Dietary guidelines
The Food Guide Pyramid is demolished
Click here for January commentary on the Food Guide Pyramid
Walter Willett and Carlos Monteiro (left and right) demolish the US food guide
pyramid (left centre), after the World Nutrition January cover commentary
Our news team reports: After 19 years, the US government has demolished the Food Guide Pyramid. Thursday 2 June was the date of the official announcement. The new graphic is in the form of a plate showing equal amounts of grains (cereals), vegetables, fruits, and food sources of protein, accompanied by a glass suggesting milk. The guide will be 'rolled out' as part of First Lady Michelle Obama's anti-obesity campaign
Two versions of the Pyramid, now discontinued in the US but often still used in other countries, are shown above. Association founder member Walter Willett undermined the Pyramid in a book published ten years ago (1). He said: 'At best the ... Pyramid offers wishy-washy advice on an absolutely vital topic – what to eat. At worst, the misinformation contributes to overweight, poor health, and unnecessary early deaths. In either case it stands as a missed opportunity to improve the health of millions of people'. Some of Walter Willett's radical criticisms of the Pyramid in its various constructions, were that it mixed up sugary with starchy foods, made little distinction between whole and refined grains, grossly overemphasised red meat, milk and dairy products (produced by politically powerful industries), and failed to distinguish between unhealthy and healthy fats and oils.
In his January WN commentary, Association Council member Carlos Monteiro generally agreed with Walter Willett, and went further, as summarised in Box 1, below. His commentary is one of his ultra-processing' series, known to be required reading in the offices of various governments, including that of the US.
He says, of successive Pyramids, that they 'muddle together fresh and minimally processed foods, processed ingredients, and ultra-processed products. This is most evident in the base section of the pyramids, which display and promote starchy foods, recommended to be consumed abundantly, in amounts higher, and usually much higher, than is typical in any higher-income country. The visuals used as examples include bowls of rice and dishes of pasta; packets of oatmeal and of ready-to-eat breakfast cereal; breads; and cupcakes, buns and crackers, as if these are roughly equivalent in value. They are not. For example, grains such as rice, and also roots and tubers such as cassava (manioc) and potatoes, when consumed after being boiled or steamed, have a nutritional value very different from that of bread and of baked fatty or sweetened or salty products such as cupcakes, buns and crackers'.
Carlos Monteiro's seven arguments against food pyramids, and to some extent any graphic guide to food and nutrition, are as follows:
Box 1
Why the Food Guide Pyramid had to be demolished
These are the seven reasons why the Food Guide Pyramid had to be demolished, given in Carlos Monteiro's January WN commentary in his ultra-processing series:
Here are seven reasons why, from the point of view of public health, Food Guide Pyramids are not part of the solution, but part of the problem. The first two reasons are to do with the intrinsic nature of pyramids. The other reasons are to do with all current official dietary guidelines, however these may be graphically represented.
1.Pyramid power
The use of a pyramid is a distraction. It associates food and nutrition with a mystical symbol in ways that are irrelevant and distracting.
2.'Top' means 'best'
The top, tip or apex of any structure is generally seen as its most valuable and attractive part. Notwithstanding what Food Pyramids (or triangles) say in their accompanying text about fats, oils and sugars, the visual impression is that these are 'the best bit'.
3.Graphics are hopelessly selective
Graphic representations of dietary recommendations have to be very selective. Also, they are hangovers from the time when most foods were purchased whole or as ingredients, with some modern additions like yoghurts and packaged milk. Many of the pictures in Food Guide Pyramids roughly correspond to some of the foods people purchased and prepared for consumption at home half a century ago. Apart from fresh vegetables and fruits, most do not look like what people actually buy now.
4.Food groups are unhelpful
'Food Groups', originally devised nearly a century ago, are agreed after negotiation with powerful sectors of industry, which in the US, the UK and other countries include producers and manufacturers of meat and meat products, and of milk and dairy products).The milling and baking industries are also powerful. The emphasis on meat, milk and bread in 'Food Groups',has always followed industry pressure, usually backed by nutritional rationales. There has also been a tendency to 'export' groupings of food devised in and for temperate high-income countries to tropical or lower-income countries, whose original or established food systems are – or have been – different. The Food Guide Pyramid is also 'imported' without much or even any adaptation, by countries whose native and established foods are often different from those displayed on the Pyramid.
5.The main issue is not nutrients
Food Guide Pyramids are descended from graphic groupings of foods seen to be relatively good sources of protein, carbohydrate, fat, vitamins or minerals. This equation of food with its chemical composition has always had limited value. This 'nutritionism' is more valuable to industry than to public health. A conspicuous example is the 'carbohydrate' grouping. This includes whole starchy foods and refined sugary foods, which have dramatically different nutritional value and metabolic effects. Grouping in terms of nutrients now is increasingly useless, as manufacturers manipulate formulations of basically worthless products to make them seem 'healthy'.
6.The main issue is not foods
Food-based recommendations make more sense than nutrient-based recommendations. But for example, what is 'meat'? Is a cheese-and-bacon burger, the 'icon' of these commentaries, 'meat'? Or is it 'cheese'? Or does its bun place it in the 'bread' group? Or is deconstruction the answer, so that to take another example, pre-cooked ready-to-heat spinach lasagne figures in the 'vegetable', and the 'pasta' and also the 'fats, oils and sweets' groups? Is apple pie 'fruit' or 'cereal' or 'fats, oils and sweets'? What about ready-to-eat breakfast cereals, positioned in the bottom of the Pyramid as a basic food? Should those varieties with 40 per cent of calories in the form of sugars also figure in the 'fats, oils, and sweets' layer, as a form of candy (confectionery)? And what about pastries, chocolate cake, and cookies (biscuits), that are not shown on Pyramids? The designers of the lower Pyramid shown above seem to be aware of such basic problems, for its apex represents 'fats, oils and sweets' by what look like snowflakes. And do the designers of Food Guide Pyramids really believe there is not much significant difference between boiled rice, pasta, uncooked oatmeal, all types of bread, any type of breakfast cereal, cupcakes, buns, and crackers?
7.The main issue is processing
To realise that Food Guide Pyramids are confusing and misleading, look at what they show, then look at what is in the shops, and try to relate one to the other. Unless you avoid almost all but fresh and the most simply packaged food and drink, it's impossible. The only really meaningful distinctions are between fresh and minimally processed foods; culinary ingredients; and ultra-processed products.
As a guide for populations, the Pyramid does not and cannot work.
Carlos Monteiro adds: 'The new US graphic 'plate', in emphasising the value of fresh foods, notably vegetables and fruits, is a step forward. But what the plate shows is a long way away from what people in the US habitually eat. What should be said above all, is that consumption – and production – of ultra-processed products needs to be minimised'. 'The Pyramid was a foolish and misleading graphic guide to what to eat' says Association publications secretary Geoffrey Cannon, an advisor on dietary guidelines for many years. 'We at the Association are pleased to have played our part in demolishing it. Now countries outside the US that use or adapt the Pyramid will need to do their own demolition. These include many countries whose traditional food systems still survive. Let's hope their alternative choices are useful'.
Reference
- Willett W. Eat, Drink and Be Healthy. The Harvard Medical School Guide to Healthy Eating. New York: Simon and Schuster/ Free Press, 2001.
