A Brief History of American Government Nutrition Recommendations and Public Health

By Dr Ernst
June 12, 2018

Since 1916, the U.S. government has attempted to influence the dietary habits of citizens through various forms of media, and their efforts have had a profound impact throughout society. We all likely remember the Food Pyramid at the very least. But what we may not realize is that the famous Food Pyramid is just one of eight iterations of this attempt at influencing Americans’ dietary habits.

Each of these eight recommendations throughout history have been different. For example, there was no mention of portion sizes until portion sizes until 1956. And when portion sizes did emerge, they changed over time and between iterations of these eating guides.

What becomes even more fascinating is to observe health trends as they change throughout time and compared to the difference in government health recommendations. It is almost common knowledge that diseases like cancer, heart disease and diabetes are on the rise—and have been for quite some time. Could there be a connection to these dietary recommendations? Let’s take a look at each of the eight iterations of U.S. government dietary recommendations and the corresponding health data to see if there’s a connection.

1916 – 1930: U.S. Department of Agriculture’s “Food for Young Children” and “How to Select Foods” Guide

These two guides identify five “nutrients” needed by the body:

  • Foods depended on for mineral matters, vegetable acid, and body-regulating substances. According to the guides, this is basically fruits and vegetables.
  • Foods depended on for protein. This includes meat, cheese, eggs, fish, nuts, beans and milk.
  • Foods depended on for starch. Basically just grains.
  • Foods depended on for sugar. Sweets and whatnot, but also includes dried fruit.
  • Foods depended on for fat. Butter, lard, oils, etc.

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Interestingly, fat is a category. Fat doesn’t get a mention again until the 70s when it is then included with sugars as something to be consumed sparingly.

These guides do offer some way of recommendations in terms of portion sizes, but it is not that helpful as it speaks rather scientifically and in terms of calories. It doesn’t have a guide for the ratio between these types of foods or what that might look like per meal or throughout the day.

The ratios are my biggest concern with this guide, as starch, sugar, fats and protein seem to be given equal weight. But it’s fine, really, as this was the first government guide and nutrition science had yet to evolve in any real way.

Nevertheless, people were simply healthier back then. I managed to find a report from 1910 by the Department of Commerce and Labor entitled “Mortality Statistics.”

Stats – 1910

-805,412 deaths total.

-Mostly Typhoid Fever, Scarlett Fever, Whooping Cough, Measles, etc.

-No mention of diabetes or obesity in the entire report.

-41,039 deaths from cancer, or ~5% of deaths.

-Heart disease: 65,971, or ~8%.

No data on obesity, which is estimated to have been lower than 1%.

1940 – 1955: U.S. Department of Agriculture’s “Guide to Eating” and the “Basic Seven”

The next iteration of U.S. government’s attempt to guide citizen dietary habits was the “Guide to Eating.” This consists of a colored wheel with seven categories.

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Again, there are no portion sizes—though the number of servings recommended for each category is included. It is mostly just a reminder to include various foods in your diet. What’s interesting about it is that fruits and vegetables are split into three different categories:

  • Green & yellow vegetables
  • Oranges, tomatoes and grapefruit are all together in a class of their own
  • Potatoes and other vegetables and fruits

Beyond that, we’ve got Butter and Fortified margarine as a single category, grains as another category, dairy as another, and proteins.

Stats – 1948

-Overall deaths: 1,444,337

-Diabetes deaths: 38,638, or ~3%.

-Cancer deaths: 197,042 deaths, or ~14%.

-Heart disease: 471,469 deaths, or ~33%

-Obesity: ~8%

1956 – 1978: Food For Fitness – A Daily Guide (The Basic Four)

Remember “The Four Food Groups”? This is where it came from.

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The feedback on the previous guide (with the Basic Seven) was that it was overly complex. So this time, the U.S. Department of Agriculture cut it down to four: milk, meat, grains and fruits & vegetables. It certainly is simpler, The difference here, though, is that this version includes recommended servings. For example, it is recommended that children have 3-4 cups per day of milk, teenagers have 4 or more cups, and adults need only 2 cups.

This guide was designed to ensure “nutritional adequacy,” or to basically make sure that people got the amount and variety of needed nutrients. It didn’t have any recommendations on sugar or fat, though, in the pursuit of simplicity. And the grain recommendations were left at “4 or more servings,” which basically left it open to as much in terms of grains as anyone thought necessary.

If we take a look at death rates (again, roughly in the middle, so let’s do 1967), we start really getting confirmation of a trend.

