Wednesday, June 2, 2010
The Scary Statistics
Within the United States, roughly 32.7 percent of adults aged 20 and older are overweight, 34.3 percent are obese and 5.9 percent are morbidly or extremely obese. (3). The prevalence of obese (BMI greater than or equal to 30) American adults has grown from 22.9 in the 1988-1994 data collection to 34.3 in the 2005-2006 data collection. Even scarier, the prevalence of extremely obese adults (BMI greater than or equal to 40) has grown from 2.9 to 5.9. (3).
The Purpose of Dietary Food Guidelines and The Attempt to Provide Improved Guidelines for the New MyPyramid
Based upon data and statistics I just reviewed, the number of obese and overweight Americans is growing, but what is being done to educate and inform citizens on proper diet and nutrition to help reverse the growing epidemic of obesity in this country? One answer to that question should be the dietary guidelines that are put in place by the US government. According to the USDA, dietary guidelines for Americans are the cornerstone of federal nutrition policy and nutrition education activities (2). These guidelines are supposed to be in place to promote health and reduce risk for major chronic diseases such as obesity (2). Every five years, the dietary guidelines are updated by the USDA and the Health and Human Services Department. In 2005, the MyPyramid was introduced, and is the most current dietary and nutrition guideline available. This new guideline was supposed to be a dramatic improvement over the previous 1992 food pyramid, addressing some of the major pitfalls of the previous pyramid. The major flaws of the 1992 pyramid included no emphasis on the importance of physical activity in combination with a healthy diet, generalizing that all fats are bad and ignoring the explanation of unsaturated fats versus saturated fats and the implication that all complex carbohydrates are good for you and should make up a large portion of daily diet. (9).
The MyPyramid Misses the Mark
The 13 years between the 1992 dietary guidelines and the 2005 MyPyramid should have been adequate time to produce a much more comprehensive and effective set of dietary guidelines for Americans to use based upon solid evidence, right? Many nutritional and medical experts disagree and some argue that the recommendations from public health organizations are not evidence-based(5). Some experts argue that these government issued guidelines can cause more harm than good and may need to be avoided, such as the case with the incorrect information provided in the 1992 pyramid about all fats being bad. (5). Even though there are beneficial improvements with the 2005 MyPyramid, such as focusing on an individualized approach to diet and adding in the focus on the importance of physical activity, experts still question whether or not the pyramid will be truly effective in positively influencing American consumers' dietary choices (6). Walter Willet, professor of epidemiology and nutrition at Harvard School of Public Health states that "The pyramid tells nothing of healthy food choices." (6). Willet argues further against the pyramid's credibility and effectiveness by commenting that it emphasizes too much dairy consumption (3 cups a day, not specific to sex, age or physical activity), in addition to the lack of informative information about the various types of fats. (6). Another solid argument against the pyramid's effectiveness is the fact that the information is only available by website, ignoring that several Americans still do not have access to the internet. (6). Even though posters and other media materials are available to schools and other institutions, it is really difficult to determine whether or not a full understanding of proper diet is gained from quickly glancing at a public poster.
We all know of the plentiful benefits of consuming adequate fruits and vegetables to help prevent disease. There is plenty of research available that documents the benefits of fruits and vegetables. Furhman devotes the entire book, Eat to live on the benefits of a diet that is mainly plant-based.(4) Yet, Furhman states that only 7% of American calories consumed are from vegetables and half of the vegetables consumed are potatoes, which are the least nutrient dense (4). Sure, the pyramid recommends daily fruit and vegetable intakes by age, gender and physical activity level, but it fails to elaborate on the multitude of benefits that are available from more fruit and vegetable consumption. The MyPyramid also fails to suggest vegetarian or vegan diets as possible healthy dietary options. While the 2005 MyPyramid does now offer serving suggestions in cups versus the 1992 version of simply suggesting servings, the fruit and vegetable consumption in the US has not increased significantly since the implementation of the 2005 dietary guidelines. In fact, CDC reports show that from 2005 (when the new dietary guidelines were introduced) to 2007, the average median percent of those who consume 5 or more fruits and vegetables daily increased only slightly from 23.8% in 2005 to 24.8% in 2007 (1). And sadly, the median percent of those who consume 0 or less than 1 serving per day stayed exactly the same at 4.4% (1).
