The 2025 Dietary Guidelines with Nina Teicholz: A Turning Point for Public Health?

Nina: 
There are 2000 papers on low carbohydrate ketogenic diets that are about clinical trials, most rigorous kind of evidence on these diets that we know are so effective for reversing metabolic diseases. Those papers have never been reviewed by any of the dietary guidelines committees.

Bret: 
Welcome to The Metabolic Mind Podcast. I’m your host, Dr. Bret Scher. Metabolic Mind is a nonprofit initiative of Baszucki Group where we’re providing information about the intersection of metabolic health and mental health and metabolic therapies such as nutritional ketosis as therapies for mental illness.

Thank you for joining us. Although our podcast is for informational purposes only and we aren’t giving medical advice, we hope you will learn from our content and it will help facilitate discussions with your healthcare providers to see if you could benefit from exploring the connection between metabolic and mental health.

The US dietary Guidelines scientific advisory committee just released their recommendations. And no surprise, we should all reduce our red meat and saturated fats. We should replace eggs and poultry and red meat with peas and lentils and beans. Makes sense, right? That’s what we’ve been hearing forever. So, must be rigorously science behind it, and everybody can agree that this is what’s going to make us healthy.

Okay, I’m being facetious. That’s obviously not the case. The dietary guidelines are a mess. The recommendations are a bit of a mess. The process is a mess. And we have an expert, Nina, Teicholz. She’s been talking about this, researching this for over a decade now. So, she’s going to discuss these most recent recommendations. And with the new administration coming in, what might change and what might the opportunities be to make these dietary guideline recommendations better so we can back to really focusing on the health of individuals?

Nina Teicholz, thank you so much for joining me again here at Metabolic Mind. 

Nina: 
Hi Bret. It’s great to see you. 

Bret: 
Yeah, it’s great to see you. You have been busy, you’ve been in the news. There’ve been lots of stuff with the dietary guidelines. So, I think we have a lot to talk about. And we’ve done other interviews and other videos about the dietary guidelines, but I think it’s important just to start, you’ve been digging into this for so long, for so many years.

You are the expert on this. So, give us an idea on what just dropped with the scientific report from the dietary guidelines committee. And then who decides on whether that actually gets into the guidelines just so we know the hierarchy, and then we’ll get into the details. 

Nina: 
Okay. Should I just set the table here a little bit by explaining why the guidelines are important to your listeners or viewers?

Bret: 
Yeah, good point. 

Nina: 
Just as a basic, a baseline, the guidelines were started in the US in 1980. They’re updated every five years. I think they’re the single most powerful lever in determining what Americans think is a healthy diet. And beyond that, they are required by law to inform, if not dictate, all of the feeding assistance programs at USDA.

So, that means kids school lunches, feeding programs for the food baskets for women, and infant children, military mess halls, education programs for SNAP. And then they’re virtually, they’re downloaded by every health professional organization. So, hospital food, cafeteria food, all the food that people think is healthy.

Plus, all your nurses, dieticians, nutritionists, most of your doctors, they teach the guidelines, if they’re teaching anything about nutrition. They’re hugely influential. Even if your listeners and viewers don’t go to a (dot)gov website to find out about diet, that diet is coming to them.

And even if you all have fixed your own diet and have taken control of your own life, you still have to deal with your elderly relative in a nursing home who’s getting really not enough protein and really poor food, children going to schools. It just affects us in so many, most of us, in so many ways. So that being said, it’s a five year cycle. During that cycle.

We’ve just reached the point where the expert committee, which is an appointed committee, a new one every five years, this one is 20 people. They come out with what’s called their, The Dietary Guidelines Advisory Committee Expert Scientific Report that dropped yesterday.

That report is not the guidelines. It is supposed to, it’s reviews the science, does systematic reviews and is supposed to inform the guidelines. But the guideline policy itself, the one that is disseminated to the public, is written by political appointees at the two agencies that run the guidelines, which is USDA and HHS.

So, this year, there’s a real twist in this whole process. Normally, this expert report comes out in early fall, and then there’s a 60 day common period required by law that elapses. And then the admin, whatever administration is in power, rushes to get the guidelines written. Get them out the door before they have to leave office January 20th.

They want to control the whole process. This time, the scientific report has come out extremely late December 10th. So, the 60 day common period, again required by law, is going to fall, is going to fall under the Trump administration. So, the Trump folks who, so whoever the secretary is at HHS and USDare going to decide which of the recommendations in this scientific report to accept or reject.

They have pretty broad leeway to do whatever they want and they. The only thing they have to do is issue some kind of dietary guidelines, but they could simply roll over the last version, and just ignore this report.

