Why Nutrition Guidelines Need a Major Overhaul | Dr. Donald Layman

Summary

Podcast Summary: "Why Nutrition Guidelines Need a Major Overhaul | Dr. Donald Layman"

Podcast Information:

• Title: The Dr. Gabrielle Lyon Show
• Host/Author: Dr. Gabrielle Lyon
• Episode: Why Nutrition Guidelines Need a Major Overhaul | Dr. Donald Layman
• Release Date: November 19, 2024
• Guest: Dr. Donald Layman, World-Class Protein Expert and Mentor to Dr. Gabrielle Lyon

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1. Introduction

In this enlightening episode of The Dr. Gabrielle Lyon Show, Dr. Gabrielle Lyon engages in a profound conversation with her longtime mentor, Dr. Donald Layman, a renowned protein expert. The discussion centers around the shortcomings of the current U.S. Dietary Guidelines and the necessity for a comprehensive revision to better reflect evolving nutritional science.

2. Historical Context of Dietary Guidelines

Dr. Layman provides a historical overview of the Dietary Guidelines for Americans, tracing their origins back to post-World War II concerns over public health and cardiovascular disease. He highlights the introduction of the first guidelines in 1980 by the Surgeon General, which emphasized reducing sugar, salt, saturated fats, and cholesterol intake.

Notable Quote:

"In the late 70s, we started to get much more interested in it... the first actual dietary guidelines that you and I are going to talk about came out in 1985."
[03:03] Dr. Donald Layman

3. Challenges and Criticisms of Current Guidelines

Dr. Lyon and Dr. Layman critique the Dietary Guidelines for their slow adaptation to new scientific evidence. Despite significant advancements in nutritional research over the past 45 years, the guidelines have remained largely unchanged. Dr. Layman emphasizes the limitations of relying predominantly on epidemiological studies, which he argues lack the precision and accuracy provided by randomized controlled trials (RCTs).

Notable Quote:

"The problem with diet information is, you know, we're still evolving the science... there's always the risk that you don't have it right."
[05:24] Dr. Donald Layman

4. Saturated Fat and Cholesterol

A significant portion of the discussion focuses on the longstanding recommendations to limit saturated fat and cholesterol intake. Dr. Layman challenges the effectiveness and scientific basis of these recommendations, arguing that dietary saturated fat has a minimal impact on blood saturated fat levels. He references studies, including the Framingham Heart Study, to illustrate that less than half of individuals with cardiovascular events had elevated cholesterol levels, undermining the direct correlation between dietary intake and heart disease.

Notable Quotes:

"We recovered the issue of cholesterol... we have almost no association between dietary intake and blood cholesterol levels."
[19:21] Dr. Donald Layman

"The idea that the Food Guide Pyramid was a way to sort of solve cardiovascular disease, it didn't change cardiovascular disease at all."
[08:56] Dr. Donald Layman

5. The Role of Carbohydrates

Dr. Layman posits that carbohydrates, particularly refined and ultra-processed varieties, are a more significant contributor to metabolic issues than saturated fats. He argues that excessive carbohydrate consumption leads to insulin resistance, obesity, diabetes, and heart disease, especially when physical activity levels are low.

Notable Quote:

"The body can only do two things with extra carbohydrates: either burn them in muscles or store them as fat. Very few Americans are getting enough physical activity to burn off the excess."
[25:34] Dr. Donald Layman

6. Protein Recommendations and USDA Equivalencies

Addressing protein intake, Dr. Layman highlights that approximately 42% of Americans do not meet the recommended dietary allowance (RDA) for protein. He critiques the USDA's protein ounce equivalence system, which inaccurately equates plant-based proteins to animal-based sources, leading to inadequate protein synthesis for muscle health.

Notable Quotes:

"One ounce of chicken breast has about 9 grams of protein, whereas one tablespoon of peanut butter only has 3.8 grams... it's not equivalent at all."
[65:11] Dr. Donald Layman

"The protein component to that recommendation, those guidelines were largely ignored."
[14:15] Dr. Gabrielle Lyon

7. Ultra-Processed Foods and Economic Influences

The conversation delves into the prevalence of ultra-processed foods in the American diet, attributing it to economic incentives and advertising strategies that favor processed grains and sugars over nutrient-dense foods like vegetables and fruits. Dr. Layman points out that despite guidelines discouraging red meat, consumption has decreased without a corresponding reduction in saturated fat intake, which has instead shifted to processed foods.

Notable Quotes:

"Most of the saturated fat now comes from hydrogenated seed oils found in fried foods and desserts, not necessarily from animal products."
[73:03] Dr. Donald Layman

"There's a lot more money to be made in ultra-processed foods than in selling eggs or dairy, which go directly from the farm to the grocery store."
[73:03] Dr. Donald Layman

8. Recommendations for Dietary Guideline Overhaul

Dr. Layman proposes a paradigm shift in establishing dietary guidelines by prioritizing protein intake based on skeletal muscle health rather than macronutrient distribution percentages. He advocates for personalized nutrition strategies that consider individual metabolic health, activity levels, and protein needs.

Notable Quote:

"Protein is the only absolute required macronutrient... You have to start with protein and then determine your remaining calorie needs."
[67:17] Dr. Donald Layman

9. Future Directions and Conclusions

Concluding the discussion, Dr. Layman emphasizes the necessity for the upcoming 2025 Dietary Guidelines to integrate more flexible and scientifically robust recommendations. He urges for greater transparency in the guideline development process and the inclusion of diverse dietary patterns that align with current evidence on protein, carbohydrates, and fat intake.

Notable Quote:

"There's too much information out there about reduced carbohydrate diets. They need to provide guidelines to help people understand the difference between low carb, high fat versus low carb, higher protein diets."
[34:43] Dr. Donald Layman

Dr. Lyon echoes these sentiments, highlighting the critical need for evidence-based guidance to navigate the complex landscape of nutrition, free from historical biases and economic distortions.

10. Final Thoughts

The episode underscores the imperative for a comprehensive reassessment of the Dietary Guidelines to better reflect contemporary scientific understanding. By addressing the overemphasis on saturated fats and inadequate protein intake, and by tackling the rampant consumption of ultra-processed carbohydrates, the guidelines can more effectively promote public health and nutrition.

Closing Quote:

"We're not just trying to reduce animal-based products; we're actually eating too many processed grains and not enough nutrient-dense foods like broccoli or blueberries."
[10:41] Dr. Donald Layman

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Key Takeaways:

• Reevaluation of Saturated Fat and Cholesterol: Current guidelines may inaccurately link dietary saturated fat and cholesterol to heart disease, necessitating a review based on recent scientific findings.

• Focus on Protein Intake: A significant portion of the population is below the recommended protein intake, especially women over 65. Guidelines should prioritize protein needs for muscle health.

• Carbohydrate Consumption: Excessive intake of refined and ultra-processed carbohydrates is a primary driver of metabolic diseases, more so than saturated fats.

• Economic and Advertising Influences: The prevalence of ultra-processed foods is influenced by economic incentives and marketing, overshadowing nutrient-dense natural foods.

• Personalized Nutrition: Future guidelines should embrace flexibility, allowing for diverse dietary patterns tailored to individual metabolic and lifestyle needs.

