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Old Wed, Mar-26-03, 18:35
neeam's Avatar
neeam neeam is offline
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Default The Food Pyramid Controversy: What Shape Should Your Diet Take?

I read Dr. Willet' book and liked it as many of you. I liked the follwing line in the entire article..

"People were told that you can't get fat eating carbohydrates," he says. "That's a huge misconception. We shouldn't be gorging ourselves on starch."


The Food Pyramid Controversy: What Shape Should Your Diet Take?

By Lisa Chippendale
Infoaging Correspondent

Until a decade ago, nutrition for most Americans was synonymous with the USDA's four official food groups: meat, dairy, fruits and vegetables, and grain. Then, in 1992, the food groups took on a new form: the now-familiar Food Guide Pyramid, with a base of carbohydrates, topped by increasingly smaller levels of fruits and vegetables, protein sources and dairy, and finally fats, oils, and sweets.

One would think that government advocacy of a diet based mostly on carbohydrates, fruits, and vegetables would have led to a new era of American healthiness. That hasn't happened. Instead, the last decade has shown a remarkable rise in the rates of two diet-related health problems: diabetes and obesity. According to the National Center for Chronic Disease Prevention and Health Promotion, the prevalence of diagnosed diabetes increased 33% between 1990 and 1998, and now more than 60% of adults are overweight or obese.

This troubling rise, as well as further nutritional research since 1992, has caused several experts to reassess the USDA Food Pyramid and to suggest new guidelines of their own for all adults, as well as older adults.

Notably, the Oldways Preservation and Exchange Trust, a nutrition think tank, has designed several specialty pyramids for Asian, Latin, Mediterranean, and vegetarian diets. The Mayo Clinic has created a Healthy Weight Pyramid, with fruits and vegetables at the base, as a tool to encourage weight loss. And researchers at Tufts University's USDA Human Nutrition Research Center on Aging have created an alternate version of the USDA pyramid for Americans 70 and older. Indeed, it seems we haven't seen this much pyramid building since the days of the Pharaohs.

The Healthy Eating Pyramid: Check Your Carbs
Most recently, Dr. Walter C. Willett, Professor of Epidemiology and Nutrition at Harvard's School of Public Health, has introduced a new, drastically different Healthy Eating pyramid, which, along with his book, Eat, Drink, and Be Healthy, has garnered a great deal of attention.

Dr. Willett's pyramid and the USDA pyramid agree in one area: fruits and vegetables are good for you. There, the similarities end. Dr. Willett's main changes to the pyramid reflect his objection to the USDA's strategy of lumping all carbohydrates and proteins together as "good" while grouping all fats together at the tip as "bad."

"People were told that you can't get fat eating carbohydrates," he says. "That's a huge misconception. We shouldn't be gorging ourselves on starch."

Accordingly, the second step of the Healthy Eating pyramid includes healthy plant oils, which raise good cholesterol (HDL) while lowering levels of bad cholesterol (LDL), as well as whole grain foods. As for refined carbohydrates like white rice, white bread, potatoes, and pasta, Willett presses them to the very tip of his pyramid. These American staples, he says, should be eaten sparingly. He cites laboratory results showing that refined carbohydrates have a high "glycemic index," meaning they turn immediately into glucose in the body, prompting an upsurge in insulin and contributing to risk for heart disease and diabetes. Healthier whole grain carbohydrates (e.g., wheat breads and wheat pastas), which tend to have lower glycemic indexes, remain near the bottom of the pyramid.

As for protein sources, Dr. Willett rates them by their health effects, with low-in-saturated fat choices like nuts and legumes winning out, followed by fish, poultry, and eggs. Because of its proven associations with heart disease and cancer, Dr. Willett considers red meat a "poor protein package" and relegates it to the pyramid's tip.

And in another change, dairy products take up sole residence near the top of the pyramid, with the number of servings reduced. Dr. Willett argues that despite popular opinion, there is no clear scientific evidence that vast quantities of calcium minimize fractures or osteoporosis.

A Muted Government Response
The USDA has issued no official response to Dr. Willett's book-or to any of the other pyramids developed. Instead, John Webster, Director of Public Information for the USDA Center for Nutrition Policy and Promotion, states, "We have a policy of not commenting on diet books. Currently, we are reassessing the Food Guide Pyramid, which may result in its revision. At this point, however, no timetable has been established for the completion of the reassessment."

