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Public health advocates worry that dietary advice will get lost in translation

Personalized nutrition advice is yours, free, from the USDA  --  if you have Web access.
Personalized nutrition advice is yours, free, from the USDA -- if you have Web access. (U.S. Department of Agriculture)

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Public health advocates say that kind of vacuum is precisely the problem: By avoiding blunt messages about what not to eat, the government has spoken in a way that baffles consumers.

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"The only time they talk about food is if it's an 'eat more' message," said Marion Nestle, a professor of nutrition at New York University and a longtime critic of the food industry. "If it's a question of eating less, then they talk about nutrients."

Moreover, decades of positive advice to eat more vegetables clearly has not persuaded Americans to do so. In September, the Centers for Disease Control and Prevention released a nationwide study showing only 26 percent of adults eat vegetables three or more times a day - far short of national targets.

For the Obama administration, the dietary guidelines offer an opportunity - one that does not require a vote in Congress. (The anti-hunger lobby and rebellious Democrats recently stalled passage of a child nutrition bill that was a centerpiece of the first lady's Let's Move initiative.)

But as in the past, translating scientific data into clear and useful recommendations poses political pitfalls. The advisory committee's emphasis on a "plant-based" diet, for example, has caused much consternation among the powerful egg and meat lobbies who say the term might be misunderstood as advocating a vegetarian diet. (In fact, plant-based is defined as a diet that emphasizes fruits and vegetables but includes moderate amounts of meat, eggs and milk.) The Salt Institute has mounted an aggressive campaign to battle the recommended 35 percent reduction in the recommended allowance for sodium, saying the advice amounted to an "uncontrolled trial on more than 300 million Americans" that could result in greater obesity as individuals eat more to satisfy their sodium appetite.

By law, the guidelines must reflect the recommendations from the scientific advisory committee. But policymakers have broad discretion about how and whether to update the food pyramid.

The current version, called MyPyramid, was unveiled in 2005 and has been widely judged a failure. Where the original pyramid placed staples in the broad bottom of the triangle and special-occasion foods at the narrow top, MyPyramid is abstract. Six swaths of color, representing grains, vegetables, fruits, oils, milk, and meat and beans, sweep from the apex of the triangle to base. The width of the color bands, which is often difficult to distinguish, is meant to represent the amount of each food group people should eat. For details about serving sizes and other information, consumers must access the Web site, MyPyramid.gov.

"We've heard a lot of views about the pyramid," said Post. "The questions we're asking are: Does it convey everything we want? Does it convey anything meaningful?"

Post gave no details about what new concepts the agency is considering. But sources say the CDC, an adviser to the process, has requested information on a proposal that would replace the pyramid with a plate of food that visually demonstrates a healthful meal - an approach developed by the National Cancer Institute.

Whatever policymakers decide, the guidelines must take a new approach, said Linda Van Horn, a professor of preventive medicine at Northwestern University and chairman of the 2010 dietary guidelines advisory committee: "What has been done till now isn't working. To do nothing more effective than we have means that five years from now we'll be in an even worse situation. And that would be unconscionable."


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