Download - Building a Better Pyramid and Plate

8/14/2019 Building a Better Pyramid and Plate

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Building a Better Pyramid andPlate

If the only goal of the USDA's food icons is to giveus the best possible advice for healthy eating, thenthey should be grounded in the evidence and beindependent of commercial interests.

Instead of waiting for this to happen, nutritionexperts from the Harvard School of Public Healthcreated the Healthy Eating Pyramid, and updated it

in 2008. And in September 2011, working withcolleagues at Harvard Health Publications, theycreated the Healthy Eating Plate.

The Healthy Eating Pyramid and the Healthy EatingPlate are based on the best available scientificevidence about the links between diet and health.

They fix fundamental flaws in the USDA foodpyramids and plate and offer sound information tohelp people make better choices about what to eat.(View a large PDF image of theHealthy Eating Pyramid , in aseparate window; view a large PDF image ofthe Healthy Eating Plate , in a separate window.)

The Healthy Eating Pyramid
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The Healthy Eating Pyramid sits on a foundation ofdaily exercise and weight control. Why? These tworelated elements strongly influence your chances ofstaying healthy. They also affect what you eat andhow your food affects you.
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Exercise and weight control are also linked throughthe simple rule of energy balance: Weight change =calories in calories out. If you burn as many

calories as you take in each day, there's nothing leftover for storage in fat cells, and weight remains thesame. Eat more than you burn, though, and youend up adding fat and pounds. Regular exercise canhelp you control your weight, and it is a key part ofany weight-loss effort.

The other bricks of the Healthy Eating Pyramid

include the following:

Whole Grains

Read more aboutwhole grains.

The body uses carbohydrates mainly for energy,

and it can get them from many sourcessomehealthful (beans, vegetables, fruit, whole grains),and some not (sugary sodas and other drinks,sweets). The best grain sources of carbohydratesare whole grains such as oatmeal, whole wheatbread, and brown rice. They deliver the outer (bran)and inner (germ) layers along with energy-rich

starch. The body can't digest whole grains asquickly as it can highly processed carbohydratessuch as white flour. This keeps blood sugar and

insulin levels from rising, then falling, too quickly.Better control of blood sugar and insulin can keephunger at bay and prevent the development of type2 diabetes and heart disease.

Healthy Fats and Oils
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Read more abouthealthy fats.

Surprised that the Healthy Eating Pyramid putssome fats near the base, indicating they are okay toeat? Although this recommendation seems to go

against conventional wisdom, it's exactly in line withthe evidence and with common eating habits. Theaverage American gets one-third or more of his orher daily calories from fats, so placing them near

the foundation of the pyramid makes sense. Note,though, that it specifically mentions healthy fats andoils, not all types of fat. Good sources of healthyunsaturated fats include olive, canola, soy, corn,sunflower, peanut, and other vegetable oils; transfatfree margarines; nuts, seeds, and avocados;and fatty fish such as salmon. These healthy fats

not only improve cholesterol levels (when eaten inplace of highly processed carbohydrates), but thefats in fish can also protect the heart from suddenand potentially deadly rhythm problems.

Vegetables and Fruits

Read more aboutveggies and fruits.

A diet rich in vegetables and fruits has bountifulbenefits. Among them: It can decrease the chancesof having a heart attack or stroke; possibly protectagainst some types of cancers; lower bloodpressure; help you avoid the painful intestinalailment called diverticulitis; guard against cataract

and macular degeneration, the major causes of
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vision loss among people over age 65; and addvariety to your diet and wake up your palate. Onthe Healthy Eating Pyramid, potatoes dont count as

a vegetable, since they are chock full of rapidlydigested starch, and they have the same effect onblood sugar as refined grains and sweets. Thatswhy potatoes are in the Use Sparingly tip.

Nuts, Seeds, Beans, and Tofu

Read more abouthealthy protein.

These plant foods are excellent sources of protein,fiber, vitamins, and minerals. Beans include blackbeans, navy beans, garbanzos, lentils, and otherbeans that are usually sold dried. Many kinds ofnuts contain healthy fats, and packages of somevarieties (almonds, walnuts, pecans, peanuts,

hazelnuts, and pistachios) can carry a label sayingthey're good for your heart. Eating nuts and beansin place of red meat or processed meat can lowerthe risk of heart disease and diabetes.

