The Medical Minute: What's for dinner? The new food pyramid

June 08, 2005

By John Messmer
Penn State Family and Community Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine

Confused about what to eat? Many people are these days. In an effort to help Americans figure out what's good to eat, the government redesigned the old food pyramid to make it easier to build a nutritious diet. It's sort of like the simplified tax code applied to food.

Fortunately it's not necessary to be a nutritionist to plan healthy meals. The food pyramid divides foods into six groups: grains, vegetables, fruits, milk, oils and one last group which includes meat and beans. This may seem complicated but it's really not.

First, consider the oils section. Oil is fat -- when it's liquid, it's oil; when it's solid, it is referred to as fat, but it's all in the same group. It's not necessary to try to include oil or fat in the diet, so already this is easier. The only reason to include it in the pyramid is to recommend healthier oils. When cooking or planning a meal, liquid fats such as olive oil are better than solid fats that often are "saturated" or "hydrogenated" -- processes that make them more likely to raise cholesterol and increase the risk of medical problems. The most important point is that the section of the pyramid for oils is very narrow -- people should try to keep the amount to a minimum. So, just because a restaurant cooks its french fries in polyunsaturated oils, it does not mean french fries are healthy. There is entirely too much oil in them to eat more than a few per serving once in a while.

Next, let's look at the dairy section -- a fairly wide section in the pyramid. Despite the government's recommendation, no one really requires dairy food. A significant portion of adults lack the enzyme necessary to digest the milk sugar, lactose. Milk is designed to feed babies, specifically baby cows in the case of cow's milk. Nonetheless, low-fat milk and milk products are a very good and nutritious food and excellent sources of calcium, which girls and women in particular need in abundant supply. However, fortified cereals often have as much calcium as milk, and fish and many vegetables also provide reasonable amounts of calcium. Many other foods, such as certain brands of orange juice, have been fortified with calcium, and calcium is available as a supplement in pill and chewable forms. Dairy foods such as cheese and yogurt often are incorporated into recipes that include vegetables and fruits.

That leaves just four food groups to consider when planning what to eat: vegetables, fruits, grains and meat/beans. Meat and beans are lumped into one group because they are the primary source of protein in our diets even though beans are also listed with the vegetables. The beans in the group are legumes, not string beans. Legumes include navy, pinto, red, black and kidney beans, plus chickpeas, lentils, peas and soy products such as tofu. These are from plants, but because they are such rich sources of protein, they also are listed in this group. The typical American diet tends to ignore legumes, with the exception of baked beans at picnics. Many ethnic recipes and vegetarian cookbooks are rich in tasty recipes that include legumes. Besides being low in fat and high in quality protein, they are high in fiber, but more on that later.

The meat group includes nuts and seeds in addition to animal meats and fish. Nuts, seeds and animal products have varying amounts of fat. Fish fats typically are better because they include the omega-3 fatty acids that improve cholesterol. Lean meats are better choices for most meat consumption, but if one chooses lean meats most of the time, it's acceptable to have steak or prime rib occasionally in moderation. Nuts and seeds are high in fat, but as a rule, these are healthier oils. They also have fiber. Unsalted nuts are a healthy snack if used in moderation, since the fat makes them loaded with calories.

Grains include wheat, rice, corn, oats and some grains not typically found in American diets: amaranth, quinoa, millet, sorghum and triticale. Bread and pasta are made from grains, as are cereals, crackers, couscous and many snack foods. People should try to include mostly "whole" grains when possible, since more nutrients are provided. Try not to stick to plain white bread and plain cereals high in sugar. They have very little nutrition for the amount of calories they include.

That leaves fruits and vegetables, two separate groups, but worth considering together. The easiest way to use these groups is to eat various types of fruits and vegetables with many different colors throughout the week. Try a little variety instead of just peas, green beans and corn. Go for dark greens such as kale and spinach; reds like beets and red cabbage; orange vegetables such as carrots and squash; and yellows in addition to starchy vegetables like potato, turnips and yams. Juices can be counted as fruits or vegetables, but juices do not include the fiber found in the actual fruit and vegetables.

Fiber is not a separate food, but it is found in many of the other groups, particularly in beans, nuts, seeds and whole grains. Although many people think of fiber as a means to healthy bowel habits, there is reason to believe it reduces the risk of diseases of the large intestine and can have beneficial effects on diabetes and high cholesterol. Most Americans get less than half the recommended 25 grams a day.

Notice there's no cake, cookie or candy group? These are discretionary calories. In other words, as long as a person is eating a variety of foods from the various groups and has kept his or her total consumed calories below what is burned off through daily activity and exercise, these foods can be eaten within reason. Current food recommendations are intimately linked to exercise. Even a person who eats only high-quality, low-fat, high fiber foods must exercise.

How much should a person eat? The new food pyramid at http://www.mypyramid.gov has several nice features, including a calculator that provides recommended amounts from each food group based on age, gender and amount of daily activity. Each food group is clickable to provide more detail including pictures of portion sizes under the "view the gallery" button. Many people who try to eat properly nonetheless eat large portions and continue to gain weight, so having a picture of a serving can help.

Eating well does not have to be confusing, but it might necessitate a change in thinking about what's good and what's not. The simple approach is to choose many types of food from the various food groups, control portions, be careful about adding discretionary foods and exercise regularly.

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Last Updated March 19, 2009