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LESSON PLAN 1

The Food Pyramid - Guide to a Healthy Diet


ESOL Competencies: Communicate Effectively on Health and Nutrition Topics;
Recognize the importance of healthy eating and maintaining a balanced diet.

Classroom Procedure:
1.
Print a copy of the food pyramid on a color transparency or draw the food
pyramid on the board. Teacher explains that for good health, people should
eat a well-balanced diet from all the food groups every day. Show students
that the higher a food group is on the pyramid, the less one should eat of it.
Distribute Food Pyramid Handout Reading Activity.
2.
Pre-reading. Before the students read the passage, the teacher checks the
students background knowledge What is a food pyramid? What do you
think this story will be about? The teacher checks students knowledge of
vocabulary and reviews those words the students dont know
3.
Teacher checks reading comprehension by asking these additional questions
aloud.

Can you get all your nutrients from one food group? What does use
sparingly mean?

Which foods should you eat the least of? Those at the base or the top
of the pyramid? Look at the key. Are there more fats and sugars in the
food groups at the top or the base of the pyramid?
4.
Teacher explains that scanning is finding details quickly by looking for
labels, bold or italicized words or numbers. Students read short reading
passage below food pyramid silently and then aloud. Students work alone or
in pairs to answer scanning questions on handout.
5.
Help students improve their scanning and reading comprehension skills by
putting these additional questions on the board:

Which food group recommends 2 to 4 servings each day?

How many servings of vegetables should a person eat each day?

Which food group should you eat the least of?

Which two food groups recommend 2 to 3 servings each day?

Should you center your diet around foods at the base or top of the
pyramid?
Filling My Pyramid Extension Activity
Print the blank pyramid from link on website. In pairs, students make a list of
what they ate yesterday. Remind them not to forget to include milk, juice or other
nutritious drinks. Together they decide which category these foods fall into and
write the food on their blank food pyramid. They decide if they are eating too
much or too little of any one food group. Students report their findings to the
class.

Text Books:
PDF handout on nutrition

Materials/Additional Resources:
Food pyramid Handout Reading Activity

Cultural Focus:
It is important to learn which foods are good for the
body and which are not.
Grammatical Focus:
Wh- questions using What
and Which
Using Should to ask
questions and give advice
Pronunciation:
Basic vocabulary
Long vowel -o- soda,
potato
Similar consonants - d, p
Plural - add -s

Community Resources:
Bring in food pyramid and
review.

Vocabulary:
food pyramid
healthy
unhealthy
Spare/sparingly
Base/top
Non-fat
lean
Minimum
maximum
fruit
meat
dairy products
vegetables
bread
grains
food pyramid

Evaluation:
Students identify foods that maintain a balanced diet.

Filling My Pyramid activity


Newspaper food ads to show types of foods.

Students answer scanning and comprehension


exercises.
Students put foods into correct categories in Filling My
Pyramid

Scanning for Details


Scanning for details is an important strategy that good readers use in their native
languages. Scanning is a strategy for finding details which does not require that students
understand every word. To scan for details students should be taught to look for numbers,
symbols, titles and headings and words that are bold or italicized. Help the students
practice scanning by having them to find the answers to the questions on the Food
Pyramid handout.
Classroom Procedure:
1. Print a copy of the food pyramid on a color transparency or draw the food
pyramid on the board. Teacher explains that for good health, people should eat a
well-balanced diet from all the food groups every day. Show students that the
higher a food group is on the pyramid, the less one should eat of it. Distribute
Food Pyramid Handout Reading Activity.
2. Pre-reading. Before the students read the passage, the teacher checks the students'
background knowledge "What is a food pyramid?" "What do you think this story
will be about?" The teacher checks students' knowledge of vocabulary and
reviews those words the students don't know.
3. Teacher checks reading comprehension by asking these additional questions
aloud.
o Can you get all your nutrients from one food group?
o What does "use sparingly" mean?
o Which foods should you eat the least of? Those at the base or the top of
the pyramid?
o Look at the key. Are there more fats and sugars in the food groups at the
top or the base of the pyramid?
4. Teacher explains that Scanning is reading for details quickly by looking for labels,
bold or italicized words or numbers. Students read short reading passage below
food pyramid silently and then aloud. Students work alone or in pairs to answer
questions on handout.
2