There’s a lot of discretion in terms of what they do. So, it’s a big question. What will happen with an administration that is very likely to be hostile to the recommendations in this report? And we can talk about what those are. 

Bret: 
Yeah. But so, talking about the structure, these 20 individuals were appointed, who appointed them?

Nina: 
That is a very good question. It’s this black box process run by, again, USDA and HHS. People are nominated. You don’t know what happens to the nominations. There’s no criteria for evaluating them. There’s no public publishing of who the candidates are. Nothing is transparent. Then the list is released.

We have, I actually tried to get through Freedom of Information Act emails, of the process and what goes on. They don’t even email each other about the process. It’s all ‘meet you in this room and we’ll come out with the list.’ We don’t know why they’re chosen. I can tell you from studying these committees for now three cycles, a lot of government insiders, a lot of people who are going to uphold the status quo.

There has almost never been a challenger that I can remember. We have nominated the Nutrition Coalition, which is the nonprofit that I run, whose goal is to have evidence-based dietary guidelines. We’ve nominated what are called evidence-based medicine experts, people like John Ioannidis and Gordon Guyatt, who really know how to evaluate science.

Because one of the problems with the guidelines we can talk about is that they just, they don’t evaluate science correctly. Like they’re mixing up observational studies with clinical trials and it’s all just a hodgepodge. But all of our nominations have been rejected, and we don’t know why.

Nobody knows why. 

Bret: 
Yeah, and there’ve been so many calls for change over the past decade or more. And really not much has changed. And it seems like it’s because it’s this completely internal black box with no real outside checks and balances. Is that sort of an accurate statement? 

Nina: 
Yeah, the movement for change has really, not to give myself too much credit here, but there really was not a movement for change until I founded Nutrition Coalition in 2015. 

I started elevating this issue. I started getting into news stories. I started raising questions. All this issue came up through our work. We started mobilizing people and social media storms and tweet storms. And what we just did a lot, we had tens of thousands of comments and letters submitted.

We brought people to the Dietary Guidelines Advisory Meeting Committee meetings to testify in public. So, this gradually has come up as an issue. We also got the National Academy of Sciences to do two reports mandated by Congress. $2 million to evaluate really the first ever outside peer review of the dietary guidelines process.

Those reports came out in 2017. So, we’ve generated, and we also did now maybe six or seven, I think pretty important peer reviewed papers by top people in the field, including former Dietary Guidelines Committee members, documenting what’s wrong with the guidelines, right? Just all the different ways in which the evidence is the best and most current science is not represented, or problems with the methodology, all of that.

So we’ve created this foundation for change, but you are right. The reason we haven’t seen change so far is that it takes political will to go up against a largely, in their entrenched interest, at USDA. So, the food industry and also the pharma industry who fund the majority of nutrition scientists.

Ninety-five percent of the 2020 dietary guideline committee had a tie with food or pharmand half that committee had 30 such ties or more. That was a systematic review that we did on them. There are 100 partnerships at the USDA office that runs the guidelines with food companies. This is the dietary guideline office partnering with large food companies.

So, those are big and very entrenched interests to stand up to that. You’re not going to go to USDA and say, hey, sclerotic bureaucratic agency, how would you like radical change? That’s not where you go. You have to go to your political leaders. And there’s always been some energy and interest in this on Capitol Hill.

That’s why we have those National Academy of Sciences reports, but clearly, this moment is very different now. Thanks to some really crusading folks, this issue of chronic disease has been elevated to a point where, I think there’s a chance to really do something significant.

Bret: 
Yeah, it’s one of those things where it’s really, for me, my response is, what took so long? Because you’ve showed these graphs. We’ve seen these graphs all the time where the dietary guidelines were instituted. And then what happened to obesity and type II diabetes after that doesn’t prove cause and effect, but surely proves that whatever we’re doing isn’t working.

So, when you see that in such stark, obvious contrast, then it’s time to change something. It’s been time to change something for so long, but it seems like now is finally the moment where we have a group of individuals who are willing to stand up for change. So, is this sort of the most optimistic you’ve ever been about seeing actual change to address the health concerns of this country?

Nina: 
Yeah, absolutely. And I’ll just say two things about what you just talked about. Like why has it taken so long? There have been, and I say this not lightly because I’ve had to document it in various pieces of journalism I’ve done, but there has been a real effort to suppress science on this. There are 2000 papers on low carbohydrate ketogenic diets that are about clinical trials, the most rigorous kind of evidence on these diets that we know are so effective for reversing metabolic diseases.

Those papers have never been reviewed by any of the dietary guidelines committees. And in the 2015 cycle when I got through Freedom of Information Act requests, some emails from that committee, there’s a Harvard professor saying, oh, let’s look at these low carbohydrate diets because there’s so much more effective for weight loss.

