The food pyramid that was released by the U.S. Department of Agriculture (USDA) in 1992 quickly became a recognizable nutrition symbol for Americans. However, during the same period of the 1990s, Americans gained more and more weight. Is the food pyramid to blame? Here, Walter Willett, M.D., author of Eat, Drink and Be Healthy; Jeanne Goldberg, professor of nutrition at Tufts University; Marion Nestle, chair of the Nutrition Department at New York University; and Dan Glickman, former secretary of agriculture, offer their criticisms of the food pyramid and discuss the politics behind its creation.
Chair, Nutrition Dep't., Harvard School of Public Health; author Eat, Drink, and Be Healthy
The food guide pyramid that was developed in 1991 really is based on the idea that all fat is bad. Therefore [if] fat is bad, and you have to eat something, carbohydrate must be wonderful. So the base of the pyramid is really emphasizing large amounts of starch in the diet. We're told we can eat up to 11 servings a day, and if that wasn't enough starch, the pyramid puts potatoes along with the vegetables, so you can have up to 13 servings a day. That's a huge amount of starch.
Fat's up at the top of the pyramid, and where it says explicitly "fats and oils, use sparingly." It doesn't make any distinction about the type of fat, and it tells us to eat basically as little as possible.
From a public health standpoint, how would you characterize this pyramid?
Well, this pyramid is really not compatible with good scientific evidence, and it was really out of date from the day it was printed in 1991, because we knew, and we've known for 30 or 40 years, that the type of fat is very important. That was totally neglected. …
Is it fair to blame the food pyramid when people don't follow it anyway?
The food guide pyramid has actually had a substantial impact on the diets of Americans. If we look back compared to 20 years ago, the percentage of calories from fat in the American diet is quite a bit lower compared to earlier days. Second, there're some important indirect impacts of the food guide pyramid, in that many tens of billions of dollars of federal food policies have to be compliant with the food guide pyramid. So many programs -- for example, what's fed to young children, to pregnant mothers, to low-income families -- have to be consistent with low-fat diets. So the impact really has been, overall, substantial.
Behind the food pyramid were a collection of constituencies. Were people receptive when you raised these criticisms in the '90s?
There was not much receptivity in the 1990s, when we raised these criticisms of the food guide pyramid. It was almost an accepted religious belief that fat was bad and carbohydrates were good. Then there were lots of economic interests behind the food pyramid as well. Clearly the dairy industry is extremely well represented in the food pyramid. The beef industry is there, and it's very convenient that beef is combined along with fish and poultry and nuts and legumes. So each one of those industries can say: It's healthy to have three servings a day of our product. …
Talk about your food pyramid.
We've tried to put together an alternative food guide pyramid that would be based on the best available science. And of course it is a little bit challenging to boil down a tremendous amount of complex science to a simple graphic, and you really have to focus on the things that are well established and important.
Right at the bottom, we put weight control and regular physical activity, because overweight is the number one nutrition problem in the United States. Almost everyone is going to need to exercise on a regular basis if they want to control their weight over the long run. And this also is a message that all forms of calories are important.
On the next level, we put healthy forms of carbohydrate, meaning whole-grain carbohydrates and healthy forms of fat, meaning from vegetable oils, in the recognition that in most people's diet, most calories are going to be coming from some source of carbohydrate and fat. And what's really important is that those both be healthy sources.
Some of those fats have come right from the top of the other pyramid.
Right. What we've done is, we've brought some of those fats from the top of the pyramid down to the base, because healthy fats are an important part of a healthy diet.
The rest of the pyramid?
Our alternative pyramid, like the USDA pyramid, does emphasize plenty of fruits and vegetables, but we've taken potatoes out of the vegetable group. We've put legumes and nuts as a layer. If you want to be a vegetarian, those are good protein sources. But moderate amounts of poultry, fish, and nuts can also make a diet be a non-vegetarian diet and still very healthy. And up at the top we've put red meat and dairy products, dairy fat, because those are high in saturated fat. ... At the top of the pyramid, we've put foods like white bread, white rice, white pasta, and sweets as those that should be used sparingly. And that was really the base of the USDA pyramid.
