Write a Public Comment to the Dietary Guidelines Advisory Committee

We Need Your Voice!

Please join us in urging the Dietary Guidelines Advisory Committee to include a true low-carb diet in the next set of U.S. Guidelines, due out in 2020.

The Dietary Guidelines are ‘High-Carb’

The Dietary Guidelines are super influential! School lunches, hospital food, plus advice dispensed by virtually all healthcare practitioners in America is influenced by these Guidelines. Our current nutritional guidelines are high‑carbohydrate, advising between 50-55% of calories as carbohydrates.

For many Americans, but especially those with chronic diet-related conditions, more than 50% of calories as carbohydrates is not an appropriate diet.

The U.S. Dietary Guidelines Needs a Low-Carb Option

We are not asking the government to get rid of its existing recommendations, which may work for a minority of Americans, but we are asking the U.S. Departments of Agriculture and Health and Human Services (USDA-HHS), which oversee the Dietary Guidelines, simply to add a true low-carb “Pattern” as one, viable option. This addition would be amply supported by the scientific evidence.

USDA-HHS are, in fact, currently looking at the science on low-carb, but they are defining low-carb as 45% of calories as carbohydrates—which we know not to be a “true” low-carb diet, i.e., significant health benefits are not seen, in clinical trials, until carbs are reduced to 25% of calories or less.

The Definition of “Low-Carb” Needs to be Accurate

This 45% definition clearly does not reflect the standards set by research leaders in the field.

Low-carbohydrate diets are defined in the scientific literature as both percentages of macronutrients and total grams of carbohydrates. The following definitions are largely accepted by leaders in the field, including now, the National Lipid Association:

  • “Low carbohydrate diet:” ≤ 25% of calories, or 51-130 grams/day [1][2][3][4]
  • “Very low carbohydrate” or “ketogenic diet:” <10% of calories or ≤ 50 grams/day.[5]

These diets generally do not ask subjects to count calories, so the kcal/day is not relevant and is the reason why the diets are more often expressed by the numbers of grams.

Anything above 25% is not considered a “low-carbohydrate” diet and usually does not have the same metabolic results. Also, it is very important that the “low carb” and “very low carb” diets be analyzed separately, for their differing impacts on health outcomes. There is ample, rigorous, clinical trial data on each of these diets. [6]

Incorrect definitions will yield misleading results and will likely misrepresent the real health outcomes of true low-carbohydrate diets.

Also, it seems that the USDA might exclude low-carb studies that don’t include a description of food and beverages. The principal aim of low-carbohydrate studies is to focus on macronutrients percentages or grams, not necessarily the exact foods consumed. Thus, it seems that the USDA, by using this criteria, will needlessly exclude many low-carb studies from review.

[1] Feinman R., Pogozelski, W., Astrup, A., et al., “Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base” Nutrition, 2014.
[2] Westman, E., Feinman, R., Mavropoulos, J. et al., “Low-carbohydrate Nutrition and Metabolism,” American Journal of Clinical Nutrition, 2007.
[3] Cucuzzella, M. et al., “A clinician’s guide to inpatient low- carbohydrate diets for remission of type 2 diabetes: toward a standard of care protocol,” Diabetes Management, 2019.
[4] Kirkpatrick, C. et al., “Review of current evidence and clinical recommendations on the effects of low-carbohydrate and very-low-carbohydrate (including ketogenic) diets for the management of body weight and other cardiometabolic risk factors: A scientific statement from the National Lipid Association Nutrition and Lifestyle Task Force,” Journal of Clnical Lipidology, 2019
[5] Athinarayanan, S., Adams, R., Hallberg, S., et al., Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial,” Frontiers of Endocrinology, 2019.
[6] https://www.nutritioncoalition.us/lowcarbohydrate-diets-have-these-been-adequately-researched

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