And then he shut down, and somebody says, we’re going to put them in the methodology section rather than the results section so that they aren’t considered. And he pipes up and says, I don’t think we should be burying the evidence. That was 2015. In 2020, they did review low carbohydrate diets and could not find a single study.

There had already been more than a hundred trials by then. They couldn’t find any of them. They excluded them all, even though one very well done study by Lydia Bazzano. She was on the Dietary Guidelines Committee, and she didn’t pipe up and say, oh, what about my trial? So, they couldn’t find a single study in 2020.

This most recent round of guidelines, the report that was just released. Again, didn’t review the clinical trial evidence on low carb. They did something else, which we can discuss, which was crazy. So, they’re ignoring and suppressing, that’s the same, as true in saturated fats. They’ve never reviewed the original science, unsaturated fats.

There is just a huge effort to have that silence, ignored, suppressed, silenced. And I, again, I just don’t say that lightly. Those are big words to say. But I have just documented this in so much detail and as you know, there have been smear campaigns against people like me and others who seek to speak out about it.

What’s different now is that, especially Casey and Calley Means. They had a huge campaign promoting them and they were very successful in elevating this issue, like for which I will be always grateful. That was something I could not do. I just don’t have that kind of crusading personality in the same way.

And it takes a lot of money, even though we spent quite a bit of money in the Nutrition Coalition to get these National Academy of Sciences reports, or whatever else we’ve done. It takes a lot more money to get yourself in every newspaper and magazine across the country. That is a big heavy lift and it just dollars.

Bret: 
Yeah, I mean it, so it has been such a different tide that we’ve seen lately. But, of course, that tide happened after the committee was already selected and after the committee had already had their meetings, which you watched all 20 plus hours of their meetings and published their 400 page report, which you read.

And I’m sure there were other things you would’ve rather been doing with your time, but thank you for doing that. But I guess the issue is when you bring people in who have preconceived notions and biases and all those biases sort of align with each other, then it’s almost a foregone conclusion.

So, you talked about the evidence that they weren’t looking at the low-carb evidence, and when they did, they dismissed it for certain reasons. You can design sort of the inclusion criteria for the evidence, or what you think is the strength of the evidence to fit your biases. So, one of the things that I, that it just seems so off-putting in a way, is that they came out and said there’s not good quality evidence to recommend lowering ultra-processed food intake. Yeah, which as you said in in your article that you wrote for Substack, is true when you look at sort of the definition of evidence and how much evidence there is.

But at the same time, they’re willing to accept this low-quality evidence of nutrition epidemiology studies, and expand that to say that is good enough quality evidence that we can apply it to the entire country for healthy food. So, to me it seems like a disconnect. I’m curious how you see that sort of in terms of their process.

Nina: 
Yeah, maybe we should just like clue in everybody listening, that you know what’s happened in this report. So in this report, they reviewed ultra-processed foods, and they said there was limited evidence, which is the third out of four categories of grading on it to show that these foods cause any kind of disease.

I know we all hate ultra-processed foods. But actually, there is only a single clinical trial that is four weeks long on, however a very small number of people, it’s too small, too short, only one. You need more than one clinical trial to make a population-wide recommendation.

You just cannot jump from some, a tiny trial to making a generalized recommendation. So, I think as unpopular as that is, that is correct. And I think we have far more science on the ingredients, the chief culprits of ultra-processed food, which is sugars and starches, okay, carbohydrates. Let us act on what we have rigorous evidence to act upon because we do not, I believe, want to get in the business of endorsing recommendations based on weak evidence or moderate evidence.

That is what got us into this wholeness in the first place, right? Guidelines come out in 1980. They’re like, lower your cholesterol, lower your saturated fats, low fat diet.

None of that was based on good evidence. And look how long it takes to undo bad advice, right? But a universe of people believed all of that advice. And it’s just so hard to undo bad advice. In a matter, as a matter of principle, you shouldn’t be telling the entire population to do something for which you do not have good evidence.

It’s much better to try to raise the standard for all of our recommendations. One way out of this mess, I think, is to have firm recommendations and then to have softer recommendations to say, this is something that actually has previously been a kind of model for other kinds, for other guidelines in the past.

Just to say, look, we don’t have the firm evidence yet on ultra-processed foods, but we can tell you we think you should try to avoid them, as a softer recommendation. And then you also create some trust and credibility with the public by letting them know where you have evidence and where you don’t.

And I think the public appreciates knowing where there’s doubt. Of course, there are people who think differently, like the public is too stupid to understand that, but I personally don’t think so. So, I think they’re right about what they did on ultra-processed foods, and I think there are better ways to attack that issue of all the starches and sugars out there, which are really the culprits.

