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Let the Pyramid Guide Your Food Choices: Capturing the Total Diet Concept Part I

June 28th, 2005

By Lori Beth Dixon, Frances J. Cronin and Susan M. Krebs-Smith

“Eat a variety of foods” was the first guideline in the Nutrition and Your Health: Dietary Guidelines for Americans, from their inception in 1980 through the fourth edition in 1995. Targeting nutrient adequacy, it was meant to convey that no single food supplies all of the nutrients and other food components required for optimum health. In all four editions, to ensure variety, Americans were encouraged to consume foods from among each of several major food groups—breads, cereals, rice and pasta; vegetables; fruits; milk, cheese and yogurt; meat, poultry, fish, dry beans, eggs and nuts. In the 1985 and 1995 editions, Americans were also encouraged to consume different foods within those groups. Variety was quantified in the text of the guideline in 1990 by including recommended ranges for the number of servings from five food groups (grains, vegetables, fruits, milk, and meat or meat alternates). These recommendations were from a food guidance system developed by the USDA, which, in 1992, was published as the Food Guide Pyramid (referred to in this paper as the Pyramid) . The Pyramid was included in the text of the 1995 Dietary Guidelines. From 1980 through 1995, the guideline statement remained, “Eat a variety of foods.”

After extensive discussion, the 2000 Dietary Guidelines Advisory Committee (DGAC) elected to change the statement to “Let the Pyramid guide your food choices” in the 5th edition of the Dietary Guidelines . Their reasons for changing the statement were threefold as follows:

that variety among (as opposed to within) the food groups was most likely to promote nutrient adequacy

that variety within some food groups might lead to excessive intakes of energy

that the original statement simply was not clear to consumers

Members of the DGAC proposed using the Pyramid in the guideline statement because of its familiarity to consumers and success as a nutrition education tool. Naming the Pyramid in the guideline statement clarified its intent and suggested action by encouraging consumers to follow its recommendations. The text accompanying the guideline suggests using plant foods as the foundation of meals, and encourages consumers to emphasize foods from the grain, fruit and vegetable groups, along with moderate amounts of low fat foods from the milk and meat groups. To alleviate concern that the Pyramid could be perceived as prescriptive rather than flexible, the text also emphasizes that there are many healthful eating patterns, and suggests ways to obtain nutrients that may be limited if the milk and/or the meat group are not included in the diet. Variety among grains and among fruits and vegetables is now emphasized by two other guidelines, “Choose a variety of grains daily, especially whole grains” and “Choose a variety of fruits and vegetables daily.”

Although the Pyramid has been featured in the Dietary Guidelines as a way to attain nutrient adequacy, the underlying food guidance system was designed to do much more. The system was based on a series of guiding principles that aimed to achieve the following:

provide a framework for a diet to meet the needs of most healthy Americans >=2 y old, based on current
nutrition research and dietary recommendations feature foods commonly eaten by Americans, classified
into easily recognizable food groups, and allowing maximum flexibility in food choices cover the range of
energy needs among the population by including a range of recommended intakes provide nutrient
adequacy without dependence on dietary supplements or highly fortified foods moderate food
components for which overconsumption was a concern (energy, total fat, saturated fat, cholesterol,
added sugars, sodium and alcohol) account for all foods and beverages consumed as part of meals and
snacks. Inherent in this idea is that any food can be part of nutritious diet, although each choice has
implications. be evolutionary. The food guidance system was built on previous food guides but considered
current research directions.

The most distinguishing feature of the food guidance system was that, in addition to promoting nutrient adequacy, it provided proportionality and moderation by accounting for all foods consumed—the “total diet”concept.4 This was a departure from the “foundation diet” concept used by a previous food guide, “Food for Fitness-A Daily Food Guide ” , popularly referred to as the Basic Four or the Four Food Groups . The Basic Four was designed to provide ~1200 kcal and >=80% of eight nutrients for which Recommended Dietary Allowances (RDA) existed in 1953. The four food groups, fruit and vegetables, milk, meat, breads and cereals, targeted specific nutrients often low in the diets of Americans. The fruit and vegetable group targeted vitamins A and C, the milk group targeted calcium, and the meat and meat alternates group targeted micronutrients that were difficult to obtain from other food groups. It was assumed that individuals would consume more food than the guide recommended to satisfy energy needs. These less nutrient-dense foods would supply additional nutrients required to bring diets close to the levels of the RDA.

By the 1970s, many scientists recognized that dietary guidance should not only target nutrient adequacy but also provide guidance related to moderation of those dietary components that were being consumed excessively. In 1979, the USDA released the “Hassle-Free Guide,” a minor revision of the Basic Four that included a fifth group called “Fats, Sweets, and Alcohol,” but did not quantify recommendations for that group . Like the Basic Four, the Hassle-Free Guide suggested amounts of foods to provide a foundation diet.

In contrast, the food guidance system developed in the 1980s and used today suggests amounts of foods for a total diet. To cover the range of energy needs of the population, a range of servings from each major food group is recommended. To achieve nutrient adequacy, certain subgroups within the food groups are emphasized. Although not illustrated in the Pyramid graphic, the text in the Pyramid brochure recommends that dark green leafy vegetables and legumes be included in the diet several times a week, and at least three or more servings from the breads and cereals group be whole grain.

Moderation of fat and lower energy intakes become possible by adjusting the amounts of discretionary fat and added sugars. Discretionary fat includes amounts of fat above that consumed if the lowest fat choices were made in all the food groups (e.g., amount of fat in 2% milk above the amount of fat in skim milk). Added sugars represent all caloric sweeteners, such as table sugar, high fructose corn syrup, and honey, added to foods during processing or preparation, or eaten separately. The system allows for the inclusion of modest amounts of fat and added sugars within an individual’s energy needs. As was the case with the subgroup recommendations, detailed suggestions of amounts of fat and added sugars are included in the Pyramid brochure, but not in the Pyramid graphic.

The food guidance system was designed to provide the recommended amounts of essential nutrients without depending on the use of supplements or highly fortified foods. This was consistent with the recommendations that nutrient needs should be met by the consumption of a variety of foods rather than from supplements. Recently, there has been the recognition of the need for supplementation to meet the nutrient recommendations for some segments of the U.S. population. The first edition of the Dietary Guidelines stated that “you rarely need a vitamin or mineral supplement if you eat a variety of foods”. The most recent edition states “some people need a vitamin-mineral supplement to meet specific needs”. It places special emphasis on foods rich in folate or folic acid supplements to reduce the risk of certain birth defects. However, because foods contain beneficial substances in addition to nutrients, it cautions against depending on dietary supplements to meet usual needs.

To promote the Pyramid only as a means to achieve nutrient adequacy is to ignore some of its most promising aspects. Unfortunately, the Pyramid, although first released as a brochure with detailed information, is most often depicted as a graphic showing quantified recommendations from only the major food groups. As such, it has become something of an icon. It is not obvious, even to a serious observer, that this simple scheme represents an entire guidance system that incorporates suggestions on the consumption of specific types of foods within the major food groups, intakes of fat and added sugars, serving sizes and energy levels. Nonetheless, “Let the Pyramid guide your food choices” is unique among the Dietary Guidelines in that it considers multiple aspects of the diet simultaneously. The themes of variety, moderation and proportionality—in sum, the total diet—have been inherent in this guideline, although to varying degrees over time.

Entry Filed under: General Nutrition

Liquid Vitamins Product Reference Let the Pyramid Guide Your Food Choices: Capturing the Total Diet Concept Part II