Pyramid Schemes

Mindy Woolbert had been feeling ill before she saw a doctor at Oakland’s Native American Health Center (NAHC). The 53-year-old mother of three, while overweight, did not expect to hear that she had diabetes. “I didn’t know what that meant,” says Woolbert, who was referred to the center by her sister, also a diabetic. Saddened but inspired by what she heard at the community health center, Woolbert wanted to take charge of her health and her disease. “Some people think that since you’re taking pills, you don’t need to worry about your health,” says Woolbert. “I didn’t want to be that way.”

Woolbert took a community nutrition class offered by the center and learned the basics of exercise and proper diet. Before her diagnosis, Woolbert didn’t put much thought into what she ate. “I was just working and going on with my life, not taking care of my health. I ate just about everything,” she says, mentioning sweets and sodas in particular. “I’ve really changed since I went to that class. Now I watch what I put into my body, and I feel a lot better.”

Woolbert wasn’t aware that her diet could contribute to disease—and she is not alone. Even those who have progressed to diabetes may not understand its management. “Patients may have had diabetes for a long time. They see a doctor who says, ‘Here, take these pills,’ but they don’t receive any education,” says the NAHC’s Cristina Weahunt, a registered dietician and health educator. “This happens a lot, especially for the lower socioeconomic population, to which all services are not available.”

Two-thirds of the US population is overweight or obese. This epidemic, which leads to a host of ills such as diabetes, high blood pressure, and heart disease, has the medical industry scrambling for solutions. Quick fixes such as gastric bypass surgery and medication are becoming common. But critics distinguish between abatement of the symptoms and stopping the disease: instead of treating the outcomes of poor food choices, shouldn’t we be addressing the fact that the food industry, in concert with federal dietary guidelines, is adversely affecting our health?

Today, sugary beverages and processed foods are available in schools, libraries, and everywhere in between. With no voice for independent nutrition education in this country, many, like Mindy Woolbert, believe these products are part of a healthy diet. After all, they’re FDA-approved. They may even display the American Heart Association’s stamp of approval, or better yet, be included among the USDA food pyramid’s recommended daily servings. But America’s spare tire illustrates that these guidelines are not working—and they may actually be contributing to disease.

In the early 1900s, when the typical diet consisted of unprocessed foods, organic-by-default meats, fresh produce, and natural fats, heart disease rates were about 1 in 20, and obesity was uncommon. These rates have skyrocketed over the century: obesity has increased by 75 percent, with the average person growing 25 pounds heavier. Today, heart disease kills 1 in 3 people. These startling stats coincide with the appearance of sodas, fast food, and the ubiquitous USDA food pyramid, a familiar sight with its dancing food groups and colorful stripes.

The USDA’s recommended daily allowance (RDA) guidelines have been a blueprint for calorie and nutrient intake since the ’40s, when it also issued its National Wartime Nutrition Guide, encouraging Americans to be strong (and eat more) by choosing from seven food groups. To avoid complexity, dietary guidelines were later condensed to the Basic Four, which included meat, milk, grains, and fruits and vegetables. In the face of expanding waistlines and disease rates, a different graphic image was needed to convey variety, proportionality, and moderation. The USDA shaped nutritional guidelines into architecture, and the food pyramid was born. The food industry pounced on the opportunity to use the pyramid to promote their products as part of a healthy diet, and they planted the image squarely where most people gaze first thing in the morning: the back of their Cheerios boxes.

“The pyramid is being used as a marketing tool,” says public health attorney Michele Simon, who is director of Oakland’s Center for Informed Food Choices. “The government has abdicated its role to promote its guidelines,” instead, she says, allowing the food industry to take on its popularization. And in fact, surveys demonstrate that most people get information about nutrition through advertising by food companies. “Now it’s up to General Mills to put the pyramid on their cereal boxes, and the food industry gets to take credit for educating the public,” says Simon. Since 93 percent of American households read their cereal boxes—on average 2.6 times over—that space is, according to an April General Mills press release, “the best real estate there is.”

And there are problems with the guidelines themselves. In her book Food Politics, author Marion Nestle states, “dietary guidelines are political compromises between what science tells us about nutrition and health and what is good for the food industry& advice issued by the government never has been based purely on considerations of public health.” The 1992 food pyramid’s one-size-fits-all message tells everyone—from active children to sedentary adults—to get 6-11 daily servings of “grains,” including bread, rice, cereal, and pasta, the majority of which, when processed into Lucky Charms and Wonder Bread, is made with unhealthful, refined “simple” carbohydrates such as white flour and sugar. Simple carbs are broken down rapidly by the body and turned into glucose, which causes a sharp spike in blood sugar, followed by a crash that leaves the eater fatigued, cranky, and craving more sugar. The result is often a cycle of over-eating and weight gain.

