Food Guide or Food Tornado?

by Ayala Lefkowitz

Image by Yaffi Lvova, RDN and dietitian extraordinaire

Over the last few months, you may have seen (or heard about) the new “upside-down”

food pyramid put out by the USDA. This new pyramid caused a big stir in the nutrition world due to its confusing presentation, conflicting information, and dramatic shift in nutrition recommendations from previous guidelines. Let’s break down the helpful and unhelpful parts of this new model.

One of the first things you may notice in the new model is that the presentation looks

pretty different from previous nutrition models. A food pyramid, whether upside down or right side up, hasn't been used since 2011 when the USDA introduced MyPlate. While a pyramid attempts to show proportions of food groups, it has historically been harder for the general public to interpret and apply consistently. MyPlate, for example, is a simpler visual representation of a balanced meal. The return to a pyramid format makes nutrition guidance less intuitive, even if it tries to convey a broader picture.

The new guidelines themselves are controversial as well. One of the largest shifts of the

new pyramid is emphasizing a diet that is very high in animal protein. While increasing protein intake to slightly above minimum levels may improve satiety and blood sugar control, the broader body of research we have does not support prioritizing red meat-heavy diets for cardiometabolic health. Actually, research shows that eating from a variety of protein sources (chicken, meat, fish, eggs, and legumes) is more consistently associated with positive long term health outcomes and reduced chronic disease.

Another category of food that is different in the new food pyramid is starches. While the pyramid does make a positive, evidence-based recommendation of promoting whole grains, the messaging around it is potentially damaging. Instead of presenting starches as a beneficial and essential part of the diet, the new messaging seems to push a “starch is bad” agenda. Starch is essential for our brain function and is our body's best source of energy. While whole grains are a preferred form of starch due to their help with blood sugar regulation and higher concentration of fiber., protein, vitamins, and minerals, more processed grains are not something that need to be feared, but rather something that should be eaten in moderation. In fact, replacing or removing starch in our diets can lead to bingeing, overeating, fatigue, and cravings.

The last, and perhaps most confusing, major shift in policy is the new guideline’s approach to fats. While there has been a positive, evidence-based move toward encouraging higher fat intake to support satiety, hormone production, vitamin absorption, and brain function, the recommendations themselves feel somewhat conflicting. Current evidence shows that unsaturated or “healthy” fats, like those found in olive oil, fish, and nuts, have a beneficial effect on long-term health and should make up the majority of fat intake. Saturated fats, found in dairy and animal products, appear to be neutral when eaten in moderation, and are recommended to make up about 10% of fat intake. While the USDA’s new written guidelines reflect this more balanced, evidence-based approach, the visual messaging of the pyramid does not. Saturated

fat sources, particularly animal proteins, appear to be heavily emphasized, which has

contributed to confusion about what is actually being recommended.

As a dietitian specializing in eating disorders, one of the most concerning aspects of this

type of guidance is the moral framing that often gets attached to food. Messaging such as “processed food is bad” or “starches should be minimized” can easily move from general guidance into rigid rules in practice. While most dietitians would agree that increasing whole grains, fruits, vegetables, and nutrient-dense proteins while limiting excess added sugar is beneficial, assigning moral value to food tends to increase food noise and rigidity. Clinically, this can increase the risk of both restriction and bingeing patterns. The new food pyramid seems to have a very limited definition of health, focusing on just the biological effect of food, and ignores the environment in which the body lives. We know that nutrition actually improves when guilt, shame and moral dilemmas are not intertwined with our food choices, and that a balanced diet

of both nutritious foods and fun foods leads to overall health - mentally and physically.

To illustrate this, the guideline suggesting zero added sugar for children may sound

appealing in theory. However, it raises important practical and developmental questions. How does this play out socially? What happens in settings like birthdays, school events, or family traditions? And perhaps more importantly, what happens when those children eventually encounter these foods without any framework for flexibility or moderation? From a behavioral standpoint, early rigidity around foods can lead to increased preoccupation and reduced long-term self-regulation skills.

Overall, the new food pyramid has gotten lots of mixed reviews. From an evidence-based

perspective, some positive highlights are the push towards a higher fat diet as well as

emphasizing whole grains. While these are beneficial recommendations, the confusing nature of the pyramid as well as the clear use of information that is not backed by strong evidence (such as pushing diets high in animal proteins and saturated fats) can make one skeptical of how the pyramid was constructed. As well, the overall fear-inducing messaging of the pyramid can be more helpful than harmful and lead to restriction or bingeing instead of balance and moderation.

There's a lot of food noise out there, and it's becoming increasingly difficult to find unbiased information. Fortunately, dietitians are trained in translating food science into practical recommendations, so if you're confused about what nutrition should look like for you, reach out to a dietitian; it's what we do!

Song M, Fung TT, Hu FB, et al. Association of Animal and Plant Protein Intake With

All-Cause and Cause-Specific Mortality. JAMA Intern Med. 2016;176(10):1453–1463.

doi:10.1001/jamainternmed.2016.4182