One
Size Does Not Fit All — The New Pyramid Food Guidance System
By Carol M. Meerschaert, RD, LDN
Today’s Dietitian
Vol. 7 No. 8 P. 42
It’s not just a graphic anymore—it’s
a system. Hear what skeptics and supporters are saying about it.
The USDA has provided consumers with dietary guidance
dating back more than 100 years. It started in 1894 when W. O. Atwater
published food composition tables.1 In 1916, Caroline Hunt published
the first food guide. Lest we think we are innovative or that today’s
nutrition issues are unique, Atwater wrote in the 1902 Farmer’s
Bulletin that “the evils of overeating may not be felt at
once, but sooner or later they are sure to appear—perhaps
in an excessive amount of fatty tissue, perhaps in general debility,
perhaps in actual disease.”
The original Food Guide Pyramid, released in 1992,
was an innovative food guide graphic at the time. The shape was
based on consumer research.1 In the past couple of years, it has
been the source of much criticism with the Food Pyramid taking the
blame for everything from obesity to diabetes.
This year has been a big year for government food
guidance as the revision of the food guide has paralleled and been
coordinated with the development of the 2005 Dietary Guidelines
for Americans, which the USDA and Health and Human Services (HHS)
released in January. According to the USDA, the overall purposes
of the revision were to improve its effectiveness in motivating
consumers to make healthier food choices and ensure that the USDA’s
food guidance system reflects the latest nutritional science.2
The 2005 Dietary Guidelines for Americans are the
basis for federal nutrition policy. The Pyramid Food Guidance System
provides food-based guidance to help implement the recommendations
of the Guidelines. Note that the USDA refers to this as a system.
No longer is the food pyramid a simple graphic. It is now a system,
complete with interactive Web sites and educational modules, and
is specifically designed so health professionals can use it as a
tool for food guidance.
The new pyramid is a tool. Just as owning and understanding
a hammer does not build a house, owning and understanding the pyramid
is only one piece of a healthy life. This will change dietetics
and especially community nutrition as we know it.
The Pyramid Food Guidance System was based on both
the 2005 Dietary Guidelines for Americans and the Dietary Reference
Intakes from the National Academy of Sciences. The USDA says it
takes into account current consumption patterns of Americans, translates
the Guidelines into a total diet that meets nutrient needs from
food sources, and aims to moderate or limit dietary components often
consumed in excess.
The key tool of this guidance system is the Web
site, www.mypyramid.gov,
which offers interactive guides and tools as well as portable document
format (pdf) files that can be printed by professionals to teach
consumers or can be accessed by consumers themselves.
In addition, MyPyramid.gov includes materials designed
for use by health professionals. The USDA states that the professional
materials are intended for use by programs and agencies in developing
consumer education materials; by nutritionists and educators as
the basis for their education efforts; and by the media to assist
them in understanding and reporting federal food guidance. Professional-level
materials are available free of charge on the Web site and include
Food Intake Patterns that identify what and how much food an individual
should eat for health. The amounts to eat are based on a person’s
age, sex, and activity level. The patterns have been published in
the 2005 Dietary Guidelines Education Framework that explains what
changes most Americans need to make in their eating and activity
choices, how they can make these changes, and why those changes
are important for health.
Why a Pyramid?
The first pyramid was used because consumer studies showed it was
the preferred symbol.1 Surveys, including the American Dietetic
Association (ADA) 1997 nutrition trends survey, show that 85% of
Americans recognize the food pyramid’s shape. The ADA recommended
to the USDA that the shape of the Food Guide Pyramid be retained.
The old pyramid is familiar, but “few Americans follow the
recommendations,” Agriculture Secretary Mike Johanns said
while unveiling the new design. “It became clear we needed
to do a much better job of communicating the nutrition messages
so Americans could understand how to begin making positive changes
in their lifestyles.”3
When the new Food Pyramid was released, ADA President
Susan Laramee stated, “The problem is that few people really
understood the Pyramid and even fewer followed it. What is needed
is what the USDA announced today: A Food Guidance System that includes
a graphic symbol plus consumer messages and motivational and educational
tools that work together to guide people toward healthy food choices.”3
The New Key Messages
The key principles included in the new pyramid are as follows:
• Variety — Eat foods from all food
groups and subgroups.
• Proportionality — Eat more of some
foods (fruits, vegetables, whole grains, fat-free or low-fat milk
products), and less of others (foods high in saturated or trans
fats, added sugars, cholesterol, salt, alcohol).
• Moderation — Choose forms of foods
that limit intake of saturated or trans fats, added sugars, cholesterol,
salt, and alcohol.
• Activity — Be physically active every
day.
Adding physical activity is new for the food guide
symbol. The visual of a person walking up steps is to remind people
that activity is important and that the number of calories appropriate
for any one person is partly determined by the activity level of
that person.