Food Pyramid: Basic Food Groups for a Healthy Diet

Eating a diet containing the correct amounts of all the food groups is important to
your health. The five major food groups are shown on the Food Guide Pyramid above.
Each of these food groups provides some, but not all, of the nutrients you need daily. You
should center your diet around the foods at the base of the pyramid, and you should eat
less of the foods at the top of the pyramid.
If youre watching your weight, eat the minimum number of recommended
servings. If you need to gain weight, eat the maximum number of servings. For any diet,
try to choose nonfat and lean groups as often as possible and choose foods without a lot
of added sugar. For example, choose nonfat or 1% milk instead of whole milk; choose
lean meat instead of fatty meat. Choose breads and cereal that are not processed with a lot
of fat and that have very little sugar, corn syrup or other sweeteners added. By using the
Food Guide Pyramid as a model, you can maintain your weight and your health.
Instructions: Finding details quickly when you read is called scanning. To scan for

details look for titles, numbers and words in italics or bold letters. Scan the reading
to find the answers to these questions.
1. How many major food groups are there? What are they?
2. Should you eat the minimum or maximum amount if youre trying to gain weight?
3. From which two food groups should you plan to eat 2 to 3 servings each?
4. Which food group should you eat 6 to 11 servings of daily?
3

5. Which food group should you eat 3 to 5 servings of?

The Food Guide Pyramid


A Guide to Daily Food Choices

Select a section of the pyramid for details


The Food Guide Pyramid is an outline of what to eat each day based on the Dietary
Guidelines . It's not a rigid prescription but a general guide that lets you choose a
healthful diet that's right for you.
The Pyramid calls for eating a variety of foods to get the nutrients you need and at
the same time the right amount of calories to maintain healthy weight.
Use the Pyramid to help you eat better every day...the Dietary Guidelines way. Start
with plenty of breads, cereals, rice, pasta, vegetables, and fruits. Add 2-3 servings
from the milk group and 2-3 servings from the meat group. Remember to go easy on
fats, oils, and sweets, the foods in the small tip of the Pyramid.

What Counts as One Serving?


The amount of food that counts as one serving is listed below. If you eat a larger
portion, count it as more than 1 serving. For example, a dinner portion of spaghetti
would count as 2 or 3 servings of pasta.
Be sure to eat at least the lowest number of servings from the five major food groups
listed below. You need them for the vitamins, minerals, carbohydrates, and protein
they provide. Just try to pick the lowest fat choices from the food groups. No specific
serving size is given for the fats, oils, and sweets group because the message is USE
SPARINGLY.

Milk, Yogurt, and Cheese


1 cup of milk or yogurt

1 1/2 ounces of natural cheese 2 ounces of process cheese

Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts


2-3 ounces of cooked lean
meat, poultry, or fish

1/2 cup of cooked dry beans, 1 egg, or 2 tablespoons of


peanut butter count as 1 ounce of lean meat
Vegetable

1 cup of raw leafy


vegetables

1/2 cup of other vegetables, cooked or


chopped raw

3/4 cup of vegetable


juice

Fruit
1 medium apple, banana,
orange

1/2 cup of chopped, cooked, or canned 3/4 cup of fruit


fruit
juice
Bread, Cereal, Rice, and Pasta

1 slice of bread 1 ounce of ready-to-eat cereal 1/2 cup of cooked cereal, rice, or pasta

Quiz on Serving Sizes


Choose the best answer.
1. Which of the following counts as 1 serving from the bread group?
a. 1 slice of bread ap
b. 1 cup of cooked pasta
c. 3 ounces of dry cereal
2. Which of the following does NOT count as 1 serving from the meat group?
a. 1 1/2 cups of cooked kidney beans a
b. 2 tablespoons of peanut butter
c. 8 ounces of roast beef c
3. For lunch, Bob had a peanut butter sandwich, a cup of skim milk, and a
medium apple. His lunch included...
a. 1 serving from the bread group, 1 serving from the vegetable group, 1
serving from the milk group, and 2 servings from the fruit group.
b. 2 servings from the bread group, 2 servings from the meat group, 1
serving from the milk group, and 1 serving from the fruit group. b
4. Sue is 30 years old. She works in an office, and does not usually exercise.
Today she ate 6 servings from the bread group, 2 servings from the vegetable
group, 2 servings from the fruit group, 2 servings from the milk group, and 2
servings from the meat group. Sue did not eat enough servings of what group?
a. the meat group
b. the fruit group
c. the vegetable group c
5. Which of the following counts as 2 servings from the vegetable group?
a. 1 cup of tossed salad
b. 1/2 cup of mashed potato
c. 1 cup of mashed potato c

