SECOND OPINION:Government must ensure that healthy eating is affordable
HEALTH PROFESSIONALS in Ireland have been using the “food pyramid” as the basis for healthy eating advice for nearly 20 years. The pyramid is a visual aid which converts scientific knowledge into easily understood information about nutrition.
It divides food into major food groups represented as pyramid “shelves”. Bread, cereal and potato are on the largest bottom shelf and foods from this group should contribute most to daily intake. The smallest shelf at the top of the pyramid contains those foods that must contribute least to daily intake, such as sugary drinks.
In 2005, Obesity, the Policy Challenges: The Report of the National Task Force on Obesity recommended that Ireland’s healthy eating guidelines be reviewed and updated because they were too general to be of much use to anybody. The Food Safety Authority of Ireland (FSAI) was asked to carry out this work in 2007.
The new food pyramid and healthy eating guidelines, for adults and children over five years, are now available from the HSE and the FSAI. There are important differences between the old and new versions of the pyramid.
The old guidelines were evaluated by modelling daily eating patterns for 11 hypothetical people of different ages and sexes, using food pyramid recommendations on serving sizes and number of servings needed per day.
Patterns were analysed for calorie and nutritional content and compared with healthy eating goals. Total fat, saturated fat, sugar, fibre, iron, calcium and vitamin D levels were calculated.
This evaluation showed that the old food pyramid actually promoted excessive calorie consumption. Almost all the eating patterns provided too much saturated fat and three-quarters excessive total fat. A majority of the patterns did not provide enough dietary fibre and 90 per cent did not provide enough vitamin D. The food patterns for children did not reach the goals for calcium.
The evaluation also found that people had difficulty interpreting advice given in the old food pyramid because the information was very specific for some foods, eg 1oz cheese, and ambiguous in others, eg a bowl of cereal. Another problem was the wide variation in the calorie content of servings within the different food groups, particularly in the bread, cereal and potato group.
The old food pyramid suggested servings of these foods were interchangeable, whereas a serving can contain 75-250 calories depending on whether it is porridge, white bread, or potatoes.
The new food pyramid and healthy eating guidelines are very comprehensive. Weekly menus for different age groups, sexes and activity levels are easy to calculate. In the bread, cereal and potato group, the “bowl” serving has changed to three dessertspoons of dry porridge oats or two dessertspoons of mashed potato. A “carton of yogurt” has changed to “a 125mls carton of yogurt” and “small amounts” of fat has changed to one teaspoon, eg mayonnaise.
The new pyramid has six shelves instead of five, with separate shelves for fats, oils and spreads, and foods high in sugars and salt, which were lumped together in the old food pyramid. Maximum is now one serving from the top shelf, eg one cup cake with no icing, one chocolate biscuit, or two plain biscuits each day. Items such as hummus (5oz), and peas and lentils (six dessertspoons), previously in the fruit and veg group, are now in the “protein” group from which you can have only two servings instead of five.
The Scientific Recommendations for Healthy Eating Guidelines in Ireland, published by the FSAI in 2011, concluded that the cost of food as a percentage of household income is a major barrier to healthy eating for many families. Food products high in fat, sugar and salt are up to 10 times cheaper than fruit and veg. Healthy foods, in the quantities recommended by the new pyramid, cost about €180 per week for a family of two adults and two children. Families with enough money will be able to develop weekly menus that ensure optimal nutrition with no obesity problems. People on social welfare and in low-paying jobs will find it extremely difficult, if not impossible, to follow the new guidelines. Reductions in social welfare payments, and new property and other taxes will exacerbate the problem. The Government must ensure that healthy eating is accessible and affordable for everyone. Advising those on low incomes to eat more beans and lentils, as recommended in the FSAI report, is the Irish equivalent of “let them eat cake”.
Dr Jacky Jones is a former HSE regional manager of health promotion