Geoffrey Grant, Ph.D. is a Professor of Science. University of Texas Arlington, TX.  ggrant@uta.edu
Cheri Fair is a freelance Writer in Fort Worth, TX. Specializing in Sports, Health and Nutrition

    At the end of April the newly published USDA food guide pyramid (1) was made public, revising the 1992 publication that has been  criticized as contributing to the present state of obesity among the US population. The 2005 pyramid is based upon a joint effort  of the  Departments of Agriculture [USDA] and Health and Human Services [DHHS] that is incorporated in “Dietary Guidelines for Americans”.(2)
According to Dr. Mathew Reeves, a Michigan State epidemiologist, 97% of all American adult’s lack a healthy lifestyle and do not practice educated eating habits. Surveying 153,000 adults Reeves found that 24% smoke, 30% are obese, 60% are overweight, 77% don’t consume enough fruits or vegetables and 78% don’t get enough exercise.(3) These statistics appear to substantiate the criticism that American society is dilettante, lacks discipline and has poor habits. The USDA (4) has concluded
 “… overweight or obese people are more likely than those at normal weight to have medical problems such as high blood pressure, high cholesterol, stroke, diabetes, and heart disease.”
Apparently we could use some sound advice !
Is the needed sound  advise contained in the USDA food guide pyramid ?
And, perhaps more important.
Does the American public care about the guidelines and what will it take to change its poor eating habits?

The USDA Food Guide Pyramid:

    The USDA says the pyramid is based upon the normal eating habits of Americans, however if 60% of Americans are overweight, and 30% are obese, the  “normal eating habits” are going to lead us astray. However, as the original advise in “Dietary Guidelines for Americans” was prepared with consultation the Food and Drug Administration (FDA), the Center for Disease Control (CDC), the National Institutes of Health (NIH), the Office of Public Health and Science (PHS). We should be in good hands. ????
    The 2005 USDA pyramid addresses some of the criticisms directed at the 1992 guide (1), for example, the new guide differentiates between whole grain foods and highly purified white flour ones, and stress the need for added fiber in our diets, along with added emphasis on exercise and weight control. It, also, discusses the differences and benefits of oils and fats as being saturated or unsaturated. To anyone associated with health and medicine these were both glaringly obvious oversights of the 1992 guide. However, examining different food categories on the 2005 pyramid shows some equally apparent voids.   It goes unmentioned in the new guide that there are obvious nutritional differences in meat, especially in the quality and quantity of protein and fat content  between animal, poultry, and fish. And although the new guide correctly points out that we should control the amount of fat in our dietary intake it does not enlighten the reader to the fact that the quality of animal meats, graded by the USDA, is dependent, in part, upon the general fat content of the meat from individual animals. The guide should point out that consuming meat graded USDA ‘select’ or USDA ‘choice’ are higher in fat than USDA ‘prime’ and have a consequential effect upon the saturated fat content of the diet. (5)
    Even though the 1992 food guide has been questioned for its recommended low-fat, high carbohydrate diets the new 2005 guide does not satisfactorily address it as an issue. The new recommended consumption of whole wheat bread, brown rice and higher fiber grains is an improvement, however, the suggested levels of these grain-based dietary ingredients do little to help the consumer decipher their attempts to fulfill the stated balance of 70% carbohydrate 30% fats for caloric requirements at any level of exercise. In addition to the above mentioned differences in fat level in meats, the caloric content and glycemic index of different breads [standard white vs. sourdough vs. pumpernickel for example] varies very widely, making the availability of carbohydrates almost an unknown quantity even to the average diet conscious person. It would be helpful if the USDA pyramid pointed out and explained the obvious quantitative differences.
    To its credit the new food guide does attempt to incorporate the obvious need for adjusting the food intake especially calories to the level of activity and exercise of each individual. However, the procedure that one must undertake to participate in the USDA’s website’s (1) interactive process of evaluating the activity level and caloric consumption is less than user friendly. Michigan State University's Dr. Reeves has pointed out the key points of healthy dietary habits and lifestyle.(3) Healthy dietary habits include maintaining a healthy body mass index (BMI) between 18.5 and 25 [a ratio of body weight divided by height], not smoking, exercising to increase the heart beat rate for 20-30 minutes per day [ 30 minutes 5 days/week], and including fruits and vegetables in every meal. To determine your BMI it is simplest to use the USDA tables or a web calculator. (5)
    The apparent shortfalls of the USDA food guide pyramid have provoked / stimulated almost every group and/or organization, that is concerned with the American diet, to generate its own customized food pyramid. This is a very positive result of the published USDA guide; stimulating both interest and input. The Atkins diet revolution, which maintains that Americas obesity problem is produced by processed, fast food consumption with its over-abundance of high glycemic index components, has its own pyramid, an inverted version of the USDA pyramid. There are Asian, Mediterranean and Mayo Clinic Diet Pyramids, all offering alternatives, and there are many international food guides, based on that countries culture and eating habits. (6)