Recently, however, the USDA and the U.S. Department of Health and Human Services (DHHS) revised the "Dietary Guidelines for Americans." This 44-page brochure, which is updated every five years, is intended to complement the Food Guide Pyramid. The 2000 guidelines are somewhat more progressive than the existing pyramid, encouraging regular exercise, recommending whole grains, and targeting saturated fat for particular reduction. "The guidelines are a step in the right direction," says Dr. Willett. "But now they are inconsistent with the pyramid." And unfortunately, due to a lack of a budget for promoting the guidelines, few Americans even know they exist.

Other Experts Weigh In
Although most nutrition researchers agree with Dr. Willett that the USDA pyramid should be updated, they express some reservations about the Healthy Eating Pyramid. Dr. Simin Meydani, Professor of Nutrition and Immunology at Tufts University, says "his idea of differentiation between refined and whole grains has merit." She also agrees that "we can't clump all fats together, and all meats are not the same." However, she objects to the placement of oil near the bottom of the pyramid, pointing out that it could urge already overweight Americans to consume large quantities of high-calorie oils.

Dr. Shiriki Kumanyika, Professor of Epidemiology at the University of Pennsylvania's Center for Clinical Epidemiology and Biostatistics, also thinks the Healthy Eating Pyramid is a step in the right direction. As one of the nutrition experts who recently helped the USDA and the DHHS revise the Dietary Guidelines, she remains frustrated that the USDA pyramid has shown no improvement in the last decade.

However, Dr. Kumanyika expresses some reservations about Dr. Willett's reliance on laboratory tests to formulate his carbohydrate classifications. She says she the evidence supporting avoidance of carbohydrates with a high glycemic index is incomplete, since it is drawn from tests of single foods in the lab instead of complete, mixed-food meals. She prefers a conservative approach to federal nutrition guidelines. "Policy should only change," she says, "when there's strong evidence in the same direction from several different types of studies, and especially from clinical trials."

Experts also disagree on the subject of Dr. Willet's de-emphasis of dairy foods. For example, Dr. Meydani believes that the evidence of calcium and vitamin D's key role in bone health is solid. In particular, she says, adequate calcium and vitamin D intake is important for older adults, who are at a greater risk of debilitating fractures. On the other hand, Dr. Kumanyika demurs. "I have never been a big proponent of high doses of calcium," she says. "Calcium intake is important in the developmental period, but there's not such great evidence as to its importance throughout life." She points out that at least a partial answer to this question may be obtained soon. The ongoing Women's Health Initiative, a study involving over 150,000 older women, includes a large randomized component testing the effects of daily calcium and vitamin D supplements on osteoporosis.

Do Older Adults Need Their Own Pyramid?
Dr. Meydani, like the other researchers at Tufts who created the over-70 pyramid, believes that older adults could use a pyramid that includes slight differences to reflect their particular needs, for example, reduced serving sizes, more calcium, and vitamin supplements. Dr. Kumanyika says she prefers general nutritional guidelines that apply to everyone, encouraging those with special needs to speak with their physician to develop an appropriate dietary plan.

Dr. Kumanyika also hopes that any revised USDA pyramid would include a guide better explaining serving numbers and sizes. She finds that older adults often mistakenly believe they should be eating the maximum number of servings listed, rather than the minimum as is usually appropriate for their age and dietary needs. Conversely, she notes that older adults often need to be reminded to consume enough water, since the ability to recognize thirst is reduced with age.

Dr. Willett says that the same healthy diet could work for everyone and is confident that his Healthy Eating Pyramid is the most accurate general pyramid yet issued. He hopes that the USDA will eventually take action to update the Food Guide Pyramid. "They will have to recognize critical differences in carbohydrates, fats, and protein sources," he says. "Unfortunately, there's a huge amount of inertia. Committees have been saying 'no fat' for so long, it's hard for them to change."


Willett, Walter C., M.D. Eat, Drink, and Be Healthy. New York: Simon & Schuster, 2001.

Harvard School of Public Health

USDA Government Nutrition Site

Tufts University Over-70 Food Pyramid

Mayo Clinic Healthy Weight Pyramid

Oldways Preservation and Exchange Trust Food Pyramids

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Old Fri, Mar-28-03, 12:23
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Scarlet Scarlet is offline
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We're getting there, very slowly but some information is starting to break through.
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