Some nutritionists have criticized your pyramid as "floating on a lake of olive oil."
The formal studies that had compared a more moderate fat intake as we've suggested, with low-fat diets, have actually consistently shown that people did as well or better controlling their weight on a moderate-fat diet compared to a high-carbohydrate, low-fat diet.
Professor, Tufts University Friedman School of Nutrition
[Some] have criticized the USDA food pyramid as simplified. Would you defend the USDA pyramid?
I would defend the USDA food pyramid. In the interest of full disclosure, I have to say I was the principal investigator on the study which led to the release of the food guide pyramid after it was withdrawn.
I think one of the problems in the confusion about the food guide pyramid is that probably one person in 10,000 doesn't understand its origins. Its origins were as a graphic to explain the content of a booklet which laid out some of the specifics of the concept of variety, which was part of a government document called "The Dietary Guidelines for Americans." It was just a graphic that was supposed to illustrate some of these points. Somehow it got from that point into a debate which made it look like a policy document, as "This is one way to eat," and then there are a myriad of other pyramids which say, "This is the way to eat."
I wish the food guide pyramid were as powerful as its has been positioned as being, because if it were, and if Americans were following the food guide pyramid with the caloric bases on which it's underpinned, a lot of the obesity problem and a lot of the eating problems that we have would just go up in smoke. I think it isn't about whether it's the food guide pyramid or a pyramid that has a different configuration. We're just eating too much, and too much of the wrong things. But the food guide pyramid didn't cause obesity. It just is not that powerful.
One of the real problems in using it though is, if you look at the food guide pyramid, or any pyramid, it contains a bunch of basic foods -- breads, fruits and vegetables, dairy products, meat, so on. Everybody's seen it. The world is acquainted with it. What happens when somebody eats a pizza, which is a simple but very popular food? Where does that fit in the food guide pyramid? And what person is going to do the mental arithmetic to look at the food guide pyramid and say, "Okay, I had a pizza. Now, the crust belongs in the base. The tomatoes belong over here. The oil belongs at the top." You see where I'm going? I mean, all it is, is a graphic, which should be used as a tool that's part of a comprehensive learning program for kids and adults to learn how to choose a diet.
Some epidemiologists argue that all fat has been unfairly lumped in…
… It's not a stand-alone graphic. There's a lot of information that goes into choosing a healthful diet. I don't care how good anyone is at designing graphics, they'll never put it into one triangle, pagoda, or any other model -- and we tried large numbers of models that might look more effective. I don't think that should be the use. I think we ought to come back to defining what is the use of the food guide pyramid, and begin from there. Wipe the slate clean and say: What are we going to do with this document? Or should we get rid of it?
Chair, Nutrition Dep't., New York University; author Food Politics: How the Food Industry Influences Nutrition and Health
The pyramid was meant to be released in 1991. At that point, the meat industry and the dairy industry got wind of it, didn't like where their products appeared, sort of towards the top of the pyramid, and complained so bitterly to the Department of Agriculture that the Department of Agriculture withdrew it, and redid the research and went through a year-long lobbying process that resulted in the 1992 release of the pyramid. It was already incredibly political, right from the outset.
Now, I thought that the advice would indicate that you were supposed to eat fewer meat and dairy products, and that would lower the fat content of the diet. … It never occurred to me, when the pyramid was released, that the sizes of servings of grain products in particular would increase so rapidly during the decade in the 1990s. What happened was that muffins that used to be 1 or 2 ounces expanded to 8 ounces. Soft drinks that used to be 8 ounces expanded to 64 ounces. Pretzels that were 1 ounce expanded to 7 ounces. You eat one of those 7-ounce pretzels and you've done your grain servings for the day. But most people don't realize that.
