The numerous nutrition guidelines promoted by the U.S. federal government are obeyed by just 2 percent of Americans. If only 2 percent of any population can obey your guidelines, they are a nutritional wishlist created by groups of experts promoting their diet fads, not evidence-based information.

However, one group is constantly criticized by everyone else - pregnant mothers - and a new study shows that no pregnant women in any demographic are able to achieve the Dietary Guidelines for Americans. Which means those guidelines are irrelevant, not that expectant moms need even more criticism.

Depending on how you frame the results, black, hispanic and less-educated women are either too poor to obey the guidelines or they have enough common sense they are not being held hostage by arbitrary epidemiology claims compared to white women.  The committee being these impossible nutrition claims argue that diet has been linked to reduced risks of preterm birth, fetal growth restriction, preeclampsia and maternal obesity. All true, but also weak observational claims based on mothers recalling what they ate and not at all causal. 


Can you meet these standards? No, probably not, unless you are rich and have a nutrition academic shopping for you. Credit: University of Pittsburgh


The short version is that if no one meets your guidelines and the rates of birth issues have not gone up (they have not) then your guidelines are simply optimal goals for people who can afford to buy things from Gwyneth Paltrow.

Lisa Bodnar, Ph.D., M.P.H., R.D., associate professor and vice chair of research in Pitt Public Health's Department of Epidemiology and colleagues analyzed the results of questionnaires completed by 7,511 women who were between six and 14 weeks pregnant and enrolled in The Nulliparous Pregnancy Outcomes Study: Monitoring Mothers to Be, which followed women who enrolled in the study at one of eight U.S. medical centers. The women reported on their dietary habits during the three months around conception.  The diets were assessed using the Healthy Eating Index-2010, which measures 12 aspects of diet quality, including adequacy of intake for key food groups, as well as intake of refined grains, salt and empty calories (all calories from solid fats and sugars, plus calories from alcohol beyond a moderate level). 

In other words, the nutritionists are using specious claims about diet to declare no women are eating well while pregnant. There is no evidence-based maximum for salt, but we know there is a minimum. And "empty" calories is a ridiculous metric for pregnant women. Refined grains are linked to zero harm, unless the members of the panel read debunked claims in books like "Wheat Belly" and "Grain Brain", which were popular at the time the recommendations were created. There is no minimum or maximum level of sugar known.

Ignoring the crippling weakness of their premise, the authors still declare that only about a quarter of the white women surveyed had scores that fell into the highest scoring fifth of those surveyed, compared with 14 percent of the Hispanic women and 4.6 percent of the black women. Almost half--44 percent--of black mothers had a score in the lowest scoring fifth. 

The scores increased with greater education levels for all three racial/ethnic groups - that corresponds to wealth - but the increase was strongest among white women. At all levels of education--high school or less through graduate degree--black mothers had the lowest average scores.  When scores were broken down into the 12 aspects of diet, fewer than 10 percent of the women met the dietary guideline for the meaningless whole grains, fatty acids, sodium or empty calories categories. 

Approximately 34 percent of the calories--or energy--the women consumed were from empty calories. Top sources of energy were sugar-sweetened beverages, pasta dishes and grain desserts. Soda was the primary contributor to energy intake among black, Hispanic and less-educated women. Women with a college or graduate degree consumed more energy from beer, wine and spirits than any other source.

Juices and sugar-sweetened beverages combined for a much larger proportion of vitamin C intake than solid fruits or vegetables for black, Hispanic and less-educated women. The opposite was true for white women or more-educated women.

For all groups, green salad was the only vegetable in the top 10 sources of iron. Green salad and processed cereals were the top two sources of folate for all groups except black women, whose second highest folate source was 100 percent orange or grapefruit juice. Folate and iron are important nutrients for developing fetuses and healthy pregnancies.

It's time for nutritionists to stop the war on pregnant mothers. Kids are clearly being fine even if the moms eat Wonder Bread instead of that annoying stuff sold in Whole Foods.