So, this scientific report also made a recommendation to they to tell everybody to reduce red and processed meat. This is the first time they’ve actually done that. They did it as a footnote in the 2015 report and then immediately retracted that after there was an outcry, but now it’s back as a formal recommendation.

They also said that for diets of 2200 calories and up, they thought that poultry, meat and eggs should all be reduced and replaced with peas, beans, and lentils. So plant-based sources of proteins. That recommendation is based on like obscenely low-quality evidence. It’s based on computer modeling.

It doesn’t take into account the fact that plant proteins are not as complete, do not have all the 22 amino acids needed to generate protein and muscle, and all the other functions that proteins do in your body. Those proteins are not as bioavailable. Those plant proteins come with a huge hefty load of carbohydrates along with them.

So, you’re getting, it’s less healthy food any way you look at it. They don’t have the same kind of nutrient content that meat and poultry and eggs do. So, that is just a terrible recommendation and should be rejected, and just reflects an overall plant-based diet, plant-based bias that has been going on for quite a while now.

Bret: 
Yeah, it reflects a plant-based diet and the elevation of low-quality evidence as being so important, and actually being able to tell us what’s healthy when it can’t. Perfect example is, we just did a video on, it was basically on healthy user bias, but specifically focusing on the study, the recent study that suggested eating more plant-based protein reduced the incidence of heart disease compared to eating animal-based protein.

But when you look at the actual quality of the study and the degree of healthy user bias, and the low-quality of the food frequency questionnaires and the small hazard ratio, the study is what it is. But we have to be able to interpret that in the context of the strength of the study.

But without fail, I get comments on the YouTube page of, yeah, but every study shows the same. There, it’s unequivocal evidence that plant proteins are better and somehow we’ve got in lulled into this belief that we can use this quality of evidence to make firm recommendations for everybody. Have you seen any deviation from that, from the dietary committee or they’re just doubling down on it?

Nina: 
I would say it’s even worse. which is a couple things. One is, and I just did this for the Substack I put out this morning, which is called Unsettled Science. I went through all the clinical trials that are listed, and there are three major reviews that are done for these dietary guidelines.

One’s on do the dietary guidelines prevent obesity? Do they prevent diet type two diabetes and then heart disease? Those are always the three major reviews that are done. I went through all the clinical trials for all those reviews, and I found that 17% of them actually might support those claims.

The rest have not statistically significant results, contradict the claims and, or not relevant trials or are observational follow-up studies on trials so should not have been included. It’s just, it’s a sham really. If you had 17% of studies supporting your conclusion, you would say, this is inadequate support.

And yet, they came out saying the evidence was in two cases strong, and for obesity, moderate. So, that is even worse. It’s not forcing weak evidence. It’s just not representing the evidence accurately. 

Bret: 
The other thing is, yeah, that’s remarkable. Seventeen percent, that’s just not even close. 

Nina: 
Okay. So, that’s like a preliminary number at three in the morning.

I’m not sure if it’s exactly right, but it’s low. The other way that the, that this dietary guideline committee has stooped to, in my belief, sort of new lows of evidence, is that they started this whole new computer modeling exercise where they model diets. So, the computer model not published, also a black box.

You have no idea about their assumptions, but you can, you can be sure they’re assuming that saturated fats are bad, dietary cholesterol is bad, and into this model, which also doesn’t take into consideration whether a protein is complete or incomplete or the bioavailability of the nutrients that are going into these foods.

They model the diets rather than looking at actual experimental tests on humans of the diets. They model them in their computer and then they spit out things like, here’s one you, like low carbohydrate diet is utterly lacking in nutrients. Why? Because they took all the carbohydrates out of a diet and they didn’t replace them with anything. So, they had basically half the amount of food.

Let’s say it was a 2000 calorie diet they took out a thousand of those calories. And then they’re like, this thousand calorie diet is nutritionally insufficient because we didn’t replace the carbohydrates with anything else. That was literally what they did. And I mean it’s mind boggling that has never been done before.

It is if you look at the pyramid of evidence, which is like clinical trials at the top, and then below that observational studies, and then below that anecdotal evidence. Computer modeling is not even on the chart because it’s like down there. So, this is, it is so mind blowing what they’ve done.

It’s just like beyond even reckoning. Okay, now we’re just going to completely ignore the clinical trial evidence and move over to our, like our, just our computer models that haven’t been studied or replicated. There has been a slow move, an effort to try to get away from the need for clinical trials because, to put it bluntly, the clinical trials, whenever they’re done, do not support the existing advice.