This episode serves as a critical call to action for nutrition professionals, policymakers, and the public to advocate for science-based, transparent, and adaptable dietary guidelines that prioritize overall health and well-being.

Transcript

[Dr. Gabrielle Lyon]

Welcome to the Dr. Gabrielle Lyon show where cutting edge science meets innovation and practical application for everybody. In this episode, I sit down with my longtime mentor, Dr. Donald Lehman. We discuss some very important components to the dietary guidelines. These guidelines are what the recommendations are to eat. We talk about the fat and the protein, the carbohydrates and really the science behind the dietary guidelines. I know that you're going to love this episode. Please join me in conversation with Dr. Diana Donald Layman. Dr. Donald Layman. You need no introduction, but welcome to the show. Just to give a brief background for the new listeners. You are my longtime mentor and best friend of going on, might even be over 20 years at this point. World class protein expert. Wait, just let me, let me lay it on thick, okay? World class protein expert. A real maverick and innovator in the nutrition space, especially when it comes to aging, well, muscle and protein. Today we are going to discuss the preliminary report of the dietary guideline, the Dietary guidelines that will come out hopefully spring of 2025. Welcome to the show.

[Dr. Donald Layman]

Well, great to be back. You've been so busy and traveling so much, it's hard for us to keep up our daily contacts.

[Dr. Gabrielle Lyon]

I know now it's weekly, which we reconciled being back to daily. So we're in a, we're in a great swing. Tell me, what have you been up to? Even though I know, but what have you been up to?

[Dr. Donald Layman]

I've had an opportunity to sort of change some of the way we think about protein. I, I get asked a lot about what do I think the future of protein is. And I, my answer, sort of off the cuff is that we're finally going to realize we don't have a protein requirement at all. We have a requirement for essential amin acids, the nine essential amino acids. And I think the future is we're going to have to start treating those as nutrients just like we do vitamins and minerals and stop treating them as some vague thing called protein, which is really just a food source that we eat. So anyway, that's sort of what I've been up to. We've written some papers, got another one coming out in Journal of the the Academy of Nutrition and Dietetics that we might get into as we go along with the discussion. So anyway, that's what I've been doing.

[Dr. Gabrielle Lyon]

Well, this is going to be a really exciting discussion and I do want to preface this by saying we're going to discuss the dietary guidelines and the advisory, the Dietary Guideline Advisory Committee, but we are also going to begin to discuss more about carbohydrates and fats. And this is really a wonderful landscape for setting that up. Tell us a little bit about the history. Number one, what are the dietary guidelines? What is a bit of the history behind why they exist and what they are intended to do for Americans?

[Dr. Donald Layman]

That's really interesting because they're sort of changing. So Post World War II, there was a lot of concern about public health, particularly heart disease, cardiovascular disease. And so there was a push to start having more government guidelines. And in the late 70s, we started to get much more interested in it. And then in 1980, the Surgeon General came out with first dietary guidelines for Americans. And they were fairly general, you know, eat a variety of foods and things. But what they finally, what they did at that point is they came out with some negative nutrient ideas. They came out with, sugar's bad for you, salt's bad for you, saturated fats bad for you, cholesterol's bad for you. And that sort of underpins sort of, you know, where we're at. You know, how do we interpret that information? The first actual dietary guidelines that you and I are going to talk about came out in 1985, and shortly after that, we got the Food Guide Pyramid. And dietary guidelines then get revised every five years. So, as you just mentioned, 20, 25 will be the next guidelines that come out.

[Dr. Gabrielle Lyon]

Why did they originally come out in the 80s? So the first dietary guidelines came out roughly 1980.

[Dr. Donald Layman]

Why? So, you know, I think really the motivation, again, was public health, and people were witnessing increased obesity. They were inter. They were concerned about the level of cardiovascular, the number of heart attacks people were having. And. And so that was sort of the motivation to see, you know, what lifesty issues related to that. And certainly in that, you know, part of what we found out in that period was that smoking was particularly bad for cardiovascular health. So, you know, a lot of our recommendations from smoking came out of that in those aspects. But one of the things is we started to get diet information. And the problem with diet information is, you know, we're still evolving the science. So basically, we're recommending, we're making recommendations in an area of evolving science. And so there's always the risk that you don't have it right.

[Dr. Gabrielle Lyon]

And what has been some of the challenges with the dietary guidelines beginning in the 80s? Now, first of all, I think it's important to note that they haven't changed much in the last 45 years, which is surprising because nutritional science has been evolving. There are a. There is a ton of new research that comes out again, nutritional sciences is seemingly slow comparative to medicine or some other fields. And probably because of the complexity of human nutrition. Where did it start versus where it is now?

[Dr. Donald Layman]

Yeah, the, the Dietary Guidelines. The, the challenge of the Dietary Guidelines is people would like to link what you eat today to what that's going to do to your health 20 years from now. And there are a lot of factors in between there. And Americans don't eat the same, you know, I don't eat the same today that I ate 10 years ago or 20 years ago, you know, as I've gotten older, first of all, within summary realm, as you know. But anyway, we want to relate it to disease. I think it's important to recognize that up until this year, the Dietary Guidelines were really designed to describe what a healthy diet should look like. This year, it looks like they're going to make a change to trying to design diets that also will prevent the onset of diseases. So we're getting a bit more of a disease orientation to it. So obesity, diabetes, heart disease, we know, are major issues. And so the guidelines look like they're going to get a little bit more leaning toward that. One of the other things that has happened is that in the 1980s, there was sort of the general belief that, well, the scientists thought, well, we can describe what people ought to eat. We know what the healthy diet looks like. And so basically they created the Food Guide Pyramid, sort of one size fits all. That didn't work out very well. We got epidemics of obesity and diabetes shortly after that, and they dropped the Food Guide pyramid finally in 2010. Now what we're getting is the belief that there's actually multiple ways to create a healthy diet, ranging from more omnivore type of diets, which is kind of characterized as a healthy U.S. diet, to more vegetarian. So there's really a wide, wide range. And I think. I think that's a big step in the right direction, is that there's a lot of flexibility, the body is very adaptable. But then we have to start asking about optimum. And I think that's where we're sort of. We haven't quite got the science up to. We haven't gotten the guidelines up to the science yet.

[Dr. Gabrielle Lyon]

When they replaced the Food Guide Pyramid, did they recognize, I think publicly perhaps, that the way in which they had designed it was a mistake, Somewhat of a mistake. And have they ever discussed publicly how they got those numbers? I think that there's a lot of questions about how are these guidelines designed in terms of what percentage of Carbohydrates, should we be having what percentage of protein and what percentage of fat? Or is it just arbitrary?

[Dr. Donald Layman]

So your first question is, when they dropped the pyramid and went to Food Guide to the My Plate, did they admit any problems? The answer is no. What they did admit was that the resulting of the Food Guide Pyramid was an increase in total calories in the American diet. So whether it was good or bad, the net result was as people started eating a lot more refined grains, processed foods, what we might call ultra processed foods, and they ended up eating between 3 and 400 calories more per day. So the idea that the Food Guide Pyramid was a way to sort of solve cardiovascular disease, it didn't change cardiovascular disease at all. And we got much worse case of obesity and diabetes. So basically we got rid of the Food Guide Pyramid and came out with MyPlate, which minimized the role of grains. The iconic, just viewing it as an icon. If you look at the food guide pyramid versus MyPlate, grains shrunk by about 50%.

