Food Pyramid Scheme
Milk is becoming the major bone of contention in a rancorous debate about racism in U.S. dietary guidelines. Designed by the Department of Agriculture, the guidelines form the basis for all public and most private nutrition programs, including school breakfast and lunch programs, the food stamp program and the Special Supplemental Nutrition Program for Women, Infants and Children. Among other things, these federal guidelines recommend that all Americans over the age of two have two to three servings of dairy products each day, despite the fact that most non-white Americans are lactose intolerant.
Among the lactocse intolerant, dairy consumption is apt to provoke uncomfortable abdominal pain, bloating, gas and diarrhea. Yet the USDA has ignored that many Americans get sick when they drink milk. According to a two-part article last year in the Journal of the National Medical Association, lactose intolerance affects approximately 90 percent of Asian-Americans, 70 percent of African-Americans, 70 percent of Native Americans and 53 percent of Hispanics. The condition - lacking the lactase enzyme, which enables digestion of the milk sugar lactose - is rare only among Americans of northern European descent.
"Although it may be unintentional," explains Dr. Milton Mills, co-author of the Journal article, "the U.S. dietary guidelines as they exist are really a fundamental form of institutionalized racism in a rather destructive and insidious format." Mills is a member of the Physicians Committee for Responsible Medicine (PCRM), a Washington-based group that promotes preventive nutrition and has been among the most vocal opponents of the USDA guidelines. In fact, the PCRM has filed a lawsuit charging that the agency's guidelines were unhealthy and catered to the food industry.
Mills, who is African-American, told In These Times that the USDA's cavalier attitude about lactose intolerance is just one aspect of the federal government's lack of concern for the health needs of minorities. He argues that the government's refusal to encourage consumption of nondairy sources of calcium or to highlight the considerable evidence linking meat and dairy diets to many of the ailments that disproportionately affect American minorities is irresponsible at best.
Diseases that occur with a higher frequency among African-Americans, like diabetes, cardiovascular problems, prostate cancer and obesity, are aggravated by the fat and cholesterol found in the animal and dairy products recommended in the federal dietary guidelines. But there is little recognition of this link in the guidelines. The "Food Guide Pyramid," which was developed as a graphic representation of the guidelines, displays a pattern of food consumption and recommended servings that allegedly encourages the most healthy diet. At the very top of the pyramid are the foods that should be eaten sparingly: fats, oils and sweets. The next level includes meat and dairy products, and recommends two to three servings a day. The third level includes vegetables and fruits, and recommends two to five daily servings. The pyramid's foundation includes breads and grains, and recommends six to 11 servings.
The recommendation that all individuals over age two consume cow's milk daily began with the 1916 federal food guide and has remained constant despite increasing evidence that dairy consumption has major downsides. Prior to the '60s, most American health professionals believed that the lack of the lactase enzyme was rare. But, according to an article in PCRM's magazine, that changed in 1965 when researchers from Johns Hopkins University found that while just 15 percent of whites had digestive problems from ingesting lactose, no fewer than 70 percent of African-Americans had problems. The following year, a study of Maryland prison inmates found that 90 percent of African-Americans and only 10 percent of European-Americans developed symptoms. Further studies concurred that lactose intolerance was widespread.
In 1988, the American Journal of Clinical Nutrition reported that "it rapidly became apparent that this pattern (lactose intolerance) was the genetic norm, and that lactase activity was sustained only in a majority of adults whose origins were in northern European or some Mediterranean populations." Health professionals now recommend a change in terminology; those unable to digest milk should be considered normal rather than "lactose intolerant," while adults who have retained the digesting enzymes should be called "lactase persistent."
Yet more than 30 years after health professionals first realized that the inability to digest milk sugar was a normal condition, the USDA persists in recommending two dairy servings each day. One reason for this nutritional obtuseness is found in the agency's origins. When Congress created it in 1862, the USDA was charged with educating the public on agricultural matters, including food policy, while working with food producers to provide a reliable, consistent food supply. The agency published its first food guide in 1916, and it was designed largely to encourage diets based on foods produced by those with the most clout. In the early '50s, the USDA created four basic food groups: milk, meat, fruits and vegetables, and breads and cereals. Food industry representatives like cattlemen and dairy farmers were integral to this process.
