Kevin C Klatt, PhD, RD

Column | New dietary guidelines promise science over bias — but come up short The Trump administration says it wants evidence driving nutrition conclusions, but bias keeps getting in the way.

There's a huge problem with the Dietary Guidelines, and it isn't tallow.

It's that the authors went all in on finding any scrap of evidence that supported their beliefs.

We all do that! But here, it's on display remarkably clearly.

(Gift link.)

wapo.st/4cRnHXl

The Surgeon General is a figurehead who can enact cultural change, but this is what's most concerning about Means. She'll be representative of a movement of integrative&functional quack medicine that shifts cultural perspectives on pseudoscience, while doing nothing to really address the food system

In all the Means fanfare, folks are losing site of the fact that we already have a nearly 40 yr old Surgeon General report on nutrition & obesity that is still quite relevant today. It's a shining example of how the Surgeon General has limited power to address nutrition-related chronic disease

They also happen to make her very wealthy in the meantime. Glad she's found a way to pay off those med school loans without a license.

Her approach is a grift built off communications 101 - if you establish shared values, you can gain trust. Means is using peoples concerns about the food system to establish that trust and so that they don't become skeptical of her proposed solutions that ultimately don't address the problem.

Exhibit A: Casey Means rightly thinks that our food environment is driving chronic disease. However, her solutions are spiritual woo woo, CGMs & supplements, despite none of those things being a serious approach that address the problems of our food supply. What happened to 'root cause'?

Someone who has identified the right problems doesn't immediately know the solutions.

we've seen zero pushback on physicians who assert nutrition expertise with zero training and use it to rise to places of power and influence (see: Attia -> Low Carb -> NuSi -> Epstein).

we've seen zero appetite from professional organizations to police their own members who have enthusiastically embraced IFM, or at least have the backbone to put out position statements calling for quelled enthusiasm for & honest comms about low evidence modalities - this is rampant in dietetics

The failures here happen at every level. We've seen the normalization of integrative & functional medicine (IFM) centers at large academic hospitals, granting their legitimacy in exchange for cash grabs from wealthy patients willing to pay for (often risky) low evidence modalities.

As we watch Means go up for her nomination to Surgeon General, don't forget that academic institutions, medical centers and professional orgs have been entirely complacent, and in many ways facilitated, the situation where a nutrition & functional medicine grift is A-OK.

ANH Sues FDA: Standing Up for Your Right to Know | Alliance for Natural Health USA - Protecting Natural Health This is a defining moment for health freedom. After the FDA rejected ANH-USA’s petition to allow truthful, government-backed nutrition science on supplement labels, we have taken the only remaining pa...

After year 1 of MAHA and a lot of noise from vaccines and speculative health claims, its easy to lose sight of the point for MAHA: cash in on wellness.

Watch out for this frivolous lawsuit from the natural products industry vs FDA on supplement health claims

anh-usa.org/anh-sues-fda....

Beta cell development and function. The case for iron www.nature.com/articles/s41...

Nope - moreso the opposite. Publishing has become so big a business with the checks/balances weakening over time - you can pay to publish pretty much anything. The industry has relied upon free labor of peer reviewers who get no real compensation for it ($ or career advancement) & that's collapsing

Its kind of wild to watch academic publishing collapsing in real time and the wheels of the system (journals, tenure & promotion committees, etc) just keep moving as tho publishing more and chasing high impact factor journals is gonna help science and society.

(Below is not an outlier situation)

yay come to team choline! Looking forward to diving in!

📣 First preprint from the TeSlaa lab 📣 We investigated how methyl-rich nutrient, choline, is used in the body and how systemic one-carbon metabolism responds to dietary methyl-donor deficiency.
www.biorxiv.org/content/10.6...

Largest leucovorin-autism trial retracted A reanalysis of the data revealed errors and failed to replicate the results.

More on the leucovorin & ASD story from @thetransmitter.bsky.social

www.thetransmitter.org/spectrum/lar...

I've tried a bunch but Alai has been really solid for me so far! Gonna keep my eye out and try others

No Affiliation at all but i've been using Alai. It has the occasional bugs (save all of your input prompt data in a google doc!) but so far great

Get a handful of your favorite review articles/chapters and prompt engineer yourself to a solid starting deck.

TBC - the major companies AI generators are pretty terrible at this (it is amazing actually how bad Copilot is at this in PP). The niche ones have been the big time savers for me.

A lot of generative AI makes slop for me but the time saving from targeted presentation generators is very real - by no means a perfect ready to go slide deck, but infinitely better than the templates out there for getting the basis of a slide deck going (with huge time savings on design/formatting)

Weird flex for Alabama when it consistently gets a failing grade on all major maternal and child health metrics.

You can't be an advocate for evidence-based practice & sit by while your colleagues who've never had nutrition training write scammy books, launch supplements, dance to 'the 5 foods id never eat' TikTok videos etc. theyre not doing this because theyre good faith advocates - they're chasing clout& $$

I hope medical/nutrition trainings broadly really speak openly about the Attia situation - it's a bioethics and professional practice issue that has been here for a long time that no one has wanted to acknowledge, but in the era of influencer medicine, it's a problem too big to ignore.

Sadly, we've seen few institutions acknowledge this threat, as they also see wellness as a money making opportunity. Academic medical centers love folks like Mark Hyman,house 'integrative medicine' centers that are bastions of pseudoscience, all because it helps w flashy brand building and cash flow

This new Epstein files release has made clear that perceived health & wellness expertise is an efficient route to get in proximity to power &move in elite circles. Biomed has always had the folks who do it for ego &prestige but the rise of wellness influencers has made it easier than ever to cash in

Recording of our convo here: open.substack.com/pub/insideme...

New JIMD Podcast

I speak with Jean-Marie Saudubray and Manuel Schiff about six decades of progress in inherited metabolic diseases from early chromatography to genomics and the changing identity of the field.

A rare, fascinating look at our history.
open.spotify.com/episode/5ve2...

Welcome! You are invited to join a webinar: MedPage Today | The Good, the Bad, and the Ugly in the New Dietary Guidelines. After registering, you will receive a confirmation email about joining the we... Welcome! You are invited to join a webinar: MedPage Today | The Good, the Bad, and the Ugly in the New Dietary Guidelines. After registering, you will receive a confirmation email about joining the we...

What do the new dietary guidelines get right, and where do they fall short?

Tomorrow at 1:30pm ET, @drjessicaknurick.bsky.social, @kcklatt.bsky.social, and @jeremyfaust.bsky.social will break down the key changes. Register for the webinar: ehgroup.zoom.us/webinar/regi... #MedSky