10

The Nutrition Source


Food Pyramids: What Should You Really
Eat?
Table of Contents

Introduction

Pyramid Building

Dietary Guidelines 2005: Two


Steps Forward, One Step Back

The USDA Pyramid, Brick by Brick

Building a Better Pyramid

Forget about Numbers and Focus


on Quality

Other Alternatives

Failing the Test

References

Introduction
More than a decade and a half ago, the U.S. Department of Agriculture
(USDA) created a powerful and enduring icon: the Food Guide
Pyramid. This simple illustration conveyed in a flash what the USDA
said were the elements of a healthy diet. The Pyramid was taught in
schools, appeared in countless media articles and brochures, and was
plastered on cereal boxes and food labels.

Carbohydrates: Good Carbs Guide the Way


Protein: Moving Closer to Center Stage
Fats and Cholesterol: Out with the Bad, In with the Good
Vegetables and Fruits: Get Plenty Every Day
Calcium and Milk: What's Best for Your Bones?

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Alcohol: Balancing Risk and Benefit


5 Quick Tips for Getting the Right Vitamins
Tragically, the information embodied in this pyramid didn't point the
way to healthy eating. Why not? Its blueprint was based on shaky
scientific evidence, and it barely changed over the years to reflect
major advances in our understanding of the connection between diet
and health.
With much fanfare, in 2005, the USDA retired the old Food Guide
Pyramid and replaced it with MyPyramid, a new symbol and
"interactive food guidance system." The new symbol is basically the
old Pyramid turned on its side.
The good news is that this dismantles and buries the flawed Pyramid.
The bad news is that the new symbol doesn't convey enough
information to help you make informed choices about your diet and
long-term health. And it continues to recommend foods that aren't
essential to good health, and may even be detrimental in the
quantities included in MyPyramid.
As an alternative to the USDA's flawed pyramid, faculty members at
the Harvard School of Public Health built the Healthy Eating Pyramid.
It resembles the USDA's in shape only. The Healthy Eating Pyramid
takes into consideration, and puts into perspective, the wealth of
research conducted during the last 15 years that has reshaped the
definition of healthy eating.

Pyramid Building
In the children's book Who Built the Pyramid?, (1)
different people take credit for building the once-grand
pyramid of Senwosret. King Senwosret, of course,
claims the honor. But so does his architect, the quarry
master, the stonecutters, slaves, and the boys who carried water to
the workers.
12

The USDA's MyPyramid also had many builders. Some are obvious
USDA scientists, nutrition experts, staff members, and consultants.
Others aren't. Intense lobbying efforts from a variety of food industries
also helped shape the pyramid.
In theory, the USDA pyramid should reflect the nutrition advice
assembled in the Dietary Guidelines for Americans. According to the
USDA, the guidelines "provide authoritative advice for people two
years and older about how good dietary habits can promote health and
reduce risk for major chronic diseases."
This document, which by law must be revised every five years, aims to
offer sound nutrition advice that corresponds to the latest scientific
research; indeed, on April 10, 2008, the USDA and the U.S.
Department of Health and Human Services announced plans to form
the advisory committee for the 2010 version of the guidelines. The
panel assembled to create the guidelines usually generates 100 or so
pages of dense nutrition-speak. This document is translated into a
reader friendly brochure aimed at helping the average person choose a
balanced and healthy diet. Of far greater importance, the Dietary
Guidelines for Americans set the standards for all federal nutrition
programs, including the school lunch program, and helps determine
what food products Americans buy. In other words, the guidelines
influence how billions of dollars are spent each year. So even minor
changes can hurt or help a food industry.
According to federal regulations, the panel that writes the dietary
guidelines must include nutrition experts who are leaders in pediatrics,
obesity, cardiovascular disease, and public health. Selecting the
panelists is no easy task, and is subject to intense lobbying from
organizations such as the National Dairy Council, United Fresh Fruit
and Vegetable Association, Soft Drink Association, American Meat

