Good Calories, Bad Calories

Having held one set of hearings before publishing the Dietary Goals, McGovern responded to the ensuing uproar with eight follow-up hearings. Among those testifying was Robert Levy, director of the National Heart, Lung, and Blood Institute, who said that no one knew whether lowering cholesterol would prevent heart attacks, which was why the NHLBI was spending several hundred million dollars to study the question. (“Arguments for lowering cholesterol through diet,” Levy had written just a year earlier, even in those patients who were what physicians would call coronary-prone, “remain primarily circumstantial.”)

Other prominent investigators, including Pete Ahrens and the University of London cardiologist Sir John McMichael, also testified that the guidelines were premature, if not irresponsible. The American Medical Association argued against the recommendations, saying in a letter to the committee that “there is a potential for harmful effects for a radical long term dietary change as would occur through adoption of the proposed national goals.” These experts were sandwiched between representatives from the dairy, egg, and cattle industries, who also vigorously opposed the guidelines, for obvious reasons. This juxtaposition served to taint the legitimacy of the scientific criticisms.

The committee published a revised edition of Dietary Goals later that year, but with only minor revisions. Now the first recommendation was to avoid being overweight. The committee also succumbed to pressure from the livestock industry and changed the recommendation that Americans “decrease consumption of meat” to one that said to “decrease consumption of animal fat, and choose meats, poultry, and fish which will reduce saturated fat intake.”

The revised edition also included a ten-page preface that attempted to justify the committee’s dietary recommendations in light of the uproar that had followed. It included a caveat that “some witnesses have claimed that physical harm could result from the diet modifications recommended in this report….” But McGovern and his colleagues considered that unlikely: “After further review, the Select Committee still finds that no physical or mental harm could result from the dietary guidelines recommended for the general public.” The preface also included a list of five “important questions, which are currently being investigated.” The first was a familiar one: “Does lowering the plasma cholesterol level through dietary modification prevent or delay heart disease in man?”

This question would never be answered, but it no longer seemed to matter. McGovern’s Dietary Goals had turned the dietary-fat controversy into a political issue rather than a scientific one, and Keys and his hypothesis were the beneficiaries. Now administrators at the Department of Agriculture and the National Academy of Sciences felt it imperative to get on the record.

At the USDA, Carol Foreman was the driving force. Before her appointment in March 1977 as an assistant secretary of agriculture, Foreman had been a consumer advocate, executive director of the Consumer Federation of America. Her instructions from President Jimmy Carter at her swearing-in ceremony were to give consumers a “strong, forceful, competent” spokeswoman within the USDA. Foreman believed McGovern’s Dietary Goals supported her conviction that “people were getting sick and dying because we ate too much,” and she believed it was incumbent on the USDA to turn McGovern’s recommendations into official government policy. Like Mottern and Hegsted, Foreman was undeterred by the scientific controversy. She believed that scientists had an obligation to take their best guess about the diet-disease relationship, and then the public had to decide. “Tell us what you know, and tell us it’s not the final answer,” she would tell scientists. “I have to eat three times a day and feed my children three times a day, and I want you to tell me what your best sense of the data is right now.”