Time to stimulate new directions to bail out failed dietary recommendations
The American Journal of Medicine published an article this week showing the utter failure of 30 years' efforts to improve the healthfulness of Americans' lifestyle habits. The findings suggest policy-makers need to be much humbler and likely less strident in their efforts to "improve" diet and other lifestyle choices. The current approach just isn't working.
In "Adherence to healthy lifestyle habits in US adults, 1988-2006," Dana King and colleagues at the Medical University of South Carolina use the government's own NHANES database to demolish the notion that advice to maintain a healthy weight, get more exercise and eat more fruits and vegetables are effecting positive change in Americans' behavior. The only "dietary" advice that's being followed is that more people are drinking alcohol -- and many would dispute that getting more people to drink alcohol is a national health priority (even on that, excessive drinking increased among non-Hispanic whites; only Hispanics slightly moderated their excess intake. But larger percentages of all groups began drinking (this was seen as a positive health development). Smoking incidence was unchanged (although Hispanics' smoking increased).
The number of obese Americans increased from 28% to 36%. Those exercising 12 times or more per month declined from 53% to 43%. And fruit and vegetable consumption plummeted from 42% to 26%. Those adhering to all five major lifestyle recommendations was cut nearly in half, dropping from 15% in 1988 to 8% in 2006. Unexamined were other minor advisories like curtailing salt intakes -- which also are unchanged over the period -- but, in this case, unchanged is an improvement over the five major recommendations where siginificant slippage continues.
The observation period began right after implementation of the 1980 Dietary Guidelines. With public acceptance levels like this, the Dietary Guidelines are looking like investments in Chrysler and General Motors. Where's the outrage? We've instilled concern, even fear, about eating. The public is convinced that the advice they've been given will make them healthier. But, as pretty as the model appears on the showroom floor, nobody's buying it.
We need to "stimulate" fresh approaches to our approach to the Dietary Guidelines for Americans to "bailout" our failed attempts for the past 30 years.
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