[Dr. Gabrielle Lyon]

Do we know what Americans are actually doing? We have issued these recommendations or the guidelines issued these recommendations. It went from the Food Guide pyramid to now myplate, yet the average American is still consuming around 300 grams of carbohydrates a day. Have we been able to make that switch? You know, it's interesting, I think, okay, so there's a Food Guide Pyramid. Was anyone even following that in the first place? And now we have My Plate. And I don't know if anyone's even following these things.

[Dr. Donald Layman]

I mean, I think that's one of the arguments that the dietary guidelines folks make, is that, well, nobody actually follows it, so we don't know whether it worked or not. Who is following it. Well, it has to be. All of those guidelines are under government control, so anything that receives government aids has to follow it. So dietitians in a hospital or people in charge of school lunch or nursing homes or daycare, all of those have to follow it. And I think there's pretty good evidence that that's not working out very well. So, you know, it did disappear. You know, how well are people following it? You know, I think we jump over to where, where do we think we're at right now? The 2025 Dietary Guidelines, their first evaluation of where Americans are at. Basically about it's 90% of Americans are not eating the vegetables recommended, 80% are not eating the fruits recommended. But on the other side, 92% are eating more refined grains than recommended, and about 60% are eating more total grains than Recommended. So, you know, the argument about plant based diets, the issue is we're eating the wrong plants. We're eating highly processed carbohydrates and we're not eating the vegetables and fruits that we should be the higher fiber. Along with that, about 45% of Americans are not eating the protein that's actually recommended. So we were eating more processed carbs, ultra processed foods, ultra processed grains, and not the amount of protein. So that's what the dietary guideline says that we're doing. It's interesting when you look at their statements though. They say, well, we're not eating enough vegetables or fruits. And the solution to that is to eat less animal foods. That's not the solution at all. The solution is to eat less processed grains and eat more high quality vegetables and fruits. The problem isn't, I mean, the issue isn't a substitution of broccoli for yogurt or, you know, asparagus for eggs. It's the issue of we're eating too much rice and too many french fries and not enough broccoli or blueberries. You know, they just have the wrong focus. And that really raises the question about bias and issues of, you know, motivation behind the dietary guidelines.

[Dr. Gabrielle Lyon]

Can you explain a little bit more as to what you mean when you mention that we recognize that 42% or so of Americans are below the recommendation for protein, which is.08 grams per kilogram? Yes.90% are below the recommendations for vegetables and 80% are below the recommendations for fruit. And did they issue a statement in correction of these things based on. I, I'm assuming that that's what I'm getting at with what you're saying. But the recommendation did not address dietary protein. It was basically eat more fruits and vegetables. And the protein component to that recommendation, those guidelines were largely ignored.

[Dr. Donald Layman]

Yeah, I, I mean, what I just quoted was the statistics out of the dietary guideline report. And you know what, what is becoming public, what are in the public statements aren't connecting the right dots, in my opinion. They're, they're, you know, are we eating the appropriate plants in the American diet? Probably not. I agree that we're not. But what's wrong with the American diet? What's wrong with the American diet is ultra processed grains. We're eating too many carbs for our level of physical activity and our level of daily needs. So in my opinion, they're missing the main point of what needs to be corrected.

[Dr. Gabrielle Lyon]

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[Dr. Donald Layman]

I think one has to approach it with understanding that there is bias out there against animal products, animal foods, and whether it's driven by the food industry that makes more money selling processed foods, or whether it's people who are culturally or religiously against that, there is a bias out there. So if you go back into, if you go back into the late 70s and early 80s, there was things like the Framingham study and there was the seven country studies by, oh, I lost his name, Ancel Keys. Thank you. Wow. Brain dead. And as we look at it, they found an association between dietary intake and heart disease or, you know, cholesterol in the blood. But if you go back and actually look at the Framingham studies of the people who actually had heart conditions, had myocardial infarctions, only 48% actually had higher cholesterol of the people who had cardiovascular events in the Framingham studies. So it's a pretty, it's less than a coin flip. It's 50, 50, which isn't very good prediction. And so there was a 20 years of research sort of looking at cholesterol in the diet, to blood cholesterol. And what we found is there's almost no association. And so that was finally dropped in 2010. You know, most of the world dropped it in 2000 because the data was so strong, but we actually didn't drop IT in the US till 2010. And the reason there's no relationship is most blood cholesterol comes from the liver. We actually make it. In fact, if the liver wasn't making cholesterol, cholesterol would be an essential nutrient. We'd have to have 1,000 milligrams per day in the diet. As it is, we get about 300 milligrams per day in the diet, and the liver makes the rest. So that was sort of the cholesterol issue that went away. Why is it still hanging around? Well, there's this sort of disconnect. There's the belief that blood cholesterol does have a relationship to heart disease, and it does at some level. And so people don't like the idea that, well, if blood cholesterol, how come you can eat it? That just doesn't seem good. You know, if you're gonna. If you're gonna sell statins to regulate blood cholesterol, but dietary cholesterol doesn't make any difference. It just. The logic isn't very good. So people like to hang on to that theory, even though the research is really clear that diet doesn't make much effect. Moving over to saturated fat, saturated fat is a more complicated question. But the reality is, is that the dietary saturated fat doesn't impact blood saturated fat very much. Again, we know that blood saturated fat does relate to heart conditions. So, you know, having elevated saturated fats in the blood, palmitate, etc. Is not a healthy outcome. But then the question is, where does it come from? And the issue. Then we resort to all this epidemiology study, and we find people that tend to have more saturated fat in their diet tend to be less healthy. But that's really complicated by a lot of lifestyle issues. And so if you really look, what you find is that blood saturated fat is a combination of total calories you're eating, exercise, total carbohydrates you're eating, and saturated fat that you're eating. So those all come together. And the problem with all the epidemiology is that 75% of adults in the US are overeating calories, they're overeating carbs, and they may or may not be overeating saturated fat. But, you know, that that makes the relationship. So my problem with saturated fat is that we're making dietary recommendations based on the saturated fat numbers. 10% of calories when the science behind it is really weak. And when you start your dietary guidelines with that premise, it distorts all decisions you have to make. Basically, it limits everything you're thinking you're going to do. And it basically drives the whole issue about animal foods. And, you know, I think that's a huge, huge problem. And one of the things in the new dietary Guidelines, as I mentioned earlier, is they. They've suggested we need. There's a variety of healthy diets, which I think is true. More animal foods are more vegetarian, both can work. But they've also highlighted American diet is decreasing in nutrient density, we're diluting out nutrients with higher calories, and that's a carbohydrate problem. And I think that's one of the issues is that the animal part of our diet, which makes up about 30% of our calories, supplies almost 65% of the nutrients in the diet. Vitamins, minerals, amino acids, et cetera. And so we've got this conflicting set of issues out there that we're not balancing nutrient density against the. The messages about plant based diets. And we're definitely driving all of this on a false belief about saturated fats.

[Dr. Gabrielle Lyon]

And, you know, you and I were talking beforehand and you had sent me this. This is a Volek paper and it is the effects of stepwise increase in dietary carbohydrates on circulating fatty acids and palm palma. Teic.

[Dr. Donald Layman]

Yeah.

[Dr. Gabrielle Lyon]

Did I say that right?

