"Of all tyrannies, a tyranny exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience."
-- C.S. Lewis

Twice today, I was reminded of the good intentions that do find their way into deliberating bodies of interested scientists and policy makers. The first instance was an email from a friend in the UK, that described a significant if little noticed decision taken at the 59th World Health Assembly meeting held in May.

Image credit: Anne-Sophie Réaud

Integrating nutrition into the overall response to HIV/AIDS

"The World Health Assembly adopted a resolution requesting countries to include nutrition as an integral part of the overall response to HIV/AIDS by identifying nutrition interventions for immediate integration into HIV/AIDS programmes. Food and good nutrition are immediate and critical needs of people living with HIV/AIDS. The Health Assembly also supported WHO to develop a five-year-plan to help achieve universal access to HIV/AIDS treatment by 2010."

The actual quote, the key paragraph in the report of the meeting, says my friend, is this one:

- - -

Micronutrient deficiencies are a significant problem for people living with HIV. However, little is known about interactions between micronutrients and physiological status or the impact of micronutrient status on disease progression. People infected with, and affected by, HIV/AIDS need a diet that provides the full range of essential micronutrients. Current evidence is inconclusive about the effect of micronutrient supplementation on transmission and progression of HIV in the absence of a specific nutritional deficiency. After a scientific review of available data, WHO recommended that multiple micronutrient supplementation for people living with HIV should not exceed one recommended daily allowance.

Very interesting. Micronutrients - that's mainly vitamins and minerals for the rest of us - are important, but don't exaggerate! For heaven's sake don't take more of them than the absolute minimum necessary to not be developing a starvation-level deficiency disease. Pellagra, scurvy, that kind of stuff. But here we are talking about Aids - people fighting serious immune deficiencies. Consequently there is a need for orthomolecular dosages of nutrients - forget about recommended allowances.

American Heart Association - Diet and Lifestyle Recommendations Revision 2006

Second instance of good intentions: A friend in Sweden says to look at this site. It describes a newly worked out version of the Diet and Lifestyle Recommendations, brought to us in a "Scientific Statement From the American Heart Association Nutrition Committee". If you read the abstract, you can feel it's dripping with good intentions:

Improving diet and lifestyle is a critical component of the American Heart Association’s strategy for cardiovascular disease risk reduction in the general population. This document presents recommendations designed to meet this objective. Specific goals are to consume an overall healthy diet; aim for a healthy body weight; aim for recommended levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides; aim for normal blood pressure; aim for a normal blood glucose level; be physically active; and avoid use of and exposure to tobacco products. The recommendations are to balance caloric intake and physical activity to achieve and maintain a healthy body weight; consume a diet rich in vegetables and fruits; choose whole-grain, high-fiber foods; consume fish, especially oily fish, at least twice a week; limit intake of saturated fat to [less than]7% of energy, trans fat to [less than]1% of energy, and cholesterol to [less than]300 mg/day by choosing lean meats and vegetable alternatives, fat-free (skim) or low-fat (1% fat) dairy products and minimize intake of partially hydrogenated fats; minimize intake of beverages and foods with added sugars; choose and prepare foods with little or no salt; if you consume alcohol, do so in moderation; and when you eat food prepared outside of the home, follow these Diet and Lifestyle Recommendations. By adhering to these diet and lifestyle recommendations, Americans can substantially reduce their risk of developing cardiovascular disease, which remains the leading cause of morbidity and mortality in the United States.