Arguments In Favor of the MyPyramid Guidelines
Despite the criticism from many, there are still arguments that favor the changes that the USDA has made with regards to the new 2005 guidelines. Despite the negative feedback with regards to most of the information presented mainly on the internet, many argue that the reach to consumers is significant. Nine months after introduction, the MyPyramid website had 1.2 billion hits and 500,000 people had already started using the interactive diet tracker (8). While, fruit and vegetable intake hasn't seemed to increase, the consumption and purchase of whole grains has. According to the USDA's economic research service, the eight weeks following the introduction of the new guide, whole-grain bread purchases went up 12% and brown-rice purchases increased by close to 19%. (8). Other argue that while there are still some flaws with the 2005 guidelines, it is a vast improvement over the 1992 guidelines. The MyPyramid now makes a better distinction between the types of fats, in addition it highlights healthier choices for proteins. In addition, the new guidelines mention the benefits of fruits and vegetables and lowering cancer risk. (9). In addition to the mentioned improvements, MyPyramid attempts to individualize nutrient guidelines, whereas previously, this was not the case.
While, the arguments for the benefits of the US dietary guidelines tout the improvements that have been made, unfortunately, these changes are not going to be enough to make a more significant change in the rising epidemic of obesity and other chronic diseases within the US. There needs to be a complete change in the entire structure and thought process of what constitutes a healthy diet in order for the US to realize a healthier future with less disease and obesity. Adding more whole grains into your diet and exercising for 30 minutes a day are changes that are too small to make a significant impact. Increased nutrition education, availability of cheaper and more easily accessible fresh fruits and vegetables and an overhaul of the school food program are just a sampling of some of the many actions that would need to be taken in tandem
with changing the way Americans view what a healthy diet is. While the changes made with the MyPyramid guidelines are better than previous US dietary guidelines, I believe they are not enough to be sufficiently effective in reversing our declining population health status.
(1) Average fruit and vegetable consumption per day 2007 vs 2005. (2008). Centers for disease control and prevention. Retrieved (2010, May 29) from http://apps.nccd.cdc.gov/5ADaySurveillance/index.asp
(2) Dietary Guidelines For Americans. (2010). United states department of agriculture. Retrieved (2010, May 29) from http://www.cnpp.usda.gov/DietaryGuidelines.htm
(3) Flegal, K.M., Carroll, M.D., Ogden, C.L., & Curtin, L.R. (2010). Prevalence and trends in obesity among us adults, 1999-2008. The Journal of the American Medical Association, 303(3), Retrieved from http://jama.ama-assn.org/cgi/content/full/303/3/235?ijkey=ijKHq6YbJn3Oo&keytype=ref&siteid=amajnls
(4) Furhman, J. (2003). Eat to live: the revolutionary formula for fast and sustained weight loss. New York, NY: Little, Brown and Company.
(5) Marantz, P.R., Bird, E.D., & Alderman, M.H. (2008). A Call for higher standards of evidence for dietary guidelines. American Journal of Preventive Medicine, 34(3), 234-240.
(6) Mitka, M. (2005). Government unveils new food pyramid: critics say nutrition is flawed. The Journal of the American Medical Association, 293(21), Retrieved from http://jama.ama-assn.org/cgi/content/full/293/21/2581
(7) Mypyramid dietary guidelines graphic. (2005). [Web]. Retrieved from http://www.mypyramid.gov/
(8) One year later: lessons from new guidelines and pyramid. (2006, February). Tufts University Health and Nutrition Letter, 4-5.
(9)Willet, W.C., & Stamfer, M.J. (2006). Rebuilding the food pyramid. Scientific American, 16(4), Retrieved from http://search.ebscohost.com.bob.csueastbay.edu/login.aspx?direct=true&db=aph&AN=23628203&site=ehost-live