The pyramid aims to persuade Americans to make gradual
changes to improve their diet. It encourages Americans to know their
daily calorie limits and stay within them by eating nutrient-rich
foods. It is not intended to be a weight-loss tool but is geared
to those wishing to maintain their weight. However, the MyPyramid
Tracker tool on MyPyramid.com can be used for gradual weight loss.
The Critics
Alana Semuels wrote in the April 20 edition of the Pittsburgh Post-Gazette
that the new pyramid “might as well have been shaped as a
lightning rod for all of the criticism it attracted.”4
“It’s flat,” read the quote from
Elizabeth Pivonka, president of Produce for Better Health, in The
Atlanta Journal-Constitution on April 20. “It doesn’t
compel me to go to a Web site; it doesn’t tell me what I should
be eating. I think it has failed America’s public health.”
According to the article, the produce industry had been lobbying
for a plate-based symbol that would devote half its space to fruits
and vegetables.5
Research done when the first food pyramid was being
considered showed that a circle shape was considered by consumers
to be old and out of date.1 Besides, how many meals today are really
eaten from a plate and how many calories are consumed from a box
or a cup? Would a plate graphic encourage the thought that only
meals count as calories?
Marion Nestle, professor of nutrition at New York
University, was quoted in the Pittsburgh Post-Gazette saying, “Taking
out the hierarchy of the old pyramid makes the new design obsolete,”
and that “they [meaning the USDA] gave a free pass to the
food industry” because the pyramid avoided labeling foods
as good or bad.
The Compliments
Others liked the new pyramid. Marilyn Tanner, RD, who works with
overweight children at St. Louis Children’s Hospital, presented
the new MyPyramid image to eight kids, aged 8 to 12, at a weight-management
class and was quoted in USA Today. “They thought it was cool,”
Tanner said. She commented on her plans to use the MyPyramid site
with the kids because “they’ll be excited that it’s
individualized because kids really like personalized attention.”
Karen Miller-Kovach, chief scientific officer for
Weight Watchers International, said, “I like the idea that
the symbol reminds you to do something [exercise and eat from different
food groups] as opposed to trying to teach you everything in one
little picture.”5
K. Dun Gifford, president of Oldways Preservation
Trust, the group that developed the Mediterranean Diet Pyramid,
says, “The new food guidance explicitly acknowledges that
‘one size does not fit all.’ We are all different sizes,
shapes, nationalities. We have wildly different taste and flavor
preferences. We want Italian, or Mexican, or French, or BBQ, or
steakhouse—we don’t go shopping for fats, proteins,
and carbohydrates. Speaking the language of foods is key to reaching
people effectively. Nutrition-speak fails; it’s become the
tool of choice of fad diet promoters.”
Why the Internet?
One of the loudest criticisms seemed to be the use of an interactive
Internet Web site to host the new guidance system. Yet, www.mypyramid.gov
was swamped with heavy traffic—between 1,000 and 1,500 hits
per second—on its first day. Gifford commented, “It’s
brilliant to put the power of the government behind the educational
power of the Internet. It encourages self-knowledge and individual
decisions, the keys to success, and the only effective channel for
change. This has the power to personalize dietary guidelines as
never before.”
The issue is what is referred to as the digital
divide. U.S. Department of Commerce data from 2001 indicated that
78.9% of people in families making $75,000 or more had Internet
access, compared with 25% of people from households earning less
than $15,000 per year. By 2004, 75% of the U.S. population was online.6
However, the divide is narrowing. Camfield Estates,
a 102-unit public housing development in Boston, installed wireless
Internet access and provided computers for its residents in 2003
and a resident poll found that virtually all participants used the
computers to read news, learn about health and housing, or shop
online. The state of Maine, a low-income and mostly rural state,
gives laptop computers to every seventh- and eighth-grade student.
For many families, this is the introduction to the online world.
The program has been so popular that some districts now offer laptops
to every student through the 10th grade. Public libraries are cited
by the Pew Family Foundation report as an important place of Internet
access.
According to a report from the Pew Internet &
American Life Project, 95 million American adults use the Internet
to find health information. Among women who use the Internet, 59%
read nutrition information online, but only 43% of men who use the
Internet do.7
The report states that “the Web has become
the ‘new normal’ in the American way of life; those
who don’t go online constitute an ever-shrinking minority.”
Since the last version of the food guide was in place for 13 years,
it seems prudent to use a media that is expanding to increase the
new pyramid’s reach.
Further, the Pew project found that when the Internet
was new, people who used the Internet were most likely to be young
white men with high incomes and education. By 2000, the Internet
population went mainstream; women reached parity and then overtook
men online, more minority families joined in, and more people with
modest levels of income and education came online.
The Internet changed the way people deal with health
issues. The Pew report states, “E-patients are creating a
new healthcare environment in which the traditional medical model—ruled
by the all-wise doctor who tells patients what is best for them—is
being challenged by a new model in which empowered patients can
access large amounts of medical information, advice, and support
online, and act as partners with their doctors in making healthcare
decisions for themselves and their loved ones.”
