I recently had the privilege of being a moderator of a session at the California Dietetic Association Annual meeting titled, Unintended Consequences of Simple Dietary Advice: Optimizing Health & Minimizing Harm. The speakers were Dr. Doris Derelian, professor of Food Science and Nutrition at California Polytechnic State University, in San Luis Obispo and Dr. Gail Frank, professor of Nutrition and Director of the Dietetic Internship at California State University Long Beach.

These speakers described a phenomenon they have noticed over the past few years -- nutrition advice is often condensed into very simple messages for the sake of consumer education and the intent to change consumer behavior. Although these messages may be useful to some, they are not intended to provide complete dietary advice and at times may cause more harm than good.

What are Unintended Consequences? Any intervention in a complex system that may or may not have the intended result, but will inevitably create unanticipated and often undesired outcomes. There are three types:

• a positive unexpected benefit, usually referred to as serendipity or windfall
• a negative unexpected drawback, occurring in addition to the desired effect of the policy
• a perverse effect, that may be contrary to what was originally intended; when a potential solution to a problem only makes the situation worse

An example, during the 1980s the popular nutrition message was to "Eat Low Fat". The intent of this message was to lose weight and reduce the risk of heart disease. As a result, calories from fat were reduced; however, calories from carbohydrates increased. The net result was significant population-wide weight gain. Health professionals need to be skilled at sharing the perspective of the total diet and equip clients to evaluate their overall nutritional needs before adopting isolated dietary changes.

The speakers had these take away messages:

• Use a food guide system (like MyPyramid) as a basis for forming a sustainable, healthy eating plan. It is flexible enough to accommodate a wide range of goals and health concerns, yet ensures adequate intake of individual nutrients.
• Choose nutrient-dense foods from all of the food groups to optimize nutrient intake while keeping calories in check.
• Before recommending a dietary change, consider the overall impact it may have particularly on long-term health and wellness.

To read more about this topic, read this paper, Unintended Consequences of Simplistic Dietary Recommendations, Good Advice Gone Awry? Considering the impact of a dietary recommendation on the total diet is an interesting twist in dietary counseling and public education. Are we up for the challenge?

Maureen Bligh, MA, RD

Project Manager