[Dr. Donald Layman]

Yes.

[Dr. Gabrielle Lyon]

Okay.

[Dr. Donald Layman]

Yeah.

[Dr. Gabrielle Lyon]

In adults with metabolic syndrome. And what I thought was so fascinating. Do you remember this study that you had sent over that?

[Dr. Donald Layman]

Sure.

[Dr. Gabrielle Lyon]

It. Do you care to explain it a little bit about how. Great. I'll let you take that away.

[Dr. Donald Layman]

Yeah, no, you know, so the point I just made a minute ago about saturated fats in the blood, I think there's good reason to believe those are a concern for heart disease, especially if you're overweight. But then the question is, where do they come from? And the obvious thinking like cholesterol was, well, you eat them, so that's where they come from. But the issue is a lot of the saturated fats in the blood actually come from carbohydrates. When you eat carbohydrates, the body has to get rid of them. And basically you can burn them in muscles. But most people are sedentary. And so the only other place to do it is make it into fat. And the only fat the body can make from carbohydrates is saturated fat, palmitate or palmidio oleic. As neither one of us can Say, which is. Which is basically a palmitate with a single double bond, which is a first step and highly related to heart disease. And so there's. There's been studies. The original one was Ted Van Italy who showed the same thing. Then there was Ron Krause, who showed that saturated fat in the blood only impacts, you know, saturated fat only is a concern when carbohydrates are high in the diet or calories are high in the diet. Then Jeff Volek showed it again, and mucefarin showed that, you know, it's carbohydrates that primarily drive it. So, you know, what we know is that there's an interrelationship between the two. And what we also know is what Americans are overeating the most is the category of carbohydrates. And so one of my biggest problems with the Dietary Guidelines is that they continue to hang on to this saturated fat number of 10% of energy, but they don't address the issue of carbohydrates being linked into it. And so, you know, I think, you know, are saturated fats something to be concerned about? Well, they are if you're overweight, if you're overeating. So, you know, if you're committed to being obese for the rest of your life, then you probably need to adjust your saturated fats. But if your goal is to be normal weight and healthy, there's no evidence that saturated fats are a problem.

[Dr. Gabrielle Lyon]

Where do you think the confusion lies? With the media and influencer space. Because the ultimate goal is how do we create a pathway to information that helps clear things up for people. Right. I still have patients and still have friends that believe that dietary cholesterol is going to impact their personal blood level cholesterol, and that saturated fat is going to do X, Y and Z. How would you respond to those kinds of things, especially when you see studies, and I'm sure you're going to say that they're epidemiology. How do you respond?

[Dr. Donald Layman]

I mean, I think it's hard to get over that hump when the Dietary Guidelines process won't recognize the research. They basically continue to stick with the same research without recognizing these contradictory pieces of information. We hear people talking about the transparency of the process. It's not that the process isn't transparent. The issue is the process chooses what to ignore. And they ignore these studies that I just mentioned. They don't comment a lot of. We now have 20 years of research showing that reducing the carbohydrates in the diet actually is Very beneficial for metabolic syndrome, obesity, weight loss, even type 2 diabetes. And yet there's no mention of it in the Dietary Guidelines. To me, that's. It's not an issue of transparency, it's more an issue of honesty. And as you point out, the Dietary Guidelines love the epidemiology because you can have a study with 5,000 people and you can have hard outcomes like heart attacks or whatever, diabetes or something. And so they reject the small studies that actually do the controlled work, where they actually do random control trials and they feed it. I mean, back in the, you know, the mid, the early 2000s, I did a series of studies working using the Food Guide Pyramid, comparing to reduced carbohydrates, higher protein diets. And what we showed was there's never was a single case where the Food Guide Pyramid was a better diet. It was an okay diet, but a lower carbohydrate, higher protein diet was always superior. It never goes the other way. So, you know, it's not that a Food Guide Pyramid type or more vegetarian diet can't work, but what we know is the alternatives, when done correctly, actually work better.

[Dr. Gabrielle Lyon]

It's fascinating because as I was preparing for this episode, I did a little bit of research and I wanted to see what the consumer or other physicians or scientists or people in this space would be looking at. And I Googled, I did a Google Scholar search, which I sent you this paper. We won't mention this, this first author's name, but basically the paper is. Was published in the American Journal of Clinical Nutrition, which is a good journal. And it's about addressing misinformation about the Dietary Guidelines for Americans and thinking about the prep. Prior to this call, you and I were speaking about the transparency and where the rigors of science come in. And this paper has a column of misinformation and then it has facts, which makes it look very scientific. And I just want to read a few of the, quote, misinformation and then the facts. So the misinformation this group of individuals stated said the Dietary Guidelines, the misinformation that people think is that the Dietary Guidelines ignores science and is not based on rigorous review of the evidence. And then the fact that they state is that there is an extensive review of scientific evidence. Three different methodological approaches are used, and it goes into this evidence and data analysis and food modeling and systematic reviews and what they while. And the last statement is while minimizing biases. And I'm sure that your answer to that would be, well, what papers did they choose? Why Is it largely epidemiology? Where are the randomized control trials? How would you answer to the misinformation, which may be true, and then the fact that was given, you know, the.

[Dr. Donald Layman]

Reality of what they're saying in terms of, you know, what they're using, these reviews is exactly correct. And they're pretty powerful tools. But the question is, when you design those tools, you have to put criteria on them. And if you set the criteria up so that it ignores all the random control trials that give you a different answer, then that's your bias. And, you know, we know that, you know, they have set up the criteria to ignore some of these studies, and they'll. They'll argue, well, they're not long enough, or they're not as enough subjects, or they're what? But the question is, if you continue to get these studies that give you contradictory data, at what point do you have to recognize that your epidemiology studies just aren't right? They have these big epidemiology studies and they keep doing these systematic studies, which presumably gives you more power. But, you know, the first, you know, day one in statistics, you learned the difference between precision and accuracy. So basically what they're doing is they're giving. They're using the same criteria, which gives them a lot of precision to get the wrong answer. Repeatedly, you know, they're very precisely wrong, but they're not accurate. And that's the problem, is that they don't admit what they're excluding.

[Dr. Gabrielle Lyon]

Where does that come from? Because another, quote, misinformation that this paper highlights is that the process to develop the Dietary Guidelines is not transparent. So this was the misinformation statement, and the answer to that was information about each step of the process and how to participate in the development of the Dietary Guidelines is made available to the public through dietaryguidelines.gov and this is all focused on transparency.

[Dr. Donald Layman]

And that, I think, is reasonably true, but it's a massive change in this guideline. So it had never been true before in the first guidelines in, in 1985. It was basically done in a black box. Mark Hagstead basically said, well, this is what I want it to be, and I'm going to ignore everybody else with a contradictory opinion. So there was nothing transparent about it and there was nothing scientific about it. Over the years, these committees have sort of functioned in a black box and came out with their reports and they've gotten criticized. So to, to their, you know, to their credit, they have made this year's process far more transparent than Any other time. So, you know, I think the, the statement that you're, that they made that it's more transparent. They're doing a lot of public input meetings. I think that is totally true. But it still is an issue of what are they choosing to ignore. And that's the issue that I don't understand. There's no explanation in the first report that has come out of why they're ignoring all these low carbohydrate kinds of studies. And I think that's what needs to be address. I don't mind their models. They have a healthy US Diet, they have a healthy Mediterranean diet. I think that's important to recognize. I call it a healthy Mediterranean diet because all Mediterranean diets aren't considered healthy. And they have what's called a healthy vegetarian diet. Again, not all vegetarian diets are healthy. So I think they, they have a variety of models. I think that's great. They're after diversity of opinions. I think those are all great steps forward. But they're still not addressing the issue of the processed carbohydrates even though they know that 92% of Americans are eating too many processed refined grains.

