The example of dietary guidelines is dedomenocracy done wrong

Dedomenocracy is my term for an authoritarian government that obligates human decision makers to impose recommendations supported by data and requires the population to follow those recommendations.   In an idealized form, such a government would create rules using only observational data without any human preconceived notions of theories, truths, or even causality.   Such a government needs to be agile to quickly change course when new data arrives that can negate earlier findings.   As a result, the rules must be both frequently updated and short in duration.    For practical purposes of informing the population of the current rules, there must be limited number of rules at any time.  As a result, most of the population will live without any governing rules most of the time.   This is like a libertarian government except one that operates within a authoritarian government that can impose new rules quickly when circumstances demand it.

I describe dedomenocracy as a possibility or perhaps even a goal but one that must wait for technology to supply the extensive amount of data required to assess the global set of all possible conditions that may need consideration.   However, I note that we already already experimenting with dedomenocracy as in examples of recent measles vaccine controversies and the public response to weather forecasts.   I presented both of those examples as demonstrations of what we can expect from a future dedomenocracy.   In both cases, decisions supported by data at the time later became embarrassments as new data arrived.

Ideal dedomenocracy will produce similar results at time.   I argue that we will tolerate such embarrassments because other decisions will provide benefits that outweigh the harm caused by less fortunate decisions.   Also, an ideal dedomenocracy is agile so that it can quickly replace or repeal a rule when new data contradicts the reasoning or expectations for the rule.

Agility is essential to minimize harm from occasional bad decisions.   That agility is possible in an ideal dedomenocracy because all decision making is automated without human interference.   There is no human deliberation or debate for making rules in a dedomenocracy.   Also, there is no requirement for demanding human accountability for a bad decision before making a new one.   When new data invalidates an existing rule, dedomenocracy can quickly end that rule and replace it with another.   In the example of avoiding measles vaccine, the new data of a growing epidemic justifies an immediate urgency to require vaccination.  In the example of weather forecasts, officials should have the ability to withdraw their earlier announcement of cancellations when new data shows the storm to be weaker than expected, or allow decision makers to point to that data as proof for not making a cancellation notice too early.

Another modern example that anticipated dedomenocracy is the government’s issuing of dietary guidelines.   Based on the evidence of the time, the government updates the guidelines to suggest foods to avoid and what proportion of a diet should come from different food groups.   Recent news concerns an update in the guidelines that admit earlier warnings about cholesterol and saturated fats may have been exaggerated.   The earlier warning discouraged the population from eating animal products such as eggs and meats with high fat content.   The updated guidance reflects that more recent data shows that these are not as bad as originally thought.   The new advice is that foods high in cholesterol and saturated fats (animal products) are safe when consumed in moderation.

This is another demonstration of agility of replacing old advice with with new advice when new data demands it.   Over time, this will result in mutually contradictory rules such as in this case concerning cholesterol and saturated fats where an earlier rule strongly discouraged consumption and a newer rule encourages consumption in moderation.

However, I would argue that a true dedomenocracy would have made this switch in rules much earlier when new data began to raise doubts on the earlier findings that supported reduced dietary intake of saturated fats and cholesterol.  Once the older guidelines were established, new studies began to show that the risks were lower than expected.   Even if the studies did not prove that the risks were trivial, they did show that the risks were not as high a priority as once perceived.  A dedomenocracy focuses its active rules only on the highest priorities of issues.  If an issue is not a priority, then the rule would be allowed to expire with no replacement rule.    The default condition in a dedomenocracy is a libertarian one where people will decide for themselves.

If we were living in a dedomenocracy, my guess is that the guidelines to avoid saturated fats and cholesterol would have been allowed to expire by 1990 because the newer data did not support the claim that this was an urgency.  Instead we live in a democracy that involves human debate and deliberation that in turn demands respect for precedence of earlier findings.   We are only just now in 2015 making the change that should have occurred by 1990: that the guidelines are no longer justified by recent data.    I assert that a dedomenocracy would have made the change much earlier because decisions in a dedomenocracy occur without any human interference.

There is a consequence of our current governmental practice of prolonging outdated rules.   This consequence is not expected directly based on the evidence.  Although the more recent evidence is that cholesterol or saturated fats are not as harmful as at first feared, there is not much evidence that their consumption is substantially helpful.   There would appear to be no harm in continuing to the old guidelines.