Stats -1967

-Total deaths: 1.9 million

-Diabetes: 35,049 deaths, or ~2%

-Cancer: 310,983, or ~16%

-Heart disease: 721,268, or ~38%.

-Obesity: 14%

1979 – 1983: Hassle-Free Daily Food Guide

This iteration is very similar to the previous “Basic Four” food group used between 1956 and 1978.

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This included a category for sugar and fat. Servings for grains were increased to 6. This became the basis for the now-famous “Food Pyramid” that we all know and remember growing up.

Again, picking a year in the middle of that stretch – say 1981, let’s look at the illnesses, keeping in mind that grains are really starting to take over the ratio here.

Stats – 1981

-Total deaths: 1,977,981

-Diabetes: 34,642 deaths, or ~1.7%.

-Cancer: 422,094, or ~21% of deaths

Heart disease: ~753,884, or ~38%

Obesity: ~15%

1984 – 1991 – Food Wheel: A Pattern for Daily Food Choices

This is similar to the food wheel of the 1940s, except that it recommends portions and daily amounts based on calories and it retains the five groups of the previous Hassle-Free Daily Food Guide.

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In this version, grains are the clear majority with a recommended 6 – 11 servings per day. 3-5 servings per day of vegetables, and a “minimal” amount of fats.

We are fully engulfed in the high carb, low fat paradigm at this point. Grains overshadow everything else in terms of priorities. And while sugar is wisely included in the “moderation” section of the wheel, there seems to be any concern that an extremely high-carb diet is effectively the same as a high-sugar diet. Let’s look at the health fallout, using the year 1989 for reference.

Stats – 1989

-Total deaths 2,150,466

-Diabetes: 46,833, or ~2% of deaths.

-Cancer: 496,152, or ~23% of deaths.

-Heart disease: 733,867 people, or ~34% of the deaths.

-Obesity: 16.1%.

1992 – 2004 – The Food Pyramid

Now we are in some very familiar territory. The pyramid is set up to illustrate what you should eat and how much in relation to everything else.

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The basis is grains, where it was recommended you eat 6-11 servings per day. Fruits and vegetables above that. Meat above that and fats and sugars (used sparingly) at the very top. Again, grains are the focus. Fats are considered “bad.” And the health trends are starting to heat up.

Stats – 1998

-Total deaths: 2.3 million people

-Diabetes: 64,751, or ~3%

-Cancer: 531,532, or ~23%

-Heart disease: 724,859, ~32%

-Obesity: 37%.

2005 – 2010 – The Sideways Food Pyramid

This version stressed exercise a bit more, and featured a graphic of a person climbing stairs up the side of said pyramid. It also walked you through your day, telling you what to eat at what times as you go through your day.

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This version also included an additional category: oils, of which you are “allowed,” even though what type of oils are not specified outright. A bit of digging finds that they recommended canola oil, vegetable oil, etc. Basically the worst kind.

Stats – 2008

-Total deaths: 2,571,984 deaths.

-Diabetes: 70,553, or ~2.3%.

~Heart disease: 565,469, or ~22.9% of deaths.)

-Obesity: 38%

2011 – MyPlate

Now, the USDA has a website where you can put in information about yourself (age, sex, etc.) and it will return information on what and how much you can eat.

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It’s actually rather complicated and takes a lot of clicking and searching before you get any specific answers about yourself, but the focus is the same: high grains, low fat, low sugars, moderate fruits & vegetables and protein.

Stats – 2015

-Total deaths: 2,712,630

Diabetes: 79,535, or ~3%.

-Heart disease: 633,842, or ~23%.

Cancer: 595,930, or ~22%.

Obesity: 38%.

Conclusions

It can be difficult to draw definitive conclusions from raw data. What does emerge is that, consistently, ~1% of the U.S. population dies every year. And consistently, they die of certain things at consistent rates, i.e., diabetes ~2-3%, cancer ~20%, heart disease ~30%. The only exception in this time frame is pre-1920s when infectious diseases were the main cause of death. This is likely due to the emergence and ubiquity of antibiotics at that time. Beyond that, nothing has changed in almost 100 years.

So what this means is that despite dietary recommendations and “advances” in medical science, nothing changes. It is almost as if destiny dictates that a certain percentage of people will die from a certain ailment regardless of changes in medicine, nutrition, society or science.

So is it fixed? Are we, as a society, on an unchangeable health track?

I would say no and posit that what is really the underlying truth is this: Regardless of time period, a certain percentage of people have poor lifestyles. That is to say, there has always been a relatively similar number of people who can’t muster the willpower, or never get the proper knowledge, or simply don’t care enough to make healthy changes.

And that doesn’t have to be the case.

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