[Dr. Gabrielle Lyon]

You know, when I look at this paper, it highlights, you know, it does say on this paper it says low carbohydrate diet and macronutrient distribution. And to, to really highlight what we're talking about is that we're addressing the Dietary Guidelines and the Dietary Guidelines that will be coming out in 2025. And there has been a series of papers published. Really, it's almost addressing this preemptively, which is interesting in and of itself. And it talks about the myths versus the facts. And another quote, misinformation is that the, it says this in the 2020 Dietary Guidelines conducted systematic reviews of diets on the basis of macronutrient distribution, including weight related outcomes and all cause mortality. And it said that the available literature lacked consistency in defining terms related to low carbohydrate diet. And potentially that's why they didn't include some of them. It they also said that the Dietary Guideline Advisory Committee was unable to provide advice regarding low carbohydrate or other macronutrient based diets because of limitations in the body of evidence.

[Dr. Donald Layman]

I think that's interesting because we had, as we mentioned earlier, 20, 30 years of cholesterol recommendations when the literature was highly confounded. There was a huge amount of contradictory research, contradictory information, and yet they stuck with it. So in other words, they're creating a bar for certain topics that they didn't follow for other topics. And, you know, I think that, I think that damages the credibility. There's, there's two ways to look at lower carbohydrate diets, and I think a little bit of the confusion may be there. There's sort of the keto approach, which was high fat, low carb. And Jerry Reevens and others kind of looked at that and they found that it always improved metabolic syndrome characteristics. But, you know, I agree, I, I really don't like super high fat diets. I don't think that's necessarily the way to go. But there's another way to look at it and it's the way we did the research which was reduced carb, higher protein. And I would challenge anyone to go out in the literature and find a single study that doesn't show that during weight control or diabetes that a lower carb, higher protein diet isn't more beneficial. You know, we, we did the food guide pyramid versus that kind of diet, and the food guide pyramid was always worse. It's simply there are studies out there that don't show a difference statistically between a lower carb, higher protein. But I don't know of a single study that ever shows the higher carb, lower protein is better. And so you've got to come up with the issue that basically there's never any harm in it, and in general it's better. And so the idea that they're copying out on it, that they think the literature is controversial, I think that is just, I think that is, in fact misinformation. The literature is far more clear than that statement would, would argue.

[Dr. Gabrielle Lyon]

I would agree. And I do want to also discuss this saturated fat. As I'm going through this paper and you're responding to some of the statements made, I think it becomes very critical. And here's why, frankly, Don, why it's so critical is that I have access to you. You are my best friend, you are my mentor of 20 years. A normal person, a normal physician, even someone trained in nutritional sciences would look at this and still struggle. And that is why it's so critical that we have people like you that can help educate us. Because looking at this saturated fat, and this is probably the biggest area of contention that you and I both face, because you and I do a lot of teaching together. And I'm going to read this statement. And this is, and just to keep in mind, right now, the guideline for saturated fat is less than 10% of the energy, and the current US average is around 11% of energy from saturated fat. This statement is that this is, quote, the misinformation statement. A large body or. This might not be the misinmer. Misinformation statement. This is what the Dietary Guideline says. A large body of evidence reviewed by multiple Dietary Guideline advisory committees, including strong and consistent evidence from randomized controlled trials reviewed by the 2020 Dietary Guidelines, show that replacing saturated fat with unsaturated fat, especially polyunsaturated fat, significantly reduced total LDL cholesterol in adults. So this was a statement made. They also said the Dietary Guidelines found strong evidence for a link. I don't know what that means, between diets lower in saturated fat and lower total and LDL cholesterol in children. And the list goes on.

[Dr. Donald Layman]

So your first statement about higher polyunsaturated having impact versus saturated. I think that's right. I think the data is really strong on that. But then you have to make the next step about amounts. There's one thing to talk about, the general direction. Then you have to get into amounts. We know that the average American's eating too much polyunsaturated fat already. We know that the ratio between polyunsaturated and monounsaturated or omega 3s is too high. We think that it's probably too high by at least double, if not four fold. So, you know, the idea that the way to correct it is to eat less saturated and layer in more poly is a. Is a mistake. We need to eat less fat. Okay, I can go with that. So, you know, I think. I think that the first step about replacing saturated with poly, I think there's a lot of good evidence of that. But then we need to go back and ask the quantity of saturated fat. Okay. And my problem with that, I'm a biochemist, so I like to think of a mechanism. Give me a mechanism to explain that. And so where does 10% of energy come from? And what does that mean? Well, that is a number that's really drawn out of the air. Let me give you the example. A lot of people have heard about the goal of 30% fat, which is still in the guidelines. So where did that originally come from? Well, there was a committee and there were people who were arguing the science, that one group said fat in the diet had to be below 20% of calories, and another group said, well, it's perfectly fine above 40. And they had both had good science. And so they were at a total stalemate. And somebody said, well, would you accept a compromise at 30? And so they basically compromised at 30 and there was no data at all to support that. And so that's kind of where the 10% comes from too. It's a compromise based on surveys and others. And, you know, as I think about it as a biochemist, I think, oh, 10%. So what does that mean? So the average, the diet that they usually think of as a standard diet is 2,000 calories. So 10% of that, that means around 22 grams of saturated fat is okay. That's your line, right? But let's say you're, let's say you're an elite athlete. You're an elite athlete who's consuming 4,000 calories or something. 10% of that means that 45 grams, 44 grams is okay. So that means twice as much. But if you were an elderly person only consuming 1200 calories, that means 14 grams is unhealthy. So how can we have, if saturated fat is so damaging to the blood, how come 44 grams in an athlete can be okay, but 14 is too much in an elderly? That makes no sense biochemically. So that 10%, I think that is the most damaging single part of the dietary guidelines is there's no justification for that number. If it's really a number, give me a number. Is it 20 grams of saturated? Is it 30, is it 40? Give me another number that's going to cause heart disease and I'll work that in. But by making it 10% basically makes all diet patterns subject to that control. You have to start your diet planning with the saturated fat number. And I think, and I think you agree, you should always start your diet planning with your protein number, make your choice and then fill in the calories.

[Dr. Gabrielle Lyon]

I mean, if it was so bad, I mean, it is a really important point. And now we're getting into some of the nuance conversation that I think will allow people not to be quote, influenced and actually really think about this from an evidence based perspective. Because if, for example, there was something that was toxic in a dose, if protein or saturated fat does all these negative things, then we should be able to say just like, I don't know, cyanide, I mean, that's a bad example, that 1 gram of cyanide will kill you. We know this. Or if saturated is saturated fat is so bad, which by the way, the body does make saturated fat, at what number would that be detrimental? X number of drinks of alcohol will bring the blood alcohol level up to a certain number.

