A coalition of doctors concerned about racial bias is mounting an attack on a national dietary institution: the food pyramid, which calls for a balanced diet of dairy and meat, vegetables and breads.
The Washington-based Physicians Committee for Responsible Medicine (PCRM) argues that because most members of minority groups can't easily digest milk, the continued inclusion of dairy products as a dietary staple is wrongheaded. They will recommend that the guidelines list dairy as an option and suggest calcium-rich alternatives to milk and cheese.
Today, the committee will hold a conference in Virginia aimed at reconfiguring the soon-to-be revamped "Dietary Guidelines for Americans."
"We learned more than 33 years ago that lactose intolerance affects a majority of the people on the planet, but milk is still required by the government," said Dr. Neal D. Barnard, director of doctors' committee.
"Racial bias stems most often from ignorance than anything else," he said. "We are simply ignoring what we have learned."
Many minority children and adults have long suffered gas, bloating and sometimes severe stomach pain because their digestive systems struggle to break down milk sugar, called lactose. About 90 percent of Asian-Americans, 70 percent of African-Americans, 50 percent of Latinos and 15 percent of whites have trouble digesting dairy products, according to medical data.
An 11-member committee of physicians and researchers organized by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture are scheduled to begin considering changes late this month and to release the next version in the summer of 2000.
The physicians' committee's stance has prompted criticism from the dairy industry and the Department of Agriculture, which say cutting dairy products without carefully replacing the vitamins and minerals those foods provide presents a health risk.
The USDA first issued dietary guidelines in a general form in 1894. They included the five food groups -- dairy, meat, fruits, vegetables and grains -- in 1916. Since then, the guidelines have changed from a chart to a circle and, in 1992, to a pyramid, said USDA spokesman John Webster.
Aside from the current emphasis on a lower fat, higher carbohydrate diet, he said, the 1916 plan was "divided up not too far from the way it's divided up now."
Legislation in 1980 required that the guidelines be updated every five years.
Based on 284 suggestions submitted by various sources, the last committee in 1995 issued what some say were only token changes to the 49-page book that accompanies the food pyramid, Webster said.
"Obviously, the guidelines are general," Webster said. "There are people who are going to be allergic to any number of different types of foods. I think our advice would be, if there's a reaction, check with a physician."
Contrary to what Barnard and others suggest, the most recent USDA guidelines do suggest where people with special dietary needs can get calcium and other nutrients -- tuna, salmon, kale, tofu and other sources, Webster said.
But as long as dairy products and meat -- the physicians' committee also promotes vegetarianism and animal rights -- are labeled a staple food group, those who struggle to digest those foods are not receiving adequate information about their options, said Patricia R. Bertron, chief coordinator of tomorrow's conference.
"Our concern with the guidelines is that they're designed to help consumers make food choices that promote health and prevent disease," she said. "For people who are lactose-intolerant, that may not be appropriate."
But dairy products are the most complete form of calcium and other nutrients, said Wendy McDavid of the Washington-based International Dairy Foods Association, which represents more than 80 percent of the country's milk, ice cream and cheese manufacturers.
"We feel that [cutting out dairy products] is dangerous because we have a calcium crisis in this country right now," McDavid said, adding that 90 percent of women and 60 percent of men have calcium deficiencies.
Research shows lactose intolerance often sets in among teen-agers and adults, often worsening from stomach pains and cramping to diarrhea.
"I am lactose intolerant and I can tell you first-hand it can be very destructive," said Dr. Alessio Fasano, a pediatrician of Italian descent who studies lactose intolerance at the University of Maryland, College Park. "It can affect your lifestyle."
But Fasano said government agencies do not consider the best options: items such as lactose-free milk and chewable tablets taken before eating dairy products to aid digestion. "I don't know how often legislators talk to physicians," Fasano said. "It's a capitalistic society. Business is the driving force, and people say this is jeopardizing business. This is what I believe is one of the reasons."
Pub Date: 9/17/98