The USDA.

    The U.S. food system is a complex network of farmers and the industries that link to them. Those links include makers of farm equipment and chemicals as well as firms that provide services to agribusinesses, such as providers of transportation and financial services. The system includes the food marketing industries that link farms to consumers, and food and fiber processors, wholesalers, retailers, and foodservice establishments. (7)
    Should we expect that the health and welfare of the American public to be the only consideration in the preparation of the Food Guide? The USDA must listen to its clientele in the agricultural industry and its mandate is to look out for the economic concerns of that industry. The fast food industry contributes extensively to the agricultural marketplace and so it makes economic sense and is not unreasonable for the USDA to consider its views.
    The economic status of the agricultural industry depends upon the sale of the grain, livestock and the farm grown commodities and the USDA’s concerns extend far beyond the health and welfare of the American people. However, the USDA’s advice is partially responsible for the obesity epidemic and it should, disclose its conflict of interest in all its recommendations. Americans who read them have a right to know that the food guide pyramid recommendations are a point of view that includes the need to support the farming industries. We have had in the past few years a plethora of defective information arising from our governmental agencies so we should question the validity of the information we receive from the USDA. We are all aware that the tobacco growers of America are regulated by the USDA which does not bode well for our dependence on the USDA to look after our health. What did it take to generate the legal and political pressure on the tobacco industry ? It took a greater economic force to attacked it on the grounds of the health expenses, risks and consequences that were costing other government agencies and the American people more money than its economic advantage to the agricultural industry. The new USDA food guide pyramid [sic] carefully does not offend its tobacco clients by referencing anywhere or suggesting that smoking is a habit to address as significant as exercise.

Government reports are conflicting and confusing. What do we believe??

    The American public is confused about diet and its consequences to our health. The CDC has changed their position on their dire prediction as to the consequences of obesity by180 degrees. During 2004 the CDC predicted that the contributions of obesity to the death of 400,000 Americans making it the #1 killer  of 2005. (8) However, a recent publication from the CDC, apparently based on a modified interpretation of the statistics, has revised the estimated consequences of obesity and now says only 25,000 persons will die in 2005 because of obesity factors. (9) It is difficult for the authors to reconcile such significant changes without extensive explanation. After all the CDC must understand that the average American [ 60% being overweight] is betting his or her life on the reports. Additionally, a June article in The Scientific American  (10) questions the whole idea of obesity being the health problem that has stirred up the medical community as well as the media. The media has taken up obesity as a storyline, during the past fifteen years obesity related articles have increased exponentially. (10)
    The USDA’s quote at the beginning of this article correlates obesity and health serious problems. Also, stressing the apparently discarded CDC position on obesity, a biostatistician, S. Jay Olshansky, an epidemiology professor of Public Health at the University of Illinois in Chicago, recently confirmed in The New England Journal of Medicine (12) the dire concerns of high fatality rates for those that are obese. Olshansky’s team of researchers predict a decline in life expectancy in the United States later this century based on the dramatic rise in obesity, especially among young people and minorities. The study determined that obesity currently reduces  U.S. life expectancy by approximately four to nine months.