13

Institute, National Cattlemen's Beef Association, and Wheat Foods


Council. (2)

Dietary Guidelines 2005: Two Steps Forward, One Step Back


Released in early January 2005, the Dietary Guidelines for Americans
2005 continues to reflect the tense interplay of science and the
powerful food industry. Several of the recommendations in the current
version represent important steps in the right direction:

The current guidelines emphasize the importance of controlling


weight, which was not adequately addressed in previous versions.
And they continue to stress the importance of physical activity.

The recommendation on dietary fats makes a clear break from


the past, when all fats were considered bad. The guidelines now
emphasize that intake of trans fats should be as low as possible and
that saturated fat should be limited. There is no longer an artificially
low cap on fat intake. The latest advice recommends getting
between 20 and 35 percent of daily calories from fats and
recognizes the potential health benefits of monounsaturated and
polyunsaturated fats.

Instead of emphasizing "complex carbohydrates," a term used in


the past that has little biological meaning, the new guidelines urge
Americans to limit sugar intake and they stress the benefits of
whole grains.

Others remain mired in the past:

The guidelines suggest that it is fine to consume half of our


grains as refined starch. That's a shame, since refined starches,
such as white bread and white rice, behave like sugar. They add
empty calories, have adverse metabolic effects, and increase the
risks of diabetes and heart disease.

14

In terms of protein, the guidelines continue to lump together red


meat, poultry, fish, and beans (including soy products). They ask us
to judge these protein sources by their total fat content, and "make
choices that are lean, low-fat, or fat-free." This ignores the evidence
that these foods have different types of fats. It also overlooks
mounting evidence that replacing red meat with a combination of
fish, poultry, beans, and nuts offers numerous health benefits.

The recommendation to drink three glasses of low-fat milk or eat


three servings of other dairy products per day to prevent
osteoporosis is another step in the wrong direction. Of all the
recommendations, this one represents the most radical change from
current dietary patterns. Three glasses of low-fat milk a day
amounts to more than 300 extra calories a day. This is a real issue
for the millions of Americans who are trying to control their weight.
What's more, millions of Americans are lactose intolerant, and even
small amounts of milk or dairy products give them stomachaches,
gas, or other problems. This recommendation ignores the lack of
evidence for a link between consumption of dairy products and
prevention of osteoporosis. It also ignores the possible increases in
risk of ovarian cancer and prostate cancer associated with dairy
products.

The USDA Pyramid, Brick by Brick


Distilling nutrition advice into a pyramid was a stroke of genius. The
shape immediately suggests that some foods are good and should be
eaten often, and that others aren't so good and should be eaten only
occasionally. The layers represent major food groups that contribute to
the total diet. MyPyramid tries to do this in an abstract way, and fails.
Six swaths of color sweep from the apex of
MyPyramid to the base: orange for grains,
green for vegetables, red for fruits, a teeny

15

band of yellow for oils, blue for milk, and purple for meat and beans.
Each stripe starts out as the same size, but they don't end that way at
the base. The widths suggest how much food a person should choose
from each group. A band of stairs running up the side of the Pyramid,
with a little stick figure chugging up it, serves as a reminder of the
importance of physical activity.
MyPyramid contains no text. According to the USDA, it was "designed
to be simple," and details are at MyPyramid.gov. Unless you've taken
the time to become familiar with the Pyramid, though, you have no
idea what it means. Relying on the Web site to provide key information
like what the color stripes stand for and what the best choices are in
each food groupguarantees that the millions of Americans without
access to a computer or the Internet will have trouble getting these
essential facts.
The USDA also chose not to put recommended numbers of servings on
the new Pyramid because these differ from individual to individual
according to weight, gender, activity level and age. Instead, it offers
personalized Pyramids at MyPyramid.gov.

