Fix Our Food: Food Reform Begins with the Dietary Guidelines (Durham, North Carolina)

America has not always been fat. Although nearly two-thirds of the population is currently overweight or obese, the rapid rise in the prevalence of obesity began recently in our nation‘s history, not long after the creation of our nation‘s first dietary recommendations. While it is recognized that origins of obesity are multi-factorial and that personal choices contribute to health outcomes, the effect of the institutionalization of national dietary recommendations on the of the elements of our society that affect food and nutrition cannot be excluded from an examination of factors that have contributed to creating a food environment detrimental to the health of Americans. Government nutritionists have been giving dietary advice to Americans for more than a century. However, the first Dietary Guidelines for Americans, issued in 1980 by the U.S. Department of Agriculture (USDA) and the Department of Health, Education, and Welfare (HEW, now the Department of Health and Human Services), differed markedly from previous guidance. They heralded a shift in focus from recommendations for consuming certain foods in order to acquire adequate nutrition to ones regarding avoiding certain foods in order to prevent chronic disease. This shift in focus has proven to be problematic as the effects of the initial Guidelines on all aspects of the food system has unfolded, as science has evolved, as the demographics of the American population has changed, and as the current understanding of the food environment has revealed increasing levels of complexity. The Dietary Guidelines are not only different from previous government dietary recommendations, they are also significantly different from other highly-influential government policies or decisions, such as the Social Securities Act or Brown v. Board of Education of Topeka. Unlike carefully-crafted legislation or a meticulously-argued Supreme Court decision, the Dietary Guidelines and the process that creates them did not develop from the deliberate construction of a Federally-guided policy or intention. Although, as the foundation of all Federal policies and programs related to food and nutrition, they touch lives of every American daily, the Dietary Guidelines arose out of a series of political maneuvers and measures that were more reactive than proactive. As a result, the method by which the Dietary Guidelines are generated remains flawed. The current process has resulted in Guidelines that perpetuate decades-long controversy over some key Guideline recommendations, reduce the relevance of the Guidelines to many Americans and undermine their confidence in these recommendations, and fail to address the complexity of the current food system.Master of Public Healt