“The magnitude of that effect may sound trivial to some, but in fact it’s greater than the negative effect of all accidental mortality, such as car accidents, suicides and homicides combined,” said Olshansky.

It is difficult to believe that Americans will change the habits of a lifetime and the appealing taste of their favorite foods for the possibility of an additional half a year of existence, especially when different agencies and scientists radically disagree on the risks we are running.

What is the real problem with the American diet and why does it contribute to the level of obesity that we see in the population today? It is undeniable that the obesity level is escalating at an impressive rate in all categories of adults and children. Starting in the late 1980’s the level of obesity has progressively increased, by 1993 in all 51 states 10% of the population were obese, by 1999 all states had 15% obese and 40% of the states now have 20% obese individuals. In 2005 four states are at the 25% level of obesity (8).  Figure 1. About 50% of all overweight adults are obese. Figure 2. (10,13) Whether being overweight or obese is unhealthy or not is the subject of the above mentioned debate. Unhealthy or not, the question remains:
Why are we getting fatter?

It would be convenient to blame a government agency but the answer is unrelated to the USDA Food guide pyramid but instead arises from the eating habits of the population. The population, in general, is not concerned with the nutritional value or balance of what they are eating and rarely consider the quantity and quality of the food or how it relates to exercise level and calorie usage. The socio-economic considerations are critical. Cheap food that is tasty and satisfying can be had on every street corner in American. Fast food consumption is a reflection of the American lifestyle and  a source of enormous economic wealth.












Who is at fault ?

Can we blame the USDA  or are the purveyors of tasty food of undefined and often unknown quality, guilty of some kind of illegal act? No! we don’t think so. The USDA is in the business of supporting and regulating the agricultural industry not what we eat. The fast food industry provides a service to those Americans who have little time, too little money or little inclination to prepare their own meals or to  manage their diet. The geographical locations of fast food providers is usually situated in socio-economic areas where sufficient numbers of customers appreciate the convenience, expense and satisfaction the food provides, making the business a success. However, fast food availability is an important factor in the obesity problem in the U.S.. Dr. Jay Maddock, a Public Health Scientist at the University of Hawaii reported a correlation between both the number of residents per fast food restaurant and the square miles per fast food restaurants with the prevalence state-level obesity (14).
    Recently, in an effort to combat criticism of the quality of its food and business model, McDonald’s Corp. the world's largest restaurant chain and fast food purveyor, has adopted some healthful meals in its menus shifting the spotlight from french fries to fruit. (15) However, in general, the consumer demands and the fast food industry delivers and still has a practice to offer bigger and better and more delicious meals without specifying the nutritional value of that meal. Not that, in the opinion of the authors, would a breakdown of ingredients change Americas’ eating habits, but it would give an opportunity to those that do care to evaluate for themselves the quality of what is offered.
    Fred Patterson, a business consultant from Austin, TX who has dieted and lost about one hundred pounds several times in his life, and who finally did not wish to repeat the process ever again, had gastric by-pass surgery. He says “the biggest problems with the American diet is ‘portion size’ together with the content of processed ingredients that are designed to improve taste and lure increased consumption that tests the will-power of the consumer. I did not have the will to control my portion sizes, or intake, so the bypass has done that for me permanently.” A gastric bypass reduces the size of the stomach, which is then connected to a lower portion of the small intestine. The operation  bypasses a portion of the upper small intestine that absorbs carbohydrates and therefore, mimics ‘enforcing’ a low carbohydrate diet (16).  
    Caloric density, essentially the number of calories per bite, may, also, be a key factor in the equation. Boston Children’s Hospital researcher David Ludwig, in a long-term investigation published recently in The Lancet, concludes there is a link between fast food, weight gain and insulin resistance (17,18 ) "Fast food is designed to promote consumption of the maximum number of calories in the minimum amount of time. This may confuse the body’s mechanisms to regulate our appetite and the intake of food."
In agreement with Paterson’s opinion, and in parallel to obesity statistics, data shows that, portion size has increased dramatically in fast food restaurants from 1988 to1998, with the portion size of hamburgers increasing by 97 kcal, french fries by 68 kcal, and soft drinks by 49 kcal (19).
    The new USDA food Guide and its web site are well presented, more interactive and informative than the old one, with advise that is well presented. The guide emphasizes is the relationship between caloric intake and daily exercise but does so in a non-impact manner, the average fast food consumer is likely to miss the massage. . The American condition is caused by bad eating habits so, no  matter how comprehensively it is presented, the food guide is not likely to significantly change anything.