Building a Better Pyramid


If the only goal of MyPyramid is to give us the best possible advice for
healthy eating, then it should be grounded in the evidence and be
independent of business.
Instead of waiting for this to happen, nutrition experts from the
Harvard School of Public Health created the Healthy Eating Pyramid,
and updated it in 2008. The Healthy Eating Pyramid is based on the
best available scientific evidence about the links between diet and
health. This new pyramid fixes fundamental flaws in the USDA pyramid
and offers sound information to help people make better choices about
what to eat. (View a larger PDF image of the new pyramid, in a
separate window.)
16

The Healthy Eating Pyramid sits on a foundation of daily exercise and


weight control. Why? These two related elements strongly influence
your chances of staying healthy. They also affect what you eat and
how your food affects you.

17

Getting to Your Healthy Weight: Science based advice on weight


control
5 Quick Tips for Getting More Physical Activity: How to fit
exercise into your life
Exercise and weight control are also linked through the 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 left over for
storage in fat cells, and weight remains the same. Eat more than you
burn, though, and you end up adding fat and pounds. Regular exercise
can help you control your weight, and it is key part of any weight-loss
effort.
The other bricks of the Healthy Eating Pyramid include the following:

Whole Grains
The body needs carbohydrates mainly for energy. The best sources of
carbohydrates are whole grains such as oatmeal, whole wheat bread,
and brown rice. They deliver the outer (bran) and inner (germ) layers
along with energy-rich starch. The body can't digest whole grains as
quickly as it can highly processed carbohydrates such as white flour.
This keeps blood sugar and insulin levels from rising, then falling, too
quickly. Better control of blood sugar and insulin can keep hunger at
bay and may prevent the development of type 2 diabetes. Plus, a
growing body of research suggests that eating a diet rich in whole
grains may also protect against heart disease.

Healthy Fats and Oils


Surprised that the Healthy Eating Pyramid puts some fats near the
base, indicating they are okay to eat? Although this recommendation
seems to go against conventional wisdom, it's exactly in line with the
evidence and with common eating habits. The average American gets
one-third or more of his or her daily calories from fats, so placing them
near the foundation of the pyramid makes sense. Note, though, that it

18

specifically mentions healthy fats and oils, not all types of fat. Good
sources of healthy unsaturated fats include olive, canola, soy, corn,
sunflower, peanut, and other vegetable oils, trans fat-free margarines,
nuts, seeds, avocadoes, and fatty fish such as salmon. These healthy
fats not only improve cholesterol levels (when eaten in place of highly
processed carbohydrates) but can also protect the heart from sudden
and potentially deadly rhythm problems.

Vegetables and Fruits


A diet rich in vegetables and fruits has bountiful benefits. Among
them: It can decrease the chances of having a heart attack or stroke;
possibly protect against some types of cancers; lower blood pressure;
help you avoid the painful intestinal ailment called diverticulitis; guard
against cataract and macular degeneration, the major causes of vision
loss among people over age 65; and add variety to your diet and wake
up your palate.

Nuts, Seeds, Beans, and Tofu


These plant foods are excellent sources of protein, fiber, vitamins, and
minerals. Beans include black beans, navy beans, garbanzos, lentils,
and other beans that are usually sold dried. Many kinds of nuts contain
healthy fats, and packages of some varieties (almonds, walnuts,
pecans, peanuts, hazelnuts, and pistachios) can now even carry a label
saying they're good for your heart.

Fish, Poultry, and Eggs


These foods are also important sources of protein. A wealth of
research suggests that eating fish can reduce the risk of heart disease,
since fish is rich in heart-healthy omega-3 fats. Chicken and turkey are
also good sources of protein and can be low in saturated fat. Eggs,
which have long been demonized because they contain fairly high
levels of cholesterol, aren't as bad as they've been cracked up to be.
In fact, an egg is a much better breakfast than a doughnut cooked in

19

an oil rich in trans fats or a bagel made from refined flour. People with
diabetes or heart disease, however, should limit their egg yolk
consumption to no more than 3 a week. But egg whites are very high
in protein and are a fine substitute for whole eggs in omelets and
baking.