Going back to the sixties and seventies when those original clinical trials were done, that replaced, it replaced saturated fats with seed oils. They did not show any benefit for cardiovascular or total mortality, and that’s why they had to be ignored or sidelined or whatever.

We never, they were never considered by any dietary guideline advisory committee. The low fat trials also failed to confirm that diet could prevent disease. So, there’s been a gradual effort to move away, formally move away, from recognizing clinical trials as superior evidence, I believe, because they never confirm our expert dogma.

In this field, like it’s better to say we can’t do clinical trials at all. They’re so difficult. They’re too hard. I don’t believe that’s true. And to say we have to rely, we are compelled to rely, on lesser evidence. That is an argument you’ll frequently see promoted by many of our top respected nutritionist.

Bret: 
That’s fairly really depressing to hear about the methodology being used, but it also brings up a great point. This computer modeling, I think brings up a great point. We’re not talking about drugs, medicines that you just pop a pill and take it. We’re talking about food and the way people eat.

So, do computer modelings factor hunger or cravings or satiety or the way you were brought up and the foods you like and don’t like? And, of course, it’s a ridiculous question because computer modeling can’t do that. So, when we’re talking about the food we eat, those are factors you absolutely have to factor in.

So when you’re making recommendations on what everybody should eat, are they paying any attention to that? 

Nina: 
These are such great points, Bret. I mean, definitely the computer models do not take into account the fact that certain foods cause cravings, others don’t. People’s addictions that, those are not, that’s definitely not part of it.

They do make an effort in this scientific report to say, we appreciate that there’s a diverse community of people out there, and we would like to provide flexibility in our, they have something called a new, healthy, flexible pattern that is supposed to allow for a wider range of choices for people of different ethnic and cultural backgrounds.

I would just say, there’s, it’s still tightly limited. All the dietary patterns are still 52 to 54% carbohydrates, 32 to maybe 34% fat. I haven’t calculated the new numbers, but they’re all, the macronutrients are very strictly limited. And the evidence base for the guidelines, when I did a report for this group called Food for Health, it was something like 89% of the evidence base was all on white, tended to be upper middle or middle class, upper middle class people.

So they just don’t have the data on different populations to really make sensitive guidelines or something that’s more like precision nutrition for different groups. They just, and it may be the evidence doesn’t really exist, we just don’t have that much evidence. So, that’s a difficult one. But most importantly, I just think there is no option for people with metabolic conditions. The biggest, if you’re talking about diversity, the greatest urgency is to provide an option for people with obesity, diabetes, heart disease, other metabolic conditions.

The guidelines do not address that population. And let’s say that population, at least 60% of the country probably, some estimates put that up at 93%. The guidelines only prevent disease, and the they’re only meant to prevent disease. So, once you tip over into ill health, the guidelines really are not relevant for you, and there’s no option for those people.

They’re still subjected to the guidelines because USDA and HHS insists the guidelines are for everyone. They do double speak on that issue. They’ll say, these are only to treat people, but they’re for everyone. But that’s the greatest urgency is to provide an option for people who are unwell.

Because as I think most people understand now in your community, the diet a healthy person can eat is very different than a diet somebody can eat once they have, their metabolism has tipped over into ill health. That’s just a reality. That’s also a reality not recognized by anyone on the guideline committee that I’ve ever seen.

Bret: 
That’s such an important point and so drastic that it’s not being addressed by the guideline committee. And by that same standard, an 80-year-old versus a 10-year-old versus a pregnant woman and then, of course, versus someone with bipolar disorder, schizophrenia or type II diabetes, or whatever the case may be, to think that there’s one way of eating for all of those.

Really just saying that out loud sounds incredibly foolish. But is that’s basically what the guidelines represent, isn’t not? 

Nina: 
Yeah, there’s a separate set of recommendations for 0 to 2 where I think they allow whole milk. And then for from 2 to 102, that’s all the same.

There’s no different recommendation for added needs of nutrients, greater protein for growing children, women, needs for pregnancy, elderly adults who need more protein. None of that. There’s no variation for those groups. Again, they will talk about it, but they will, that’s not the actual implementation.

Bret: 
So, is it arrogant to think that we can be in a position to tell everybody what’s healthy to eat? What do they, how do they, I know you can’t speak for them, but how would they respond when they see people using meat to heal their medical problems, having a meat-based diet and being healthier than they’ve ever been?

But no, you can’t eat that way because it’s not healthy. Like that just seems so arrogant and out of place. Like how would they even respond to that? 

Nina: 
First of all, they’re the government, so they get to do what they want. And the approach that they have taken to challenges is, actually most recently I co-authored a paper with some very senior nutrition people, including former dietary guideline and committee members.