During the '70s, studies revealed the health dangers of fatty foods, and a Senate committee suggested the basic four food groups be revised to reduce the intake of cholesterol and saturated fat and increase the consumption of fruits, grains and vegetables. But outrage from influential groups of food producers forced a revision of the report from a message of "eat less meat and milk" to "choose lean meat and nonfat milk." In 1991, the USDA attempted to release an "Eating Right Pyramid," which emphasized grains and vegetables rather than animal products. But, according to the PCRM, "the Cattlemen's Association joined forces with the National Milk Producers Federation and other trade associations in opposing publication of this new model. Within weeks the Eating Right Pyramid was withdrawn."
The continuing influence of food producers in designing the USDA's dietary guidelines has prompted a lawsuit from the PCRM against the USDA and the Department of Health and Human Services (DHHS), another federal agency involved in setting the dietary guidelines. The suit alleges racial bias and conflict of interest in the formulation of the guidelines and the food pyramid. American minorities are disproportionately affected by chronic diseases, the suit charges, and would be better served by dietary guidelines more inclusive of their needs.
The group claims that those concerns are missing because six of the 11 advisory committee members who devise the guidelines have explicit links to the meat or dairy industries. Specifically, the PCRM charges, the committee chairman and at least five other committee members have had links to the National Dairy Board, the National Dairy Council, the American Egg Board, the National Cattlemen's Beef Association, the American Meat Institute, the Dannon Research Institute and other similar groups.
"Having them on the very panel that is supposed to decide what's healthy for Americans to eat is like having Joe Camel on a committee designed to help people quit smoking," said PCRM president Neal D. Barnard when he announced the suit. While all Americans are ill-served by these questionable guidelines, Barnard noted, the problems are magnified in groups that are hardest hit by chronic, diet-related diseases.
The suit's primary goals are to encourage the committee to make recommendations that recognize the role diet plays in contributing to the high rates of heart disease, cancer, diabetes, stoke, hypertension, obesity and lactose intolerance among Americans in general and people of color in particular; to promote the healthiest possible diet to reduce this toll; to make dairy products optional in the dietary guidelines; and to ensure that, in the future, the USDA and the DHHS choose members of advisory committees without conflicting ties to any food industries.
A number of organizations and individuals are supporting the PCRM position, including the Congressional Black Caucus, the NAACP, the National Hispanic Medical Association, former Surgeon General Joycelyn Elders, Rep. Jesse Jackson Jr. and Martin Luther King III. What's more, several supporters have joined in the lawsuit against the federal government. Massachusetts state Sen. Dianne Wilkerson joined the suit because of concerns that federally subsidized nutrition programs pushing milk may cause children in her primarily African-American district who have difficulty digesting lactose to suffer through the day with bloating and abdominal cramps.
The federal government insists that the food industry exerted no inappropriate pressure to design the guidelines. The National Dairy Council and the International Dairy Foods Association take issue with claims that milk products are dangerous. "A broad body of scientific data continues to demonstrate that dairy products are excellent sources of nutrients that are critical to disease prevention and normal physical growth and health," reads a statement issued jointly by the two groups, rebutting the PCRM's charges. "This attack is blatantly untrue and particularly irresponsible given that dairy products are an economical, widely available source of excellent nutrition for all Americans."
But critics charge that much healthier alternative sources of calcium - collard greens, broccoli, kale and beans - are omitted from the Food Guide Pyramid. In fact, the PCRM and its growing number of supporters have the USDA running for cover on the issue of inappropriate influence of the food industry in guidelines designed for optimal nutrition. By combining the dietary struggle with issues of racial fairness, the PCRM may finally have hit on a combination that will force the federal government to take a principled stand on preventive nutrition.
Salim Muwakkil is a senior editor of In These Times.