (specifically salt or sodium), the process appeared to be highly flawed. Rather than independently and objectively assessing ALL of the scientific and medical data currently available, the DGAC merely adopted the conclusions of the 2005 Dietary Guidelines. Was there no additional new evidence to consider?

In 2005, the DGAC made its salt/sodium recommendations by simply adopting the figures from the Dietary Recommended Intakes (“DRIs”), published in 2004 by the Institute of Medicine (“IOM”) (1). But this document stated, “..because of insufficient data from dose-response trials, an Estimated Average Requirement could NOT be established and thus a Recommended Dietary Allowance could NOT be derived.” Nevertheless, despite acknowledging a lack of dose-response evidence, the document went on to make totally arbitrary recommendations - recommendations that are followed to this day (2) - recommendations that have since been shown to be all wrong (3).

How could this happen?

Looking deeper into the matter, it appears that one common thread links ALL the decisions to adopt flawed recommendations in the original DRIs, and then base two subsequent sets of Dietary Guidelines on those figures. Believe it or not, the Chairperson of the 2010 DGAC’s subcommittee on electrolytes did exactly the same job for the 2005 US Dietary Guidelines! But it doesn't stop there. That individual was also the Chairperson of the IOM Panel on Electrolytes the original DRI’s!

In other words, in what was supposed to be a fully independent analysis, the very same individual repeatedly evaluated his own recommendations! What did anyone expect the outcome to be? It's no different than a judicial appeal process that asks the same judge to evaluate his own previous judgement! Any ethical judge would recuse himself from the process.

You simply cannot have an independent, objective analytical process featuring the same person creating the original standards, then being asked to evaluate his own recommendations and then five years later, being tasked once again to evaluate his prior evaluation. Yet, that is exactly what happened.

What is worse is that all the US public health institutions, as well as public health institutions around the world have uncritically adopted these recommendations. This has resulted in what may be the biggest delusion in modern public health history!

References

1) Institute of Medicine, Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate, v.-xiii (2004).

2) Both the Dietary Guidelines and the 2005 Dietary Guidelines contain the same sodium limit range of 1500-2300 mg/day. Because a Recommended Daily Allowance could not be determined, the IOM set DRIs that are the basis for the sodium limits in both the 2010 Dietary Guidelines and the 2005 Dietary Guidelines. See IOM, Dietary Reference Intakes: Water, Potassium, Sodium, Chloride, and Sulfate (2004).

3) Maillot M, Drewnowski A. A Conflict between Nutritionally Adequate Diets and Meeting the 2010 Dietary Guidelines for Sodium. Am J Prev Med. 2012;42(2):174-179.

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