[Dr. Donald Layman]

Correct?

[Dr. Gabrielle Lyon]

I mean, is that true? I don't drink.

[Dr. Donald Layman]

I don't know, yeah.

[Dr. Gabrielle Lyon]

We do have to begin to think about if we are going to in science, we have to be able to put things together. If we are going to. We can't say 60 milligrams of vitamin C is the minimum to prevent scurvy and anything over a thousand milligrams might become water soluble and it's not an issue. Right. We still have to have numbers. Anything below that number is a problem. The same, the same way saturated fat would also have to be. If 10 grams of saturated fat is the amount that a human can eat, then that's the amount a human can eat. I think we really are, because we could say that for essentially. But then if I were to play devil's advocate for myself, would I be able to say this number of carbohydrates would be safer human consumption? And I guess there's obviously there's metabolic differences, there's muscle differences, there's activity differences. But we need clearer, clearer answers to this.

[Dr. Donald Layman]

Yeah, I mean it, it has to be, it has to be a metabolic base number. I mean it. You know, Jeff Volake, the paper you mentioned earlier, he used saturated fat in the diet from 30 grams to 85. And you know, again, I just said, you know, a 10% of a 2000 calorie diet is only 22. So all of his values were way above that minimum standard. And yet he found absolutely no effect of the dietary cholesterol, dietary saturated fat on changing blood saturated fat levels. And so there's this disconnect. And so we know that one of the primary sources of saturated fat in the blood is de novo lipid synthesis. We know it's coming from carbohydrates. And so we've got to put these two pieces together. We know that the relationship of total calories, total carbs and saturated fat are somehow interrelated. And that's what's missing in the guidelines. It's all about the saturated fat and the diet, when in fact I think it's all about the carbohydrates in the diet. And you know, the Dietary Guidelines Committee copying out on that by saying, well, there's conflicting data. Well, you know, there's conflicting data on a saturated fat number at 10% too. Give me some really good data about that. So again, they're, they're picking and choosing numbers without any real credibility to it. So, you know, they want to argue transparency, but they really don't have a mechanism to back up that number.

[Dr. Gabrielle Lyon]

Do you believe that we are going to come to the same conclusion? We I say we like, hey, how's it going, Don? That with dietary cholesterol, it was a story through Ancel Keys, the seven country study for a long period of time. Eventually, you know, I actually thought that they were taken out of the guidelines. In 2015.

[Dr. Donald Layman]

Keys was a, Keys was more interested in saturated fat than cholesterol. But go ahead. Okay.

[Dr. Gabrielle Lyon]

But what happened was eventually cholesterol was taken out of the guidelines because it wasn't found to have a significant impact. Do you foresee saturated fat falling, falling into that same category eventually, that it's just a matter of time?

[Dr. Donald Layman]

Yeah, my crystal ball is not very good on that. I would certainly hope that it would. You know, I think the pressures and I think that the, you know, I, you know, I think the number of people that have to backtrack on careers based on this argument is so high that I doubt it. You know, and I, you know, I think it's, I think it's one of the issues, you know, we think about, you know, why do government based recommendations not have much credibility? I think it's because a lot of people have gone out and they've done research or they've even followed it as a lifestyle and they simply know it's not true. And so, you know, I think we have to, I think we have to learn how to deal with flexibility more. And you know, and I'll give the current guidelines people more credit that they're looking at more diverse diets. You know, their early statements are as, there's not just one way to eat that's healthy. We need to recognize personal preferences and we need to recognize cultural differences and things like that. I think that's a huge step in the right direction. But I think they need to be more transparent in giving people accurate information. And there's just way too much information out there about reduced carbohydrate diets. They need to be giving people guidelines on how to understand that. They're concerned about the conflicting information right now. They're hiding their head in the sand as opposed to trying to help people sort it out. You know, is there a difference between low carb, high fat diets versus low carb, higher protein diets? I would say there is and I would like the guidelines to help people understand that. And that's, to me, what they're missing is they're saying, well, we can't give you a real good guideline. It doesn't fit our current model. So we're going to say that it's not reproducible enough and that's just not true.

[Dr. Gabrielle Lyon]

It's also interesting when you think about, based on the saturated fat fat guidelines, that something like an egg, which is a highly nutrient dense food, would never then be considered a, a healthy food option. And that's because it contains 1.8 grams of saturated fat, which would be, I have a note here, 18% of energy. Is that true?

[Dr. Donald Layman]

Yeah. So, you know, I, I was director of research at the American Egg Board for four years and, and you know, when we basically got the cholesterol guideline dropped. So, you know, I'm sort of intimately involved in these numbers. And an egg is a very good source. It would be an Excellent source of B12 niacin, of multiple nutrients, but it can never be considered an excellent source of a nutrient because of the saturated fat. And as you said, it has about 1.6 grams of saturated fat in 77 calories and a large egg, which gives it at 18%. So it's above that 10% threshold. So therefore it's considered not healthy. And that's just ridiculous. Again, let's say 22 grams are the issue. How does 1.6 relate to that? You know, it's, you know, if I, if I didn't have any other saturated fat from any other food, I've only got 1.6 for the day. So we're limiting foods based on a concept of a percent of energy. That has no relevance. If it's 25 grams per day is going to kill me. Tell me that. But don't tell me it's a percentage of calories because that's just dumb.

[Dr. Gabrielle Lyon]

Said by Dr. Donald Layman. What about.

[Dr. Donald Layman]

You can quote me on that.

[Dr. Gabrielle Lyon]

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[Dr. Donald Layman]

Inherent problem with the epidemiology is that when you take the individuals that they sort out as unhealthy they tend to have a lot of unhealthy lifestyle issues. You know, carbohydrates, exercise, lack of fiber, lack of vegetables, smoking, drinking, what you know, they have a lot of things. And people will say, well, we can covary those out, but you can't covary out an entire lifestyle. You know, we, you know, we did some research at the egg board. If you, if you just take the NHANES data and you look at egg consumption across the quartiles, what you find is higher egg consumption can relate to obesity and diabetes and heart disease. But if you then go in and do the research and factor out the people who eat all of their eggs at fast food quick serve restaurants and then go to people who eat them at home with vegetables and healthy lifestyle, you find out that eggs are actually beneficial. They reduce obesity and they reduce heart disease and they reduce diabetes. So again, you have to sort the epidemiology. I mean, we tend to say, well, here's a vegetarian with an absolutely healthy lifestyle. And then we take the unhealthiest American and say, well, see, they're different. Well, of course they're different, but we have to compare, you know, apples and apples. We have to take healthy lifestyles on both ends. And again, I'll go back to the Dietary Guidelines and give them credit. They're indicating that there are multiple ways to have healthy diets and I think that is a huge step forward. The last dietary guidelines in 2015 began that modeling exercise. I think that is enormously important and you know, we need to build on that. But again, we need to get the right information out there.

[Dr. Gabrielle Lyon]

Of course, then we have to bring up protein. There is evidence to support 42% of Americans are below protein recommendations. I don't see any age stratification here. I will say that you and I have spoken in 40% of adults, 40% of women over the age of 65 are below the RDA for protein. And the recommendation, the current dietary guideline recommendation recommends for more plant based foods. And the USDA created this ounce equivalent, I do think that we should mention that for substituting plant for animal proteins. And this is a lot of the work that you're doing now. You know, this morning I guess I just woke up and chose violence. Anytime I talk about the variation between plant and animal protein which you and I have been talking about for 15 years on the regular, this is, this is a very violent conversation. It's not intended to be.

