Shifting sands of food research yield a new pyramid worth study


June 21, 1994|By Colleen Pierre, R.D. | Colleen Pierre, R.D.,Special to The Sun

There's another food pyramid being launched this week. But don't be confused.

This one is to encourage research, not summarize it.

The "Traditional Healthy Mediterranean Diet Pyramid" was developed by Dr. Walter Willett of the Harvard School of Public Health. It is promoted by the World Health Organization (WHO) European Regional Office and Oldways Preservation and Exchange Trust, a nonprofit organization dedicated to preserving traditions and fostering cultural exchange in the fields of food, cooking and agriculture. This pyramid is not endorsed by the Harvard School of Public Health.

The new pyramid reflects eating patterns in the Mediterranean region during the 1960s. Then and there, life expectancy was high, and rates of heart disease and diet-related cancers were low. So the object is to trigger discussion and research among science and health professionals as to what made this diet so healthful.

Stimulating chefs, cooks and food manufacturers to produce tasty new dishes emphasizing plant foods is another goal.

Oldways states, "This pyramid, together with its accompanying notes, should be seen as preliminary and subject to modification." So this is to be a thought-provoker, not the last word.

The Med Pyramid, like the USDA Food Guide Pyramid, begins with a base of grains, fruits and vegetables. The pyramid shape gives perspective on quantities. Eat lots of foods from the big boxes at the bottom, and just a little of the foods in the small boxes at the top.

With so much space allocated to fruits, vegetables and grains, it's clear they're the bulk of what we should eat.

But the Med moves beans, legumes and nuts out of the protein box and down with the fruits and veggies in the "daily" category. Presumably it's trying to show that all plant foods can be eaten in generous quantities. I like this idea, but I have a problem with it as a teaching tool. Americans who "go vegetarian" often eliminate meat, chicken and fish, then fill in with chips, cupcakes and cookies, making their diets less, not more, nutritious. It's easier to show protein trade-offs (beans, legumes and nuts) when they're included in the same box.

The Med pyramid also shows olive oil in the daily category in "variable" amounts, and contains no other category for fats. This implies we can eat as much olive oil as we want, but must eliminate all other fats.

The American Dietetic Association does not endorse this concept, noting, "The Mediterranean Diet Pyramid's implication that liberal use of a single type of fat -- olive oil -- can lower the risk of heart disease is not supported by research."

In the United States, we need to cut down on all kinds of fat. Even heart-healthy fats increase our cancer and obesity risks, so more guidance on quantities is needed. And there's no evidence small quantities of other fats are harmful. Is there no room at all for a dot of butter, squeeze of margarine, or an occasional dollop of mayo?

Still, the idea of shifting toward more mono-unsaturated fats may hold up under scientific scrutiny. We'll have to wait and see.

Cheese and yogurt fall in the daily category, providing needed calcium. Mediterraneans ate the full fat varieties, posing an interesting problem translating the food of one culture into another. Could Americans get away with eating saturated fat from dairy foods if they gave up most of the fat from meat and snack foods? Would we do this?

The mid-section of this pyramid lists fish, poultry, eggs and sweets in the "few times per week" category, showing variety in entrees. Again, quantities are missing. Are the small boxes enough to guide us?

Red meat sits in an ivory tower, limited to a "few times per month." This isn't very far off the old Heart Association guidelines limiting red meat to two 3-ounce portions per week.

Dr. Willett's point is the Mediterranean eating style, consistent for hundreds of years, promoted human health. So let's see if we can capture its benefits, and encourage them in the United States. Good idea.

But note that food alone is not the answer.

Mediterraneans are much more physically active than Americans. Appropriately, the pyramid recommends daily physical activity.

Once again, it seems nutrition research is taking us back to the future!

Colleen Pierre, a registered dietitian, is the nutrition consultant to the Union Memorial Sports Medicine Center and Vanderhorst & Associates in Baltimore.

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