The unexpected consequence is that people will turn to other food groups to replace what they previously enjoyed from the food group.   That enjoyment was the feeling of being satiated after a meal.    Lacking the high protein and high fat content from animal products to provide this feeling with moderate servings, the population turned to high carbohydrate (grain-based) diets that required more frequent consumption of larger servings to restore the lost benefit.   The argument is that this lead to the current epidemic of obesity and type-II diabetes:

This led food makers to create low-fat spreads, including cholesterol-lowering products, while consumers shunned cheese, milk and cream.
However, now some scientists even say the advice is responsible – in part – for the obesity crisis because it encouraged an increase in carbohydrate in our diets.

and:

By 1991 the official advice in the UK was actually to increase carbohydrates to provide 50 per cent of food energy.
This was partly to make up for the ‘energy gap’ caused by cutting the recommended amount of fat in the diet to 35 per cent.
But there has been growing disquiet with research suggesting eating more carbs, and sugar, has coincided with rising levels of obesity and type 2 diabetes.

The advice was based on earlier studies that recently received criticism for being inadequate to support such large scale recommendations.

The study, which reviewed data available at the time the guidelines were issued, states: “It seems incomprehensible that dietary advice was introduced for 220 million Americans and 56 million UK citizens, given the contrary results from a small number of unhealthy men.

“The results of the present meta-analysis support the hypothesis that the available [randomised controlled trials] did not support the introduction of dietary fat recommendations in order to reduce [coronary heart disease] risk or related mortality.”

This article also presents immediate criticisms of this study.  For this post, I’m focusing only on the fact that there is a debate about the merits and the urgency that justified the issuing of the guidelines.   For example, this study references studies as early as the late 1960s that presented results that cast doubts on the fat-consumption intervention strategies.  Over the decades since the guidelines have been introduced, I have read many articles in popular press and media criticizing the guidelines for exaggerating the risks of these foods and under-estimating their healthy contributions of moderating people’s eating habits.

It may be that by 1983 there was enough evidence for a dedomenocracy to issue a short-term rule that matched the dietary guidelines introduced in US.   However, that rule would have expired within a few years.   By the early 1990s, there was probably enough information to raise doubts about both the risks and the urgency.  As a result, it is unlikely that a dedomenocracy would have renewed the rules after they expired.

We have a representative republic instead of a dedomenocracy.  In a representative republic, rules do not have expiration dates.  Once a representative republic makes a rule, the burden of proof shifts to those who would repeal the rule.   In contrast to the dedomenocracy that requires new evidence to justify renewing the rule, our government required evidence to prove that continuing the rule was harmful.   It appears that now in 2015, we are persuaded that the rule is not helpful.

In the mean time, we suffered unintended consequences of a continued recommendation of an outdated rule.  Although the guidelines were voluntary, the population’s desire for healthy living motivated them to follow the rules.   They began to avoid fats and animal products and replace them with plant products and grains in particular.   To compensate for the reduced or temporary feeling of fullness from consuming most calories from carbohydrates, people ate more and more frequently.   There are claims (credible to me) that lack of fat in diets encouraged more frequent eating and in larger quantities.   This may have lead to the increased obesity rates.   In addition, the high carbohydrate loads may be contributing to the increased rates of Type-II diabetes that requires expensive lifetime management of the illness.

Following a dedomenocracy model of short-lived rules may have avoided these consequences because the guidelines, if issued at all, would probably only have been in place for a few years.   Once expired, there would be a return to leaving the dietary choices up to the individual.  As I noted above, the decision not to renew the guidelines would have sent a message that the risks are not high and that this was no longer a priority.

In my earlier discussions of dedomenocracy, I noted that rules have lasting effects even after they expire.   People would probably continue to follow the expired guidelines out of habit.  But as new eating options became available, people interested in trying new things will be more free to try them because there is no current guideline that says this would be harmful.

I speculate that a short-lived dietary guideline would have caused a similar result of our prohibition experiment.  In prohibition, the alcohol consumption after prohibition became comparable to what it was before, but the way people consume alcohol changed radically from consuming in bars before prohibition to consuming in homes afterwards.   A similar result would have occurred with the short-lived dietary guidelines where the consumption of fats and cholesterol would change from focus on meals centered on meat portion (such as the meat and potatoes standard) to using animal products as part of more creative recipes.  The proportion of diet from animal products may match the proportion before the guidelines, but the meals would be fundamentally changed.

Unlike governments involving democratic debate and persuasion, a dedomenocracy makes no claim about Truth.  It emphasize this agnosticism with deliberately short-lived rules.  Dedomenocracy makes short-lived rules because of the anticipation of newer data that will either change the rule or redirect attention to higher priorities.  In effect, this form of government admits up front that the rules are likely not Truth.   Instead, the rules are the best course of action for the near term.   When new data becomes available, there will be new rules and in particular there will be no obligation to continue old rules.   A dedomenocracy can not be embarrassed by making new rules that contradict earlier rules.

