Food-based dietary guides… are they really useful for educating the population?

Food Guides are a very useful tool to educate the population to achieve a healthy diet. Currently, a new approach is being proposed in which these guides are sought to be developed taking food as a reference, instead of basing them on nutrients as was previously done; This is how the Food-Based Dietary Guidelines (GABA).

GABA constitute relatively simple systems where, through a series of recommendations, an attempt is made to transmit information to the general population about what diet should be like to guarantee an optimal state of health and prevent a series of diet-related diseases. They are designed considering eating habits, food availability and the level of access to food in each country, among other aspects.

These guides must be of a national nature, consider the health and nutrition situation of the country's population, and have as their purpose, through nutrition education, both the prevention of nutritional diseases caused by the deficit in energy consumption or specific nutrients. , such as the prevention of diet-related chronic non-communicable diseases, the prevalence of which is increasing. Therefore, It is expected that dietary guides, as well as the graphic representations that usually accompany them, will differ between countries.

Several countries have developed their dietary guides, generally accompanied by graphics that seek to visually transmit the main ideas. Below we will develop only two examples of Food Guides: those from the United States and those from Argentina.

Dietary Guidelines for Americans (GAE).

They were formulated for the population over 2 years of age and in their latest edition (2010) they describe a healthy diet as one that:

  • Emphasize the consumption of fruits, vegetables, whole grains, and low-fat or low-fat dairy products.
  • Includes lean meat, poultry, fish, legumes, eggs and dried fruits.
  • It is low in saturated fats, fatty acids transcholesterol, salt (sodium) and added sugar.

The GAE were traditionally disseminated through the well-known Food pyramid, whose first version dates back to 1992 (Figure 1). It was a widely used nutritional education tool that served to translate nutritional recommendations into types of foods and quantities that should be consumed daily. At the time of its launch, some advantages: firstly, it gave a complete idea of ​​the diet; secondly, that it was supposedly an image that was easy for the public to understand; and thirdly, it highlighted three very important concepts when talking about food education: variety, moderation and proportionality.

Figure 1. Food pyramid (1992).

However, several critics. Mainly that it did not discriminate the effect of different fats (saturated and trans vs. unsaturated) on health. This led to the popularization of an overly simple concept: “fats are bad”, and therefore must be restricted. Since it was not recommended to increase protein consumption (many protein sources, particularly those of animal origin, are also rich in saturated fats), this implied that it was recommended to increase carbohydrate consumption (“CHOs are good”).

Another point in question was the health effect attributed to carbohydrates. The reasoning was too simple (as with fats): since sugars only provide “empty calories” (only calories, without providing vitamins, minerals or other important nutrients), then complex CHO must be prioritized and placed at the base of the pyramid. However, this CHO classification system (simple vs. complex) has several errors. Additionally, the grain refining process produces an easily absorbable complex CHO (starch), but removes many vitamins, minerals, and fiber from the grain.

Finally, another questioned point was that the differences in health between some types of meat (beef, pork and lamb) compared to other members of this group (chicken, fish, legumes, eggs and dried fruits) were not highlighted.

That is why after extensive debate and evaluation over several years the old pyramid was replaced at the beginning of 2005 by a new one, called My Pyramid (My Pyramid)

(Figure 2).

In this version we tried to update the pyramid strategy based on new knowledge about the relationship between food and health. Firstly, an attempt was made to give a more personalized approach to the model, emphasizing that a single recommendation cannot be adjusted to all individuals, and that to achieve a better state of health, correct nutrition is necessary along with carrying out exercises. physical activity.

Figure 2. The new Food Pyramid (2005).

Although the emphasis is maintained on 3 key concepts from previous editions (variety, proportionality and moderation), among the new concepts that stand out in this version, one of the ones that stands out the most is the incorporation of physical activity
(represented by the steps and the person who climbs them), which highlights the importance of doing physical activity daily. Another concept that we try to highlight is that of food customizationrepresented by the individual and the motto.

Although some improvements were made in this attempt to update the pyramid (the emphasis on maintaining a healthy weight, highlighting the different effect of different types of fats on health, not placing emphasis on complex CHO but on reducing sugars and highlight the importance of consuming whole grains), some consider that they were not enough and that this image was not understood very well.

Thus, in the latest edition (7th) of the GAE (2010) the pyramid was replaced by a new, much simpler image: a plate divided into the 4 food groups that must be taken daily to have a balanced diet: vegetables, cereals, proteins and fruits (in that order), accompanied by dairy products (Figure 3). The campaign is called “My Plate” (MyPlate).

Figure 3. “My Plate” (MyPlate) (2010).

The use of a more familiar image to represent food (a plate) could be recognized as an advantage, but some criticism could also be made, such as the fact that the presence of physical activity was eliminated from the main message conveyed by the image.

Food Guides for the Argentine Population (GAPA).

They were published in 2000 by the Argentine Association of Dietitians and Nutritionists. The GAPA consist of 10 messageswho point out that to maintain an adequate state of health it is recommended:

1. Eat in moderation and include a variety of foods at each meal.

2. Consume dairy products (milk, yogurt and cheese) every day. They are necessary at all ages.

3. Eat fruits and vegetables of all types and colors daily.

4. Eat a wide variety of meats (red and white) removing visible fat.

5. Prepare meals with preferably raw oil and avoid fat for cooking.

6. Reduce sugar and salt consumption.

7. Eat a variety of breads, cereals, pastas, flours, starches and legumes.

8. Reduce the consumption of alcoholic beverages and avoid them in children, adolescents, pregnant women and nursing mothers.

9. Drink plenty of drinking water throughout the day.

10. Take advantage of meal times to meet and dialogue with others.

The graph that accompanies these guides (Figure 4) is called “Food oval” (or “Healthy Eating Chart”), and has been designed to reflect 4 fundamental aspects to take into account in your daily diet:

  • Eat a wide variety of foods.
  • Include foods from all groups throughout the day.
  • Consume an appropriate proportion of each group (reflected by the size of each food group in the figure).
  • Choose safe water to drink and prepare food.

Figure 4. Oval of foods (Food Guides for the Argentine Population, 2000).

Some positive elements can be highlighted, such as that it includes water, an essential macronutrient, and that it also splits energy sources (sugars and fats), giving relevance to the consumption of good quality fats (source of essential fatty acids), over the contribution of empty calories. But it could also be criticized for the fact that it does not reflect the importance of regular physical activity to complement good eating habits, and thus achieve an optimal state of health.

In conclusion, all Food Guides, as well as the graphics that accompany them, have positive and negative aspects. It is really difficult to simplify (and even more so in a single image) the complex relationship between food and health, and the large number of variables that can affect it. The central point is to keep in mind that the Food Guides are basically educational materials that should accompany food education programs, and that they are also dynamic, that is, they require periodic updates in light of new scientific knowledge, and they should be sufficiently flexible. to be able to adapt to the individual characteristics of the different subjects.

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