“The pyramid has had a huge impact on weight because its fundamental message is that all fat is bad and all carbs are good,” says the Harvard School of Public Health’s Dr. Walter Willett, author of the best-selling book Eat, Drink, and Be Healthy. Willett says other questionable guidelines include three daily servings of dairy and the suggestion to “eat fats sparingly” by choosing margarine over butter in order to reduce saturated fat consumption—advice that can put us at risk for certain cancers and other diseases.

The food industry has responded to our fat phobia by manufacturing and distributing products high in refined carbohydrates and low in fat. Fat-free products exploded onto the grocery store shelves as Kraft and Nabisco cashed in on emerging health trends. Hydrogenated vegetable oils and margarine replaced saturated fats, but are these products healthier? Any product containing hydrogenated or partially hydrogenated oils—made by hardening normally liquid vegetable oil to give it the solid consistency of a saturated fat—contains artery-clogging trans-fatty acids. Nutrition experts currently agree that these are the real disease-causing agents. Refined carbs and trans-fats give our bodies a double whammy, and they’re directly linked to obesity, cardiovascular disease, and diabetes. Both are extremely cheap to produce, making them popular in snack food items, but we’re paying a staggering $78 billion per year to treat diseases associated with diet.

Yesterday’s fat phobia is becoming today’s trans-fat phobia as the government and food industry scramble to correct their mistake. “The food industry is good at taking criticism about some element in their food and turning it into marketing opportunity,” says Simon. “If fat’s not good for you, OK, we’ll make fat-free cookies. Now we see that trans fat isn’t good for you, so we’ll make trans-fat-free cookies.’ The public gets the message that industry cares about them since they’ve changed Oreos to trans-fat-free. The fact is, it’s still an artificial product loaded with sugar and refined ingredients.”

Meanwhile, we are food industry guinea pigs. The public receives so much conflicting nutrition info because it is not developed through independent research. Often we don’t hear about the hazards of previously approved foods until they begin causing problems. “People are not given the right information,” says Willett. “They’re not getting information from proper sources, and everyone’s needs are different.” Furthermore, according to a 1996 USDA phone survey almost half of the population agrees that there is so much information about “healthy eating” that it’s hard to know what to believe.

And as it does so well, the food industry also profits from our confusion. According to Simon, “Industry perpetuates the ‘nutrition is confusing’ myth, because as long as people remain confused, they’ll throw up their hands and keep on eating their Twinkies. Why bother trying to figure it out today when scientists will just say something new tomorrow?” In the meantime, portion sizes are growing, snacking is increasing, and it’s becoming ever more efficient to get a meal on the go or in a box. While we eat our Whoppers in front of the TV (the at-home meal!), we’re bombarded with punchy ads for green ketchup and Twizzlers.

This year, the government decided it was time to get people off their couches and reaching for whole wheat instead of Wonder Bread, so in January, it remodeled the pyramid again. Now it’s three-dimensional, with a stick figure bounding up the side steps: it is called “my pyramid,” presumably to increase consumer buy-in. A stop by reveals an interactive web site where the user can type in personal information to receive detailed guidelines. Updated recommendations include exercise and incorporating whole grains and a colorful variety of vegetables into one’s diet. Surely this is better?

“It’s laughable and totally bogus,” says Harvard’s Willett. “It’s sad because this was a lost opportunity to portray useful and updated information. It conveys that every food can be part of a healthy diet, when this is not the case, as with trans fats.” The personalized food portion information, which gives quantities down to the ounces, can be confusing to follow and difficult to measure. “It gives highly specific recs that are way off,” Willett says.

“The pyramid has never been a good tool for information,” says Simon. But corporations such as General Mills wasted no time climbing up the new version, releasing a line of whole and multi-grain products and launching “healthy initiative” nutrition and weight management campaigns. “Food companies are tripping over each other to jump on the ‘healthy bandwagon’ and pile on as much nonsense health information on their packaging as possible, but it’s just more noise in the marketplace,” she says. Like trans-fat-free Oreos, whole grain Cocoa Puffs are still a refined product with high sugar content. “Desserts in disguise,” Nestle calls them.

So how can anybody uncover honest and accurate information? “This is a very important role for health care providers that is not always being assumed in the community,” says Willett. “We need nutrition education in schools and on worksites, and we need clarity and honesty about what’s really in products.”

Healthy living requires lifestyle adjustment, usually not popular among Americans unless it involves a quick fix. “We have a skewed value system in this country that says it’s OK to be working 24 hours a day,” says Simon. “If you want to make living healthfully a priority in your life, you have to take a look at how you’re living.” People need to be reminded to make time for themselves, including spending time exercising and preparing healthy food, says Simon.

By taking charge, Woolbert found a path through the confusion. “I’m now able to control my diabetes through diet, and everything has changed for the best,” she says. “My class taught me that you that you can beat your disease if you take care of yourself, and that was inspiring. There should be more nutrition classes available in the community.”

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