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


Building bone and keeping it strong takes calcium, vitamin D, exercise,
and a whole lot more. Dairy products have traditionally been
Americans' main source of calcium and, through fortification, vitamin
D. But most people need at least 1,000 IU of vitamin D per day, far
more than the 100 IU supplied by a glass of fortified milk. (See the
multivitamins section, below, for more information on vitamin D
needs.) And there are other healthier ways to get calcium than from
milk and cheese, which can contain a lot of saturated fat. Three
glasses of whole milk, for example, contains as much saturated fat as
13 strips of cooked bacon. If you enjoy dairy foods, try to stick mainly
with no-fat or low-fat products. If you don't like dairy products, taking
a vitamin D and calcium supplement offers an easy and inexpensive
way to meet your daily vitamin D and calcium needs.

Use Sparingly: Red Meat and Butter


These sit at the top of the Healthy Eating Pyramid because they
contain lots of saturated fat. Eating a lot of red meat may also increase
your risk of colon cancer. If you eat red meat every day, switching to
fish , chicken, or beans several times a week can improve cholesterol
levels. So can switching from butter to olive oil. And eating fish has
other benefits for the heart.

Use Sparingly: Refined GrainsWhite Bread, Rice, and Pasta; Potatoes;


Sugary Drinks and Sweets; Salt
Why are these all-American staples at the top, rather than the bottom,
of the Healthy Eating Pyramid? White bread, white rice, white pasta,

20

other refined grains, potatoes, sugary drinks, and sweets can cause
fast and furious increases in blood sugar that can lead to weight gain,
diabetes, heart disease, and other chronic disorders. Whole grain
carbohydrates cause slower, steadier increases in blood sugar that
don't overwhelm the body's ability to handle carbohydrate. The salt
shaker is a new addition to the "Use Sparingly" tip of the Healthy
Eating Pyramid, one that's based on extensive research linking highsodium diets to increased risk of heart attack and stroke.

Multivitamin with Extra Vitamin D (For Most People)


A daily multivitamin, multimineral supplement offers a kind of
nutritional backup, especially when it includes some extra vitamin D.
While a multivitamin can't in any way replace healthy eating, or make
up for unhealthy eating, it can fill in the nutrient holes that may
sometimes affect even the most careful eaters. You don't need an
expensive name-brand or designer vitamin. A standard, store-brand,
RDA-level one is fine for most nutrientsexcept vitamin D. In addition
to its bone-health benefits, there's growing evidence that getting some
extra vitamin D can help lower the risk of colon and breast cancer. Aim
for getting at least 1,000 IU of vitamin D per day; multiple vitamins
are now available with this amount. (Many people, especially those
who spend the winter in the northern U.S. or have darker skin, will
need extra vitamin D, often a total of 3,000 to 4,000 IU per day, to
bring their blood levels up to an adequate range. If you are unsure,
ask your physician to check your blood level.) Look for a multivitamin
that meets the requirements of the USP (U.S. Pharmacopeia), an
organization that sets standards for drugs and supplements.

Optional: Alcohol in Moderation (Not for Everyone)


Scores of studies suggest that having an alcoholic drink a day lowers
the risk of heart disease. Moderation is clearly important, since alcohol
has risks as well as benefits. For men, a good balance point is one to
two drinks a day; in general, however, the risks of drinking, even in
21

moderation, exceed benefits until middle age. For women, it's at most
one drink a day; women should avoid alcohol during pregnancy.

Forget about Numbers and Focus on Quality


You'll notice that the Healthy Eating Pyramid
does not give specific advice about the
numbers of cups or ounces to have each day
of specific foods. That's because it's not
meant to be a rigid road map, and the
amounts can vary depending on your body size and physical activity.
It's a simple, general, flexible guide to how you should eat when you
eat.
There's just one basic guideline to remember: A healthy diet includes
more foods from the base of the pyramid than from the higher levels
of the pyramid. Within this guideline, however, there's plenty of
flexibility for different styles of eating and different food choices. A
vegetarian can follow the Healthy Eating Pyramid by emphasizing nuts,
beans, and other plant sources of protein, and choosing non-dairy
sources of calcium and vitamin D; someone who eats animal products
can choose fish or chicken for protein, with occasional red meat.
Choosing a variety of fresh, whole foods from all the food groups
below the "Use Sparingly" category in the Healthy Eating Pyramid will
ensure that you get the nutrients you need. It will also dramatically
lower your salt intake, since most of the salt in the U.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 are foods that contain
trans fat from partially hydrogenated oils. Luckily, in the U.S. and
Canada, trans fats must be listed on nutrition labels. More and more
food manufacturers, restaurants, and even entire communities are

22

going trans fat-free, making it easier to avoid this health-damaging


type of fat.