Fish, Poultry, and Eggs

Read more aboutomega 3s.

These foods are also important sources of protein. Awealth of research suggests that eating fish canreduce the risk of heart disease, since fish is rich inheart-healthy omega-3 fats. Chicken and turkey arealso good sources of protein and can be low in

saturated fat. Eggs, which have long been
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demonized because they contain fairly high levels ofcholesterol, aren't as bad as they've been crackedup to be. In fact, an egg is a much better breakfast

than a doughnut cooked in an oil rich in trans fatsor a bagel made from refined flour. People withdiabetes or heart disease should limit their egg yolkconsumption to no more than three a week; theycan try egg whites, instead, which are very high inprotein and are a fine substitute for whole eggs in

omelets and baking.

Dairy (1 to 2 Servings Per Day) or VitaminD/Calcium Supplements

Read more aboutcalcium and milk.

Building bone and keeping it strong takes calcium,vitamin D, exercise, and a whole lot more. So why

does the Healthy Eating Pyramid recommendlimiting dairy products, which have traditionallybeen Americans' main source of calcium and vitaminD? Because most people need more vitamin D than

they can get from drinking three glasses of milkand they need less calcium than three glasses ofmilk provide. Though there are some health benefits

from modest dairy intake, high dairy intakes areassociated with increased risk of fatal prostate andmaybe ovarian cancers. There are other healthier

ways to get calcium than from milk and cheese,which can contain a lot of saturated fat; cheese isalso high in sodium. If you enjoy dairy foods, stickto one to two servings a day; you may also need totake a multivitamin or vitamin D supplement to getenough vitamin D. If you don't like dairy products,
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taking a vitamin D and calcium supplement (ortaking the right multivitamin) offers an easy andinexpensive way to meet your needs for these

micronutrients.

Use Sparingly: Red Meat, Processed Meat, andButterThese foods sit at the top of the Healthy EatingPyramid because they contain lots of saturated fat.Processed meats, such as bacon, hot dogs, and delimeats are also very high in added sodium. Eating a

lot of red meat and processed meat has been linkedto increased risk of heart disease, diabetes, andcolon cancer. So its best to avoid processed meat,and to limit red meat to no more than twice a week.Switching to fish, chicken, nuts, or beans in place ofred meat and processed meat can improvecholesterol levels and can lower the risk of heart

disease and diabetes. So can switching from butterto olive oil. And eating fish has other benefits forthe heart.

Use Sparingly: Refined GrainsWhite Bread,Rice, and Pasta; Potatoes; Sugary Drinks andSweets; Salt

Read more aboutcarbohydrates.

Why are these all-American staples at the top,rather than the bottom, of the Healthy EatingPyramid? White bread, white rice, white pasta,other refined grains, potatoes, sugary drinks, and

sweets can cause fast and furious increases in bloodsugar that can lead to weight gain, diabetes, heart
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disease, and other chronic disorders. Whole grainscause slower, steadier increases in blood sugar thatdon't overwhelm the body's ability to handle

carbohydrate.

Read more aboutsalt and sodium.

The salt shaker should be used sparingly, based onextensive research linking high-sodium diets to

increased risk of heart attack and stroke. Sincemost of the sodium in our diets comes fromprocessed foods, such as cheese, breads, deli meats,spaghetti with sauce, and food prepared away fromhome, make sure to compare food labels andchoose foods with the lowest sodium values.

Multivitamin with Extra Vitamin D (for MostPeople)

Read more aboutvitamins.

A daily multivitamin, multimineral supplement offersa kind of nutritional backup, especially when itincludes some extra vitamin D. While a multivitamin

can't in any way replace healthy eating, or make upfor unhealthy eating, it can fill in the nutrient holesthat may sometimes affect even the most carefuleaters. You don't need an expensive name-brand ordesigner vitamin. Look for a multivitamin thatmeets the requirements of the USP (U.S.

