Does anyone else see problems with this?
New dietary guidelines reconstruct food pyramid

By Gerard DeFlitch
TRIBUNE-REVIEW
10/31/04


A decade of diets, debates and controversies will reach an apex early next year when the federal government rolls out its new food pyramid for a nation that has become too big for its britches.

Some say the oft-criticized pyramid itself has been one of the culprits in the rise of obesity and heart disease rates in the United States.

"Maybe the pyramid works as a reminder that people should have variety in their diet," says Dr. Madelyn Fernstrom, director of the UPMC Weight Management Center in Pittsburgh. "But other than that, as the pyramid is currently interpreted, if you eat according to the pyramid, you'll look like a pyramid."

The first few months of 2005 are going to be busy for the Center for Nutrition Policy and Promotion.

An agency under the U.S. Department of Agriculture, the center first will present its revised dietary guidelines -- which it does every five years -- and then use that data to reconstruct the pyramid, which may or may not still resemble a pyramid.

In fact, the 2005 Dietary Guidelines report now on the desks of the secretaries of the USDA and Health and Human Services notably does not reference the "pyramid" as it did in its 2000 report.

Instead, the report refers to the "revised USDA food intake pattern."

John Webster, director of public information for CNPP, said a final decision on how the new dietary guidelines will be presented in graphic form hasn't been made. He acknowledged that "it may not be a pyramid at all."

The ubiquitous symbol was adopted in 1992 in response to the educational community, which sought an easily understood tool to help teach nutrition. In that sense, the pyramid succeeded.

"We know that 80 percent of Americans recognize the food pyramid," says Webster. "But we also know that only 4 percent of Americans actually follow it."

The pyramid is a guide to the basic foods that should be consumed regularly, but has been maligned for its vagueness, from a lack of defined serving sizes to its failure to delineate the differences in foods within the same category.

The protein group, for example, lumps meat, poultry, fish, dry beans, eggs and nuts into one group. Nutritionists say there's a great disparity between fish and red meat, between eggs and beans, that the pyramid doesn't explain.

The tip of the pyramid includes fats, oils and sweets with the advice to "use sparingly." However, some oils -- olive, for example -- now are perceived as having benefits in the body.

The base of the pyramid includes bread, cereal, rice and pasta, with no mention of the whole-grain alternatives nutritionists say must be emphasized.

Nor is there a physical activity component, while "daily physical activity" is the foundation of the much-heralded Mediterranean Diet Pyramid. Its influence is expected to show up throughout the revised pyramid.

In fact, Fernstrom says, "a person can have the best intentions, follow the pyramid as it is now, and not realize that the pyramid itself is actually sabotaging their effort to lose weight."

Nutrition experts expect that the new pyramid will address the key concerns, but also wonder if it will make much difference in a culture where food is plentiful and available 24 hours a day.

The dietary guidelines will re-emphasize considerable daily physical activity, as well as the increased consumption of foods higher in fiber, which has been shown to reduce the risk of heart disease.

Whether Americans can cut the mustard is another matter entirely.

"I like to say that there are no bad foods, just bad portions," Fernstrom says. "It's more important to ask yourself how often you eat and how big is the serving. You have to allow yourself a little bit of chocolate, for example, and you should also associate food with a little bit of fun.

"But this is a unique country, one where we have the most diet plans in the world, and yet, we're still the fattest people in the world. Food is readily available, we're stressed, we're bored, we're all working, we eat on the go. The reality is, we contribute to our own obesity."

Cheryl Byers Shipley, a registered dietitian and professor in the culinary arts program at Westmoreland County Community College near Youngwood, agrees.

"We've certainly become more knowledgeable about what we eat," Shipley says. "But we're also schizophrenic. We love the Food Network. We read labels, but we're still consuming high-calorie foods, eating lots of red meat and buying lots of less healthy products.

"It's just like, we all know the speed limit, but ..."

Shipley says the pyramid sought to expand on the basic four food groups but, for example, "almost seemed to pretend that fats and sweets didn't exist. All oils were bad, but we know now that some oils are advantageous. Grains were all lumped together in bread, but whole grains also bring more fiber into the diet. There is protein in red meat and fish, but fish and legumes are much healthier."

The Mediterranean diet expected to influence the new dietary guidelines is based on the diet traditions of Crete, much of the rest of Greece and southern Italy.

It attracts considerable attention because, in that region, the rates of chronic diseases are among the lowest in the world and adult life expectancy is among the highest.

In addition to regular daily exercise, the Mediterranean diet emphasizes high-in-fiber plant sources, such as fruits and vegetables, potatoes, grains and breads, beans, nuts and seeds. Olive oil is the principal fat, with low overall consumption of total fat and cheese and low to medium consumption of fish and poultry (weekly), with a higher value placed on fish.

Red meat only shows up at the tip of the pyramid and is recommended only monthly.

A couple of glasses of wine -- one for women -- with meals is generally part of the diet, though experts always call for moderation and caution in the consumption of alcoholic beverages.

"When they study the second and third generations in this country, they showed the kind of heart disease that is not seen in their relatives in Greek culture," Shipley says.

Shipley says, too, that none of the new guidelines will make much difference if Americans continue to shun regular exercise. "It all fits together: the diet, the portion sizes and the exercise," she says, "but if you're just a couch potato, nothing will matter."

Americans eat about 50 percent of their food away from home, which makes the restaurant industry a major player in nutrition, Shipley says.

"We're starting to see the chains provide nutrition analysis, and that's good," she says. "It's part of giving people the right information. What they do with it is another matter. At its heart, eating is a very private and personal function.

"On the other hand, I think we're seeing the food service industry become more creative, of getting away from the usual steak and potatoes, white bread routine. It is an opportunity for creativity, for using healthier products and still serving an excellent dish."

Webster acknowledged that the pyramid does not contain some specific explanatory information. However, he pointed out that data is available in the text portion of a pamphlet distributed by the USDA about the pyramid and nutrition.

For example, it is only by reading the accompanying text that someone would realize that the "6-11 servings" of the bread, cereal, rice and pasta group from the pyramid doesn't mean that six is a minimum and 11 a maximum. The calorie breakdown in the text is for a 1,600-calorie diet, for which six servings from that group are recommended; 2,200 calories, up to nine; and 2,800 calories, up to 11 servings. And it takes further reading to learn that 1,600 calories is "about right for many sedentary women and some older adults; 2,200 calories is about right for most children, teenage girls, active women and many sedentary men; and 2,800 calories is about right for teenage boys, many active men and some very active women."