The rule making will provide benefits that outweigh the harms, but that can happen without any claim of knowing a Truth.   The lack of such claim enables agile government because there is no burden to disprove a previous claim.   In a dedomenocracy, the default condition is liberty for the population to come up with their own choices.   In the case of dietary guidelines in particular, people’s desire for healthy living provide adequate motivation to seek out good choices on their own.

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3 thoughts on “The example of dietary guidelines is dedomenocracy done wrong

  1. Another NY Times article makes sugar the new threat to health:

    The panel also dropped a longstanding recommendation that Americans restrict their intake of dietary cholesterol from foods like eggs and shrimp – an acknowledgment of decades of research that shows that dietary cholesterol, for most people, has little or no effect on their blood cholesterol levels.

    and confirms these recommendations could have ended earlier:

    “For many years the cholesterol recommendation has been carried forward but the data just doesn’t support it,” said Alice Lichtenstein, the vice chair of the advisory panel and a professor of nutrition science and policy at Tufts University.

    Also the article describes the Dietary Guidelines Advisory Committee does not issue official guidelines but it does convene every 5 years consistent with my concepts of a periodic review of rules in a dedomenocracy if they were allowed to issue official guidelines.

  2. More information about the history of the dietary cholesterol guidelines is in this Wonkblog that states:

    In 1977, as a Senate committee was published the first set of dietary guidelines – which called for limiting cholesterol- three on the committee objected, noting that the Canadian government had recently concluded that “a diet restricted in cholesterol would not be necessary.”

    “Because of these divergent viewpoints, it is clear that science has not progressed to the point where we can recommend to the general public that cholesterol intake be limited to a specific amount,” according to the letter from Senators Charles Percy(R-Illinois), Richard Schweiker(R-Pennsylvania) and Edward Zorinsky(D-Nebraska).

    The rule was not very well justified to begin with and there were already studies to discredit the risk of cholesterol and the urgency for a guideline to restrict its consumption.

    As far back as 1955, Ancel Keys, one of the key researchers in this field, could conclude in the Journal of Nutrition that repeated studies had shown that “cholesterol level [in the blood] is essentially independent of the cholesterol intake over the whole range of natural human diets.”

  3. Another NYTime opinion piece makes a point about warning that the guidelines were not right in the 1980s:

    It’s not that health authorities weren’t warned. “They are not acting on the basis of scientific evidence, but on the basis of a plausible but untested idea,” Dr. Edward H. Ahrens Jr., a top specialist at Rockefeller University and prominent critic of the growing doctrine on dietary fats and cholesterol, cautioned back in the ’80s. In the face of urgent pressure to offer a solution to the rising tide of heart disease, however, he turned out to be the Cassandra of his day.

    The opinion places blame on a weak form of scientific enquiry;

    But the primary problem is that nutrition policy has long relied on a very weak kind of science: epidemiological, or “observational,” studies in which researchers follow large groups of people over many years. But even the most rigorous epidemiological studies suffer from a fundamental limitation. At best they can show only association, not causation. Epidemiological data can be used to suggest hypotheses but not to prove them.

    Making my point about historical data in general suggesting new hypothesis instead of proving them. However, in context of my later thinking of dedomenocracy I no longer fault such leaps to conclusions based on suggestions from data. Instead, I place blame on the duration that this bad advice was allowed to remain in effect. My claim is that it may have been reasonable to set the guidelines when they did, but they erred in making the guidelines perpetual leading to at minimum unhelpful advice to the population. The guidelines should have expired in 5 years and new guidelines set on data available at that time. By the 1990s, the guidelines would have relaxed its warnings because of the lack of data to support their continuation.

    Today, we are poised to make the same mistakes. The committee’s new report also advised eliminating “lean meat” from the list of recommended healthy foods, as well as cutting back on red and processed meats. […] It’s possible that a mostly meatless diet could be healthy for all Americans — but then again, it might not be. We simply do not know.

    Dedomenocracy does not recognize mistakes. Assuming there is data to support the newer guidelines for emphasizing plant-based diets, the guidelines would be okay as long as they have an automatic expiration date. After 5 years or so, the guidelines would expire leaving the default of no guidelines unless the government issues something new based on evidence available at that time.

    The mistake is not that the policy is later proven to be wrong. The mistake is in assuming a policy is perpetual so that the burden of proof is on disproving the policy. The policy should have to re-defend itself every few years based on data available at the time. The burden of proof should always be on policies that attempt to restrain liberties.

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