Getting Nutrition Guidance

Is the USDA food pyramid giving you the right information?

From the WebMD Archives

May 8, 2000 -- The ancient pyramids have long conjured up visions of King Tut, golden statues, and the dusty sands of Egypt. Our own homegrown version of the pyramid symbolizes something a little less exalted: good nutrition. Even so, the U.S. Department of Agriculture's (USDA) Food Guide Pyramid, the nation's official advice on diet, promises the key to a long and healthy life.

But in an age of ethnic and fusion cuisines, when was the last time you saw tortillas and jalape?os on the pyramid? Or bok choy and edamame soybeans? They don't appear, of course, which is just one reason why critics have complained recently about the official guidelines. Instead of reflecting the fast-changing face of America, they charge, the pyramid remains culturally biased. Worse yet, it's out of touch with current nutrition research. Some critics say that the pyramid places too much emphasis on dairy and meat products. Others worry that it encourages people to eat more meat than is healthy.

Most Minorities Can't Take Lactose

More immediate are the severe cramps, diarrhea, and gas that millions of lactose-intolerant Americans can suffer from eating the dairy products emphasized on the pyramid. Without the ability to digest the sugars in milk, people with lactose intolerance, including 90% of Asians, 70% of African-Americans and Native Americans, and 50% of Latinos, aren't likely to get enough bone-strengthening calcium. They avoid dairy products without substituting other foods that are also rich in calcium.

To remedy that situation, the Physicians' Committee for Responsible Medicine (PCRM), a pro-vegetarian advocacy group, is currently lobbying health officials to list other calcium-rich foods on the pyramid. Broccoli, collards, and other dark-green leafy vegetables are great sources of calcium, says Milton Mills, MD, an associate director of preventive medicine at PCRM.

Other good alternatives are lactose-free dairy products, available in many grocery stores, and yogurt or buttermilk. Though these last two are officially dairy foods, both contain bacteria that digest lactose.

No Limits Needed on "Good" Fats

Another disagreement centers on how much fat a healthy diet should contain. The USDA Dietary Guidelines proposed for the year 2000 recommend that no more than 30% of the day's total calories should come from fat. But people who follow the traditional heart-healthy Mediterranean diet typically consume as much as 45% of their daily calories as mono- and polyunsaturated fats.

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In the days of lard and tropical oils, it made sense to cut back on total fat. But if you use unsaturated oils like canola and safflower oils, says Meir Stampfer, MD, professor of epidemiology and nutrition at the Harvard School of Public Health, there's no need to fret about how much you consume.

"I wanted them to get rid of the restriction on 'total fat' entirely," Stampfer says. It is true that saturated fats are directly linked to elevated cholesterol levels. He goes on to explain that mono- and polyunsaturated fats, like those found in olive and canola oils, have been shown to prevent blood cholesterol levels from climbing.

Yet even those findings may require slight refinement. Recent work presented at the March 2000 meeting of the American College of Cardiology in Anaheim, Calif., comparing canola, fish, and olive oils found that olive oil, unlike the other two types that continued to show heart-healthy benefits, may be nearly as dangerous as saturated fats when it comes to clogging arteries. See: Best Heart Benefits From Canola and Fish Oils -- Not Olive Oil.

At the moment it would appear that, unless you have a weight problem and need to cut back on calories, you can't go wrong by adding salmon, mackerel, soybeans, nuts, and avocados -- all rich in unsaturated fats -- to your diet. Consider avoiding olive oil in favor of canola and fish oils, and go easy on saturated fats such as palm and coconut oils, and animal fats, such as lard, butter, and cream.

Putting Nuts and Meat Together Is -- Well -- Nuts

Nuts, too, contain mostly heart-healthy unsaturated oils, which is why some nutritionists object to grouping them with meats in the pyramid. "Nuts are a plant product with protein, vitamin E, and fiber. It's ridiculous in this day and age to put nuts in with beef," says Frank Sacks, MD, a professor of nutrition at the Harvard School of Public Health.

However, defenders of grouping nuts with meats say that the two contain similar amounts of protein and energy and can be used in place of each other. Besides, "not everyone wants to be a vegetarian," says Cutberto Garza, PhD, MD, chair of the pyramid advisory panel and a professor of nutritional sciences at Cornell University.

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Most of the criticism, he says, comes from groups advocating either vegetarian or vegan (completely plant-based) diets, which do not reflect the tastes of all Americans. The Dietary Guidelines need to be general enough, he says, to "apply to everyone from age 2 to age 90, across all ethnic and income groups."

Still, with scientists linking antioxidant-rich nuts with a reduced risk for certain cancers and heart disease, nuts could be a good way to go. Almonds, hazelnuts, pecans, and almonds are thought to protect the heart. Brazil nuts and cashews may help prevent some types of cancer. One word of caution: Nuts contain a lot of fat, so you'll have to adjust your diet to account for the extra calories.

Alternative Pyramids Emerge

You're not completely on your own, however. The USDA's web site provides a list of the alternative food pyramids that have sprung up over the years, including Arabic, Russian, and even Catalan pyramids (http://www.nal.usda.gov/fnic/etext/000023.html). All are designed to help you plan meals and make healthy changes to your diet, no matter what kinds of foods you prefer.

While these pyramids may provide some guidance, most of us still have plenty to learn from the mainstream pyramid. Regardless of culture, the average American is getting more than 40% of the day's calories from added sugars and fat, according to a recent USDA survey.

The best advice, nutritionists say, is to go back to the basics that provide the foundation of a healthy diet -- including at least five servings of fruits and vegetables every day and plenty of fiber-rich whole grains. Says Garza, "I would hate for the bickering to undermine that very important message."

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