The Government's Food Pyramid Correlates to Obesity, Critics Say

The Government's Food Pyramid Correlates to Obesity, Critics Say

With obesity reaching epidemic proportions in the U.S., some critics say it's the government's food pyramid that should go on a diet.

The pyramid, dating from 1991, pictorially reflects the U.S. Department of Agriculture's guidelines on what Americans should eat every day to maintain a healthy weight. From a broad base of six to 11 servings of food in the grains-and-carbohydrates group, the pyramid narrows upward to fewer servings of vegetables and fruits, to fewer still of such foods as milk and meat. Finally, at the pyramid's pointed top are fats, oils and sweets, which consumers are advised to "eat sparingly."

While the government has stood by this regimen for 11 years, some critics say it's no coincidence that the number of overweight Americans has risen 61% since the pyramid was introduced -- and almost instantaneously appeared on the sides of pasta boxes, bread wrappers and packages of other food products in the pyramid's six-to-11-servings category.

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David S. Ludwig, an obesity researcher at Children's Hospital in Boston, says the pyramid and guidelines focus too much on reducing fat. He says people are getting fat because they are eating too many refined carbohydrates, such as those in white bread, that make them feel hungrier later so they overeat. The habitual consumption of foods with refined carbohydrates "may increase risk for obesity, type 2 diabetes, and heart disease," he wrote in a May article in the Journal of the American Medical Association.

Steven Christensen, an official at the USDA's Center for Nutrition Policy and Promotion, says the pyramid represents guidelines for healthy eating -- not the next fad diet. "It wasn't meant as a way to reduce your weight, but if you eat this way, you're going to be all right."

The debate is particularly relevant in that the USDA currently is reviewing its dietary guidelines, as it does every five years. It's an exercise that attracts not only critics from the world of medicine but industry lobbyists and those promoting the virtues of various food groups and diets.

During the last revision, the advisory committee considered changing the 1995 recommendation of adhering to a diet "moderate" in salt and sugar to "eating less salt and sugar." The powerful sugar industry fought the change, and the guidelines now tell consumers to "moderate your intake of sugars." (The "less salt" revision stuck.)

Unlike the guidelines, the pyramid isn't reviewed periodically. But the USDA decided recently to review the pyramid's serving sizes and try to make the depiction clearer for the guide's 10th anniversary -- an exercise that has produced a flood of suggestions.

Among the most vocal of the pyramid's critics is Walter Willett, chairman of the Harvard School for Public Health's nutrition department. "The pyramid really ignored 40 years of data and condemned all fats and oils," he says. While the pyramid indicates that only fat calories count, Dr. Willet says, "calories are calories."

He and other critics say the government's focus on reducing calories from fat has helped propel sales of low-fat foods that still pack a lot of calories -- SnackWell cookies, for example, and potato chips made with the fake fat Olestra. "That probably has contributed to the explosion in obesity," says Dr. Willett, who is an unpaid consultant on a clinical trial comparing low-fat and low-carbohydrate diets. The trial is funded by the Robert C. Atkins Foundation, which advocates the Atkins low-carbohydrate diet.

But many mainstream dieticians argue that the Atkins low-carbohydrate diet is dangerous because it has too much fat and that cutting out any food group isn't healthy. Plus, there have been no long-term studies on the effects of the diet and whether people can keep the weight off.

Some experts think other parts of the pyramid need changes as well. Some suggest beans be removed from the meat category, where they are placed because of their protein content, and moved to the vegetable category. If bottled-water companies get the government to issue specific advice to drink more water in the 2005 guidelines, as they are trying to do, that, too, could alter the pyramid.

And then there is exercise.

"What I would like to see chiseled in the side of the pyramid are steps" and someone running up them to emphasize exercise, says Alice Lichtenstein, a professor of nutrition at Tufts University in Boston and a member of the committee that drew up the 2000 dietary guidelines. While the 40-page dietary-guidelines booklet advocates physical activity, the pyramid has no such message.

Ms. Lichtenstein also says the dairy products pictured on the pyramid should be designated as low-fat or nonfat. "There's probably no one over the age of two that needs full fat [dairy products]," she says.

It will be years before all the complaints are weighed, but the USDA, at least for now, doesn't seem inclined to abandon the basic premise that a low-fat diet is healthiest. "You can't pinpoint the cause of obesity … to carbohydrates," says the USDA's Mr. Christensen.

Beyond the debate over fats and carbohydrates, many nutrition experts say the pyramid needs to better define serving size to be effective. Most people don't realize that one USDA-size grain serving is about the size of a minibagel, says Marion Nestle, chairman of the Department of Nutrition and Food Studies at New York University. She also says the pyramid "emphases grain products too heavily without specifying whole grains ... They're not talking about white bread."

Suzanne Murphy, a nutrition researcher at the University of Hawaii and vice chairman of the advisory panel that wrote the 2000 dietary guidelines, worries that consumers don't realize that all foods within a food group are not equally healthy. She is concerned consumers look at the recommended six-to-11 grain servings and "think that means six to 11 servings of cakes and cookies."

Meanwhile, consumers are trying to sort through the conflicting messages. "Every year they come up with a style for the way people should eat … if you go by their [advice] you'll go crazy," says Roy Thompson, 50 years old, as he finishes a recent lunch at a Sbarro's pizza restaurant in Washington.

A few tables away, Marilyn Maxwell, 62, has ordered pasta and salad. Is she an adherent of the food pyramid? "I really don't pay a bit of attention to it," she says.

Write to Jill Carroll at jill.carroll@wsj.com⁶

Updated June 13, 2002