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Editorial: Racial Bias in Food GuidelinesWhen
doctors or dietitians advise patients about what they ought to be eating, they often model
their recommendations on the Food Guide Pyramid, the government graphic that favors
grains, vegetables, and fruits, but also includes two to three daily servings of both meat
and dairy products. School lunches use the same tool, as do food assistance programs. The
Pyramid is based on the Dietary Guidelines for Americans, a slim booklet that is updated
every five years amidst heavy lobbying by the food industry.
When the Pyramid was unveiled in 1992, it was already out of date. People who ignored
its recommendations for meat and dairy, eating none of these products at all, were
healthier than those who followed them. Diets conforming to the Pyramid make artery
blockages worse, not better, and do nothing at all to prevent cancer. We also knew, from
Dr. Dean Ornishs studies published two years earlier, that skipping the meat and
dairy groups and following other healthy lifestyle changes could help the arteries begin
to clean themselves out.
We all pay a price for bad nutritional advice, but some groups suffer more than others.
The most obvious example is the recommendation for milk. What is the point of recommending
two to three servings of milk every day for the 70 percent of African Americans who are
lactose intolerant? If the idea was to prevent osteoporosis, African Americans have much
less risk of the disease than whites, yet are much more likely to have pain, bloating, and
gas from milk consumption.
The Pyramid reflects the outdated idea that lactose intolerance was rare. In 1965,
scientists in Baltimore discovered it to be the norm among African Americans, and the same
soon emerged for those of Asian, Hispanic, or Native American ancestry. In fact, the only
racial group that typically tolerates milk sugar is Caucasians, 85 percent of whom carry a
genetic mutation that causes the lactase enzymes to persist throughout life. That may be
no advantage, however, because when lactose is digested, it releases galactose, a smaller
sugar that is under investigation for its role in cataracts, infertility, and ovarian
cancer.
The Pyramid also pushes regular meat consumption. Along with the products in the dairy
group, meat perpetuates the epidemics of hypertension, prostate cancer, and other
conditions that take a disproportionate toll among minorities. Prostate cancer, in
particular, is an urgent problem. It is clearly linked to meat consumption, and takes an
extraordinary toll among African American men.
Who needs this Pyramid, anyway? What family arriving in the U.S. from Asia with a taste
for rice and vegetables needs to pack fat and cholesterol into its diet by following the
Pyramids recommendations? If a Mexican American or Native American preferred to
stick with traditional corn, beans, and other plant foods, could the Pyramid do anything
other than compromise a healthy diet?
Of course, stores sell milk with an enzyme additive that breaks lactose sugar into
galactose and glucose, preventing stomach upset. Likewise, pharmaceutical manufacturers
sell drugs for diabetes, high blood pressure, prostate cancer, and other epidemics that
are aided and abetted by fatty, meat-based diets.
There is a better solution: lets change the meat and dairy groups from daily
requirements to, at most, options. Meat and dairy are the equivalent of cigars, coffee,
and liquorsome people like them, but nobody needs them. And there is compelling
evidence that we are better off leaving animal products off our plates entirely.
Does this mean that we should be dictating to all population groups what they should be
eating? No. But it does mean that those who choose to follow a healthy diet should not be
discouraged from doing so by out-of-date government guidelines.
All population groups pay a price for nutrition guidelines that are out of date and
clearly ineffective. But the price is appreciably higher among those groups that are
hardest hit by illness.
Neal Barnard, M.D.
President of PCRM
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