Abstract
Dietary guidelines, especially those designed to prevent the diseases of dietary excess,
are a relatively new phenomenon in the United States. National dietary guidelines
have been promulgated based on scientific reasoning and indirect evidence. In general,
weak evidentiary support has been accepted as adequate justification for these guidelines.
This low standard of evidence is based on several misconceptions, most importantly
the belief that such guidelines could not cause harm. Using guidelines against dietary
fat as a case in point, an analysis is provided that suggests that harm indeed may
have been caused by the widespread dissemination of and adherence to these guidelines,
through their contribution to the current epidemic of obesity and overweight in the
U.S. An explanation is provided of what may have gone wrong in the development of
dietary guidelines, and an alternative and more rigorous standard is proposed for
evidentiary support, including the recommendation that when adequate evidence is not
available, the best option may be to issue no guideline.
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© 2008 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