1. The 2005 USDA Food Guide Pyramid.   http://www.mypyramid.gov
    1992 version http://www.agnic.msu.edu/hgpubs/modus/00000249.htm

2. New Dietary Guidelines Will Help Americans Make Better Food Choices, Live Healthier Lives.  http://www.hhs.gov/news/press/2005pres/20050112.html
http://www.healthierus.gov/dietaryguidelines/dga2005/document/pdf/dga2005.pdf

3. Reeves M J, Rafferty AP. Healthy lifestyle characteristics among adults in the United States, 2000. Archives of Internal Medicine.165(8): 854-857, 2005

4. USDA Center for Nutrition Policy and Promotion. Body Mass Index and health. 16. 2000
 www.usda.gov/cnpp/Insights/Insight16.pdf. http://www.bcm.edu/cnrc/caloriesneed.htm

5. USDA: How to Buy….meat. http://www.ams.usda.gov/howtobuy/meat.htm

6. PAINTER J, RAH JH, LEE YK . Comparison of international food guide pictorial representations
http://www.eatright.org/images/journal/0402/commentary.pdf

7. USDA: Economic research Service. http://www.ers.usda.gov/Briefing/FoodMarketStructures/

8.  Mokdad AH, Marks JS, Stroup DF, et al. Actual causes of death in the United States, 2000. JAMA 291(10): 1238-1245, 2004

9. Flegal KM, Graubard BI, Williamson DF, et al. Excess deaths associated with underweight, overweight, and obesity. JAMA. 293(15):1861-7. 2005

10. Gibbs W W. Obesity: An overblown Epidemic? Scientific American. 292(6): 70-77. 2005

11. Gard M, Wright J.  The Obesity epidemic: Science Morality and Ideology. Routledge, 2005

12. Olshansky SJ, Passaro DJ, Hershow RC, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med.  352(11):1138-45. 2005

13. 11. Sturm R. Increases in clinically severe obesity in the United States, 1986-2000. Arch. Intern. Med. 163(18): 2146-2148. 2003.

14. Maddock  J.  The Relationship Between Obesity and the Prevalence of Fast Food Restaurants: State-Level Analysis. Amer. J. Health Promot..: 19, No. 2, pp. 137–143. 2004.
 
15. READ M. Assoc. Press  McDonald's Unveils Healthy Living Campaign March 09, 2005  NEW YORK

16. WebMD:  Weight Loss: Weight Control Glossary of Terms. http://psychologytoday.webmd.com/content/article/46/2731_1672

17.    Pereira MA, Kartashov AI, Ebbeling CB, et al.     Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet. 365(9453):36-42. 2005.

18. American Obesity Association <http://www.obesity.org/subs/fastfacts/obesity_youth.shtml

19. French SA, Story M, Neumark-Sztainer, et al. Fast food restaurant use among adolescents: associations with nutrient intake, food choices and behavioral and psychosocial variables. IntJ Obes Relat Metab Disord. 25:1823–1833. 2001.