[Dr. Donald Layman]

It's a highly biased and polarizing conversation. And you know, I think One needs to just, I mean, I think one needs to recognize there are different opinions and different ways people want to eat, and that's fine. The idea that everyone should eat the way I eat or the way a vegetarian eats is just nonsense. And so we need to allow for variation. You mentioned the USDA protein ounce equivalents and the paper in AJCN, you mentioned a number. 50% of those authors are from the USDA and they're talking about transparency. If you look at the protein ounce equivalence, and we published a paper and we have another one coming out, the Journal of the Academy of Nutrition and Dietetics, that's been accepted, so it'll be coming out shortly. There's nothing equivalent about these. They say that one ounce of chicken breast is equal to a fourth cup of beans, is equal to one tablespoon of peanut butter is equal to a half ounce of almonds. Well, those things aren't equivalent at all. And there's no transparency to that. What we've shown is that a cooked ounce of chicken breast has about 9 grams of protein in it, where if you look at beans, it's under 4. It's like 3.9 grams per 4 cup. If you look at a tablespoon of peanut butter, it's 3.8. And if you look at a half ounce of almonds, it's three. So, you know, it takes, you know, it takes four tablespoons of peanut butter to be equal to one ounce of chicken breast. I mean, nobody can eat that. So the idea that those and Bob Wolf and others have published data that show that if you use these ounce equivalents, you will decrease muscle protein synthesis. So, you know, these people talk about transparency, but then they translate it into food guide information that is totally false. To get your protein from eating almonds to reach your minimum RDA by eating almonds would take something like 350 almonds per day. And that would be, you know, an outrageous amount of fiber. If you, if you try to get your protein requirement, the minimum protein requirement from beans, it takes around 4 cups, which is somewhere around 54 grams of fiber. I mean, these are just not, they're not relevant. They're not, they're not usable numbers for the average person.

[Dr. Gabrielle Lyon]

Yeah. And also when we think about this narrative about say, reducing saturated fat, if we were to pick that, then we have to then, just as you had mentioned, replace high quality or nutrient dense proteins because where did the majority of saturated fats come from would be dietary protein. And then now if we go more plant based, we're now increasing carbohydrates, which seems to really be a problem.

[Dr. Donald Layman]

I mean, it's, it's interesting that, you know, we have this belief that saturated fat comes from animal proteins. But, you know, after the food guide Mirabid, we decreased the consumption of red meats, eggs and dairy by about 35 cent, by about 35% in all three categories. And yet saturated fat didn't go down. So where did it go? Well, we're now getting saturated fat from hydrogenated seed oils. And so we're, you know, fried foods and desserts and candies have a lot of hydrogenated oils in them. And so it's not, you know, that, you know, animal products are not the solution. Give me, give me an actual number for saturated fat and then let us work it into the diet in a healthy way. You know, it's, you know, it's a convenient way to blame animal products when in fact that's not actually the source.

[Dr. Gabrielle Lyon]

Do you have a sense of what you would do to design a diet? And I, I, I'm gonna guess, here's what you're gonna say. You tell me if I'm right or wrong. You're gonna say, determine how many calories that that person needs. Then you will prioritize dietary protein based on skeletal muscle health. And then you will choose whether you want saturated fat or carbohydrates, or let's just say fats or carbohydrates. Depending on your metabolic health. If you are metabolically compromised, you might do and go lower in carbohydrates. If you are metabolically healthy, then you can choose.

[Dr. Donald Layman]

Yeah, I think we've had this issue of thinking about macronutrients as percentage of calories, which I think distorts the process. Protein is the only absolute required macronutrient. I mean, there's some requirement for saturated fat, but we have no requirement for carbohydrates at all. And so I think you have to start with protein. And once you make that decision, it determines other lifestyle issues. If you choose to be vegetarian, then you better be very physically active because the physical activity, particularly resistance exercise and protein kind of go hand in hand in maintaining your lean body mass. There's evidence that, you know, if you have higher resistant activity, your ability to use dietary protein becomes more efficient. So I think, you know, that's a trade off there. Or you can choose to be higher. Once you choose your protein level, you know, that kind of determines how many calories you have left. You know, I'm, I'm, I'm active. I'M sedentary. I. How many calories do I have left? And then you can choose between carbohydrate and fat. Personal preference. I like to argue that your carbohydrate diet should start at about 130 grams per day, which is in fact the RDA. And that will allow you to have five servings of vegetables, three servings of fruit, and three servings of whole grains. That's totally inadequate diet. As you go above that, then you have to decide, how's the body going to use them. There are only two things the body can do with the extra carbohydrates, either muscle activity or store it as fat. And so basically, I always tell people that you basically earn your carbohydrates above 130 with physical activity at around 50 to 60 grams per hour. So as you mentioned at the beginning, the average American is eating 300 grams of carbohydrates per day. So that means they need three hours of fairly intense physical activity per day. And very few Americans are getting that.

[Dr. Gabrielle Lyon]

Wait per day. Three hours of intense physical activity per.

[Dr. Donald Layman]

Day, per day to justify 300. To justify 300 calories of carbohydrates.

[Dr. Gabrielle Lyon]

We should definitely increase our push ups before the episodes then. Now, a lot of this is a discussion on these upcoming dietary guidelines that are going to.

[Dr. Donald Layman]

I was looking here at the dietary guidelines document talking about, you know, saturated fats. Only 3% come from meats. And you know, where the meat is eaten alone. You know, where it's, you know, like eating a steak or something. 19% comes from sandwiches. And a lot of that is cheese has nothing to do with meat. 11% comes from desserts and sweets. Those are all processed. Those are hydrogenated and, you know, so you can go through it. About 6% coming from pizza, that's all cheese. You know, you can kind of go through their diet. There's as much comes from, you know, eating vegetables and starchy vegetables as there is from coming pure eating, pure meats in the American diet. So, you know, we have this distorted view.

[Dr. Gabrielle Lyon]

I'm sorry, where were you looking at this before you continue? Where were you looking at this?

[Dr. Donald Layman]

So this is in the Dietary Guidelines Advisory Committee report that came out at the beginning of the process. So they have a chart in here of where saturated fat comes from in the American diet. And the two biggest categories are sandwiches and desserts and snacks.

[Dr. Gabrielle Lyon]

I see.

[Dr. Donald Layman]

And most of that has nothing to do with eggs or dairy. You know, it's cheese. It's cheese. And processed, you know, processed vegetable oils it's very fascinating.

[Dr. Gabrielle Lyon]

It's so fascinating because what we are being told to do is different than perhaps where we're even getting it. So if we, if the conversation is to reduce animal based products yet where we're getting higher levels of saturated fat is really in this, these processed food realms and desserts, then maybe we should just be eating less processed foods and not throw the baby out with the bath water.

[Dr. Donald Layman]

We're getting that discussion now in the literature about ultra processed foods. Kevin hall and others have sort of raised those questions. And I, I think that's an important direction that one of the things we've seen since the 1980s is a lot more highly processed foods in the American diet. These foods appear to have lower satiety. People tend to eat more of them, they're less nutrient dense and, and you know, I think that, you know, we're ignoring some of the form of food. And as I said, we, we decreased our intake. You know, beef consumption in the US has gone down 40% since the 1975. And so which was the peak. And so, you know, I think we're misplacing our targets. And so then you really have to wonder what's the motivation for misplacing it?