Secretary of Agriculture, 1995-2001
How did the USDA get into the business of giving nutrition advice?
… Actually, the largest part of the Department of Agriculture, in dollars spent, is in its federal nutrition programs: the National School Lunch Program, the Food Stamp Program, the Women Infant and Children Program. So over the years, the belief was that since the government was providing all this food assistance to the needy and the poor, that there was a reason to try to provide nutritional advice and information as well, and that's how it began. …
Once you start talking about specific health outcomes for certain types of food, you get into a political problem.
That's correct. You know, certainly at the beginning, the idea was kind of a joint coalition between farmers and needy people, to get rid of surpluses of food, because we've always produced more food in this country than we've consumed, either domestically or even internationally. So the idea was to join the farmers, the producers, with the consumers and the people who needed the food. But gradually, as we began to look at what foods were good for you or what foods weren't good for you, you began to get differences of opinions and resistance from some parts of the food production industry. …
Still, the USDA, in giving advice, had to deal with, for example, saturated fats, which have consequences for health, but also for people who produce animal protein.
Yeah. USDA basically was in an unusual role of not wanting to say that there were any good foods or any bad foods; that all foods were okay, [presumably] eaten in some degree of moderation or discretion. So USDA was always very careful at not defining evil as part of any particular food category.
Part of that was the multiplicity of missions in the Department of Agriculture, because politically, the heart of the Department of Agriculture was food producers, was making sure that there were enough farmers alive and they could continue to produce food. So farmers produce all sorts of things, from fats to carbohydrates to proteins and everything in between. USDA has always had this little bit of conflicting mission between the producers of food and the consumers of food, and how to bridge that gap between the two of them hasn't been all that easy.
A food pyramid is a complicated political compromise?
It's complicated. Although I would have to say the government over the years, working within the agencies -- it's not just USDA; the food guide pyramid is also in partnership with the Department of Health and Human Services, although traditionally USDA has taken the lead in all of this -- has tried to kind of cut the baby in half, try to provide information without being terribly controversial on the food production side of the picture.
You get the sense that the stuff at the top, you're supposed to have less of; the stuff at the bottom, you're supposed to have more of.
That led to the notion that you should limit the amount of total fat. Therefore you have to eat something else, which would be carbohydrate. When you look back, do you think there were unintended consequences?
I think that based on what I know of the science at the time, the food guide pyramid was largely governed by nutritional information and science at the time, which was, carbohydrates were good and fats were bad. And quite frankly, the medical community was pretty much on line with that in the 1960s, 1970s and 1980s.
Science only fairly recently has begun to break down issues of carbohydrates and fats, particularly the fats, to show that some fats are good for you and some fats aren't good for you, and that carbohydrates are not necessarily good for you, and complex carbohydrates or whole grains are better for you than others are. A lot of that is fairly recent information in the science community. And USDA kind of lags [in] that period. It does not lead the science. It follows the science.
So against the changing nutritional science background, all this stuff plays out.
That's right. And again, the government was not going to take the lead in areas where the science was evolving or changing. In that sense, the government operates rather conservatively. …
We were talking about the food pyramid before. Walter Willett, also at Harvard, [designed his own food pyramid, the base of which] is exercise. Do you think that's a good idea?
I do. And I think that that is something that's non-controversial too. My judgment is that the next pyramid -- which will come out [in the] year 2005, I think -- will include exercise as a big part of it.
How about his next level up, which are oils? That used to be up at the very top. "Don't mess with oils. They're fattening." Suddenly olive oils, canola oil, others, he says it's very good for you.
I think he's correct on that as well. I'm not a scientist, and I can't tell you exactly which oils are good and which aren't, but I think he makes a good case that we need to go to the next level of sophistication and break the oils down, so that the olive oils, the mono-unsaturated oils are in a better position than, let's say, the saturated fats and the trans fats, which are in a very bad position. And I think that will also happen in the next segment of the food guide pyramid.
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posted april 8, 2004
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