Dr. Dariush Mozaffarian explains why the U.S. dietary guidelines work only for metabolically healthy people, not the majority of Americans who are metabolically unhealthy. The guidelines were designed for one population but don't account for the needs of people with insulin resistance, obesity, or metabolic disease.
The dietary guidelines really are dietary guidelines for healthy Americans, for healthy Americans. So nine out of 10 Americans are unhealthy and those guidelines really don't apply to them. And so maybe when we look at the guidelines, we need to be thinking about what we should be recommending for a unhealthy population that's metabolically unhealthy. That means high cholesterol, high blood sugar, high blood pressure, that's 88% of Americans. So we're sick and the guidelines are for healthy people, which, you know, you may be able to tolerate more carbohydrates if you're metabolically healthy. You may be able to tolerate a wider range of foods, but when you're unhealthy, and particularly from the perspective of food is medicine, you need to be guided to eat the right things, which.
Our policies really don't help us do. That is one of the most astonishing things that I discovered about the guidelines when I started to dig into them. And I realized what a mismatch they are for the American population. So they are supposed to be, according to the congressional statute, they're supposed to be for the general public. Well, when they began in 1980, the general public was healthy, more or less healthy. And so the guidelines are supposed to be for prevention only, only preventing chronic disease, right? So that's only the healthy people who haven't yet contracted disease, right? So but over time, America has, as you say, it's just become dramatically far greater proportion of us are unhealthy. We could go through many statistics, but more than half are pre-diabetic or have diabetes. As you said, 42% or more have obesity. And so now we have a policy that is applied to everyone, right? And think especially about those kids, underprivileged kids, receiving school breakfast or end school lunches. Their rates of obesity and diabetes and hypertension are even higher. Think about that kid who's being fed from the Women and Infant Children program with a mother who's obese. I mean, and the guidelines, when we say that they're not for unhealthy people, what we mean is that the expert committee that prepares the science for the guidelines, they do not even look at studies. They do not look at studies on how to help people lose weight, how to help somebody to reverse hypertension, how to help somebody to try to reverse diabetes. They do not look at that literature. So that's saying that they don't even consider that literature because they consider that treatment, treatment belongs to the medical practices, you know, the specialty practices of doctors. They don't want to do treatment. And all of that is totally understandable, but then the guidelines should not be applied to all Americans, which they are.