[Dr. Gabrielle Lyon]

Do you have thoughts on that? I mean I know that you, you probably do. But where, you know, why, why so much complexity? Why so much confusion?

[Dr. Donald Layman]

I think you can go out and you know, you can start with the advertisements you see. When was the last time you saw an advertisement for broccoli or blueberries? What you see is advertisements for grains and that should tell you something about the food chain. There's a lot more money to be made in ultra processed foods than there isn't than selling eggs or dairy which go directly from the farm to the grocery store, have to have refrigeration at every step and have spoilage. You know, we're not advocating, we're not advertising for the things that people really should eat. You know, the things like vegetables and fruits, you don't see those as advertised. And so why, and even accessibility, I mean, are the people who are at higher risk for diabetes and things, you know, like obesity and heart disease. Now we start getting into things like food deserts and we get into different population issues and what we find out is that they don't have the same access to the same kinds of foods. And so they're often confronted with eating more ultra processed foods. And so, you know, we have to find a way to sort out the nuance of all of these things. And again, I'll give the Dietary Guidelines credit now that they're beginning to model these in different ways. But. And we know that one size fits all doesn't fit all. But again, they're ignoring part of the equation, which is the risk of carbohydrates. We know that one of the most inflammatory things that the body faces is insulin resistance and that underlies diabetes, it underlies metabolic syndrome, it underlies heart disease, it underlies long term obesity. And yet we're not addressing one of the most fundamental parts of that, which is the carbohydrate intake.

[Dr. Gabrielle Lyon]

What do you think people need to know or take away from this conversation? What do you think is the critical they were to say, okay, thank you guys so much. I now understand that I'm completely confused and I have no idea what, what is the goal for them to be able to take away?

[Dr. Donald Layman]

I mean, I think if you take, given the Dietary Guidelines credit, what they show you people are not eating enough protein, particularly high quality protein.

[Dr. Gabrielle Lyon]

Wait a second. But people will say that if, if you look at many of the, and I hear this all the time, the quote longevity experts, they will say, if I increase my protein, it's going to stimulate MTOR and it's going to decrease my longevity. Or you will hear, I will never forget this. I actually, I was at a, this was many years ago. This is when Longo had just started these conferences, I don't think I ever told you this. And there were two women there and they were talking all about protein restriction. And obviously I'd been trained by you. And again, 10 years ago, I mistakenly rose my hand and said, wait, but how are we going to recommend below the RDA, the minimum to prevent a deficiency for muscle health. And these two women, they turned to me and they laughed at me and they said, you are absolutely wrong. Americans are over consuming dietary protein. You're basically an idiot. And you know, I thought to myself, well, okay, kind of rude or. And I recognized that in this one. And I think both of them were PhDs. And I remember thinking to myself, they are basing their understanding of Americans are getting too much protein on what on this minimum amount of dietary protein. And even that is probably too low for a minimum. What would you say to that? When people will say, but the average woman is getting 68 grams of protein and the average male is getting 90 grams of protein. How are we below the recommendation?

[Dr. Donald Layman]

So the DRI say that the dietary guideline for every nutrient is a range going from the rda, which is the absolute minimum, up to some Upper limit. And so what we know is that the average American female is just barely above the minimum RDA. And it's important to recognize that RDA was established by nitrogen balance and 25 year old males who are physically active, ideal weight and eating high quality, it was all high quality protein. And so how do you translate that number to a 65 year old female who's sedentary and eating marginal protein? There's no relationship. So we know, and even the Dietary Guidelines recommend that the goal for dietary protein is around 1.2 or higher grams per kilogram, not the minimum 0.8. If you go through those ideal models of the diet of the protein in MyPlate, you'll find that the models actually give you a higher protein diet. So again, I think that what we recognize is most males are probably eating adequate protein, but a large number of females are at or below the rda. So again, if I'm just taking the Dietary Guidelines, which by the way, don't quote those protein numbers for longevity at all, so they don't buy it either. What we know is that 42% of people are below the minimum recommendation. You then go to the other part of the equation. The vast majority, 90% of Americans aren't eating enough fruits and vegetables and 90% are eating too many refined grains. Those are the corrections that I would try and get out to people. You need to minimize your grain consumption. You need to eat more higher fiber fruits and vegetables. By the way, the Dietary Guidelines have moved the category of beans. Peas and lentils are vegetables. They're not protein rich sources, they're vegetables. And the reason for that is they have a three or four to one carb to protein ratio. So they're great vegetables. Substituting beans for rice is a great idea. Substituting beans for French fries is an outstanding idea. But they're not really very good protein sources for yourself.

[Dr. Gabrielle Lyon]

Yeah, that, that's it. Those are all very important clarifications. Well, Dr. Donna Layman, if there is anything else that you'd like to add. Again, you guys, this is a series of conversations that we're getting back into, myself and Dr. Donna Layman, and what we're going to be hitting are emerging topics. Again, so this is early for the Dietary Guidelines. You know, and I do think that we should circle back because we do need to speak about nutrition for children when it comes to the Dietary Guidelines. You know, I know that the last guidelines also increased the consumption of animal based products, red meat being one of the nutrient dense sources of protein that should be Added. Right. I'm remembering that correctly. We were talking to our mutual friend.

[Dr. Donald Layman]

Sure. Again, that this dietary guidelines coming out definitely goes through and talks about different ages. And one of the things we know is that our knowledge of young children is not actually very good. We have really good data about infants, like through a year, but our ability to study a 10 year old, you can't really ethically do the same kinds of studies we do with adults, you know, because the child can't give consent. And so we have really limited data on, you know, what should an 8 year old or a 14 year old do, simply because we can't study them very well. And so a lot of the data as well, what do they actually eat now? And they seem to be basically healthy. So that's what their guidelines are. That's not very good science because, you know, we don't know how what a person does when they're 10 turns out to how they function when they're 60. So the guidelines are focusing on younger children. But they acknowledge we don't have very good data.

[Dr. Gabrielle Lyon]

All really important conversations. Again, because we're not trying to, number one, raise children. We're trying to build strong, healthy humans.

[Dr. Donald Layman]

You know, I think we probably offended almost everybody today, so we probably covered it pretty well.

[Dr. Gabrielle Lyon]

Well, Don, I love you as always. And you guys don't follow him on Instagram because he doesn't post. But definitely follow Dr. Donald Layman on Twitter and you can find him under Google Scholar. He's also proud professor emeritus from the University of Illinois and just won a lifetime achievement award and most importantly, my best friend. Thanks, Don.

[Dr. Donald Layman]

Love you, Gabrielle.

[Dr. Gabrielle Lyon]

Love you too. The Dr. Gabrielle Lyon podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing home or other professional health care services, including the giving of medical advice. And no patient doctor relationship is formed. The use of information on this podcast, YouTube or materials linked from the podcast or YouTube is at the user's own risk. The content of this podcast is not intended to substitute for professional medical advice, diagnosis or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their healthcare professional for any such conditions. This is purely for entertainment and educational purposes only.