It came out in a journal of the National Academy of Sciences. We made some pretty strong claims about evidence that was not considered or various problems in the guidelines. The USDA staff, USDA HHS staff wrote a paper that is entitled something. It’s like addressing misinformation in the dietary guidelines in which they did not cite our paper, but went after every single one of our points.

So, that is their response. You are misinformation. We do not want to hear you. We are going to actually try to smear you. And I, of course, it’s arrogant, but once you have that supreme power, I suppose you think it’s justified. And I guess there are some people who work in these institutions, I have to assume, who really think they’re doing the right thing.

I just I don’t know to what, how cynical to be about it. But I think there are probably some people, there’s some women at the USDA who’ve been there 20 plus years, and like I have to believe they really believe in the work that they’re doing. 

Bret: 
Yeah, and then the other part that we touched on but haven’t gotten too far into is the outside corporate influence of the members on the committee.

And then, of course, within the government itself for the decisions that are being made. Is there any, I’ll use that as a transition to what’s coming, and what could possibly change and what could be different? Is there a possibility of just wiping out, starting clean and saying, with the new administration, saying if you’ve got outside influences and corporate influences, you’re not going to be on this committee?

We’re going to just wipe the slate clean and, focus on health rather than industry. Is that possible? 

Nina: 
So, that’s a really good question. The National Academy of Sciences, when they did their review of the guidelines, said there can be conflicts of interest on the committee. I think up to about half the committee, which is a standard in guidelines committees, but they must be disclosed.

Currently, they’re not disclosed. And there must be a, they must be balanced and there must be a management plan for them. So, that would mean like somebody who’s funded, has a lot of funding from just the meat industry. Maybe they would be on a panel with somebody who’s gotten a lot of funding from the plant-based industry, or beyond meat or something like that?

I think it’s, this doesn’t sound good, but it’s possibly unrealistic to say we can have people with zero conflicts of interest. Because if you know anything about nutrition science, you know that pretty much everybody gets some kind of funding from the food industry or groups associated with the food industry because there’s just not enough money coming from the NIH and USDA to do the kind of research people want to do.

So. I think it’s possible to try to balance and manage conflicts of interest and disclose them and just be much more transparent about it. But I would also say I would love to have, if I were forming a committee, I would also have, as I mentioned, these evidence-based medicine experts who could say, no, we’re not using computer modeling.

Weak form of evidence. No, we are not elevating observational studies to be strong evidence. We can’t do that like referees who could be in there, who could help with that process. I think that would be helpful. But if you spent any time in Washington, I think it’s just the food industry is just, all policy is pretty, like the food industry is everywhere.

They’re just all over Capitol Hill, and they’re meeting with folks at USDA. And they’re called stakeholders, and you have to consult with the stakeholders because they just, that’s the reality of Washington.

They drive a lot of policy. And so you have to figure out how to make something that works for them or some group of them so you don’t run into too much opposition and have, and be shut down. 

Bret: 
So, will that change? Rather than trying to appease them, will there be a chance to just shut them out and say, we’re not going to deal with lobbyists, we’re not going to deal with people with who we don’t believe their interests are in the health of the country?

And we’re going to focus on that? Is that a possible? 

Nina: 
Yeah. I don’t know. I’ll have to talk to my political advisors about that. 

Bret: 
Yeah. 

Nina: 
You want to be as idealistic as possible and truly operate in the interest of the public health, and in the interest of the best science. And then, there has to be, you can’t ignore these forces.

There has to be some strategy to bring people around or so that you are not just facing a wall of opposition. And I don’t know exactly what that looks like, but I think that, isn’t that the difficulty of all people in government service who want to get something meaningful done?

Bret: 
Yeah, that’s a good point. And then, I guess, one other point to bring up is just the degree of how dense these recommendations are, right? Four hundred twenty pages of these recommendations. The guidelines are enormous. And then, but the question is, what does that translate to in reality? So, the fact that my kid goes to school. And they offer breakfast at his public school, and it’s danishes and muffins and cereal and orange juice.

Could anybody on the committee actually think that’s a healthy breakfast, even though it’s completely within the realm of the guidelines and that’s why it’s being served? So there’s a, I think there’s, a total disconnect between these 400 pages and what’s happening in reality. Like, we got to wake them up.

Nina: 
Yeah, so let me explain one thing, which is that the guidelines are used, are taken over to a separate part of USDA and then are used to drive these food and nutrition assistance programs, like school lunches. But the guidelines are not translated perfectly, right? So, school lunches, this is an incredible fact, there is no limit on the amount of sugar they can give to your kids in school.

The guidelines say maximum 10% of calories, which is still I think a lot, but they didn’t take that rule over to school lunches. They can serve your kid 55% of their diet is sugar, and it often seems like that’s what they do.