Other Alternatives
The Healthy Eating Pyramid summarizes the best dietary information
available today. It isn't set in stone, though, because nutrition
researchers will undoubtedly turn up new information in the years
ahead. The Healthy Eating Pyramid will change to reflect important
new evidence.
This isn't the only alternative to the USDA's MyPyramid. The Asian,
Latin, Mediterranean, and vegetarian pyramids promoted by Oldways
Preservation and Exchange Trust are also good, evidence-based guides
for healthy eating. The Healthy Eating Pyramid takes advantage of
even more extensive research and offers a broader guide that is not
based on a specific culture. The original Healthy Eating Pyramid is
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 and Nutrition in the
Departments of Nutrition and Epidemiology at Harvard School of Public
Health) with Patrick J. Skerrett (published by Free Press, 2005).

Failing the Test


Back in the 1990s, the USDA's Center for Nutrition Policy and
Promotion created the Healthy Eating Index "to measure how well
American diets conform to recommended healthy eating patterns." (3)
In its original form, this score sheet used five elements from the
longstanding USDA Food Guide Pyramid (number of daily servings of
grains, vegetables, fruits, meat, and dairy products) and five from the
1995 Dietary Guidelines for Americans (total fat in the diet, percentage
of calories from saturated fat, cholesterol intake, sodium intake, and
variety of the diet). A score of 100 meant following the federal
recommendations to the letter while a score of 0 meant totally

23

ignoring them. (The USDA has since updated the score sheet to reflect
the Dietary Guidelines for Americans 2005.)
To see how well the principles embodied in the Healthy Eating Pyramid
stacked up against the government's advice, Harvard School of Public
Health researchers created an Alternate Healthy Eating Index with a
scoring system similar to the USDA's index. They then compared the
two indexes, using information about daily diets collected from more
than 100,000 female nurses and male health professionals taking part
in two long-term studies.
Men who scored highest on the USDA's original Healthy Eating Index
(meaning their diets most closely followed federal recommendations)
reduced their overall risk of developing heart disease, cancer, or other
chronic disease by 11 percent over 8 to 12 years of follow-up
compared to those who scored lowest. Women who most closely
followed the government's recommendations were only 3 percent less
likely to have developed a chronic disease. (4)
In comparison, scores on the Alternate Healthy Eating Index did
appear to correlate more closely with disease in both sexes. Men with
high scores (those whose diets most closely followed the guidelines in
the Healthy Eating Pyramid) were 20 percent less likely to have
developed a major chronic disease than those with low scores. Women
with high scores lowered their overall risk by 11 percent. Men whose
diets most closely followed the Healthy Eating Pyramid lowered their
risk of cardiovascular disease by almost 40 percent; women with high
scores lowered their risk by almost 30 percent.
"The new USDA dietary pyramid is a lost opportunity to help
Americans make informed choices about diet and long-term health,"
says Dr. Willett. "It's clear that we need to rebuild the pyramid from
the ground up, not just tip it on its side and dress it up with new
colors. Every American deserves it."

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References
1. Hooper M, Heighway-Bury R. Who Built the Pyramid? Cambridge,
Mass.: Candlewick Press, 2001.
2. Abboud L. Expect a food fight as U.S. sets to revise diet guidelines.
Wall Street Journal: August 8, 2003, B1.
3. U.S. Department of Agriculture, Center for Nutrition Policy and
Promotion. The Healthy Eating Index. 1995. Accessed on 18 April
2007.
4. McCullough ML, Feskanich D, Stampfer MJ, et al. Diet quality and
major chronic disease risk in men and women: moving toward
improved dietary guidance. Am J Clin Nutr. 2002; 76:1261-71.

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