The most amazing finding was that 10% of households
having an annual income of less than $10,000 per year had broadband
Internet service in 2004. Eleven percent with incomes of $10,000
to $20,000 per year and 14% of households with incomes of $20,000
to $30,000 per year had broadband. Those numbers are double what
they were in 2002. Imagine what the numbers will be 13 years from
now and then decide whether the Internet was the way to reach consumers
with food guidance.
How to Teach the New Pyramid
Dietetics professionals can explain the messages in the MyPyramid
symbol. The messages are physical activity, variety, proportionality,
moderation, gradual improvement, and personalization. These messages
can be found on the “Anatomy of MyPyramid” handout available
at www.mypyramid.gov/downloads/MyPyramid_Anatomy.pdf.
We can help consumers find the kinds and amounts
of foods they should eat each day at MyPyramid.gov. When they enter
their age, gender, and activity level, consumers get their own plan
at an appropriate calorie level. The food plan includes specific
daily amounts from each food group and a limit for discretionary
calories (fats, added sugars, alcohol). The food plan is at one
of the 12 calorie levels of the food intake patterns from the Dietary
Guidelines. Consumers can print out a personalized miniposter of
their plan and a worksheet to help them track their progress and
choose goals for tomorrow and the future.
A section on the MyPyramid Web site called “Inside
the Pyramid” explains each food group, discretionary calories,
and physical activity. Answers to questions on serving sizes and
what foods are in each group are found on this section of the Web
site.
If you visit no other part of the MyPyramid.gov
site, go and play with the MyPyramid Tracker. This free tool offers
consumers a service for which many private practice RDs could charge
$50. The dietary and physical activity assessment tool asks for
entry of all foods eaten each day and all physical activities performed.
From this, a consumer’s current status in comparison with
the 2005 Dietary Guidelines recommendations, nutrient intake, and
energy balance is shown. A history function allows consumers to
track progress over time, up to one year (www.mypyramidtracker.gov).
What Else is Needed?
The Food and Nutrition Science Alliance (FANSA) is a partnership
of the American College of Nutrition, the ADA, American Society
for Clinical Nutrition, American Society for Parenteral and Enteral
Nutrition, American Society for Nutritional Sciences, Institute
of Food Technologists, and Society for Nutrition Education. FANSA
says research is needed to ensure that MyPyramid goes beyond the
awareness stage where consumers readily identify the shape and intent
(pyramid and healthy eating) and truly apply and use the information
when making informed choices on a daily basis.
In the document “MyPyramid Food Guidance System
Education Framework,” the USDA asks professionals to help
teach the key concepts of calories; physical activity; grains; vegetables;
fruits; milk, yogurt, and cheese; meat, poultry, fish, dry beans,
eggs, and nuts; fats and oils; sugars and sweets; salt; alcohol;
and food safety. Under each topic area, information is presented
on what actions should be taken for a healthy diet, how these actions
can be implemented, and why those actions are important for health
(the key benefit). According to the document, “These key concepts
are not intended as direct consumer messages, but rather as a framework
of ideas from which professionals can develop consumer messages
and materials.” In other words, consumers need you.
The 19-page document outlines the education required
by individuals to implement the food guidance system. Clearly, no
one feels the pyramid symbol is a stand-alone education tool.
What is really needed is marketing. Gifford says,
“Like it or not, most objects and even ideas are ‘sold,
not bought.’ Yesterday’s food guides were not sold well,
and they certainly were not bought by the overweight two-thirds
of Americans. Now, the government is enlisting advertising and marketing
professionals to help promote the new food guidance. This is terrific
news. It’s exactly what happened the last time the government
effectively promoted a food program—when they enlisted Madison
Avenue professionals to promote food rationing during World War
II. It’s not a bad analogy: this time we are in war against
obesity, and we need to win this one, too.” All who care about
nutrition must go sell the concepts of whole grains, more fruit
and vegetable consumption, and learning to balance calories eaten
with those burned.
— Carol M. Meerschaert, RD, LDN, is a freelance
writer, corporate consultant, and lecturer in Falmouth, Me.
References
1. USDA’s Food Guide Background and Development: USDA Human
Nutrition and Information Service. Misc publication 1514; 1993.
2. MyPyramid Education Framework. Available at:
http://mypyramid.gov. USDA Pyramid unveiling Web cast April 19,
2005.
3. ADA Press release. Available at http://www.eatright.org.
Accessed April 19, 2005.
4. http://www.post-gazette.com/pg/05110/491020.stm
5. http://www.usatoday.com/news/health/2005-04-20-food-pyramid_x.htm
6. U.S. Department of Commerce, Economics and Statistics
Administration, National Telecommunications and Information Administration
Falling Through the Net: Toward Digital Inclusion. Available at:
http://www.ntia.doc.gov/ntiahome/fttn00/falling.htm#36
7. Pew Family Foundation. The Digital Economy Fact
Book, Sixth Edition 2004. Report available at http://www.pewinternet.org
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