And nobody is crying about that, but that’s not really the job of the committee. The committee’s job is to review the science, and then you have other people at USDA whose job it is to translate that science into even worse food for programs. There’s another thing that they’ve done in school meals.

To me, these would be like day one actions for, in the new administration. Put a cap on sugar in schools. Bring back whole milk to schools rather than chocolate and strawberry milk with as much sugar as a Mars bar. Bring back whole milk. There’s no evidence to show that whole milk is unhealthy for kids.

There’s just no data on kids, and we could dispute the data on adults, too. Like immediate actions that should be done in the women and infant children food baskets. Literally, in some states, they have Dora the Explorer cereal, Wheat Chex whatever, orange juice, one carton of eggs per month and maybe a can of tuna fish. No meat, hardly any sources of protein.

And that’s a supplemental program. So, they’re like, you get your basic needs, and we’re going to supplement you with what you probably can’t get. What you probably can’t get is a whole bunch of fruit juice and cereal boxes and like nothing essential for your body. The whole program is upside down. Like they should be feeding, giving those people healthy fats and proteins, and they’re doing the reverse.

And actually in this recent revision for the food baskets, they increase the amount of allowable sugar allowed to women and infant children. So, the whole thing is completely messed up, but that’s not the committee’s fault. That’s the fault of the folks at USDA who are designing, implementing these programs.

And that also needs to be fixed. 

Bret: 
It’s a very important differentiation. So, now let’s talk about more about what can change, and it’s not just talking in the abstract. This could be actual reality. And on social media, I’ve seen posts that your name has been floated to, maybe have a role.

And time will tell what happens with that as other names have been floated. People who would really stand for change. So, what could be done if you had the power to do it? What would you say? One, two, and three needs to change now and can realistically change that will bring us back to focusing on health and not get lost in all this quagmire?

Nina: 
I think one really critical point is to say, we usually, when a policy’s not functioning well, you say, hey, let’s hit the pause button and do an analysis or an evaluation of that policy. In this case, that has already been done. We already have the National Academies of Sciences reports. So, we don’t need to spend several years just studying the problem.

Thank goodness we have that. We could start on day one. As I said, caps on sugars in schools, whole milk back in schools. We could say USDA finally needs to adopt those National Academies of Sciences recommendations. There were 11 of them and USDA did not fully adopt even one of them. So, get the methodology on track.

And then it turns out that the law allows for there to be continuous updates. Like you do not need to wait till 2030 to provide some updates along the way of the guidelines. So, conceivably, you could start a new review of saturated fats, a new review of low carbohydrate diets. You could maybe do that in the first year.

Get that done, appoint committees to do. I think that is actually possible to try to do things in short order. And then for the current, this current scientific report that is clearly not evidence-based, I think, I’m not in control here, but I would say, probably reject most of those or fill all of those recommendations, and just say, we’ll, publish the guidelines. We don’t have any obligation to promote them. We’re just going to hang tight and not really do much with this scientific report. So, those are just some ideas. 

Bret: 
Would it ever go back to the states, or not back to the states, but go to the states and each state sets their own guidelines?

Or does that become too complicated? And then the wheat state, growing states will be very different than the cattle states, and California will be its own thing, of course. And would that be too much of a wild west? 

Nina: 
Yeah, I don’t know. If it’s related to this argument, shouldn’t we just get rid of the guidelines altogether?

And I think there’s a decent argument to be made. Let’s just get rid of national dietary guidelines that have not produced good health, and let people eat what they want. And I guess, first of all, I think that’s probably pretty infeasible politically. I don’t think that USDand especially USDA, is going to give up the guidelines.

The other reason I think that some kind of advice is needed is that we have had literally 60 years of misinformation about diet, and there needs to be a very public course correction with a lot of education around it to try to give people. The truth about the science and how they can get healthy, and if you just leave the whole, if you just retreat, who will fill that space? Who’s delivering news will be the food companies and the pharma companies because they’re the ones with the funds to generate news coverage and articles.

So, I think only the government is really capable of doing the kind of course correction. Public course correction that is needed to really deliver this advice. I think it’ll take years, too, but it’s so that’s why I argue for them. We have so much unlearning to do and so much learning to happen, and I just don’t see any other agent that can do that with authority other than a new leadership in government. 

Bret: 
Yeah, it’s just hard to come out and say, okay, here’s what we really meant. Everything we told you before wasn’t really right. So, here’s what we should have told you. That’s, it takes a lot of bravery. 