Pharmacopeia), an organization that sets standards

for drugs and supplements. A standard, store-brand,RDA-level one is fine for most nutrientsexcept
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vitamin D. In addition to its bone-health benefits,there's growing evidence that getting some extravitamin D can help lower the risk of colon and

breast cancer. Aim for getting at least 800 to 1,000IU (international units) of vitamin D per day;multiple vitamins are now available with thisamount. (Many people, especially those who spendthe winter in the northern U.S. or have darker skin,will need extra vitamin D, often a total of 2,000 IU

per day or more, to bring their blood levels up to an

adequate range. If you fall into one of these groups,which would include most of the U.S. population,taking 2,000 IU is reasonable and well within thesafe range. As always, its a good idea to discussuse of supplements with your doctor, and he or shemay want to order a vitamin D blood test.)

Optional: Alcohol in Moderation (Not for

Everyone)

Read more aboutalcohol.

Scores of studies suggest that having an alcoholicdrink a day lowers the risk of heart disease.Moderation is clearly important, since alcohol has

risks as well as benefits. For men, a good balancepoint is one to two drinks a day; in general,however, the risks of drinking, even in moderation,exceed benefits until middle age. For women, it's atmost one drink a day; women should avoid alcoholduring pregnancy.

Focus on Food Quality
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You'll notice that the Healthy Eating Pyramid doesnot give specific advice about the numbers of cupsor ounces to have each day of specific foods. That's

because it's not meant to be a rigid road map, andthe amounts can vary depending on your body sizeand physical activity. It's a simple, general, flexibleguide to how you should eat when you eat.

To follow the Healthy Eating Pyramid, there's justone basic guideline to remember: A healthy dietincludes more foods from the base of the pyramid

than from the higher levels of the pyramid. Withinthis guideline, however, there's plenty of flexibilityfor different styles of eating and different foodchoices. A vegetarian can follow the Healthy EatingPyramid by emphasizing nuts, beans, and otherplant sources of protein, and choosing non-dairysources of calcium and vitamin D; someone who

eats animal products can choose fish or chicken forprotein, with occasional red meat.

Choosing a variety of fresh, whole foods from all thefood groups below the "Use Sparingly" category inthe Healthy Eating Pyramid will ensure that you getthe nutrients you need. It will also dramatically

lower your salt intake, since most of the salt in theU.S. diet lurks in processed foodcanned soups,frozen dinners, deli meats, snack chips, and the like.

Perhaps the only foods that are truly off-limits arefoods that contain trans fat from partiallyhydrogenated oils. Luckily, in the U.S. and Canada,trans fats must be listed on nutrition labels. More

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even entire communities are going trans fatfree,making it easier to avoid this health-damaging typeof fat.

The Healthy Eating Plate

When its time for dinner, most of us eat off of aplate. So think of the Healthy Eating Plate as ablueprint for a typical meal, for yourself and yourfamily. Its similar in concept to MyPlate, withcolorful quadrants reserved for vegetables (green),fruits (red), protein (orange), and grains (brown).
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But unlike MyPlate, it offers important messagesabout diet quality, not just quantity:

Fill half of your plate with vegetables and fruits. The more color, and the more variety, the better.Most Americans don't get enough vegetables, especially the dark green and red-orange types, or fruits.

On the Healthy Eating Plate, just like the Healthy Eating Pyramid, potatoes and French fries don't count

as vegetables.

Save a quarter of your plate for whole grainsnot just any grains: MyPlate tells you to reserve aquarter of your plate for grains. But grains are not essential for good health. Whats essential is to make

any grains you eat whole grains, since these have a gentler effect on blood sugar and insulin than

refined grains. Whole grains include whole wheat, brown rice, oats, barley, and the like, as well as

foods made with them, such as whole wheat pasta. The less processed the whole grains, the better:

Finely ground grain is more rapidly digested, and in turn, has a greater impact on blood sugar than

more coarsely ground or intact grains. So choose steel cut oats instead of instant, sugared oats orchoose whole wheatberries instead of whole wheat bread.

Pick a healthy source of protein to fill one quarter of your plate: On MyPlate, the proteinquadrant of the plate could be filled with a hamburger or hot dog. The Healthy Eating Plate, in contrast,

acknowledges that some protein sources (fish, chicken, beans, nuts) are healthier than others (red meat

and processed meat).

