Towards better dietary guidelines

Executive summary

* A special issue of Nutrients has just been published entitled "Towards Better Dietary Guidelines: New Approaches Based on Recent Science."

* The special edition comprised three papers related to the Dietary Guidelines for Americans (DGAs): one on saturated fat; one on low carb diets; and the third on salt/sodium intake.

* This week's note focuses on the saturated fat and sodium papers – should they be nutrients of concern?

* The saturated fat paper provided a historical perspective of how saturated fat came to be demonised and an excellent summary of the most recent evidence confirming that saturated fat should not be a nutrient of concern.

* The paper found that the Dietary Guidelines Advisory Committee (DGAC) had not considered all available evidence and had relied too heavily on examining assumed relationships between saturated fat and LDL-cholesterol, rather than events and mortality – things that matter.

* The salt/sodium paper was also an excellent summary of the literature on this essential nutrient. It found that the current low sodium targets are based on false premises. The targets have not been achieved by any population. The targets are probably unachievable and the relationship between sodium intake and health risk is J-shaped (I would call it U-shaped).

* The U-shaped association suggests that the ideal sodium intake should be between 3 and 5 g/day, which is what most populations are already consuming.

* The DGAC members had significant fake food conflicts and did not consider all available evidence. The direct consequence has been guidelines that are not evidence based. The indirect consequences on population health are more serious.