Nina: 
I mean, we’re experiencing, if it’s a new team, they’re not rejecting their own set of beliefs and their own, but you’re right. Bureaucrats, I would say bureaucracies, are very loathed to reverse themselves. You lose the faith of the public. This is the crisis we’re facing across public health, right?

We don’t need to talk about COVID so much, but there’s a set of public health recommendations that people came to distrust. They didn’t believe they were healthy, and then an complete inability to course correct for fear of losing the public trust. If they’ve already lost the public trust, and what they need I think, I really believe the only way to reestablish that is by bringing out good science.

And in this case, science that helps people become healthy. Then they will see for themselves that this is the truth. Now, that is coming out, let’s say the truth is a little heavy. Evidence-based advice coming out from the government. And if that’s the case, then the trust I believe can be rebuilt. 

Bret: 
Yeah, I think that’s important to be able to rebuild the trust, but there is a long way to go. But could, and I guess one last question, is it too simplistic to say what the guidelines really should say is just eat real food?

Don’t eat food that’s made in the factory. Eat in a way that makes you feel full and satisfied and promotes your health. That would be pretty basic guidelines. Why does that have to be more complicated? 

Nina: 
What is real food? Are you going to go, are you going to have a vegan diet or a carnivore diet?

Very different results, very different nutritional profiles. And I actually believe that we can tell everybody, it’s unrealistic for everybody to expected to cook all their own food all the time. I can’t cook every meal every night for my family. And we have, can you tell people you can’t buy soup in a can to feed your family, working two jobs?

I just think we can’t banish all foods and packages and boxes. Some of it is more healthy than others that’s evaluated based on legitimate health criteria. People need reasonable ways to feed themselves at reasonable cost, and that is going to involve packaged and processed foods.

They’re not all bad. You do need to go into a little bit more detail than just eat real food. 

Bret: 
Yeah, that’s a great point, too. 

Nina: 
That, it’s true. We can all hold hands on eat real food. 

Bret: 
In food equity is a big point that they use that term over and over again in these recommendations.

But then at the same time, to think that someone who has food insecurity is going to be able to get enough lentils and beans and peas to get enough protein, and have a complete diet that’s a little shortsighted, as well. So, again, they’re talking out of both sides of their mouth there. 

Nina: 
Yeah, the most sustain, the easiest to store and freeze and prepare foods are animal foods, right? What spoils faster with fewer nutrients are, I’m sorry to say, but fruits and vegetables. I’m, we’re constantly throwing them out, not eating them in time to cook them. And then the meat I just throw in the freezer.

If I’m a family on a budget, I want something I can freeze that will last long, that is not going to spoil. And frankly, I can I tell you like 3% of the American public likes to eat lentils. So, that’s completely unrealistic. People are not interested in needing lentils. So, you have to also be respectful of people’s tastes.

Yeah, I don’t see it. Big consumer shift to pea beans and lentils, except for maybe on the dietary guideline advisory committee itself. So, at their celebration dinner, let’s hope that’s what they’re eating, right? 

Bret: 
That’s right, there’s so many other aspects that we could keep talking about, but I want to be mindful of your time because I know you were up very late writing your Substack article about the report that just dropped.

So, thank you so much for all your diligent work on this, for being a very reasonable voice in this whole space. And who knows? Maybe in the future, we’re going to hear a lot more from you in positions of authority? The way things are going, there’s always that chance. But it’s clear something is going to change.

Question is just how much and by whom? And time will tell us. It’s going to be very interesting future. If people want to read more about you, find your Substack article, and follow you, where would you direct them to go? 

Nina: 
So it, my column is called Unsettled Science. It’s on Substack.

I’m also active on Twitter under bigfatsurprise, and that’s pretty much it. At the moment, I do have as a website that I haven’t updated in years called ninateicholz. But if you want to understand the guidelines better, I really suggest going to nutritioncoalition.us, and we just redid the homepage.

You can just, you can just scroll down the homepage to try to understand, like what are the issues with the guidelines. I think that’s pretty useful tool for people to learn more if they want to. 

Bret: 
Great, and we’ll include all those in our descriptions so they can access that. Thank you very much.

Really appreciate your time. 

Nina: 
Thank you, Bret. I really appreciate your having me on. 

Bret: 
I want to take a brief moment to let our practitioners know about a couple of fantastic free CME courses developed in partnership with Baszucki Group by Dr. Georgia Ede and Dr. Chris Palmer. Both of these free CME sessions provide excellent insight on incorporating metabolic therapies for mental illness into your practice.

They’re approved for a MA category one credits, CNE nursing credit hours, and continuing education credits for psychologists, and they’re completely free of charge on mycme.com. There’s a link in the description. I highly recommend you check them both out. Thanks for listening to the Metabolic Mind Podcast.

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