Enjoy healthy fats. The glass bottle near the Healthy Eating Plate is a reminder to use healthy oils, likeolive and canola, in cooking, on salad, and at the table. Limit butter, and avoid unhealthy trans fats.

Though the Dietary Guidelines for Americans 2010 acknowledges that Americans need to consume

more plant oils, these healthy oils are nowhere to be found on MyPlate.

Drink water, coffee or tea. On the Healthy Eating Plate, complete your meal with a glass of water, orif you like, a cup of tea orcoffee(which also are low calorie and have health benefits)not the glass of

milk that MyPlate recommends. (Questions about caffeine and kids? Read more.) Limit milk and dairy

products to one to two servings per day and limit juice to a small glass per day. Skip the sugary drinks.

Stay active. The figure scampering across the bottom of the Healthy Eating Plates placemat is areminder that staying active is half of the secret to weight control. The other half is eating a healthy diet

with modest portions that meet your calorie needs. Since two out of three U.S. adults and one in three

children are overweight or obese, one thing is clear: Many of us have been choosing plates that are too

large.

Using the Healthy Eating Pyramidand the Healthy Eating PlateThe Healthy Eating Pyramid and the Healthy EatingPlate complement each other. Both emphasize foodsthat promote good health. And both encouragepeople to limit or avoid foods and drinks that are

harmful, or that provide lots of calories but havelittle nutritional value.
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Think of the Healthy Eating Pyramid as your grocerylist: Vegetables, fruits, whole grains, healthy oils,and healthy proteins like nuts, beans, fish, and

chicken should make it into your shopping cartevery week. Add a little yogurt or milk if you like.Skip the soda and snack food aisle, the deli counter,and the steaks and chops at the butcher counter.

Let the Healthy Eating Plate be your guide toplanning a healthy, balanced meal and serving it ona dinner plateor packing it in a lunch box. Put a

copy on the refrigerator at home or at work, to giveyou a visual guide to portioning out a healthy plate,and a reminder to pump up the produce.

The Healthy Eating Pyramid also addresses otheraspects of a healthy lifestyleexercise, weightcontrol, vitamin D and multivitamin supplements,

and moderation in alcohol for people who drinksoits a useful tool for health professionals and healtheducators.

Other Alternatives to MyPlateThe Healthy Eating Pyramid and the companionHealthy Eating Plate summarize the best dietary

information available today. They arent set in stone,though, because nutrition researchers willundoubtedly turn up new information in the yearsahead. The Healthy Eating Pyramid and the HealthyEating Plate will change to reflect important newevidence.

The Healthy Eating Pyramid and the Healthy Eating

Plate aren't the only alternatives to the USDA's


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MyPlate. The Asian, Latin, Mediterranean, andvegetarian pyramids promoted by OldwaysPreservation and Exchange Trust are also good,

evidence-based guides for healthy eating. TheHealthy Eating Pyramid and the Healthy Eating Platetake advantage of even more extensive researchand offer a broader guide that is not based on aspecific culture. The original Healthy Eating Pyramidis described in greater detail in Eat, Drink, and Be Healthy: The Harvard

Medical School Guide to Healthy Eating, by Walter C. Willett, M.D. (the

Fredrick John Stare Professor of Epidemiology andNutrition in the Departments of Nutrition andEpidemiology at Harvard School of Public Health)with Patrick J. Skerrett (published by Simon &Schuster, 2001, and Free Press, 2005).

Evidence that Following theHealthy Eating Pyramid and

Healthy Eating Plate LowersDisease RiskWhats the payoff for following the Healthy EatingPyramid and Healthy Eating Plate? A lower risk ofheart disease and premature death, according toresearch done at Harvard School of Public Health

and elsewhere. (7-9)Back in the 1990s, the USDA's Center for NutritionPolicy and Promotion created the Healthy Eating

Index "to measure how well American diets conformto recommended healthy eating patterns." (10) Ascore of 100 meant following the federalrecommendations (including those of the original

USDA Food Guide Pyramid) to the letter while ascore of 0 meant totally ignoring them.
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To see how well the principles embodied in theHealthy Eating Pyramid stacked up against thegovernment's advice, Harvard School of Public

Health researchers created an Alternate HealthyEating Index with a scoring system similar to theUSDA's index. They then compared the two indexes,using information about daily diets collected frommore than 100,000 female nurses and male healthprofessionals taking part in two long-term studies.

Men who scored highest on the USDA's original

Healthy Eating Index (meaning their diets mostclosely followed federal recommendations) reducedtheir overall risk of developing heart disease, cancer,or other chronic disease by 11 percent over 8 to 12years of follow-up compared to those who scoredlowest. Women who most closely followed thegovernment's recommendations were only 3

percent less likely to have developed a chronicdisease. (6) In comparison, scores on the AlternateHealthy Eating Index created at the Harvard Schoolof Public Health did appear to correlate more closelywith better health in both sexes. Men with highscores (those whose diets most closely followed theHealthy Eating Pyramid guidelines) were 20 percent

less likely to have developed a major chronicdisease than those with low scores. Women with

high scores lowered their overall risk by 11 percent.Men whose diets most closely followed the HealthyEating Pyramid lowered their risk of cardiovasculardisease by almost 40 percent; women with highscores lowered their risk by almost 30 percent.

Two recent studies offer further evidence of thedisease prevention benefits that accrue from
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following a diet similar to the Healthy EatingPyramid: A study that tracked 7,319 British civilservants for 18 years found that men and women

with the highest scores on the Alternate HealthyEating Index had a 25 percent lower risk of dyingfrom any cause, and a 42 percent lower risk ofdying from heart disease, than people with thelowest scores. (7) Another observational study in93,676 post-menopausal women found that

following a Healthy Eating Pyramidstyle diet (as

measured by adherence to the Alternative HealthyEating Index) was superior to following a low-fatdiet at lowering cardiovascular disease and heartfailure risk. (8)

References1. Hooper M, Heighway-Bury R. Who Built thePyramid? Cambridge, Mass.: Candlewick Press,

2001.

2. Abboud L. Expect a food fight as U.S. sets torevise diet guidelines. Wall Street Journal: August 8,2003, B1

3. U.S. Department of Agriculture, U.S. Departmentof Health and Human Services.Dietary Guidelines for Americans ,

2010. 7th Edition, Washington, DC: U.S.Government Printing Office, December 2010.Accessed September 7, 2011.4. Bernstein AM, Sun Q, Hu FB, Stampfer MJ,Manson JE, Willett WC. Major dietary proteinsources and risk of coronary heart disease inwomen. Circulation . 2010;122:87683.

5. Pan A, Sun Q, Bernstein AM, et al. Red meatconsumption and risk of type 2 diabetes: 3 cohorts
http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid-full-story/index.html#Referenceshttp://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid-full-story/index.html#Referenceshttp://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htmhttp://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htmhttp://www.ncbi.nlm.nih.gov/pubmed/20713902http://www.ncbi.nlm.nih.gov/pubmed/20713902http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htmhttp://www.ncbi.nlm.nih.gov/pubmed/20713902http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htmhttp://www.ncbi.nlm.nih.gov/pubmed/20713902http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htmhttp://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid-full-story/index.html#Referenceshttp://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid-full-story/index.html#References


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of U.S. adults and an updated meta-analysis.Am J ClinNutr .2011 Aug 10. [Epub ahead of print]6. World Cancer Research Fund, American Institute

for Cancer Research. Continuous Update Project Report Summary . Food,Nutrition, Physical Activity, and the Prevention ofColorectal Cancer. 2011.7. McCullough ML, Feskanich D, Stampfer MJ, et al.Diet quality and major chronic disease risk in menand women: moving toward improved dietary

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8. Akbaraly TN, Ferrie JE, Berr C, et al. AlternativeHealthy Eating Index and mortality over 18 y offollow-up: results from the Whitehall II cohort. Am J ClinNutr .2011;94:24753.9. Belin RJ, Greenland P, Allison M, et al. Dietquality and the risk of cardiovascular disease: theWomen's Health Initiative (WHI).Am J Clin Nutr .2011;94:4957.10. U.S. Department of Agriculture, Center forNutrition Policy and Promotion. The Healthy Eating Index (PDF).1995. Accessed on September 7, 2011.
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